The Brain That

Changes Itself
Stories of Personal Triumph
from the Frontiers of Brain Science

NORMAN DOIDGE, M.D.

A James H. Silberman Book

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First published in the United States of America by Viking Penguin,

a member of Penguin Group (USA) Inc. 2007
Published in Penguin Books 2007

19 20 18

Copyright© Norman Doidge, 2007

All rights reserved

THE LIBRARY OF CONGRESS HAS CATALOGED THE HARDCOVER EDITION AS FOLLOWS:

Doidge, Norman.
The Brain that changes itself: stories of personal triumph from the frontiers
of brain science I Norman Doidge.
p. cm.
ISBN 978-0-670-03830-5 (he.)
ISBN 978-0-14-311310-2 (pbk.)
1. Neuroplasticity. 2. Brain damage-Patients-Rehabilitation. I. Title.
QP363.3,D65 2007
612.8-dc22 2006049224

Printed in the United States of America

Set in Minion
Designed by Spring Hoteling

Except in the United States of America, this book is sold subject to the condition
that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise
circulated without the publisher's prior consent in any form of binding or cover other
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of copyrighted materials. Your support of the author's rights is appreciated.
 Brain Lock Unlocked 165

.There are many kinds of worriers and many types of anxiety-

phobias, post-traumatic stress disorders, and panic attacks. But among
the people who suffer most are those with obsessive-compulsive dis-
order, or OCD, who are terrified that some harm will come, or has 1
come, to them or to those they love. Though they may have been
.· fairly anxious as children, at some later point, often as young adults,
they have an "attack" that takes their worrying to a new level. Once
self-possessed adults, they now feel like anguished, terrified children.
6 Ashamed that they've lost control, they often hide their worry from
others, sometimes for years, before they seek help. In the worst cases
they cannot awaken from these nightmares for months at a time or
Brain Lock Unlocked
even years. Medications may quell their anxieties but often don't
eliminate the problem.
Using Plasticity to Stop Worries, Obsessions,
OCD often worsens over time, gradually altering the structure of
Compulsions, and Bad Habits
the brain. A patient with OCD may try to get relief by focusing on
his worry-making sure he's covered all the bases and left nothing to
chance-but the more he thinks about his fear, however, the more he
worries about it, because with OCD, worry begets worry.

All of us have worries. We worry because we are intelligent be- There is often an emotional trigger for the first major attack.
ings. Intelligence predicts, that is its essence; the same intelligence A person might remember that it is the anniversary of his mother's
that allows us to plan, hope, imagine, and hypothesize also allows us death, hear about a rival's car accident, feel an ache or lump in his
to worry and anticipate negative outcomes. But there are people who body, read about a chemical in the food supply, or see an image of
are "great worriers:' whose worrying is in a class of its own. Their burned hands in a film. Then he begins to worry that he is approach-
suffering, though "all in the head:' goes far beyond what most people ing the age that his mother was when she died and, though not gen-
experience precisely because it is all in the head and is thus in- erally superstitious, now feels he is doomed to die that day; or that
escapable. Such people are so constantly traumatized by their own his rival's early death awaits him too; or that he has discovered the
brains that they often consider suicide. In one case a desperate col- first symptoms of an untreatable disease; or that he has already been
lege student felt so trapped by his obsessive worries and compulsions poisoned because he was not vigilant enough about what he ate.
that he put a gun in his mouth and pulled the trigger. The bullet We all experience such thoughts fleetingly. But people with OCD
passed into his frontal lobe, causing a frontal lobotomy, which was at lock onto the worry and can't let it go. Their brains and minds march
the time a treatment for obsessive-compulsive disorder. He was them through various dread scenarios, and though they try to resist
found still alive, his disorder cured, and he returned to college. thinking about them, they cannot. The threats feel so real, they think

