What Is Neuroplasticity and How Does it Work?

Aug 31, 2022
Eleanor Stein, MD FRCP(C)
What Is Neuroplasticity and How Does it Work?

The neurons in the brain and spinal cord are “plastic”, always changing in how they connect with each other. The changes are based on experience, our thoughts, emotions and actions. The process of constant change in the wiring of our brain based on experience is called neuroplasticity. Neuroplasticity can cause problems and can provide almost miraculous cures. Understanding what factors influence neuroplasticity is important because with this knowledge you can change your brain in ways that benefit you and correct problems that happened without your awareness.

To take a common and well researched example. We now know that all persistent pain is caused by neuroplasticity – the neurons in the brain and spinal cord become overly sensitive, responding to things that are not damaging to the body as if they were dangerous. I have talked about this sensitive brain and how therapy directed to rewire the brain significantly improves chronic or persistent pain in two previous blog posts. (fibromyalgia research update and the low back pain study). You can refer to them to learn more about what neuroplasticity is and how it causes persistent pain. This blog explains what you can do to improve a problem like persistent pain that is caused by neuroplasticity. There is a saying in the field that anything that is caused by neuroplasticity can be cured by neuroplasticity.

What Triggers Neuroplasticity?

We can start with the first law of neuroplasticity “what fires together wires together”. This means that whatever we experience most often will have the most impact on how our brain is wired. If you have optimistic thoughts, they are hardwired, if you are fearful, ditto. If you are in pain, the brain senses danger and hardwires to become ever more vigilant. So even though the actual process of neuroplasticity occurs below the level of consciousness, the choices you make each day about what you do, feel and think about direct your brain about what is important.

Knowing this, can you think of any things you could do to change how your brain is wired? For example, when you are experiencing a repeated symptom, one that makes you miserable, but you know isn’t life threatening, could you focus instead on something that brings you joy, meaning or connection? If you can do that, and I get that sometimes it is very difficult, you can strengthen the connections for the solution and weaken those for the problem. The next time you notice a pessimistic thought such as a prediction that your health will never improve, could you remind yourself that you can’t predict the future and that others get better from what you have? Could you hardwire optimism rather than despair? If you don’t really believe you can get better, search for stories of recovery for your illness. With very few exceptions, they are out there.

How Do You Stimulate Neuroplasticity?

Say you decide to make a change and respond to circumstances in your life differently. How does your brain know what you want it to pay attention to and strengthen?

1. First make sure you are alert. If you are drowsy your brain will be too, and your learning efforts will be less successful. This may mean setting aside time to practice the new skill or attitude at a time of day when you generally feel more alert.

2. Pay attention. When you focus, your brain gets the message that the focus of your attention is important. Focus is like a bright yellow highlighter; it alerts the brain to what you want it to hardwire.

3. Then practice the new skill. For an attitude, you could create a saying that embodies the belief you are trying to hardwire. Consider the opposite of the attitude you are working to overcome. For an emotion, have a list of things you can do to generate that emotion. For a behavior such as your reactions to a symptom, practice, practice, practice.

4. Use setbacks such as when you get totally swept up in fear or discouragement before you even realize it as an opportunity to get back on track. Believe it or not, when you are frustrated, you hardwire more effectively. The brain notices errors and mismatches and works to correct them.

5. Rest or sleep help the brain consolidate or remember what you have just practiced. So make time for deep relaxation, power nap or a good night’s sleep. Deep sleep helps you consolidate factual learning like the declension of a verb or new information on neuroplasticity. REM sleep helps you remember experiential learning like how to play an instrument.

How Long Does it Take to Rewire Your Brain?

This is a question I am commonly asked. The answer is “it depends”. In general, the more you focus on new learning and the more times during the day you repeat it, the faster you will notice changes. Some people who make neuroplastic practice a priority see small, temporary changes within a couple of weeks. Then, over time, with ongoing focus and practice, the positive changes get stronger and last longer. After 4 – 6 months many people notice that their symptoms don’t arise as often. They have rewired their brain’s default from being overly sensitive to being healthy. A tip here is to pair neuroplasticity practice with tools to regulate the nervous system – things like meditation, paced breathing and progressive muscle relaxation.

And after you notice improvement, ongoing practice is recommended. The more you practice, the stronger and more durable the benefits. If you go back to your old habits, the brain will rewire again - this time back to the original structure and function. That’s how the brain works. It constantly changes neural connections according to your daily decisions and experiences.

A related question is whether it takes longer to heal if you have been ill longer, if you are severely ill or if you are older. The answer is not necessarily. Some of the best success among patients in my practice has been in people severely ill for decades including those in their later years. Older dogs can recover as well as young ones.

What Is Neuroplastic Practice?

You may be wondering what “neuroplastic practice” means. Do you have to meditate for hours a day, say mantras or devote every waking moment of your life to change. The answer to all of these is NO. But it does take awareness and commitment. Practice means making a decision in the moment you are experiencing upsetting thoughts or symptoms to retrain your brain towards the thoughts and sensations you want to have. This is the recommendation, even if, and perhaps especially if, you don’t feel like it.

Anything you do that requires focus, elevates mood and is different from your usual response to your symptoms will work. You could call a friend, paint a picture, say a prayer or affirmation, go for a walk, look at photos of a favorite holiday, cuddle your pet, lie on the grass and stare at the cloud formations.

And if any of those are too difficult, you can use your imagination. Research shows that imagining an experience activates almost as many neurons in the same brain locations as actually doing the activity. So, if it is the middle of the night, or you are too ill or fatigued to do an active practice, try imagining something you would like to do including how it will feel to do that activity with ease and comfort.

Are There any Downsides to Neuroplasticity?

I am often asked whether neuroplasticity could be so successful that your body won’t respond as needed in a real emergency – like a broken bone or a heart attack. I haven’t heard of a case of this happening in my patients or in the community in general. Neuroplastic practice can return the brain's warning systems to normal function. The mind is a different situation. You can convince your mind of almost anything – consider people who are brainwashed in cults. You can look at the sky that is blue and convince yourself it is purple. But fortunately, the brain receives input from many sources and makes decision based on consensus. If your hand is on a hot stove, your brain will send you the message repeatedly until you take action. Have no fear.

What Can Get in the Way of Neuroplastic Change?

There are things that can interfere with progress. These include not regularly changing your symptom-related behaviors and thoughts. If you don’t really believe your efforts will help, your progress will be less. Some people think that if belief is required for change, then the intervention must not be valid. However, science shows that mindset has a profound impact on our biology. The placebo effect is one example of this. A percentage of people who believe they are receiving an active treatment like a medication or surgery improve as a result even if the intervention was a sham. The mind is powerful and you are better off having it working for you, adding to the effort you are putting into change rather than against you.

If you want to learn more about the science of neuroplasticity and how to implement neuroplasticity-based practices to decrease your symptoms, read about my new course Healing Through Neuroplasticity: Pathways to Pain-free Living.

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