There is hope for neurological recovery: Redirect behaviors of habit

Although many neurological disorders appear to be structural and the result of neurological dysfunctioning, recent research suggests that there is much more hope that people can learn to restore function.  Even people affected by  stroke, cerebral palsy, or epilepsy can regain function.  The observed symptoms and dysfunctional movement patterns can be understood as the nervous system’s best strategy to solve a problem at that moment and is the best response the person could perform under the circumstances.  For example in the case of  stroke, a spastic movement is the best solution that becomes a conditioned habit pattern. It may occur because the person tries to achieve the previous motor behaviors which  can no longer be performed because of the neurological damage. With cerebral palsy, the initial damage at birth changed the motor patterns as the child attempted to walk.  While in cases of epilepsy, the spreading of the seizure across the brain is not inhibited. Despite the neurological damage, improvement is possible as demonstrated by Jill Bolte Taylor’s presentation of her experience and  remarkable recovery from a left hemisphere stroke.

Application to stroke rehabilitation

A useful premise underlying neural regeneration and development is that it healing follows developmental movement sequences which cannot be skipped.  Thus after a neurological injury such as a stroke, the movement sequence needs to be re-integrated. It is not relearning what was lost; it is learning the new skills as if the skills are being learned for the first time. This includes an attitude of acceptance, non judgment, fun, play and exploration concurrent with many, many, many training practices until the skills are mastered.  Thus stroke patients sitting in wheelchairs may try to repeat movements which were present before the stroke but which are now beyond the biological developmental stage due to the neural damage. The person instead needs to learn anew the movement sequences that a baby mastered (lifting the head, rolling over, cross crawl moment, crawling, etc). This takes lots of practice. Compare the many hours a baby/child practices in order to be able to stand to the limited time people with strokemay spent performing their prescriptive exercises.  Thus, children usually show mastery while many people with stroke demonstrate limited improvement.  It is practice, practice and practice; it is not mindless practice, it is practice with awareness and intent.

Dysfunctional patterns can be understood as over learned conditioned chained behaviors which occur automatically. A superb explanation of this process is described by Charles Duhigg in his book, The power of habit-Why we do what we do in life and business. Clinical success is to identify these chains and the sequential steps  and then teach the person to redirect the behavior.

Application to epilepsy

Some people with epilepsy can learn to identify the initiation of the seizure and then interrupt the cascading sequence by doing something different. In this way the seizure process is interrupted and no seizure will occur.  For example, one man hyperventilated before a grand mal seizure. When the therapist taught him to become aware and  change his breathing pattern each he began to hyperventilate, his epileptic seizures did not occur. Similarly, a young woman with epilepsy turned her head to the right and slightly lifted her chin upward just before an absence seizure occurred. Teaching her to interrupt her initial head movement and looking straight ahead while slowly exhaling inhibited her seizures. The efficacy of this type of behavioral analysis for the treatment of epilepsy has been described by psychologists, Joanne Dahl, PhD and Tobias Lundgren, PhD in their superb article, Behavior analysis of epilepsy: Conditioning mechanisms, behavior technology and the contribution of ACT.

Another powerful treatment approach to treat seizures was developed by M. B. Sterman, Ph.D. at UCLA who taught people with epilepsy to control their own electrical activity of their brain with neurofeedback. Many people benefited from neurofeedback training and significantly reduced their seizures.

Application to cerebral palsy

To appreciate the power of interrupting the chained behaviors and the possibility that there is hope for people with cerebral palsy. This is illustrated in the remarkable TEDx Winnepeg talk, Baby brains DO recover, but habit hides it, by Karen Pape, MD.

Improve recovery from diseases. Youtube interviews of Erik Peper, PhD by Larry Berkelhammer, PhD

The psychophysiology of health and recovery from cancer and other medical conditions

Discussion about remarkable recoveries from life-threatening diseases following a visit to a shaman, medicine man, faith healer, voodoo master, or other indigenous healer. Also discussed is the importance of deep trust in the doctor, healer, healthcare team, the treatment, and in the ability of the immune system to improve their health.

Shifts in consciousness improve recovery rates for cancer and other diseases

This discussion explored shifts in consciousness that are associated with improved recovery rates for cancer and other diseases. Patients with a sense of control and who are empowered tend to heal faster. Acceptance for our present circumstances, when combined with hope for the future, and a belief in possibilities contribute to speedier recoveries. An optimistic view of the future and of health have physiological correlates that are associated with healing.

Improve health with fun movements: Practices you can do at home and at work

Physical fitness promotes health.    For one person it may be walking, for another jogging, bicycling or dancing. Increase the joy and pleasure of movement. In most cases about 20 minutes of continued activity is enough to keep in shape and regenerate. When the urge to watch TV or just to crash occurs, do some of the movement—you will gain energy. The exercises this article are are developed to reduce discomfort, increase flexibility  and improve health.  Practice them throughout the day, especially before the signals of pain or discomfort occur. First read over the General Concepts Underlying the Exercises  and then explore the various practices.

General Concepts Underlying the Exercises

While practicing the strength and stretch exercises, always remember to breathe. Exercises should be performed slowly, gently and playfully.  If pain or discomfort occurs, STOP. Please consult your health care provider if you have any medical condition which could be affected by exercise.