. .
166 The Brain That Changes Itself Brain Lock Unlocked 167

they must attend to them. Typical obsessions are fears of contracting I have had several patients whose worries about their health were
a terminal illness, being contaminated by germs, being poisoned by so intense that they felt as though they were on death row, each day
chemicals, being threatened by electromagnetic radiation, or even awaiting their execution. But their drama does not end there. Even if
being betrayed by one's own genes. Sometimes obsessionals get pre- they are told their health is fine, they may feel only the briefest flash
occupied with symmetry: they are bothered when pictures are not of relief before they harshly diagnose themselves as "crazy" for all
perfectly level or their teeth are not perfectly straight, or when objects they have put themselves through-though, often, this "insight" is
are not kept in perfect order, and they can spend hours lining them obsessional second-guessing in a new guise.
up properly. Or they become superstitious about certain numbers and
can set an alarm dock or volume control only on an even number. Soon after obsessive worries begin, OCD patients typically
Sexual or aggressive thoughts-a fear they have hurt loved ones- do something to diminish the worry, a compulsive act. If they feel
might intrude into their minds, but where these thoughts come from they have been contaminated by germs, they wash themselves; when
they do not know. A typical obsessional thought might be "The thud ·that doesn't make the worry go away, they wash all their clothing, the
that I heard while driving means I may have run somebody over." If floors, and then the walls. If a woman fears she will kill her baby,
they are religious, blasphemous thoughts might arise, causing guilt she wraps the butcher knife in doth, packs it in a box, locks it in the
and worry. Many people with OCD have obsessive doubts and are basement, then locks the door to the basement. The UCLA psychia-
always second-guessing themselves: have they turned off the stove, trist Jeffrey M. Schwartz describes a man who feared being contami-
locked the door, or hurt someone's feelings inadvertently? nated by the battery add spilled in car accidents. Each night he lay in
The worries can be bizarre-and make no conceivable sense bed listening for sirens that would signal an accident nearby. When
even to the worrier-but that doesn't make them any less torment- he heard them, he would get up, no matter what the hour, put on spe-
ing. A loving mother and wife worries, "I am going to harm my cial running shoes, and drive until he found the site. After the police
baby," or, "I will get up in my sleep and stab my husband with a left, he would scrub the asphalt with a brush for hours, then skulk
butcher knife in the chest while he's sleeping." A husband has the ob- home and throw out the shoes he had worn.
sessive thought that there are razor blades attached to his fingernails, Obsessive doubters often develop "checking compulsions." If
so he cannot touch his children, make love to his wife, or pat his dog. they doubt they've turned off the stove or locked the door, they go
His eyes see no blades, but his mind insists they are there, and he back to check and recheck often a hundred or more times. Because
keeps asking his wife for reassurance that he hasn't hurt her. the doubt never goes away, it might take them hours to leave the
Often obsessives fear the future because of some mistake they house.
may have made in the past. But it is not only the mistakes that have People who fear that a thud they heard while driving might
happened that haunt them. Mistakes that they imagine they could mean they ran someone over will drive around the block just to
make, should they let their guard down for a moment-which they, make sure there is no corpse in the road. If their obsessional fear is of
being human, eventually will-also generate a sense of dread that a dread disease, they will scan and rescan their body for symptoms
cannot be turned off. The agony of the obsessive worrier is that or make dozens of visits to the doctor. After a while these checking
whenever something bad is remotely possible, it feels inevitable. compulsions are ritualized. If they feel they have been dirtied, they
168 The Brain That Changes Itself
Brain lock Unlocked 169
must dean themselves in a precise order, putting on gloves to turn
s~ans of people with OCD and those without it, then used these in-
on the tap and scrubbing their bodies in a particular sequence; if
sights to develop his new form of therapy-the first time, to my
they have blasphemous or sexual thoughts, they may invent a ritual
knowledge, that such brain scans as the PET helped doctors both t
way of praying ·a certain number of times. These rituals are probably
understa_nd a disorder and to develop a psychotherapy for it. He the:
related to the magical and superstitious beliefs most obsessionals
tested this new treatment by doing brain scans on his patients before
have. If they have managed to avoid disaster, it is only because they
~nd af~er their psychotherapy and showed that their brains normal-
checked themselves in a certain way, and their only hope is to keep
ize~ with treatment. This was another first-a demonstration that a
checking in the same way each time. talking therapy could change the brain.
Obsessive-compulsives, so often filled with doubt, may become
Nor~a~ly, when _we ,?1ake a mistake, three things happen. First,
terrified of making a mistake and start compulsively correcting them-
we get a mistake feeling, that nagging sense that something is wrong.
selves and others. One woman took hundreds of hours to write brief
Second, we become anxious, and that anxiety drives us to correct the
letters because she felt so unable to find words that didn't feel "mis- t
miS a~e. Third, when we have corrected the mistake, an automatic
taken." Many a Ph.D. dissertation stalls-not because the author is a
~e~rshift in our brain allows us to move on to the next thought or ac-
perfectionist, but because the doubting writer with OCD can't find
tivity. Then bo~ the "mistake feeling" and the anxiety disappear.
words that don't "feel" totally wrong.
But the bram of the obsessive-compulsive does not move on or
When a person tries to resist a compulsion, his tension mounts
to a fever pitch. If he acts on it, he gets temporary relief, but this
"t
th "
um e page. Even though he has corrected his spelling mistake,
W~she~ t~e germs off his hands, or apologized for forgetting his
makes it more likely that the obsessive thought and compulsive urge
friend s birthday, he continues to obsess. His automatic gearshift
do~s ~o~ work, and the mistake feeling and its pursuant anxiety
will only be worse when it strikes again.
.build m mtensity.
OCD has been very difficult to treat. Medication and behavior
·We now know, from brain scans, that three parts of the brain are
therapy are only partially helpful for many people. Jeffrey M. Schwartz involved in obsessions.
has developed an effective, plasticity-based treatment that helps not
We detect mistakes with our orbital frontal cortex, part of the
only those with obsessive-compulsive disorder but also those of us
frontal lobe, on the underside of the brain, just behind our eyes.
with more everyday worries, when we start stewing about something
Scans show that the more obsessive a person is, the more activated
and can't stop even though we know it's pointless. It can help us the orbital frontal cortex is.
when we get mentally"sticky" and hold on to worries or when we be-
One~ the orbital frontal cortex has fired the "mistake feeling," it
come cQmpulsive and driven by such "nasty habits" as compulsive sends a signal _to the cingulate gyrus, located in the deepest part of the
nail biting, hair pulling, shopping, gambling, and eating. Even some Cortex. The cmgulate triggers the dreadful anxiety that something
forms of obsessive jealousy, substance abuse, compulsive sexual be- . bad is going to happen unless we correct the mistake and sends sig-
haviors, and excessive concern about what others think about us, nals to both the gut and the heart, causing the physical sensations we
self-image, the body, and self-esteem can be helped. . associate with dread.
Schwartz developed new insights into OCD by comparing brain
The "automatic gearshift:' the caudate nucleus, sits deep in the
170 The Brain That Changes Itself
Brain Lock Unlocked 171
center of the brain and allows our thoughts to flow from one to the next
is happening .to him, so that he realizes that what he is experiencing is
unless, as happens in OCD, the caudate becomes extremely"sticky."
not an attack of germs, AIDS, or battery acid but an episode of OCD.
Brain scans of OCD patients show that all three brain areas are
He should remember that brain lock occurs in the three parts of the
hyperactive. The orbital frontal cortex and the cingulate turn on and
brain. As a therapist, I encourage OCD patients to make the following
stay on as though locked in the "on position" together-one reason
summary for themselves: "Yes, I do have a real problem right now. But
that Schwartz calls OCD "brain lock." Because the caudate doesn't
