Changing Your Mind: The Plasticity of the Brain and Its Impact on Ment

This is the nature of things. Until very recently, our best and brightest scientists and physicians believe that the adult brain couldn't change. Our brain circuits were formed and finalized in childhood. Now we discover that the brain's plastic, meaning changeable, but not all changes good. That changing brain can actually do us harm. Obsessive compulsive disorder, post-traumatic stress disorder, and even schizophrenia. But the mind can harness the damage brain's plastic he did to change itself, and now we are finding new treatments for mental diseases and disorders once thought incurable. When you would tell people, hey, this is your brain sending you a false message. It would help them. We might actually change the whole course, the whole trajectory, of someone's life. This is medicine. This house out comes that are medical. It changes brain physically. It changes them chemically. It changes them functionally. There's a lot that can go wrong inside your head. Fabias, panic attacks, schizophrenia, destroy lives. But scientists now know that the brain can change. It has the amazing ability to reorganize itself throughout life, allowing us to treat mental disorders. My name is Dr. Norman Doyech, and I wrote a book called The Brain The Changes itself. The discovery of neuroplasticity is the discovery that our brains can change their structure and function through mental experience alone. It signals the most important change in our understanding of the brain and 400 years. Because for 400 years, we thought of the brain as though it were like a machine with parts. And that view of the machine-like brain gave rise to a neurological fatalism, because it meant people who were born with brain damage or who sustained brain damage as they developed. We're condemned to live with it, because machines demeneglorious things, but they don't grow new parts, and they can't reorganize themselves. All of us have worries. We worry because we are intelligent creatures. The same intelligence that allows us to plan, imagine, hypothesize, also allows us to anticipate negative outcomes. There are many kinds of warriors, but among those who suffer the most are people with obsessive compulsive disorder or OCD. Their problem, though all in the head, goes far beyond what others might experience, precisely because it's in the head, and therefore, inescapable. It's a disorder that can often be treated by understanding neuroplasticity. This is the discovery of UCLA's Dr. Jeffrey Schwartz. People get intruding into their stream of consciousness unwanted thoughts and urges. You basically have an inner conflict where you get insneared in really bad obsessive compulsive disorder, because it gets worse and worse and worse, and more you relent to it. So, it's an nasty thing. Let's see that OCD basically feels like you're trapped in your own mind. It feels like there's almost like a puppeteer really kind of making us do things and rituals that we don't want to do, but we have to. You're dealing with such a high level of anxiety and high level stress that you physically are sick. And this is happening day after day, hour after hour. It wasn't long before I fell into a depression. And contamination fears I constantly was washing my hands. It even got to the point where I would lie saw my head and face at arms and legs. You... you had a falling apart. I always felt guilty, which is part of my OCD, and my feeling that I'm always doing something, not sinful. And I found a while, I found a way to get rid of that feeling that I could pray to God and ask for forgiveness. I would pray throughout the day, even though, like, when I'm taking care of the kids, I'm cooking, or I'm changing the diaper, or I would say, oh, forgive me for this. And I kept praying for the same thing over and over again. But that when I pray, I didn't felt like I was forgiven that guilty feeling never left me. Cleaning and washing compulsions. When I first was starting to get those incredibly uncomfortable anxious feelings and not knowing why, those were really difficult times where I was very low. I feel like I trapped and locked into this. And like, I have to do this, even though I don't want to. Wow, I'm seeing people around me that aren't having to do this. What the hell is going on with me? There's a worry circuit in the brain, and when we worry, three things usually happen. First, a part of our brain behind our forehead, detects the mistake. And it sends a signal to another part of the brain, called the anterior singular. The anterior singular makes you anxious about the mistake, so you'll stay focused on it until you've corrected. And finally, once you have corrected it, a third part of the brain called the caudate, functions like a mental gear shift, and shifts you onto the next thing. But in people with those CD, that mental gear shift is very sticky. It stays stuck, so they try to correct the mistake again and again. Each time the correct from the stake, their anxiety drops very briefly. Because neurons that fire together wire together, they get the idea that to lower anxiety, they should keep correcting the mistake. It works in the short run, but in the long run, it makes them more obsessive. The vicious cycle of obsessive impulse of disorder is the more you wash, the more you check, the worse it gets. This makes a lot of plastic sense, because the more time you spend thinking about germs, the more he inadvertently wires the connection between germs and danger into his brain, rather than strengthening the thing he has to strengthen, that mental gear shift. If the brain can get worse by people doing the symptom again and again, maybe if I can get them through understanding to resist the acting on the urge, then they can strengthen alternative brain circuitry