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on March 25, 2007
Neuroplasticity has recently become a bit of a buzzword. Long the preserve of neuroscientists, this is one of a number of new books on the topic written for the public.

I recently reviewed Sharon Begley's superb book - Train Your Mind, Change Your Brain - and this one is in a similar vein. Though it is rather different from Sharon's book in which the main focus was on the changes wrought in the brains of meditators, while this one looks at the extraordinary responses of the brain to injury or congenital absence of sensory organs. Since this book went to press, yet another study, this time from India, has shown that some blind children may be able to regain their sight, an observation that is helping turn a lot of neurology on its head.

Neuroplasticity is a topic of enormous practical importance. The increasing evidence that the brain is a highly adaptable structure that undergoes constant change throughout life is a far cry from the idea that we are simply the product of our genes or our environment. Our genes help determine how we can respond to the environment; they do not make us who we are. And we all have untapped potential. This is more than the old nature/nurture debate in a new bottle. It has implications for human potential: how much can you develop your own brain and mind? Can you really teach a child to be a kind, loving person who can dramatically exceed his or her potential? Can psychotherapy really help change your brain for the better? Can we help re-wire the brain of a psychopath? Do we have the right to try?

The author is both a research psychiatrist and a psychoanalyst who has interviewed many experts in the field. His book is full of well chosen and detailed stories about scientists and their discoveries as well as case reports of triumph over unbelievable adversity. There is also a good discussion of people who have remarkable abilities despite the absence of key regions of the brain.

This book is a good complement to Sharon Begley's and if you can afford it, then I strongly recommend that you get both books. If your interest is more in personal development and its effects on the brain, then Sharon's book will be the one for you. If you are more interested in the science and anecdotes about scientists and some amazing patients, then this book may be the one to go for.

Highly recommended.

Richard G. Petty, MD, author of Healing, Meaning and Purpose: The Magical Power of the Emerging Laws of Life
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on July 11, 2007
This is one of the most interesting nonfiction books that I have *ever* read. I found the book fascinating, but lest that be chalked up to my being a psychologist, my husband the computer scientist found it fascinating, too.

Scientists used to believe that the brain was relatively fixed and unchanging -- some of them still believe that -- but recent research shows that the brain is much more mutable than biologists, psychologists, physicians (and any other scientists who studied brains) had ever thought.

For example, anecdotal evidence had long supported the idea that blind people hear better than sighted people, but scientists pooh-poohed this idea, saying that there was no mechanism for that to occur. Well, they recently discovered that the area of the brain usually called the visual cortex is taken over for auditory processing in blind people. So blind folks have twice as much brain space devoted to processing sounds, which means that they really do hear better, and now we know why. Scientists were astounded to discover that the "visual" cortex was really just brain space that could be used for anything.

Psych 101 and Bio 101 textbooks often have a picture in them that shows which areas of the brain control which bodily functions, and this is all presented as fixed and unchanging. Imagine our surprise to learn that the brain can make fairly large shifts in just a few days -- for example, if you blindfold somebody for five days, the area of their brains that's usually called the visual cortex starts using large sections of itself to process touch and sound, and this change is made in as little as two days. Two days!

The book is not just theoretical, though -- the author is interested in the theory, but he's even more interested in how all of this can be applied to better the lives of real people. He talks about people with strokes who've learned to walk again, people with vestibular problems who've learned to substitute something else for their missing vestibular system, people who've been helped with ADHD, autism, retardation, and many other "incurable" conditions by altering their brains.

The downside of the book is that the author is a Freudian, so there are some annoying comments about how Freud knew it all along, but if you can overlook that, it's all fascinating. The author does an excellent job of drawing the reader in with a story about a real person, then elaborating on the ideas by talking about studies that show the basic principles and their implications, then explaining how this can be used to ameliorate or even cure conditions that were considered incurable.

This book blew me away!