it.is not germs, it is my OCD," This relabeling allows them to get some
"shift the gear" automatically, the orbital frontal cortex and the cin-
dIStance from the content of the obsession and view it in somewhat
gulate continue to fire off their signals, increasing the mistake feeli~g
the same way Buddhists view suffering in meditation: they observe its
and the anxiety. Because the person has already corrected the mis•
effects on them and so slightly separate themselves from it.
take, these are, of course, false alarms. The malfunctioning caudate is
The O~D patient should also remind. himself that the reason the
probably overactive because it is stuck and is still being inundated
~ttack doesn't go away immediately is the faulty circuit. Some pa-
with signals from the orbital frontal cortex.
tients may find it helpful, in the midst of an attack, to look at the pic-
The causes of severe OCD brain lock vary. In many cases it runs
tures of the abnormal OCD brain scan in Schwartz's book Brain Lock,
in families and may be genetic, but it can also be caused by infections
and compare it with the more normal brain scans that Schwartz's
that swell the caudate. And, as we shall see, learning also plays a role
patients developed with treatment, to remind themselves it is possi-
in its development. ble to change circuits.
Schwartz set out to develop a treatment· that would change the
Schwartz is teaching patients to distinguish between the universal
OCD circuit by unlocking the link between the orbital cortex and the
form of OCD (worrisome thoughts and urges that intmde into con-
cingulate and normalizing the functioning of the caudate. Schwartz
sciousness) and the content of an obsession (i.e., the dangerous germs).
wondered whether patients could shift the caudate "manually" by
The more patients focus on content, the worse their condition becomes.
paying constant., effortful attention and actively focusing on some-
For a long time therapists have focused on the content as well.
thing besides the worry, such as a new, pleasurable activity. This ap•
The most common treatment for OCD is called "exposure and re-
proach makes plastic sense because it "grows" a new brain circuit
sponse prevention," a form of behavior therapy .that helps about half
that gives pleasure and triggers dopamine release which, as we have
of OCD patients make some improvement, though most don't get
seen, rewards the new activity and consolidates and grows new neu•
completely better. If a person fears germs, he is incrementally exposed
ronal connections. This new circuit can eventually compete with the
to more of them, in an attempt to desensitize him. In practice this
older one, and according to use it or lose it, the pathological networ~
.. could mean making patients spend time in toilets. (The first time I
will weaken. With this treatment we don't so much "break" bad habits
heard of this treatment, the psychiatrist was asking a man to wear
as replace bad behaviors with better ones.
~ dirty underwear over his face.) Understandably, 30 percent of patients
refused such treatments. Exposure to germs doesn't aim to "shift" the
Schwartz divides the therapy into a number of steps, of gear on to the next thought; it leads the patient to dwell more in-
~~~~~ .
tensely on them-for a while, at least. The second part of the standard
The first step is for a person having an OCD attack to relabel what
behavioral treatment is "response prevention," preventing the patient
 Brain Lock Unlocked 173
172 The Brain That Changes Itself

from acting on his compulsion. Another form of therapy, Cognitive patients that though their "manual transmission" is sticky, with hard
Therapy, is based on the premise that problematic mood and anxiety . work it can be shifted using their cerebral cortex, one effortful thought
states are caused by cognitive distortions-inaccurate or exaggerated or action at a time.
thoughts. Cognitive therapists have their OCD patients write down Of course, the gearshift is a machine metaphor, and the brain is
their fears and then list reasons they don't make sense. But this proce- not a machine; it is plastic and living. Each time patients try to shift
dure also immerses the patient in the content of his OCD. As Schwartz gears, they begin fixing their "transmission" by growing new circuits
says, "To teach a patient to say, 'My hands are not dirty: is just to repeat and altering the caudate. By refocusing, the patient is learning not to
something she already knows ... cognitive distortion is just not an in- .get sucked in by the content of an obsession but to work around it. I
trinsic part of the disease; a patient basically knows that failing to . suggest to my patients that they think of the use-it-or-lose-it princi-
count the cans in the pantry today won't really cause her mother to die •" ple. Each moment they spend thinking of the symptom-believing
a horrible death tonight. The problem is, she doesn't feel that way," :~;: .that germs are threatening them-they deepen the obsessive circuit.
Psychoanalysts too have focused on the content of the symptoms; · By bypassing it, they are on the road to losing it. With obsessions and
many of which deal with troubling sexual and aggressive ideas. They · compulsions, the more you do it, the more you want to do it; the less
have found that an obsessive thought, such as "I will hurt my child:' · you do it, the less you want to do it.
might express a suppressed anger at the child, and that this insight Schwartz has found it essential to understand that it is not what
might, in mild cases, be enough to make an obsession go away. But this you feel while applying the technique that counts, it is what you do.
often does not work with moderate or severe OCD. And while "The struggle is not to make the feeling go away; the struggle is not to
Schwartz believes that the origins of many obsessions relate to the kind give in to the feeling' -by acting out a compulsion, or thinking about
of conflicts about sex, aggression, and guilt that Freud emphasized, the obsession. This technique won't give immediate relief because
·these conflicts explain only the content, not the form of the disorder. lasting neuroplastic change takes time, but. it does lay the ground-
work for change by exercising the brain in a new way. So at first one
After a patient has acknowledged that the worry is a will still feel both the urge to enact the compulsion, and the tension
symptom of OCD, the next crucial step is to refocus on a positive, · and anxiety that come from resisting it. The goal is to "change the
wholesome, ideally pleasure-giving activity the moment he becomes. channel" to some new activity for fifteen to thirty minutes when one
aware he is having an OCD attack. The activity could be gardening, e'Jtas an OCD symptom. (If one can't resist that long, any time spent
helping someone, working on a hobby, playing a musical instrum~t, \·, resisting is beneficial, even if it is only for a minute. That resistance,
listening to music, working out, or shooting baskets. An activity tlia,t '.. \:'.that effort, is what appears to lay down new circuits.)
involves another person helps keep the patient focused. If OCD One can see that Schwartz's technique with OCD has parallels
strikes while the patient is driving a car, he should be ready with an -.· with Taub's CI approach to strokes. By forcing the patients to "change
activity like a book on tape or a CD. It is essential to do something,~ .the channel" and refocus on a new actiyity, Schwartz is imposing a
c:onstraint like Taub's mitt. By getting his patients to concentrate on
"shift" the gear manually. ..
This may seem like an obvious course of action, and may s?und ·· - ,.the new behavior intensively, in thirty-minute segments, he is giving
simple, but it is not for people with OCD. Schwartz assures his them massed practice.
174 The Brain That Changes Itself
Brain Lock Unlocked 175
In chapter 3, "Redesigning the Brain," we learned two key laws of
Emma is now in her forties. When she was twenty-three, a spon-
plasticity that also underlie this treatment. The first is that Neuro1:5
taneous genetic mutation led to an illness called retinitis pigmentosa
that fire together wire together. By doing something pleasurable m
th_at caused her retinal cells to die. Five years ago she became totally
place of the coinpulsion, patients form a new circuit that is gradually
' blind and began using a seeing-eye dog, Matty, a Labrador.
reinforced instead of the compulsion. The second law is that Neurons
· Emma's blindness has reorganized her brain and her life. A num-
that fire apart wire apart. By not acting on their compulsions, pa-
. ber of us who were at the dinner are interested in literature, but since
tients weaken the link between the compulsion and the idea it will
<~he has gone blind, Emma has done more reading than any of us. A
ease their anxiety. This delinking is crucial because, as we've seen,
. computer program from Kurzweil Educational Systems reads books
while acting on a compulsion eases anxiety in the short term, it
worsens OCD in the long term.
}: i ~oud to her in a monotone that pauses for commas, stops for peri-
. ods, and rises in pitch for questions. This computer voice is so rapid,