and quiet down the pathological brain circuitry, and that process when done regularly changes how the brain works. Short-swendered, whether patients could shift the cod aid manually by first becoming aware they were having an OCD attack and then using their constant effort full attention to actively focus on something wholesome besides the worry. Human beings uniquely have the capacity to have true insight, true awareness, the capacity to stand outside yourself to use a term called the impartial spectator, and we are not what our brain is. This ability to develop a third-party awareness is difficult to master but the key to Schwartz's treatment. The impartial spectator tells me, it's not real, this is just a brain, take up, brain doing what brain does. But I always knew there was almost like a part of me, like a different me that was sort of inside saying, this is irrational, this is a disorder. Don't believe everything you think. Don't believe everything you think turns out to be a very good one line or for understanding obsessive compulsive disorder because your brain is making you think stuff that clearly it's just due to a brain circuit on rogue. The therapy device by Schwartz draws on ancient Buddhist teachings above mindfulness. Schwartz's treatment is divided into four steps to harness the plastic properties of the brain to work for the sufferer, not against them. The first step is for a person having an OCD attack to step back and mindfully reliable what's happening to him so that he realizes that what he's experiencing is not a dangerous attack of germs, but an attack of OCD. When I get an obsessive thought and a compulsive urge that I can, you know, step one, I can relabel it as such. Call it OCD. Don't say I haven't urged to wash my hands, say OCD is causing me to feel like I have to wash my hands. The next step is to reattribute those thoughts and urges to the pathological brain circuitry and to remember how brain lock occurs in the three parts of the brain. So you reattribute the fear to something your brain is doing. The third step is to re-focus to manually turn one's attention away from the pathological thoughts and urges onto a constructive, wholesome behavior. Whatever's bothering me, I go and do something else. That's where the neuroplasticity comes in because when you're using your brain now in a constructive way and focusing your attention in a constructive way you stabilize alternative brain circuitry. The final step occurs as you notice that your obsessions and compulsions are beginning to fade and you revaluate them. Realizing their worthless distractions to be ignored. When you do that regularly, you really do start changing your brain. Now when you get the urge to wash the urge to check, you no longer go, that's me, you go, oh, I know what that is. That's OCD and now your brain is working with you instead of against you. When shorts and his teams scan the brains of their improved patients they found that the firing of the sticky gear shift had normalized. The brain had changed its structure in response to thought. You're making major changes in the deep aspects of your biological nature constructively through insight, awareness, effort and focus attention. The OCD is kind of under my control. I feel like, wow, this is something that everybody should know. If I could go on a mountain top and shout, how great it is, I would do it. I feel like mindfulness is the way to peace, peace inside of you. My hands, they used to, from all the wash and knees to bleed, they used to crack at the knuckles, they used to hurt. My hands are sort of a small, like physical testament to where I am today. The idea is that Dr. Schwartz has exposed me to, I'm eternally grateful because they've allowed me to shape my own brain and shape the outcome of my disorder in my life. Self-directed neuroplasticity is a real thing. You can use it to help you with your suffering. But there are many kinds of suffering. And new advancements in neuroplasticity can rescue us from the horrendous memories that would haunt anyone. I sort of lost 10 or 12 years in my life. I would have sort of flashbacks and nightmares. Before this happened, I was settled down. Three golden retrievers, a girl that I love, nice home. Something happened and I couldn't have that kind of life. Because every day I would wake up and I wanted to die. I didn't want to go through another day. PTSD is a neuroplastic disorder, par excellence. A person with an often normally functioning nervous system experiences a crushing mental event. The changes in the meaning of their lives and fundamentally alter their nervous system. Now, as they repeatedly relive the event, the wires itself more and more deeply into their minds, further disrupting normal functioning. Everyone was able to move on with life, but I felt like I was left behind. Sounds or anything could trigger it, and then all of a sudden you were down in this pit again. Sound the dog barking. The sound of kids screaming. It would just send me right back. The rot weather, grat, the back of my leg. And started whipping me around like I was a rag doll. I could see my son trying to get out of his stroller and it caught the attention of the dog. And the dog turned and lunched at the baby's head. I came home from work that day and found my brother hanging in our front hallway. It's never going to be something that I'll be able to forget. The fact that our brains are plastic also makes them vulnerable. And allows trauma to alter them and create post-traumatic stress disorder or PTSD. But a lame brune, the clinical psychologist at McGill University, has found a way to use the same neural plasticity to cure patients of this debilitating disorder. The sad truth is that everyday people are exposed to trauma and are at risk of developing post-traumatic stress disorder. Rave