The Brain’s Way of Healing

Lisa Appignanesi in The Guardian:

BrainDr Michael Moskowitz, an American psychiatrist specialising in treating pain, had long been his very own laboratory rat. After breaking his femur jumping from the turret of an army tank, he made an important discovery: the brain could be taught to turn off even screaming pain, once the body had sent the necessary alarm signal. Years of chronic pain linked to a neck injury sustained in a waterskiing accident meant Moskowitz already knew that neurons can misfire, becoming hypersensitive. The initial cause of pain may have gone, but the injured area still seems to hurt. Once habituated to pain, the smallest thing can set it off. But if repeated bodily experience or movement leads to structural changes, so can mental experience and exercise. Treatment that involved visualizing the affected brain areas when pain struck and imagining them shrinking (engaging in “neuro-stimulation” and creating “competitive plasticity”) cured Moskowitz’s long-standing neck problem. Having systematised the practice for his patients, he went on to improve the lives of many suffering from a range of chronic pain conditions, from back discomfort to multiple sclerosis.

Norman Doidge, a psychiatrist, psychoanalyst and author of the bestselling book The Brain that Changes Itself, says such treatments are neither hypnosis, self-hypnosis nor due to a placebo effect. All of those may have some beneficial impact on certain chronic sufferers, but what is at play is a (re)modelling of the brain, a change in the way its neurons fire. Important among Moskowitz’s findings and those of many others in the field is the suggestion that, after a short time, the opioid narcotics used for pain treatment cease to work. The plastic brain’s own opioid receptors grow saturated. It produces new ones less sensitive to the medication, rendering the patient more and more dependent on higher and higher doses. For Moskowitz, weaning the patient away from opioid-induced brain sensitivity is one of the first tasks in a treatment process that engages the patient in relentless mental effort.

More here.