Schwartz has had good results with severe cases. Eighty percent ,
\ I cannot make out a single word. But Emma has gradually learned to
of his patients get better when they use his method in combination
f~~sten at a faster and faster pace, so she is now reading at about 340
with medication-typically an antidepressant such as Anafranil or a
l ;~rds a minute and is marching through all the great classics. "I get
Prozac-type drug. The medication functions like training wheels on
into an author, and I read everything he has ever written, and then
a bike, to ease anxiety or to lower it enough for patients to benefit
I move on to another." She has read Dostoyevsky (her favorite),
from the therapy. In time many patients get off the medication, an~,
G<>~ol, Tolstoy, Turgenev, Dickens, Chesterton, Balzac, Hugo, Zola,
some don't need it to start with.
:'P,lauoeit, Proust, Stendhal, and many others. Recently she read three
I have seen the brain lock approach work well with such typical
Trollope novels in one day. She asked me how it might be possible
OCD problems as fear of germs, hand washing, checking comp~:
:for her to read so much more quickly than before she went blind. I
sions, compulsive second-guessing, and incapacitating hypochondn•
theorized that her massive visual cortex, no longer processing sight, ·
acal fears. As patients apply themselves, the "manual gear shift" ge
'had been taken over for auditory processing. .
more and more automatic. The episodes become shorter and less
That particular evening Emma asked me if I knew anything about
quent, and though patients can relapse during stressful times, th .
can quickly regain control using their newfound technique.
heeding to check things a lot. She told me that she often has a lot of
· uble getting out of the house, because she keeps checking the stoves
When Schwartz and his team scanned the brains of their impro
d the locks. Back when she was still going to her office, she might
patients, they found that the three parts of the brain that had be
for work, get halfway there, and then have to go back to make sure
"locked" and, firing together in a hyperactive way, had begun to
had·Jocked the door properly. By the time she got back, she would
separately in a normal way. The brain lock was being relieved.
·. obliged to check that the stove, electrical appliances, and water were
ed ?ff. She'd leave, then have to repeat the whole cycle several more
es, all the while trying to fight the urge. She told me that her author-
an father had made her anxious when she was growing up. When
I was at a dinner party with a friend, whom I shall call Em
e left home, she'd lost that anxiety but noticed that it now seemed
her writer husband, Theodore; and several other writers.
have been replaced by this checking, which kept getting worse.
176 The Brain That Changes Itself

I explained the brain lock theory to her. I told her ~hat often w~
check and recheck appliances without really concentratmg. So I sug
ested she check once, and once only, with utmost care. ,, .
g The next time I s~w her, she was delighted. ''I'm better, she .sa1~.
"I check once, now, and I move on. I still feel :he !
~r~e, but resist it,
and then it passes. And as I get more practice, it is passmg more

quic::'~ave her husband a mock scowl. He had joked that it was not
polite to bother the psychia~rist with her neuroses while we were at a 7
"Theo dore," she sa1'd ' "1't's not that I'm crazy. It's just that my
party.
brain wasn't turning the page." Pain

The Dark Side Of Plasticity

When we wish to perfect our senses, neuroplasticity is a bless-

ing; when it works in the service of pain, plasticity can be a curse.
Our guide to pain is one of the most inspiring of the neuroplas-
.ticians, V. S. Ramachandran. Vilayanur Subramanian Ramachan-
. dran was born in Madras, India. He is a neurologist, of Hindu
background, and a proud relic of nineteenth-century science who
tackles twenty-first-century dilemmas.
Ramachandran is an M.D., a specialist in neurology, with a
Ph.D. in psychology from Trinity College, Cambridge. We met in
San Diego, where he directs the Center for Brain and Cognition at
the University of California. "Rama" has black, wavy hair and wears a
black leather jacket. His voice booms. His accent is British, but when
is excited, his r's are like a long drumroll.
Whereas many neuroplasticians work to help people develop or
 The Brain That
! Changes Itself
I
t

l Stories of Personal Triumph

t from the Frontiers of Brain Science

NORMAN DOIDGE, M.D.

A James H. Silberman Book

PENGUIN BOOKS
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First published in the United States of America by Viking Penguin,

a member of Penguin Group (USA) Inc. 2007
Published in Penguin Books 2007

I 9 20 I 8

Copyright © Norman Doidge, 2007

All rights reserved

THE LIBRARY OF CONGRESS HAS CATALOGED THE HARDCOVER EDITION AS FOLLOWS:

Doidge, Norman.
The Brain that changes itself: stories of personal triumph from the frontiers
· of brain science/ Norman Doidge.
p. cm.
ISBN 978-0-670-03830-5 (he.)
ISBN 978-0-14-311310-2 (pbk.)
I. Neuroplasticity. 2. Brain damage-Patients-Rehabilitation. I. Title.
QP363.3.D65 2007
612.8-dc22 2006049224

Printed in the United States of America

Set in Minion
Designed by Spring Hoteling

Except in the United States of America, this book is sold subject to the condition
that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise
circulated without the publisher's prior consent in any form of binding or cover other
than that in which it is published and without a similar condition including
this condition being imposed on the subsequent purchaser.

The scanning, uploading and distribution of this book via the Internet or via any other means
without the permission of the publisher is illegal and punishable by law. Please purchase only
authorized electronic editions, and do not participate in or encourage electronic piracy
of copyrighted materials. Your support of the author's rights is appreciated.
1·

Appendix 1

The Culturally Modified Brain

Not Only Does the Brain Shape Culture,

Culture Shapes the Brain

What is the relationship between the brain and culture?

The conventional answer of scientists has been that the human
brain, from which all thought and action emanate, produces culture.
tBased on what we have learned about neuroplasticity, this answer is
no longer adequate.
Culture is not just produced by the brain;. it is also by definition
a series of activities that shape the mind. The Oxford English Dictio-
nary gives one important definition of "culture": "the cultivating or
~ development ... of the mind, faculties, manners, etc .... improve-
\ment or refinement by education and training ... the training, de-
f velopment and refinement of the mind, tastes and manners;' We
;_:become cultured through training in various activities, such as cus-
:ttoms, arts, ways of interacting with people, and the use of technologies,
;;. and the learning of ideas, beliefs, shared philosophies, and religion.
288 Appendix 1 The Culturally Modified Brain 289

Neuroplastic research has shown us that every sustained activity But what distinguishes these children, for our purposes, is that
ever mapped-including physical activities, sensory activities, learn- they can see clearly at these great depths, without goggles. Most hu-
ing, thinking, and imagining-changes the brain as well as the mind. man beings cannot see dearly under water because as sunlight passes
Cultural ideas and activities are no exception. Our brains are modi- through water, it is bent, or "refracted," so that light doesn't land
fied by the cultural activities we do-be they reading, studying music, ~· where it should on the retina.
or learning new languages. We all have what might be called a cultur- ,Anna Gislen, a Swedish researcher, studied the Sea Gypsies' abil-
ally modified brain, and as cultures evolve, they continually lead to ity to read placards under water and found that they were more than
new changes in the brain. As Merzenich puts it, "Our brains are vastly twice as skillful as European children. The Gypsies learned to control
different, in fine detail, from the brains of our ancestors ... In each .the shape of their lenses and, more significantly, to control the size of
stage of cultural development ... the average human had to learn their pupils, constricting them 22 percent. This is a remarkable find-
complex new skills and abilities that all involve massive brain ing, because human pupils reflexively get larger under water, and
change ... Each one of us can actually learn an incredibly elaborate . pupil adjustment has been thought to be a fixed, innate reflex, con-
set of ancestrally developed skills and abilities in our lifetimes, in a trolled by the brain and nervous system.
sense generating a re-creation of this history of cultural evolution via This ability of the Sea Gypsies to see under water isn't the prod-
brain plasticity;' uct of a unique genetic endowment. Gislen has since taught Swedish
So a neuroplastically informed view of culture and the brainim:. children to constrict their pupils to see under water-one more in-
plies a two-way street: the brain and genetics produce culture; but . stance of the brain and nervous system showing unexpected training