victims, child abuse, car accident victims, and you are changed by your experience and you're never going to be the same again. Never. We have developed a new treatment for PTSD. And this new treatment could change the way of psychologists and mental ill-professional treat people. During the course of experiencing the trauma, a person and even the brain is so overwhelmed that they cannot properly file away the thoughts, feelings and perceptions that are happening into memory. And thus, they keep emerging over and over again as though they're happening in the present. It's like you're in hell and there's no escape. It's living with a bad memory and the bad memory is so vivid that you're reliving it many times a day. I would really get sick, the sweating, the shaking, the feeling like I just wanted to hide in a closet somewhere in the dark, so nobody could even know that I exist in. What is required for the treatment to work is that the memory needs to be brought back. Researchers have found that each time any mental event is brought to conscious awareness, there's a moment of heightened plasticity in its circuit. This provides an opportunity to alter that circuit and its connections. And in the case of trauma, file those mental events in their proper place in the past. So in the treatment that we have developed, we have people think of their traumatic event under the influence of a medication. Propanolol dampens this emotional memory. In this treatment the patient has given a low dose of propanolol, an old drug typically used to relieve hypertension. Then they write out a narrative account of the trauma in explicit detail. And then they read the account of their trauma, and that last less than 10 minutes. When I first tried this, I did not think it would work because it's deceptively simple. We find that about three quarters of the people no longer made the criteria for PTSD after this treatment. It really changes their lives. While working with that link, when I wrote down what had happened to me, I found out I still had that range. That night I remember coming home, having nightmares again major and I was going, what am I getting into? And after each session I had to read the whole story. And it was always difficult for me. The young comedian I was saying to my client, I couldn't tell my mother. I was going to say that the girl who was going to see me, she was going to get in the back door and open the fucking safe. We walked to the back towards the safe and he has the gun on my head and back. I am certain, as I am a témoin, who will come and kill me. My heart is very weak. When I was 12, I had to have my tonsils taken off. So I was alone in the hospital. When I walked into this doctor's office, the first thing I noticed was that the walls were patted and then he closed the door locked and put the key in his pocket and I thought, oh my God. When he started touching me, I knew that I was just caught in the trap and that he would do whatever he wanted to do with me. When your 12 years old and you have no idea that a man can hurt you in this way and it was especially degrading and extremely humiliating. The girl was a little girl, a little pop-up, a little girl who was a little girl, and I'm just a little girl who will die. I just sang a gun, a little pop-up, a little pop-up, a little pop-up. I don't think it was the fifth week. I had to read the story again and then while reading it, all the sudden, there was a sort of idea of having a attachment. It was like reading a book. It was violent, but it wasn't me. It was something else. And I felt like smiling and laughing. And then after I remember telling my doctor saying, you guys have something. Very hot here. This is going to help a lot of people. Because neurons that fire together, wire together, every time a person who's been traumatized, remembers their trauma, they're at risk of more deeply connecting the remembered trauma with the firing of the threat system. But it also turns out to be the case, the neurons that fire apart wire apart. So by chemically blocking the arousal of the threat system, while narrating the trauma, we can actually disconnect them. We can decynchronize them because neurons that are out of sync failed to like. The memories don't make me suffer anymore. I still remember occasionally, but I can watch a movie that has something close to the event happening. And I don't even relate it back to my memory anymore. And then I remember, oh, I'm sure of this. All of our new treatments for trauma take advantage of the fact that when the patient is remembering the traumatic event, the network for that memory enters a more malleable, labile state. What is unique about a lamp or an ace approach is that it uses our understanding of neuroplasticity both the mental and biochemical levels. We're not trying to erase people's memory. We just want to transform it into something that they can recall willingly, and which is certainly a bad memory, but a memory that belongs to the past. You still remember everything. It's just that you don't remember them very often anymore, but it doesn't hurt you anymore. So you can just go on with life. It's a bad memory, just like everybody has bad memories. And it's not a trauma anymore. Some of my dear friends that know me for years, they said, the old Joelle's back. I have ambition, I have a drive to live again, and I appreciate things. And it can be just simple emotions falling in love again. Wow, that's fun. I missed that. Now that we're understanding how neuroplasticity can be applied to mental disorders, what's next? Can this knowledge of the plastic brain even help treat schizophrenia? Sophia Vina Gratov has spent her career researching schizophrenia, an illness in which the sufferer often can't distinguish what is real from what is not. It's fascinating because