The chapter titles will give you more information about the subject matter:

1. A Woman Perpetually Falling...: Rescued by the Man Who Discovered the Plasticity of Our Senses
2. Building Herself a Better Brain: A Woman Labeled "Retarded" Discovers How to Heal Herself
3. Redesigning the Brain: A Scientist Changes Brains to Sharpen Perception and Memory, Increase Speed of Thought, and Heal Learning Problems
4. Acquiring Tastes and Loves: What Neuroplasticity Teaches Us About Sexual Attraction and Love
5. Midnight Resurrections: Stroke Victims Learn to Move and Speak Again
6. Brain Lock Unlocked: Using Plasticity to Stop Worries, Obsessions, Compulsions, and Bad Habits
7. Pain: The Dark Side of Plasticity
8. Imagination: How Thinking Makes It So
9. Turning Our Ghosts into Ancestors: Psychotherapy as a Neuroplastic Therapy
10. Rejuvenation: The Discovery of the Neuronal Stem Cell and Lessons for Preserving Our Brains
11. More than the Sum of Her Parts: A Woman Shows Us How Radically Plastic the Brain Can Be
Appendix 1: The Culturally Modified Brain
Appendix 2: Plasticity and the Idea of Progress

Highly recommended!
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on July 6, 2008
I have a general professional interest in psychology and brain science, which often leads me to be frustrated by the tendency towards reductionism and exaggeration. This book looked promising to me because the author is advertised as a psychoanalyst--something that usually does not mesh well with neuroscience. I was intrigued to see how Freud might think about modern psychology's biological determinism. On that score, I found The Brain That Changes Itself reasonably satisfying; the chapter on how neural plasticity can help us understand the impact of psychotherapy was among the best in the book. I very much appreciate the emphasis on how experience (including talk therapy) and culture, not just genes and drugs, shape the brain. That is something that is easy to miss in viewing the pretty brain scans of contemporary popular science. I also found the appendix on how culture works through neural plasticity interesting, although I don't find it helpful to define culture as Doidge seems to--something akin to cultivation and taste (a definition that leads to a problematic hierarchy of cultures based on somewhat arbitrary criteria). It is, however, important to recognize that culture and the brain have a reciprocal relationship.

My main concern with the book is that much of the argument seems to imply that the brain is infinitely malleable with the right exercises and effort. Though Doidge does note at points that plasticity is not infinite, he also seems to endorse the very American cultural script that individuals have total control over everything that happens to them. If babies are properly stimulated they will all be geniuses! If ADHD children go through the proper attentional exercises they will suddenly excel! If the elderly go to brain gyms they will never lose their memory! These, unfortunately, are primarily openings for marketers rather than scientific realities. Of course we have some control, and the key findings of neural plasticity research have been helpful in supporting that, but there are some things that are not just about effort--but also about care and community. Overall, I did find this book interesting and worth reading, but also found myself worried about what seemed to me strategic exaggeration.
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on April 17, 2007
I have taken an interest in mind/brain science over the past several months. Having started my nursing career on a medical neurology ward, I "grew up" with the localizationist interpretation of brain function and of the irreversible nature of brain damage. One couldn't help, however, having seen evidence in the course of ones practice that overwhelmingly contradicted the accepted view, so I was very pleased to see that so much has been done lately in researching the plasticity of the brain and its ability to "fix" or at least bypass damage to its structure.

The author, a psychologist with a practice in Canada, approaches his narrative almost as a journalist. He has researched the field and interviewed many of those who have been responsible for breakthroughs in mind/brain science. He gives a brief personal biography and characterization of the scientist as an individual, and then goes on to report the results of their research and the contributions that the work has provided individual patients. Here too the persons' lives and experiences are provided so that each becomes real to the reader. In this way the actual advances are given very personal meaning and significance.

In my opinion, the book should be a must read for neurology residents--if it or something like it has not already been added to the core curriculum. The research and the individual representative cases provided are an amazing illustration of what has and may be done in the near future of neurological diseases and disorders. Certainly anyone with a neurological disorder will find the information inspiring and hopeful. No longer is he or she expected to learn to "accept" their disability or to "learn to live with it." More active approaches to treatment seem to work far better than had been believed by earlier generations of neuroscientists and physiotherapists. Most important is the issue of providing treatment for disabilities, of extending and intensifying therapies not just to a fixed time decided upon arbitrarily but to a point when actual change and improvement are seen to occur. Some of the illustrative cases are certainly exceptional, maybe even just "lucky" individuals, but many of them derived considerable benefit from the approaches used to treat their disability by researchers.