culture also shapes the brain. Sometimes these changes can be dra- effects that alter what was thought to be a hardwired, unchangeable
matic. circuit.

The Sea Gypsies · Cultural Activities Change Brain Structure

The Sea Gypsies are nomadic people who live in a cluster of · ·. The Sea Gypsies' underwater sight is just one example of
tropical islands in the Burmese archipelago and off the west coast of .· how cultural activities can change brain circuits, in this case leading
Thailand. A wandering water tribe, they learn to swim before.~ey. .to a new and seemingly impossible change in perception. Though
learn to walk, and live over half their lives in boats on the operi ~.C the Gypsies' brains have yet to be scanned, we do have studies that
where they are often born and die. They survive by harvesting da~; ':,~how cultural activities changing brain structure. Music makes ex-
and sea cucumbers. Their children dive down, often thirty feet t>e~· ·f traordinary demands on the brain. A pianist performing the eleventh
neath the water's surface, and pluck up their food, indudirig small {Variation of the Sixth Paganini Etude by Franz Liszt must play a stag-
morsels of marine life, and have done so for centuries. By learajpg. 't_gering eighteen hundred notes per minute. Studies by Taub and oth-
'-!,·,t'
lower their heart rate, they can stay under water twice as long as m.os L'trs of musicians who play stringed instruments have shown that the
swimmers. They do this without any diving equipment. One'tribi "'." more these musicians practice, the larger the brain maps for their ac-
the Sulu, dive over seventy-five feet for pearls. tive left hands become, and the neurons and maps that respond to
290 Appendix 1 The Culturally Modified Brain 291

string timbres increase; in trumpeters the neurons and maps that re- under water. For those of us living in the information age, signature
spond to "brassy" sounds enlarge. Brain imaging shows that musi- activities include reading, writing, computer literacy, and using elec-
cians have several areas of their brains-the motor cortex and the tronic media. Signature activities differ from such universal human
cerebellum, among others-that differ from those of nonmusicians. activities as seeing, hearing, and walking, which develop with mini-
Imaging also shows that musicians who begin playing before the age mal prompting and are shared by all humanity, even those rare peo-
of seven have larger brain areas connecting the two hemispheres. ple who have been raised outside culture. Signature activities require
Giorgio Vasari, the art historian, tells us that when Michelangelo training and cultural experience and lead to the development of a
painted the Sistine Chapel, he built a scaffold almost to the ceiling new, specially wired brain. Human beings did not evolve to see
and painted for twenty months. As Vasari writes, "The work was exe- dearly under water-we left our "aquatic eyes" behind with scales
cuted in great discomfort, as Michelangelo had to stand with his head and fins, when our ancestors emerged from the sea and evolved to
thrown back, and he so injured his eyesight that for several months he· see on land. Underwater sight is not the gift of evolution; the gift
could only read and look at designs in that posture." This may have is brain plasticity, which allows us to adapt to a vast range of envi-
been a case of his brain rewiring itself, to see only in the odd position ... ronments.
that it had adapted itself to. Vasari's claim might seem incredible, but
studies show that when people wear prism inversion glasses, which
turn the world upside down, they find that, after a short while, their Are Our Brains Stuck in the Pleistocene Age?
brain changes and their perceptual centers "flip:' so that they perceive• A popular explanation of how our brain comes to perform
the world right side up and even read books held upside down. When cultural activities is proposed by evolutionary psychologists, a group
they take the glasses off, they see the world as though it were upside of researchers who argue that all human beings share the same basic
down, until they readapt, as Michelangelo did. i• brain modules (departments in the brain), or brain hardware, and.
It is not just "highly cultured" activities that rewire the brain, these modules developed to do specific cultural tasks, some for lan-
Brain scans of London taxi drivers show that the more years a cabl:>ie '"'· guage, some for mating, some for classifying the world, and so on.
spends navigating London streets, the larger the volume of hi5: bip•. These modules evolved in the Pleistocene age, from about 1.8 million
pocampus, that part of the brain that stores spatial representati~. ·· to ten thousand years ago, when humanity lived as hunter-gatherers,
Even leisure activities change our brain; meditators and meditatfon . and the modules have been passed on, essentially unchanged gene-
teachers have a thicker insula, a part of the cortex activated by paying • tically. Because we all share these modules, key aspects of human na-
" .. ,.,,
"-,,

close attention. :t: ture and psychology are fairly universal. Then, in an addendum,
these psychologists note that the adult human brain is therefore
Unlike musicians, taxi drivers, and meditation teachers,.~. anatomically unchanged since the Pleistocene. This addendum goes
Sea Gypsies are an entire culture of hunter-gatherers on' the openi too far, because it doesn't take plasticity, also part of our genetic her-
sea, all of whom share underwater sight. . . itage, into account.
In all cultures members tend to share certain common. activities, · · The hunter-gatherer brain was as plastic as our own, and it was
the "signature activities of a culture." For Sea Gypsies it is .s~g not "stuck" in the Pleistocene at all but rather was able to reorganize
292 Appendix 1
The Culturally Modified Brain 293
its structure and functions in order to respond to changing condi-
images were used to represent objects-not a big change. Next, these
tions. In fact, it was that ability to modify itself that enabled us to
hieroglyphic images were converted into letters, and the first pho-
emerge from the Pleistocene, a process that has been called "cogni-
netic alphabet was developed to represent sounds instead of visual
tive fluidity" by the archaeologist Steven Mithen and that, I would
images. This change required strengthening neuronal connections
argue, probably has its basis in brain plasticity. All our brain mod-
between different functions that process the images of letters, their
ules are plastic to some degree and can be combined and differenti-
sound, and their meaning, as. well as motor functions that move the
ated over the course of our individual lives to perform a number of eyes across the page.
functions-as in Pascual-Leone's experiment in which he blind-
As Merzenich and Tallal learned, it is possible to see reading cir-
folded people and demonstrated that their occipital lobe, which nor- · ·
cuits on brain scans. Thus signature cultural activities give rise to
mally processes vision, could process sound and touch. Modular s:,
signature brain circuits that did not exist in our ancestors. According
change is necessary for adaptation to the modern world, which ex-'.:
to Merzenich, "Our brains are different from those of all humans be-
poses us to things our hunter-gatherer ancestors never had to con•,'.;··
fore us ... Our brain is modified on a substantial scale, physically
tend with. An fMRI study shows that we recognize cars and trucks
and functionally, each time we learn a new skill or develop a new
with the same brain module we use to recognize faces. Clearly, the ·
ability. Massive changes are associated with our modern cultural
hunter-gatherer brain did not evolve to recognize cars and trucks. It
specializations." And though not everyone uses the same brain areas
is likely that the face module was most competitively suited to pro-
to read, because the brain is plastic, there are typical circuits for
cess these shapes-headlights are sufficiently like eyes, the hood like
reading-physical evidence that cultural activity leads to modified
a nose, the grill like a mouth-so that the plastic brain, with a little brain structures.
training and structural alteration, could process a car with the facial . .
recognition system. ..
The many brain modules a child must use for reading, writing, Why Human Beings Became the
and computer work evolved millennia before literacy, which is ~nly Preeminent Bearers of Culture
several thousand years old. Literacy's spread has been so rapid that
One could rightly ask, why is it that human beings, and not
the brain could not have evolved a genetically based module spedfi-
other animals, which also have plastic brains, developed culture?
cally for reading. Literacy, after all, can be taught to illiterate hQ.llte,l'•
True, other animals, such as chimpanzees, have rudimentary forms
gatherer tribes in a single generation, and there is no way ~e whole ·•.
of culture and can both make tools and teach their descendants to
tribe could develop a gene for a reading module in that time. A <:bild~;