it's a window into how the brain operates. It helps you think about what is memory, what makes us human. I mean, all these are very, very cool questions, but I was getting increasingly frustrated by the fact that nothing and what I was doing was really actively supporting new ideas about how people could actually get better. But when she began to realize that the schizophrenic brain, though ill, is nonetheless neuroplastic, new treatment approaches open up. If her current approach is right, and there are strong signs it is, we will be treating people with schizophrenia in a new way just a few years from now. This actually lowers disease on the face of your, you live a totally isolated life sometimes with very little friends and contacts. What you hear in your head can be very scary. The words, the one I first got sick was kill, kill, kill, and I did not know what to do about it. I just thought of myself as a silent witness to horror. It's like another world or a twilight zone when there's no answers and you don't know what's happening to your child, and you can't believe the behavior and there's nobody to turn to, to ask a question. It's all in my head, and I cannot take a vacation from my head. Everybody can take a vacation right? We want to know well, but not me. Molly Hammaker runs his center, just outside San Francisco, that gives people with mental illness, including schizophrenia, a place to receive support and assistance while reintegrating themselves into society. When families hear the diagnosis, it's kind of like the cancer diagnosis for mental health. And I know this because when my own daughter became ill, and then was diagnosed as having schizophrenia, we went through extraordinary grief. We felt that our daughter was basically snatched away from us. Six years ago, Molly's daughter, Alita, started hearing voices. I remember it was strongly connected to the experience of doing yoga, and I thought my yoga teacher was sending me telepathic messages, and that was like the beginning of it. I was bombarded by voice at all the time. It's just scary that I was so convinced the voices were the truth. It's like you are psychic, you have supernatural powers, and so that kind of makes me feel good. But they also told me some horrible things, like my whole family was infected with HIV. Some pretty disturbing things actually. Here's a picture when I was psychotic. I don't think I was being honest about my voices. It was really the worst moment of my life as a mother. And it was like she was there but not there. People diagnosed with schizophrenia, typically have a constellation of three different kinds of symptoms. The first kind are called the positive symptoms, and this includes hallucinations and delusions. Second, they're the negative symptoms, and these include apathy, an inability to express emotion, and a general lack of gold erected behavior or action. And third, there are cognitive deficits, problems with memory, concentration, and even the organization of one's own thoughts. There's a range of cognitive impairments that we find in schizophrenia in many of the really key domains of functioning for the brain, and that can range from attention. They believe the brain to focus and sustain attention. The signal is kind of being dispersed in ways that are not as crisp and integrated as one might wish. And so the brain and the sense is struggling with a lot of noise in the system. If the brain is having trouble with that, that it's going to impair many aspects of day-to-day functioning, it's going to be much more difficult to simply learn and understand new information. Neural physicians had recently shown that it was possible to take children with learning disorders and develop brain exercises for them, so that they could function at normal and even above normal levels. So it made good sense to see whether the same thing could be done with people with schizophrenia. Dr. Michael Merzenic is a neuroscientist who is a giant amongst neural plasticians, particularly if there is ability to take work in the lab out into the world at large to help people. Not only is your brain plastic, but the schizophrenia is plastic. And that means that we had the potential to drive that brain in a corrective direction. His ideas were extremely fascinating. They were intriguing to me. I was eager to see how we could apply them, but there was a part of me that had a fairly healthy dose of skepticism because I was again operating from that model, a very nihilistic model, which is that this is a broken brain and it's irretrivably broken, and how are you possibly going to move it in more adaptive directions? What was going to move the brain in more adaptive directions was a simple looking video game. Simple on the surface, but actually a highly sophisticated tool designed to stimulate the brain to repair its underperforming areas. Five, two, three, three, two, For instance, patients with schizophrenia typically have cognitive difficulties with verbal processing, difficulties recognizing words, encoding words, and retrieving words, all of which are necessary for us to manipulate information in working memory. That fundamental breakdown in keeping track and holding things in memory is something that we've known for a long time to some extent, improveable by forms of intense and training. A series of video games was designed to create this and other deficits in the schizophrenic brain. Merzenic, working with a team of neuroscientists, including Henry Monka, designed numerous exercises that are deceptively simple. So I'm going to show you an exercise called higher low, and this is an auditory exercise that works under a hearing system, and it's designed to improve what we call speed of processing, so listen carefully. So those are two little sweeps of sound, and one of them went down, and one