Among the most amazing stories are those of stroke victims who have recovered almost entirely from their neurological damage and returned to an active life. Others are about new technologies for providing sight to the blind, hearing to the deaf, and greater autonomy to the movement impaired. Some of the findings about the aging brain are especially interesting and hopeful. In fact I was so impressed with some of it, that I gave the book to a friend who also worked in neurology in "the old days" and who is now dealing with the issues of living with her mother whose memory is gradually failing and whose everyday life is getting to be more and more difficult and complicated.

A superb book.
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on November 2, 2009
The most fascinating thing about this book is the nearly complete lack of honest critical response to Doidge's book.

Doidge, a Freudian psychoanalyst, has no training in neurobiology, and prior to this book has published next to nothing relevant to the topic. He makes two fundamental errors in the way he tells his story.

The first of these is the division he makes between "localizationists" and "neuroplasticians". No one working in neuroscience would take seriously the straw man position that Doidge puts forth for localizationists, that there is "one location, one function" and that the brain operates as an unchangeable machine. It is one of the most fundamental axioms of neuroscience that neural changes underlie any learning mechanism. No one would seriously postulate that brains *don't* change a great deal during the life of an organism. Even those involved in the practice of understanding how functions are localized (e.g., speech in the left hemisphere) would not suggest that there is anything special or unchangeable about the physical location, that this location couldn't change after brain injury. Mainstream neuroscience, not a marginalized fringe, has long been aware of the adaptations and plasticity that can happen after a stroke or other brain damage. Doidge seriously misrepresents himself as the champion of a movement.

The second error is the implication that brains are infinitely malleable. He presents a cherry-picked set of case studies and select experiments that might suggest that this is the case, but there is plenty of evidence to suggest exactly the opposite conclusion. Doidge even goes as far as to intimate that any neurological condition can be fixed with the right training. Autism, dyslexia, maybe even Alzheimer's. This is seriously misleading at best.

One of the traps that Doidge falls into is the excessive use of "brainspeak". Many of the examples and implications that he talks about are behavioral, and a brain description is really not the appropriate level. After a while, the term "brain map" has lost a good deal of it's punch as it's applied to anything at all. He suggests that Freud was ahead of his time because, in essence, psychotherapy is "changing your brain maps". Well, yes. But so is any learning at all; there's no privileged place for psychoanalysis. In essence, Doidge is trying to convince you that evidence for brain plasticity should let you know that YOUR brain (and life) can be changed. But in many ways the brainspeak is an unnecessary diversion. The world is full of stories of personal triumph, and those enough are evidence that personal triumph is possible.
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on August 29, 2008
For decades now there has been a longstanding feud between biologists and psychologists on how the human brain forms and develops -- otherwise known as the nature versus nurture debate. Evolutionary biology teaches us that genes is destiny, and with his book the Canadian psychiatrist Norman Doidge makes his case for individual agency and cultural influences.

Like Jared Diamond's "Guns, Germs, & Steel" Dr. Doidge's book is not original research but rather a synthesis and summary from the frontiers of brain science. Supplemented with case studies "The Brain that Changes Itself" is about neuroplasticity, which argues that the brain is "plastic," or organic and malleable. For hundreds of years, thanks to thinkers like Rene Descartes, scientists have thought of the brain as mechanical, certain functions localized to certain sectors in this machine -- over time it rusts, with no chance of regeneration. Thanks to decades of research by a brave few who dared to defy their mainstream bethren and to the invention of brain scans neuroplasticity is now the accepted view.

The good news about neuroplasticity is that the brain you have is the brain you make it. New external stimuli (such as learning a new language) causes new neural connections in the brain (the "neurons that fire together wire together" rule of neuroplasticity). Often when we're learning a new language or skill after some fast improvement in the early stages we reach a plateau where we seem to have no improvement at all. Then after a while we suddenly make a great leap. That's because it takes time (as measured by nights of good sleep) for these neural connections to consolidate themselves but once they do we can move onto the next level. Of course if we don't keep on practising this skill these connections will weaken (the "use it or lose it" rule of plasticity) because space in the brain is, after all, limited.