use them, or perform rudimentary operations with symbols. But
today, when it learns to read, recapitulates the stages humanity went:
· kfthese are very limited. As the neuroscientist Robert Sapolsky points
through. Thirty thousand years ago humanity learned to clrflW ~
1 '(out, the answer lies in a very slight genetic variation between us and
cave walls, which required forming and strengthening links'b(:twt:
\,diimpanzees. We share 98 percent of our DNA with chimpanzees.
the visual functions (which process images) and the motor1func.
,~ The human genome project enabled scientists to determine precisely
tions (which move the hand). This stage was followed in about3000,
~'which genes differed, and it turns out that one of them is a gene
8 .c. by the invention of hieroglyphics, where simple standardized
£that determines how many neurons we will make. Our nt>nrn,.., - ·
·,,;,,
,''
,,,,
294 Appendix 1 The Culturally Modified Brain 295

basically identical to those of chimps and even of marine snails)n. variation-of introducing new biological brain structures in individ-
the embryo, all our neurons start from a single cell, which div~~~ •· uals by non-Darwinian means. When a parent reads, the microscopic
and makes two, then four, and so on. A regulatory gene determines structure of his or her own brain is changed. Reading can be taught
when that proces~ of division will stop, and it is this gene that differs be-, ·to children, and it changes the biological structure of their brains.
tween humans and chimps. That process goes on for enough rounds The brain is changed in two ways. The fine details of the circuits
until human beings have about 100 billion neurons. It stops a few connecting the modules are altered-no small matter. But so are the
rounds earlier in chimps, so they have a brain one-third the size of olir •· . original hunter-gatherer brain modules themselves, because, in the
own. Chimpanzee brains are plastic, but the sheer quantitative differ- plastic brain, change in one area or brain function "flows" through
ence between ours and theirs leads to "an exponentially greater number · · the brain, typically altering the modules that are connected to it.
of interactions between them:' because each neuron can be connected Merzenich demonstrated that change in the auditory cortex-
to thousands of cells. increasing firing rates-leads to changes in the frontal lobe con-
As the scientist Gerald Edelman has pointed out, the human cor- rt . nected to it, and says, "You can't change the primary auditory cortex
tex alone has 30 billion neurons and is capable of making 1 million · without changing what is happening in the frontal cortex. It's an ab-
billion synaptic connections. Edelman writes, "If we considered the . solute impossibility." The brain doesn't have one set of plastic rules
number of possible neural circuits, we would be dealing with hyper- for one part and another set for another part. (If that were the case,
astronomical numbers: 10 followed by at least a million zeros. (There ·the different parts of the brain would not be able to interact.) When
are 10 followed by 79 zeros, give or take a few, of particles in the two modules are linked in a new way in a cultural activity-as when
known universe.)" These staggering numbers explain why the human .· reading links visual and auditory modules as never before-the
brain can be described as the most complex known object in the uni- modules for both functions are changed by the interaction, creating a
verse, and why it is capable of ongoing, r1assive microstructural new whole, greater than the sum of the parts. A view of the brain that
change, and capable of performing so many different menta1·fqn~"'.r .takes plasticity and localizationism into account sees the brain as a
tions and behaviors, including our different cultural activities: .. ·complex system in which, as Gerald Edelman argues, "smaller parts
{; · form a heterogeneous set of components which are more or less inde-
·pendent. But as these parts connect with each other in larger and
A Non-Darwinian Way to Alter Blological Structures'
· larger aggregates, their functions tend to become integrated, yielding
Up until the discovery of neuroplasticity, scientists believed that new functions that depend on such higher order integration."
the only way that the brain changes its structure is through evol~tion Similarly, when one module fails, others connected to it are al-
of the species, which in most cases takes many thousands of years. Ap· tered. When we lose a sense-hearing, for example-other senses
cording to modern Darwinian evolutionary theory, new biological . become more active and more acute to make up for the loss. But they
brain structures develop in a species when genetic mutations arise, · increase not only the quantity of their processing but also the quality,
creating variation in the gene pool. If these variations have survival . becoming more like the lost sense. The plasticity researchers Helen
value, they are more likely to be passed on to the next generation, Neville and Donald Lawson (measuring neuronal firing rates to de-
But plasticity creates a new way-beyond genetic mutatio~ anA'. termine which sectors of the brain are active) found that deaf people
296 Appendix l The Culturally Modified Brain 297

intensify their peripheral vision to make up for the fact that they Freud, following Darwin, divided the brain into "lower" parts that
can't hear things coming at them from a distance. People who can:· we share with animals, and that process our brute animal instincts,
hear use their parietal cortex, near the top of the brain, to procesS • and "higher" parts that are uniquely human, and that can inhibit the
peripheral vision, whereas the deaf use their visual cortex, at the: expression of our brutishness. Indeed, Freud believed that civiliza-
back of the brain. Change in one brain module-here a decrease in tion rests on the partial inhibition of sexual and aggressive instincts.
output-leads to structural and functional change in another br~. He also believed we could go too far in repressing our instincts, lead-
module, so that the eyes of the deaf come to behave much more like ing us to develop neuroses. The ideal solution was to express these
ears, more able to sense the periphery. instincts in ways that were acceptable and even rewarded by our fel-
:, low humans, which was possible because the instincts, being plastic,
could change their aim. He called this process sublimation, yet as he
Plasticity and Sublimation: How We Civilize conceded, he never really explained exactly how an instinct might be
Our Animal Instincts
transformed into something more cerebral.
This principle that modules working together modify each· •The plastic brain solves the riddle of sublimation. Areas that
other may even help explain how it is possible for us to mix together~ evolved to perform hunter-gatherer tasks such as stalking prey can,
brute predatory and dominance instincts (processed by instinctual< because they are plastic, be sublimated into competitive games, since
modules) with our more cognitive-cerebral tendencies (proces .our brains evolved to link different neuronal groups and modules in
by intelligence modules), as we do in sports or competitive games novel ways. There is no reason why neurons from the instinctual
such as chess, or in artistic competitions, to come up with activities. parts of our brains cannot be linked to our more cognitive-cerebral
that express both the instinctual and the intellectual in one activity; ,1
·ones and to our pleasure centers, so that they literally get wired to-
An activity of this kind is called a "sublimation:' a hitherto myste- gether to form new wholes.
rious process by which brutish animal instincts are "civilized." How These wholes are more than, and different from, the sum of their
sublimation occurs has always been a riddle. Clearly, much of parent, parts. Recall that Merzenich and Pascual-Leone argued that a funda-
ing involves "civilizing" children by teaching them to restrain o{ mental rule of brain plasticity is that when two areas begin to inter-
channel these instincts into acceptable expressions, such as in contact . act, they influence each other and form a new whole. When an
sports, board and computer games, theater, literature, and art In ag- instinct, such as stalking prey, is linked up to a civilized activity,
gressive sports such as football, hockey, boxing, and soccer, fans often. such as cornering the opponent's king on the chessboard, and the
express these brute wishes ("Kill him! Flatten him! Eat him alive! »an4 neuronal networks for the instinct and the intellectual activity are
so on), but the civilizing rules modify the expression of the instinct. sQ. also linked, the two activities appear to temper each other-playing
the fans leave satisfied if their team wins enough points. chess is no longer about bloodthirsty stalking, though it still has
For over a century, thinkers influenced by Darwin conceded that·· some of the exciting emotions of the hunt. The dichotomy between
we had within us brutish animal instincts, but they were unable to "low" instinctual and "high" cerebral begins to disappear. Whenever
