Our ability to appropriately integrate stimuli from the environment is crucial to our self-perception and neurological wiring — ultimately altering our capacity for optimal function and performance. This month's additions to the Recommended Readings List focus on two books that address the use of specific stimuli on neuroplastic healing and how the brain determines where we are in space.
The Brain's Way of Healing by Norman Doidge
We influence the brain and body thru receptors — auditory, visual, mechanical, vestibular, etc. — to alter and induce neuroplastic and eventually bioplastic changes in the structure and function of the entire human system. In his follow-up to The Brain That Changes Itself, Doidge elaborates on how scientists and clinicians are utilizing energy to modulate existing neural pathways and forming new ones, ultimately altering how we perceive reality. I especially enjoyed his chapter on Moshe Feldenkrais as well the use of auditory stimuli in changing functional networks in the brain. Although it can be a bit effusive in the praise of a certain technique, this is a fantastic book on the basics of neuroplastic healing.
Making Space: How the Brain Knows Where Things Are by Jennifer M. Groh
The ability to perceive our location relative to the environment goes largely unnoticed consciously, despite a great many resources devoted to it. Our resting neurological state of being is predicated, at least in part, on our ability to accurately perceive space - alterations of this are often manifested in dysfunctional states. Groh discusses the neurophysiology of how the brain synthesizes multi-modal information to determine our location and how our memory is an innate process of our spacial reasoning. This book is rather straightforward and can be a bit dry but an excellent book for the basics on how we know where things are.
P.S. If you haven't yet watched my interview with Dave Tilley, DPT you are missing the boat! Check it out in my prior post or on Dave's website, The Hybrid Perspective.
The Nervous System and Performance: My Webcast Episode with Dr. Dave Tilley of The Hybrid Perspective
Dr. Dave Tilley, DPT and I spoke recently as part of a webcast series on his excellent website HybridPerspective.com. The talk is broken up into two chunks secondary to technical difficulties as I think our highlighter yellow shirts broke the internet for a minute.
In it we discuss topics including but not limited to:
I really enjoyed and appreciate being a part of this webcast series as Dave is on point while making a name for himself in the physical therapy and gymnastics world. Enjoy!
And how about that fantastic face I'm making in the opening, pretty great right?
In case you haven't been following this blog (looking at you, people of Mongolia), the last few posts have centered on the appraisal of threat by the limbic system of the brain, the resting tone of the nervous system based upon said threat, and how consistency and security provide an environment for better learning. Light reading, no doubt. As I've alluded to in those writings, learning is optimized when resting tone of the nervous system is low and attention can be sufficiently diverted to the task at hand.
A question we must ask ourselves as coaches/clinicians is are we truly teaching a new skill versus further engraining a conditioned response that has been adapted for survival? Without a knowledge of what we're actually affecting, improvements are more random and less reproducible. So here's a brief discourse on conditioning and how attention is a valuable resource in altering habits.
But first, a quick definition: Learning as I'm operationalizing it here, is the state in which novel skills or neural patterns are developed. Novel learning requires prefrontal cortex activity, attention (mediated thru the nucleus basalis), and mild transient stress to capture the pathways. As I've stated previously, mild stress/arousal is necessary for a baseline of attention but needs to come from a place of underlying security to allow errors to occur without threat that sends the nervous system into freakout and repeating conditioned responses.
Conditioning is the automatizing of habitual, previously learned patterns that are reinforced by the immediate environment. Novel learning can eventually become a conditioned response (or is it a conditioned prediction?) provided the stimulus and repetition are sufficient, however a conditioned response cannot become novel learning. The same machinery that allows for psychomotor variability can also make conditioned responses "deeper" and more conditioned, this is the plastic paradox discussed below.