Perform the practices in a playful, exploratory manner.  Ask yourself:  “What is happening?” and “How do I feel different during and after the practice?” Practice with awareness and passive attention. Remember, Pain, No gain — Pain discourages practice.  Pain and the anticipation of pain usually induce bracing which is the opposite of relaxation and letting go.  In addition, many of our movements are conditioned and without knowing we hold our breath and tighten our shoulders when we perform an exercise.  Explore ways to keep breathing and thereby inhibit the startle/orienting/flight response embedded and conditioned with the  movements.  For example, continue to breathe and relax instead of holding your breath and tightening your shoulders when you initially look at something or perform a task.

Learn to reduce the automatic and unnecessary tightening of muscles not needed for the performance of the task.  As you do an exercise, continuously, check your body and explore how to relax muscles that are not needed for the actual exercise.  Become your own instructor in the same way that a yoga teacher reminds you to exhale when you are doing an asana (yoga pose). If you are unsure whether you are tightening, initially look another person doing the exercise to observe their bracing and breath holding patterns.  Ask them to observe you and give feedback.  In many cases, the more others are involved the easier it is to do a practice.

It is often helpful to perform the practice in a group.  Encourage your whole work unit to take breaks and exercise together.  Usually it is much easier to do something together, especially when you are not motivated—use social support to help you do your practices.

Problems with neck, back and shoulders

The number one overall work-related complaint is the back pain and this is also true for many people who work at the computer. In many cases there are correlations between backache and stress, immobility, and lack of regeneration. Back pain is often blamed on disk problems which may be aggravated by chronic tension that may have some psychological factors.  When you experience discomfort, explore some of the following questions:

  • Is there something for which I am spineless?
  • Who or what is the pain in my neck or back?
  • What is the weight I am carrying?
  • Am I rigid and not willing to be flexible?
  • What negative emotion, such as anger or resentment, needs to resolved?

Be willing to act on whatever answers you observe.  Back and neck pain is often significantly reduced after emotional conflicts are resolved (see the book by John Sarno, MD., Healing Back Pain: The Mind-Body Connection). The best treatment is prevention, emotional resolution, and physical movement. Allow your back to relax and move episodically.  Allow tensions to dissipate and explore the physical, psychological and social burdens you carry.  To loosen your neck practice  the following exercise.

Free your neck and shoulders[1]

This is a slightly complicated, but very effective process. You may want to ask a friend or co-worker to read the following instructions to you.

Pretest: Push away from the keyboard. Sit at the edge of the chair with your knees bent at approximately 90 degrees and your feet flat on the floor about shoulder width apart.  Do the movements slowly.  Do NOT push yourself if you feel discomfort.  Be gentle with yourself.

Look to the right and gently turn your head and body as far as you can go to the right. When you have gone as far as you can comfortably, look at the furthest spot on the wall and remember that spot.  Gently rotate your head and body back to center.  Close your eyes and relax.

Movement practice: Reach up with your right hand; pass it over the top of your head and hold on to your left ear. Then gently bend to the right lowering the elbow towards the floor.  Slowly straighten up. Repeat a few times, feeling as if you are a sapling flexing in the breeze as shown in Figure 1.


Figure 1. Illustration of  side ways bending with hand holding ear.

Observe what your body is doing as it bends and comes back up to center. Notice the movements in your ribs, back and neck.  Then drop your arm to your lap and relax.  Make sure you continue to breathe diaphragmatically throughout the exercise.

Reach up with your left hand, pass it over the top of your head and hold on to your right ear.  Repeat as above, this time bending to the right.

Reach up with your right hand and pass it over the top of your head, now holding onto your left ear.  Then look to the right with your eyes and rotate your head to the right as if you are looking behind you. Return to center and repeat the movement a few times.  Then drop your  arm to your lap and relax for a few breaths as shown in Figure 2. Slide3Figure 2. Illustration of  rotational movement with hand holding ear.

Repeat the same rotating motion of your head to the right, except that now your eyes look to the left. Repeat this a few times, then drop your arm to your lap and relax for a few breaths.

Repeat the exercise except reach up with your left hand and pass it over the top of your head, and hold on to your right ear.  Then look to the left with your eyes and rotate your head to the left as if you are looking behind you.  Return to center and repeat a few times.  Then drop your arms to your lap and relax for a few breaths.

Repeat the same rotating motion of your head to the left, except that your eyes look to the right.  Repeat this a few times, then drop your arm to your lap and relax for a few breaths.

Post test: look to the right and gently turn your head and body as far as you can go. When you cannot go any further, look at that point on the wall. Gently rotate your head back to center, close your eyes, relax and notice the relaxing feelings in your neck, shoulders and back.

Did you rotate further than at the beginning of the exercise? More than 95% of participants report rotating significantly further as compared to the pretest.

For additional exercises on how to loosen your neck, shoulders, back, arms, hands, and legs, click on the link for the article, Improve health with movement: There is life after five or look at the somatic relaxation practices in part 3 of our book, Fighting Cancer-A Nontoxic Approach to Treatment.

[1] Adapted from a demonstration by Sharon Keane and developed by Ilana Rubenfeld