of them went up, and I'm just going to tell the computer, well, the first one went down, and the second one went up. Now, why is that important? Well, hearing quickly is important. If you're going to follow a pattern of speech, in which there are many rapid sounds, you need to have a brain that can keep up with how fast those sounds come in. And if your brain doesn't keep up, you won't be able to follow the threat of a conversation, and that's, of course, exactly the kind of memory problems that people with schizophrenia suffer from. So, and all of these exercises, they're designed to start off easy, so that even a person with very strong impairments can do them, and then progressively and incrementally get more and more challenging, so they can drive a person to very high levels of performance. So now I'm going to show you an executive function exercise. Five, one, four. They're going to see a number of objects on the screen, and they're going to hear a number that's spoken. One, one, two. People with a mental illness, often have a hard time integrating that information, and they either stick with just what they see or just what they hear. We decided to begin a study to see if this approach would be effective. Really, at that point I was interested, was more feasibility than anything. Would people, people with schizophrenia come in and do this? And if they do this, does it work? Five, three, four, four, four, two, five, one. The call went out for participants, and Molly's daughter, Alita, became one of them. The first time I went in there, I walked out, and I was really upset to be there. I wasn't on medication, and I think the voices were telling me you don't want to do this. Doing the video game, sometimes I didn't want to do it. I was kind of like, I have to do this again. But I could sometimes sort of feel something in my brain happening a little bit. Like, I could feel a little more focused, or a little bit from it. Four, one, four, three. The improvements were looking kind of maybe even more robust than I might have guessed. We have 12 patients who are assigned to the cognitive training. Amazingly, those getting the treatment showed increases in cognitive processing speed, verbal language skills, and verbal retention. Often regions, after these, we found that their improvement in that kind of a task had improved to the point that really probably would start to be somewhat meaningful in terms of day-to-day life. Brain imaging also showed that the participants' brains were changing. Beginning to look less like schizophrenia brains, and more like the brains of people without mental illness. After training, they're able to recruit the same region that the healthy control is able to recruit. That's a very cool results. Yeah. It is suddenly very cool. It's evidence of neural plasticity. Good to see you. When I think of the lead a now, I think of her as recovered. She is really a lead-a, again. I feel like I'm doing well, but I feel like I could always be doing better. I think someone is accepting the fact that I have schizophrenia's little challenging for me, but I see myself probably always taking my medication. I think it's a great tool for healing and recovery. The idea that a computer game can actually defeat some symptoms of schizophrenia might seem implausible to anyone raised in a pre-neural plastic era. We know that there are abnormal patterns in the brain of someone who gets a schizophrenia. What we seem to be showing is that after the cognitive training, the brain activation patterns are normalizing. The vinaigradov and her fellow researchers know there's something to what they did with that video game, causing incremental changes that might not be a sudden as those that occur with a drug. Which is why they're branching out and testing their theory on other types of people with schizophrenia, with studies that might prove this little video game holds huge potential. Even for long-term sufferers who now might find hope where up to now, there's been very little. When severe mental illness goes untreated, the sad results are often seen in any downtown area in any large city around the world. Sophia Vinagradov is running a study in downtown San Francisco. The purpose is to see what effect the neuroplastic treatment has on those who've been living with schizophrenia for a very long time. The chronic sufferers. People with schizophrenia frequently have cognitive problem-solving difficulties that make it difficult to hold a job, maintain a relationship, or function in everyday life. So, a cognitive intervention that improves problem-solving skills is a major advance for schizophrenic patients. Charles Stackhouse was diagnosed with schizophrenia 41 years ago. Do you still hear voices? Yeah, all the time. Yeah, I don't know the voice and say you know. Well, it's like more like whispered now. I just ignore because I have some really good medication. That helps me relax with it. Have you heard voices today? Oh yeah, well, all the time. So, the notion is we're going to deliver the cognitive training. So, hopefully we're getting the brain to be better and better at thinking and learning. And now we're going to have people who are getting that training also get a set of skills and support to go back to work. Takes a lot of effort. You know, really apply myself. If I'm successful, you know, I feel successful when I come into the news programs. And yet another study, using the same concepts, then a crowd of a scene, what effect the software training has on social abilities. And ever present deficit in those who get to the front end. We're developing some more sets of exercises that are going to target areas we have not yet targeted. In this case, social cognition, so the ability to process information that is related to really being able to read expressions on people's