So when we are working on changing a movement pattern, or changing perceptions, we need to be acutely aware of one's current state. Are we teaching a new skill or are we further engraining a habit? My position is that those who are locked in a neurologic state of being — as measured by loss of HRV, loss of triplanar movement, persistent apical breathing, or whatever measures you use — are likely to further engrain their conditioned responses rather than novel learning unless we give them a reason not to. This is because we do what we know, particularly when under duress. We have to be given a reason to produce a different output.
It should be mentioned that I don't think conditioned patterns (aka habits) are inherently "bad". Like everything in life, it is context that gives them value. Conditioned patterns provide efficiency in neural processing. Patterns are what allow high-level performers to function in flow states and for Average Joes to streamline their morning routines and drive to work whilst thinking about their day.
In an example of stress and survival, someone under acute duress will typically hyperinflate and extend the spine in an attempt to improve oxygenation - this is an adaptive response to modify respiration in a sympathetic state. This is a good thing and highly effective to maintain survival for the organism but may make us more rigid when stressors are no longer present. From Stress Signaling Pathways That Impair Prefrontal Cortex Structure and Function:
high levels of dopamine release in corticobasal ganglia circuits during stress serve to capture whatever successful behaviour has just rescued subjects from danger and engrain this pattern as a habit. But this same evolutionary solution could make humans vulnerable to maladaptive behaviours
So when stressors are not present such as in what should be a low tone position like laying down trying to sleep, these folks will often continue to extend and hyperinflate literally driving their backs into the mattress. Seriously, palpate a stressed client's paraspinals while they're supposedly "relaxed" on your treatment table. No wonder the neurotag associated with back pain or fatigue is continuously facilitated. The chronic facilitation of a habitual pattern then makes that pattern more likely to be called upon in less and less stressful situations. This is the definition of classical conditioning - the innate response to a potent stimulus comes to be elicited in response to a previously neutral stimulus. Now you have a habit on your hands.
The Plastic Paradox
The problem with conditioned patterns lies in the inability to get out of them when the task/environment requires it. The neuroimmune process of neuroplasticity is inherent to the system and this machinery can allow for novel learning or the further conditioning of a response. This is the plastic paradox as defined by Norman Doidge in The Brain That Changes Itself.
The same neuroplastic properties that allow us to change our brains and produce more flexible behavior can also allow us to produce more rigid ones
The more practiced a pattern becomes, the deeper and deeper the subcortical groove, increasing the demand of attentional resources to unlock the pattern and learn something new. The conditioned response is therefore self-sustaining without a significant redirection because they are subconscious, occurring without our attention (see pictograph above). And our addition of stressors, whether purposeful or not, only serve to drive that further because conditioned responses are what's easy for a stressed organism.
So, first we calm them through parasympathetics which we've discussed at length on this here blog, then we redirect.
Attention and Redirection
Regulation from the prefrontal cortex (PFC) as well as the anterior cingulate cortex and insula (the executive homeostatic network) allows us to respond to numerous inputs and cues and assign meaning to them - this is essentially the explicit learning of a new skill. And it requires attention. Redirecting our attention is what breaks the habitual cycle, opens valuable cortical real estate for novel learning, and changes our perception of reality.
So, HOW do you redirect attention? That depends on the individual and their particular conditioned response. Sounds like a cop-out I know but n=1, bro. Respiration, interoception, therapeutic neuroscience education, altering sensory stimuli (visual, auditory, and stomatognathic have a lot of receptors devoted to them if you're looking for a place to start). This will probably require several future posts so stay tuned.
I am big fan of internal cues, particularly early in this process of novel learning, and my friend Dr. Aaron Swanson has a fantastic piece on it that brings the information in this post full circle. James Clear also has an interesting post on habit stacking - a technique I use often in those with persistent pain or fatigue syndromes in order to change the nervous system's appraisal of threat.
Ultimately, an awareness of the difference between novel learning and conditioning of a previously learned response is critical because when we allow a previously facilitated behavioral output to persist, we are only serving to perpetuate that response - context will provide whether or not that's valuable for the client's goals.