Touching Changes
SenseAbility Issue 66
Wednesday, April 15, 2015
by: Patricia Buchanan, PhD, ATC, PT, GCFT Chair, Esther Thelen Research Committee

Section: Neuroplasticity





Seriously, for a Moment

The excitement has been palpable. Earlier this year, physician Norman Doidge released his second book, The Brain's Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity. He shares the stories of people with “brain” conditions including chronic pain, autism, developmental delay, and stroke. His first book, The Brain That Changes Itself, offered intriguing accounts of the of twentieth century scientists (Doidge dubs them the first generation) to “discover” the many ways in which the cells, or neurons, of the nervous system, including the brain, change their patterns of connecting to and communicating with one another, and even grow new cells. This ability to change function and structure, now known as neuroplasticity, is essential to learning, adapting, and recovering. Contrary to the long held belief that beneficial alterations in the nervous system ended once humans reached their adult stature, accumulating research demonstrated the capacity of the brain and nervous system to change throughout the life span. 
 
Now, Doidge explores the ways in which a “second generation of neuroplasticians” has moved beyond the need to demonstrate neuroplasticity’s existence and begun investigating its workings and applications. What has Feldenkrais® teachers doing head stands is that two of the eight chapters of this fascinating storybook are about Moshe Feldenkrais and his method. 
 
Doidge tells of meeting the people whose stories he shares, including “clinicians and patients who together stumbled upon neuroplasticity and perfected effective treatment techniques, even before plasticity had been demonstrated in the lab.” Doidge could not meet Moshe Feldenkrais, who died in 1984, but he met people who knew and studied with Feldenkrais, became teachers of his method, and benefited from his approach to learning. Feldenkrais’s story is so compelling that Doidge gave it its own chapter. Doidge dedicates a second chapter to the case of David Webber, a Feldenkrais teacher who used the method to recover functional vision after being legally blind.
 
If Feldenkrais “stumbled,” he did so methodically, beginning after a knee injury while a young man in Palestine. Unwilling to accept his condition, Feldenkrais set out to learn to improve his function. He shared what he learned about self-improvement throughout one’s life with thousands of students and personally taught three groups of teachers. 
 
In advance of the term neuroplasticity, Feldenkrais proposed it as early as 1972 in his book Awareness Through Movement. He knew of neurosurgeon Wilder Penfield’s efforts during brain surgeries to identify the sensory and motor areas of the outer layer of the brain, the cortex. Because brain cells are not pain sensitive, Penfield could apply a small electrical stimulus to a tiny area and ask the patient where he or she felt the sensory stimulus (tip of left thumb, right ear lobe, etc), or observe the motor response (lifted the big toe, raised an eyebrow, etc). As Penfield documented these locales on the brain, he developed sensory and motor maps, like the topographical maps used by hikers, sometimes called the homunculus (“little man,” because of the correspondence with the body’s form). Based on his direct experience and work with students, Feldenkrais believed that we change our maps throughout life. Specifically, he hypothesized that the sensorimotor maps of the left ring fingers of musicians would differ from nonmusicians because of their extensive, attentive touching of fingers to strings and keys. Two decades later, “first generation” neuroplasticians used new technology to confirm his hypothesis (Elbert).
 
Doidge states, “Most of the interventions this book make use of energy— including light, sound, vibration, electricity, and motion. These forms of energy provide natural, noninvasive avenues into the brain that pass through our senses and our bodies to awaken the brain’s own healing capacities….I will show how it is possible to use these different forms of energy to modify the patterns of the brain’s electrical signals and then its structure" (xviii).
 
Doidge omits touch here, but not in the book. Touch is another form of energy that influences the function and structure of the brain, whether presented through the feet contacting the ground, the hand stroking the chin, or the teacher supporting and guiding the student’s arm to explore options for reaching.
 