explain how sublimation of these instincts might occur. Nineteenth-. · the low and the high transform each other to create a new whole, we
century neurologists, such as John Hughlings Jackson and the young · can call it a sublimation.
 The Culturally Modified Brain 299
298 Appendix l

its brain filters out thousands of sounds. A Japanese six-month-old

Civilization is a series of techniques in which the hunter-gatherer: .
can hear the English r-l distinction as well as an American infant. At
brain teaches itself to rewire itself. And the sad proof that civilization is :.
one year she no longer can. Should that child later immigrate, she
a composite of the higher and lower brain functions is seen when ciyi~ .
lization breaks down in civil wars, and brutal instincts emerge full.
will have difficulty hearing and speaking new sounds properly.
Immigration is usually an unending, brutal workout for the adult
force, and theft, rape, destruction, and murder become commonplace•.
brain, requiring a massive rewiring of vast amounts of our cortical
Because the plastic brain can always allow brain functions that itbas 1.
real estate. It is a far more difficult matter than simply learning new
brought together to separate, a regression to barbarism is alwayspos..:.x
things, because the new culture is in plastic competition with neural
sible, and civilization will always be a tenuous affair that must h'.e ·
networks that had their critical period of development in the native
taught in each generation and is always, at most, one generationdeept/
land. Successful assimilation, with few exceptions, requires at least a
generation. Only immigrant children who pass through their critical
When the Brain Is Caught Between Two Cultures periods in the new culture can hope to find immigration less disori-
enting and traumatizing. For most, culture shock is brain shock.
The culturally modified brain Is subject to the plastic pa~adox
Cultural differences are so persistent because when our native cul-
(discussed in chapter 9, "Turning Our Ghosts into Ancestors»),
ture is learned and wired into our brains, it becomes "second nature;'
which can make us either more flexible or more rigid-a major
seemingly as "natural" as many of the instincts we were born with.
problem when changing cultures, in a multicultural world.
The tastes our culture creates-in foods, in type of family, in love,
Immigration is hard on the plastic brain. The process of learn,mj
a culture-acculturation-is a,n "additive" experience, of learn'
in music-often seem "natural:' even though they may be acquired
tastes. The ways we conduct nonverbal communication-how close
new things and making new neuronal connections as we "acquit{
culture. ·Additive plasticity occurs when brain change involves
we stand to other people, the rhythms and volume of our speech, ho¼:
growth. But plasticity is also "subtractive" and can involve"'f ,,, · ·1ong we wait before interrupting a conversation-all seem "natural" to
things away;' as occurs when the adolescent brain prunes away
us, because they are so deeply wired into our brains. When we change
cultures, we are shocked to learn that these customs are not natural at
rons, and when neuronal connections not being used are lost;
time the plastic brain acquires culture and uses it repeatedly, there is
all. Indeed, even when we make a modest change, such as moving to a
an opportunity cost: the brain loses some neural structure in
new house, we discover that something a~ basic as our sense of space,
,which seems so natural to us, and numerous routines we were not even
process, because plasticity is competitive. . •· .
Patricia Kuhl, of the University of Washington in Seattle;- aw:are we had, must slowly be altered while the brain rewires itself.
done brain-wave studies that show that human infants are cap~~
hearing any sound distinction in all the thousands of languages Sensing and Perceiving Are Plastic
our species. But once the critical period of auditory cortex d~
ment closes, an infant reared in a single culture loses the capacity "Perceptual learning" is the kind of learning that occurs
hear many of those sounds, and unused neurons are prup.ed, ~WI whenever the brain learns how to perceive with more acuteness or, as
until the brain map is dominated by the language of its culture;Nc{ occurs in the Sea Gypsies, in a new way and in the process develops
300 Appendix l
The Culturally Modified Brain 301

new brain maps and structures. Perceptual learning is also involved. ·

different aspects of the world, or taught different things." The most fa-
in the plasticity-based structural change that occurs when Merzenich's .
mous European psychologist of the mid-twentieth century, Jean Piaget,
Fast ForWord helps children with auditory discrimination problems'" ·
believed he showed, in a series of brilliant experiments on European
develop more refined brain maps, so they can hear normal speech ,
. children, that perceiving and reasoning unfold in development in the
for the first time. .
same way for all human beings, and that these processes are universal.
It has long been assumed that we absorb culture through univer-
True, scholars, travelers, and anthropologists had long observed that
sally shared, standard-issue, human perceptual equipment, but per•
the peoples of the East (those Asian peoples influenced by Chinese tra-
ceptual learning shows that this assumption is not completely
ditions) and those of the West (the heirs to the traditions of the ancient
accurate. To a larger degree than we suspected, culture determines what .
Greeks) perceive in different ways, but scientists assumed these differ-
we can and cannot perceive.
ences were based on different interpretations of what was seen, not on
One of the first people to begin thinking about how plasticity
microscopic differences in their perceptual equipment and structures.
must change the way we think about culture was the Canadian cogni-.
For instance, it was often observed that Westerners approach the
tive neuroscientist Merlin Donald, who argued in 2000 that culture·
world "analytically," dividing what they observe into individual
changes our functional cognitive architecture, meaning that, as with . ·
parts. Easterners tend to approach the world more "holistically," per-
learning to read and write, mental functions are reorganized. We nq'Y
. ceiving by looking at "the whole," and emphasizing the interrelated-
know that for this to happen, anatomical structures must change too...
ness of all things. It was also observed that the differing cognitive
Donald also argued that complex cultural activities like literacy and
1 styles of the analytic West and the holistic East parallel differences
language chang~ brain functions, but our most basic brain functions·
between the brain's two hemispheres. The left hemisphere tends to
such as vision and memory are not altered. As he put it, "No one sug~· ;, ,
· perform more sequential and analytical processing, while the right
gests that culture determines anything fundamental about vision.qr<ft
hemisphere is often engaged in simultaneous and holistic processing.
basic memory capacity. However, this is obviously not true of the
Were these different ways of seeing the world based on different in-
functional architecture of literacy and probably not oflanguage.)),_:,
terpretations of what was seen, or were Easterners and Westerners
Yet in the few years since that statement, it has become dear th~t
actually seeing different things?
even such brain fundamentals as visual processing and memory ca- .
The answer was unclear because almost all the studies of percep-
pacity are to some extent neuroplastic. The idea that culture may
tion had been done by Western academics on Westerners-typically,
change such fundamental brain activities as sight and perception is a
on their own American college students-until Nisbett designed ex-
radical one. While almost all social scientists-anthropologists, soci-
periments to compare perception in the East and the West, working
ologists, psychologists-concede that different cultures interpret the
with colleagues in the United States, China, Korea, and Japan. He did
world differently, most scientists and lay people assumed for several
·so reluctantly because he believed that we all perceive and reason in
thousand years-as the University of Michigan social psychologist
_the same way.
Richard E. Nisbett puts it-that "where people in one culture differ
·}, In a typical experiment, Nisbett's Japanese student, Take Ma-
from those in another in their beliefs, it can't be because they haye,
1":,, suda, showed students in the United States and Japan eight color
different cognitive processes. Rather, they must have been expose<;I to ·
' animations of fish swimming under water. Each scene had one "focal
302 Appendix l
The Culturally Modified Brain 303
fish" that moved faster or was bigger, brighter, or more prominent .
they focus on prominent objects. Other studies show that people
than the other smaller fish it swam among.
raised in a bicultural situation actually alternate between Western
When asked to describe the scene, the Americans usually re-
and Eastern perception. Hong Kongers, having lived under both a