Individual agency over our brains gives great hope to those who suffer from aging and brain damage. Scientists have developed brain exercises on the computer to help the elderly maintain a sharp and alert mind, and help stroke victims restore once lost cognitive functions.

The bad news is that the brain you have is the brain that you make it, and unfortunately most of us choose the path of least resistance and decide not to use it at all. As Dr. Doidge explains the plastic paradox means that exposing yourself to new stimuli can make the brain flexible but choosing to stay within your comfort zone will also make the brain rigid. Learning is fast and furious when we're kids but as we reach adulthood the brain becomes less plastic, making learning more difficult, and instead of choosing to learn most of us choose merely to rely on our current belief system. And when the world challenges this belief system we choose to ignore the world, and if forced we'll opt to fight the world. Thus, the plastic brain that allows us to learn new languages can also paradoxically make us intolerant and racist.

Indeed, as Dr. Doidge warns us, the individuals that he profiles who have managed to change themselves have done so because they make a honest and hard commitment to change themselves. Dr. Doidge's patients went into psychotherapy (which operates from the principles of neuroplasticity) to discover how trauma created unhealthy neural connections, and how through discussion, self-analysis, and will-power to create new neural connections. But this process is painful and costly and takes many years.

And it's so hard because the brain is so adept at protecting us. When we suffer a physical injury the brain will actually decide on what the appropriate level of pain we feel is. And when we're traumatized when we're young (for example, our mother dies or we're sexually abused) the brain will often decide to not convert this experience into long-term memory, and build defenses to disassociate ourselves from the possible pain of further trauma. The net effect is that our hippocampus -- the area of our frontal lobe that transfers experience into long-term memory, and thus what governs our ability to learn -- will shrink, thereby giving a scientific explanation to why adult victims of childhood trauma seem so adolescent and immature.

Neuroplasticity offers hope though: love. It seems that our neural network will automatically become more flexible in two critical periods of our adulthood: when we fall in love, and when we have children. Presumably it's because in both instances we need to urgently learn a new skillset to match the two most important circumstances we could find ourselves in. So being in love with someone does allow you to change who you are. Of course, being the circumspect doctor, Dr. Doidge reminds us that if we find ourselves in love with the wrong person we can change for the worst as well, seeing our confidence and healthy attitude suddenly shatter.

I'm not sure how Dr. Doidge would view my summary of his book, because I've taken great liberty in summarizing it. It's a pithy book and there's really a lot of refreshing and insightful material in the book but I'm not happy about the writing style -- which seems rushed and choppy to me -- and the organization, which hurts the clarity and effectiveness of the book. I've read quite a lot on the workings of the brain so I could follow through most chapters but I think a novice will have a particularly hard time reading this book. For a great introduction to how the mind works I suggest watching the BBC documentary series "The Human Series," hosted by Robert Winston -- possibly the greatest documentary series ever made.
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on September 30, 2009
The Brain that changes itself is about brain plasticity, or the brain's ability to adapt and change in the face of adversity...for the most part. The book has its flaws (see "the bad", and "the ugly") but the full range of damage and injury that is covered in this book makes it a must read. I believe that everyone will will encounter someone in their lifetime with at least one of these injuries and understanding what this book teaches will help us understand the situation and treatment options much more completely. Because of the flaws, I think this is a good read as long as you take the time to think about the text and draw connections between the chapters.

The Good:

Most of the chapters in this book are devoted to striking and impressive examples of brains overcoming damage caused from genetic learning disabilities, acquired injuries, cancer, and strokes. Norman Doidge for the most part does an admirable job of showing how all sorts of diseases and injuries that were considered incurable are now curable with a variety of different treatment methods developed by a serious of very interesting and intelligent people.

Also, to me, the most interesting section was in the appendix that explained about not only the plasticity of the brain but plasticity associated with culture and physical changes (and how that related to the brain), I would love to see a whole book on the subject.