Foreshadowing chapters five and six, Doidge emphasizes two prominent elements of the Feldenkrais Method: the skillful use of touch and the attentive use of mental imagery. He references “…the slow, soft movements of the human hand over the body to cure a girl, born missing a huge section of her brain, of cognitive problems and near paralysis. I will show how all these techniques stimulate and reawaken dormant brain circuits. Among the most effective ways to do so is by using thought itself to stimulate brain circuits, which is why most of the interventions I witnessed paired mental awareness and activity with the use of energy (Doidge, Healing xix).” 
 
In the Feldenkrais Method, thought is one strand of an interwoven fabric also comprised of sensation, feelings (emotions), and movement (action) by humans situated in cultures, contexts, and conditions from which emerges the best behavior currently available. With attention and motivation, we learn, change, and improve.
 
Doidge writes, “It may seem odd that the ways of healing described in this book so frequently use the body and the senses as primary avenues to pass energy and information into the brain. But these are the avenues the brain uses to connect with the world, and so they provide the most natural and least invasive way to engage it (Doidge, Healing xix).” 
 
This is not odd at all to Feldenkrais teachers and students, nor to movement scientists adhering to dynamic systems theory (including developmental psychologist and Feldenkrais teacher Esther Thelen) who recognize the interrelationships among the parts that form our bodies, our history of experiences, the tasks we want to do, and more. The brain is just a brain incapable of being of use to us unless it is integrated into a body that is situated in an environment with something essential or interesting to do. Each element influences and is influenced by the others. Behavior in all its forms emerges from those interactions and is facilitated by what we pay attention to while we sense, feel, think, and move. Doidge importantly notes, “The body and mind become partners in the healing of the brain, and because these approaches are so noninvasive, side effects are exceedingly rare (Doidge, Healing xx).” 
 
Doidge slips in and out of dualistic, reductionist language as he speaks of people changing their brains: “What follow are stories of people who have transformed their brains, recovered lost parts of themselves, or discovered capacities within that they never knew they had. But the true marvel is less the techniques than the way that, through millions of years, the brain has evolved, with sophisticated neuroplastic abilities and a mind that can direct its own unique restorative process of growth" (Doidge, Healing xxii).
 
While Doidge uses habitual language to describe what is uncommon understanding, his books are changing language and understanding. His latest stories are of people transforming their lives. Changes in the brain are just part of the interrelated components within these stories of self-transformation. Feldenkrais Teachers and students can find insights and recognize parallels with many of the tales of self-improvement throughout Doidge’s new book. I invite you to get in touch with it all.
 
I also invite you to explore a closely related book published around the same time. Eric Linden is a neuroscientist and self-proclaimed “fanboy” of touch. His latest book is Touch: The Science of Hand, Heart, and Mind.
 
Linden opens with a story of teenagers playing a game of “would you rather lose” your sense of hearing or sense of vision, etc. The game pitted each of the major senses against one another and invited the participants to contemplate life without one of these modes of sensation. He noticed no one picked the sense of touch, and wondered why:
was it that we could easily imagine what it would be like to experience the loss of sight or hearing (we had all shut our eyes or plugged our ears), or even of taste or smell, yet none of us had ever actually been able to re-create the sensation of the loss of touch. Perhaps touch was woven so deeply into our sense of self that we could not truly imagine life without it (2).
 
Many of us have briefly lost touch with a leg that “went to sleep,” a sprained ankle after icing, or a cheek after dental anesthesia. Very rarely, an infection can disrupt much of one’s ability to be in touch with nearly one’s whole self. (See Cole, 1995 for the story of Ian who, through persistence and attention, remarkably adapted to his severely impaired touch and recovered much of his function. See also http://www.dailymotion.com/video/x12647t_the-man-who-lost-his-body-bbc-documentary_tech.)
 