faces, understand nuances and the voice and so on. So, it's going to be a very real world test. What do you feel that you've gained from the training? I sort of feel like I'm waking up. Ever since I started here, I'm getting to be more involved in things. Any time that's a good job. Yeah. Really the next step where we have to go is we have to apply this to younger people. So the idea was, well, if we can come in early in the course of illness with an intervention that's going to improve cognition, we might actually change the whole course, the whole trajectory of someone's life. Howly far would as 21 years old. She doesn't have schizophrenia, but has displayed some early warning symptoms. I was in high school and I was really depressed and hospitalized for a little while. A couple of years ago, howly began having the occasional delusion. I did keep thinking that I was hearing electrical sounds like a ringing telephone or a little like, but it says you have a message on your computer or like I kept thinking that someone had left the fan on downstairs, but really they hadn't. Howly was exactly the type of person's Sofia of an agradoff was looking for. Because these are such precious subjects we're having them go through. And in our researchers are among others racing to identify and treat people who don't have schizophrenia now, but who are already experiencing symptoms that often evolve into the illness. So they might not have full blown hallucinations, but from time to time maybe they're starting to have unusual beliefs or interests and things, which are a little bit on the edge of unusual, but they're not frankly delusional. So what we're doing is trying to target that year or two before the full illness onset. The hypothesis is that the cognitive training will improve people's attention, memory, and then potentially that it may even prevent the onset of full psychosis. I remember the program being somewhat monotonous. As they're being an e-benefit, I don't think it really had any particular effect on me. I still have it terribly vivid imagination. In our plastic interventions are based on exercising the brain. So like all exercise, they're incremental and change takes place over time. Sometimes it's even imperceptible to the patient as it's occurring, but the changes do show up on tests that the patients do. One of our unexpected findings was with a measure that was actually from the blood called BDNF. BDNF is brain-derived neurotrophot factor, and it's a compound that is found in the brain. It can be thought of as the brain's fertilizer. People that get to freniat typically have lower than normal BDNF levels, but astonishingly after 10 weeks of receiving the computer training, their BDNF increased to normal. And so this was some really interesting evidence that something was changing biologically in the systems of people who got the cognitive training, and this something had to do or shared some relationship with this interesting molecule called BDNF. This is medicine. This has outcomes that are medical. It changes brains physically. It changes them chemically. It changes them functionally. In fact, it changes them on a broader scale, because we're driving these complex natural processes. Done does any pill that you can take. What Vintegrata hopes for is the development of a new approach to dealing with schizophrenia. One that is a three-level approach. Medications will be one piece of that, but some form of cognitive enhancement or cognitive training is going to be a second piece. And I'm hopeful that the work we've been doing is setting the stages for that kind of treatment. Then of course, the third area is to take that brain, which is now functioning in a much more efficient, better fashion, and let the person learn the skills, the work skills, the social skills that they need to establish the recovery that is going to be meaningful for them. So I really see treatment as being this three-pronged approach. Three, two, three, two, one. So a few of the integrative studies will be complete in just a few years, and perhaps that is when schizophrenia treatment throughout the world will undergo a neuroplastic revolution. I think there's every reason to be extremely hopeful now in terms of the treatment of schizophrenia. We're learning that the earlier you're intervening, the better your outcomes, we now are beginning to develop these novel approaches to treatment that no one had sort of really considered. There's every reason to expect that people will make a recovery and we'll go on to have satisfying lives. But we're thinking about this true correction. Machine is intact. There's nothing in most of these conditions missing. We're trying to drive the machine, which is plastic, reversibly plastic. Back as far and completely as possible, in a way that actually corrects itself. The whole idea is to help the person get back in life and connect with their family again, and connect with the world again, in ways that could help them live a happier life. One of the deepest things about neuroplasticity is that it shows that we can make choices about what our brain is doing to us, and we can focus our attention in different ways in adaptive ways. And when you do that, you align your brain with the greater good. When we think of neuroplasticity, we tend to think of what we like about it, that it gives rise to more flexible behaviors. But in fact, neuroplasticity is no one's friend, not yours or mine, because it can equally give rise to rigid behaviors. This happens in OCD or PTSD or even in psychosis, when negative thoughts repeated get wired more and more deeply into the brain. But while neuroplasticity is not our friend, understanding it is, and it's that understanding that's allowing us in many cases now to reverse the course of illnesses that we thought were intractable.