The Bad:

There is some serious problem with organization. For some reason, he throws the chapter "Acquiring Tastes and Loves" in the middle of the book. It is a chapter devoted to more subtle forms of brain plasticity and how it relates to love and fetishes...nothing to do with any of the exciting stuff like caner or any of that (I actually never finished the chapter because it interrupted the book so much). I think this chapter and a different chapter "Turning our ghosts into ancestors" belongs in a different section of the book that specifically relates brain plasticity to more normal psychological conditions and explains how psychotherapy can be beneficial in aiding these less radical changes (I am pretty sure that is the point he wants to make).

Also, (A more personal peeve) I think he missed out on a great opportunity to talk about those few baffling people that appear to have virtually no brain just a bunch of cerebrospinal fluid in their skulls and yet lead reasonably normal lives. He could have speculated on the density of the brain cells or even the potential for other nerve cells to take over brain function. Or just left it as a medical marvel and indicated that there is yet more to learn about brain plasticity. (I am aware of the doubts regarding this info, but he could have easily addressed all the issues and opened our minds up to the possibilities of even more plastic change)

The Ugly:

He is very opinionated and really loves some of these scientists paying them far more attention in the text than other equally impressive scientists. He does tend to take a more permissive view on animal experimentation, so if that bothers you, get the book from your library (I borrowed it from a friend), it's still worth reading for the information on techniques for overcoming disadvantages.

There were several places where he made implied contradictions; they could be easy to miss since the contradicting sentences are at the beginning and the end of the book. Also, I think he missed out on some great places to tie things together for the reader and perhaps smooth over the contradictions.
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on May 28, 2008
This is a book that my men's book club enjoyed. I also enjoyed the book, but found the author to be a bit of true believer - if what he claims is true most every case of autism, paralysis, tinitis, and other neurological disorders can be fixed by taking advantage of the new understanding that the brain can create new routes and perhaps new nerves. The range of impact of this approach is staggering and will have implications for many years to come. The topics covered include sexual attraction, social skills, 'itches' of amputated limbs, fetishism, spatial reasoning, stroke recovery, feelings from phantom limbs, pain of phantom limbs, pornography addiction, cognitive decline, OCD, and even blindness. As you can tell, I found the information of various cases exciting and offering great promise, but I also found the lack of a balanced presentation by the author to be disconcerting.
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"The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science" by Norman Doidge, is an easily readable, enjoyable, and thought-provoking book that gives the nonprofessional an overview of the new science of neuroplasticity--the brain's ability to reorganize itself by forming new neural connections over the life span. We learn that the brain is no longer thought of as being hard-wired, that people are no longer believed to be merely products of their genes and environment, and that damaged brains have the remarkable ability to repair themselves.

Doidge recounts stories of real people who have benefited from advances in neuroplasticity. He gives us just enough background information about each case so that we find ourselves genuinely caring about these people--each person comes to life, like characters in a fine novel. He tells us stories about stroke victims with major physical dysfunction who were able to recover nearly everything that they lost, and then go on to live normal lives again. There is an astonishing story of a woman who lost her balance mechanisms; with help from neuroplasticians, she was able to rewire her brain to use other senses to achieve the same goal. We learn that neuroplastic physicians can design high-technology devices capable of bringing sight to the blind, hearing to the deaf, and movement to the paralyzed. We learn about an utterly courageous woman who, completely on her own, was able to rewire her brain to compensate for a large number of severe learning disabilities. Eventually, she goes on to found a very successful network of schools devoted to the methodologies she used.

The basic concept is simple: the brain can change itself--rewire itself, so to speak. Often it needs only a little structured help to force it into making the new connections.

The implications of this new science are staggering. Imagine retraining the brains of the severely mentally disadvantaged--the learning disabled, the autistic...perhaps even the psychopath--so that they are able to function almost normally in society. Imagine the impact this new science may have on prison rehabilitation, special education, psychiatry, and rehabilitation therapy, to name but a few. This is a truly astonishing new frontier, and Doidge makes the concepts easy and enjoyable. I recommend this book highly.
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This book is interesting, informative, straight to the point, professional, and easy to read. The basic premise is that the brain is not permanently hardwired, its plastic, and can be changed. It gives examples of those that have been chronically injured and impaired, and have been able to recover based on creating new mind maps through various types of rehabilitation, and many more. A very good book.
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