Linden explains and explores the myriad ways in which touch informs and shapes our lives. My touch experiences help me know the firmness of my chair, the fit of my jeans, the safety of a fallen log for crossing a stream, the path to the toilet in the dark of night, and the intention of another’s hand on my shoulder. Touch extends beyond sensation to include our language (“He rubs me the wrong way”) and emotions (“I’m touched”). Humans can impressively adapt to the loss of certain sensory input (e.g., hearing or vision), but the absence of touch has major, maladaptive impact. Linden writes, 
…deprive a newborn of social touch, as occurred in grossly understaffed Romanian orphanages in the 1980s and 1990s, and a disaster unfolds: Growth is slowed, compulsive rocking and other self-soothing behaviors emerge, and, if not rectified, emergent disorders of mood, cognition, and self-control can persist through adulthood. Fortunately, even a relatively minor intervention— an hour per day of touch and limb manipulation from a caregiver— can reverse this terrible course if applied early in life. Touch is not optional for human development. We have the longest childhoods of any animal— there is no other creature whose five-year-old offspring cannot live independently. If our long childhoods are not filled with touch, particularly loving, interpersonal touch, the consequences are dramatic (4).
 
Linden reports that torturers intentionally and malevolently use tactile deprivation. He counters,
Fortunately the same emotional and cognitive control circuitry that is exploited by torturers to maximize pain can potentially be used beneficially to reduce pain, particularly chronic pain. A number of mindfulness-based practices—including meditation, yoga, Tai Chi, and the Feldenkrais Method— have been reported to decrease both chronic and acute pain sensations....[T]here are indications from some large, randomized, well-conducted studies that these techniques can be efficacious for certain forms of chronic pain (171).
 
Pain is the primary reason students come to the Feldenkrais Method (Buchanan et al, 217). Touch—whether through the skillful, mindful application by a Feldenkrais teacher during a Functional Integration® lesson, or by the attentive self-touch that occurs as a student experiences an Awareness Through Movement® lesson—is an essential aspect of the process of learning to transform pain and improve function. (You can support Feldenkrais Method research with a contribution to the Esther Thelen Research and Education Fund.
 
Throughout his book, Linden describes for readers how “all touch sensation (or sensation of any kind) is ultimately in the service of action" (196). He helps Feldenkrais teachers and students understand why touch is so profoundly impactful for clarifying and expanding our self-images, and improving function throughout our lives. It is a fitting complement to Doidge’s book about our self-healing abilities. Both books offer touching stories about how we can change our brains and enrich our lives. 
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Everyone who makes a $25 or greater donation to the Thelen Fund before the publication of the next issue of SenseAbility will receive a thank you gift of “The Coordination Cascade and the Feldenkrais Method,” developed by Certified Feldenkrais Trainers Ulla Schläfke and Roger Russell.

Roger Russell described the coordination cascade in a previous SenseAbility article.

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Pat Buchanan, PhD, ATC, PT, GCFT helps female athletes create powerful performance. Her unique, holistic approach is based on expertise developed through over thirty years in movement science, education, and healthcare. Pat loves guiding girls and women to master their movement, get rid of pain, and play at the top of their game.


References 
 
Buchanan, P. A., Nelsen, N., & Geletta, S. (2014). United States Guild Certified Feldenkrais Teachers®: A survey of characteristics and practice patterns. BMC Complementary and Alternative Medicine, 14, 217.
Cole, J. (1995). Pride and a Daily Marathon. Boston: MIT Press.
Doidge N. (2007). The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York: Penguin Books.
Doidge, N. (2015). The Brain's Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity. New York: Viking Press.
Elbert, T., Pantev, C., Wienbruch, C., Rockstroh, B., & Taub, E. (1995). Increased cortical representation of the fingers of the left hand in string players. Science, 270, 305–307.
Linden, D. J. (2015). Touch: The Science of Hand, Heart, and Mind. New York: Viking Press.
Penfield, W. & Rasmussen, T. (1950). The Cerebral Cortex of Man. New York: Macmillan.
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