ferred to the focal fish. The Japanese referred to the less prominent
British and a Chinese influence, can be "primed" to perceive in either
fish, background rocks, plants, and animals 70 percent more ofteij..
Eastern or Western fashion by experiments showing them a Western
than did the Americans. Subjects were then shown some of these ob-
image of Mickey Mouse or the U.S. Capitol, or an Eastern image of a
jects by themselves, not as part of the original scene. The Americans
temple or a dragon. Nisbett and his colleagues are thus doing the first
recognized the objects whether they were shown in the original
experiments that demonstrate cross-cultural "perceptual learning."
scene or not. The Japanese were better able to recognize an object,if
Culture can influence the development of perceptual learning
it was shown in the original scene. They perceived the object, in
because perception is not (as many assume) a passive, "bottom up"
terms of what it had been "bound" to. Nisbett and Masuda also mea~
process that begins when energy in the outside world strikes the
sured how quickly subjects recognized objects-a test of how autq..'(i
sense receptors, then passes signals to the "higher" perceptual centers
matic their perceptual processing was. When objects were put against
in the brain. The perceiving brain is active and always adjusting it-
a new background, the Japanese made mistakes. The Americans ~,
self. Seeing is as active as touching, when we run our fingers over an
not. These aspects of perception are not under our conscious co,ntr~i
object to discover its texture and shape. Indeed, the stationary eye is
and are dependent on trained neuronal circuits and brain maps. .:
virtually incapable of perceiving a complex object. Both our sensory
These experiments and many others like them confirm that· &si..
and our motor cortices are always involved in perceiving. The neuro-
erners perceive holistically, viewing objects as they are related to each ·
. scientists Manfred Fahle and Tomaso Poggio have shown experi-
other or in a context, whereas Westerners perceive them in isolation.
mentally that "higher" levels of perception affect how neuroplastic
Easterners see through a wide-angle lens; Westerners use a narrowone
change in the "lower," sensory parts of the brain develops.
with a sharper focus. Everything we know about plasticity suggests that
these different ways of perceiving, repeated hundreds of times a day, in
The fact that cultures differ in perception is not proof that one
massed practice, must lead to changes in neural networks respon~b~ ·
perceptual act is as good as the next, or that "everything is relative"
for sensing and perceiving. High-resolution brain scans of Easterne.rs ..
when it comes to perception. Clearly some contexts call for a more
and Westerners sensing and perceiving could likely settle the matte( <: narrow angle of view, and some for more wide-angle, holistic percep-
Further experiments by Nisbett's team confirm that when peopl5.:
tion. The Sea Gypsies have survived using a combination of their ex-
change cultures, they learn to perceive in a new way. After ~e~~~!J
perience of the sea and holistic perception. So attuned are they to the
years in America the Japanese begin to perceive in a way .i~~~(:
moods of the sea that when the tsunami of December 26, 2004, hit
guishable from Americans, so dearly the perceptual differen~~~:~f
.the Indian Ocean, killing hundreds of thousands, they all survived.
not based on genetics. The children of Asian-American imm!f_~ts::
't, They saw that the sea had begun to recede in a strange way, and this
perceive in a way that reflects both cultures. Because they a~e s~w~ct: drawing back was followed by an unusually small wave; they saw dol-
to Eastern influences at home and Western influences at scho~h~,
phins begin to swim for deeper water, while the elephants started
elsewhere, they sometimes process scenes holistically, and som~~~
. stampeding to higher ground, and they heard the cicadas fall silent.
304 Appendix 1
The Culturally Modified Brain 305
The Sea Gypsies began telling each other their ancient story abo\lt aging individual acts to preserve the structures within, and when
"The Wave That Eats People;' saying it had come again. Long before there is a mismatch between his internal neurocognitive structures
modern science put this all together, they had either fled the sea to the and the world, he seeks to change the world. In small ways he begins
shore, seeking the highest ground, or gone into very deep waters; to micromanage his environment, to control it and make it familiar.
where they also survived. What they were able to do, as more modern But this process, writ large, often leads whole cultural groups to try to
people under the influence of analytical science were not, was put all impose their view of the world on other cultures, and they often be-
these unusual events together and see the whole, using an exception- come violent, especially in the modern world, where globalization has
ally wide-angle lens, exceptional even by Eastern standards. Indeed, brought different cultures closer together, exacerbating the problem.
· Burmese boatmen were also at sea when these preternatural events . Wexler's point, then, is that much of the cross-cultural conflict we see
were occurring, but they did not survive. A Sea Gypsy was asked how · is a product of the relative decrease in plasticity.
it was that the Burmese, who also knew the sea, all perished. One could add that totalitarian regimes seem to have an intuitive
He replied, "They were looking at squid. They were not looking awareness that it becomes hard for people to change after a certain
at anything. They saw nothing, they looked at nothing. They don't age, which is why so much effort is made to indoctrinate the young
know how to look." from an early age. For instance, North Korea, the most thoroughgo-
ing totalitarian regime in existence, places children in school from
Neuroplasticlty and Social Rigidity ages two and a half to four years; they spend almost every waking
I . . hour being immersed in a cult of adoration for dictator Kim Jong II
Bruce Wexler, a psychiatrist and researcher from Yale Univer- and his father, Kim II Sung. They can see their parents only on week-
sity, argues, in his book Brain and Culture, that the relative decline in. ·
ends. Practically every story read to them is about the leader. Forty
neuroplastidty as we age explains many social phenomena. In chil~· · percent of the primary school textbooks are devoted wholly to de-
hood our brains readily shape themselves in response to the· world,·· scribing the two Kims. This continues all the way through school.
developing neuropsychological'structures, which include our pictures Hatred of the enemy is drilled in with massed practice as well, so that
or representations of the world. These structures form the neuronal a brain circuit forms linking the perception of"the enemy"with neg-
basis for all our perceptual habits and beliefs, all the way up to coni- ative emotions automatically. A typical math quiz asks, "Three sol-
plex ideologies. Like all plastic phenomena, these structures tend to diers from the Korean People's Army killed thirty American soldiers.
get reinforced early on, if repeated, and become self-sustaininS,:: , How many American soldiers were killed by each of them, if they all
As we age and plasticity declines, it becomes increasingly idifficult
,}killed an equal number of enemy soldiers?" Such perceptual emo-
·for us to change in response to the world, even if we want to. '\,\Te !i:¥ L ftional networks, once established in an indoctrinated people, do not
familiar types of stimulation pleasurable; we seek out like-mm.deairl...: • .lead only to mere "differences of opinion;, between them and their
dividuals to associate with, and research shows we tend to ignore or ·~ adversaries, but to plasticity-based anatomical differences, which are
forget, or attempt to discredit, information that does not match our much harder to bridge or overcome with ordinary persuasion.
beliefs, or perception of the world, because it is very distressing and
Wexler's emphasis is on the relative tapering-off of plasticity as
difficult to think and perceive in unfamiliar ways. Increasingly, ~ · • we age, but it must be said that certain practices used by cults, or in
 Appendix l The Culturally Modified Brain 307
306

brainwashing, which obey the laws of neuroplasticity, demonstrate ogists, because they have generally been sensitive to how outside in-
that sometimes individual identities can be changed in adulthood, fluences might harm brain development
even against a person's will. Human beings can be broken down and Television watching, one of the signature activities of our cul-
then develop, or at least "add on," neurocognitive structures, if their ture, correlates with brain problems. A recent study of more than
daily lives can be totally controlled, and they can be conditioned by twenty-six hundred toddlers shows that early exposure to television
reward and severe punishment and subjected to massed practice, between the ages of one and three correlates with problems paying
where they are forced to repeat or mentally rehearse various ideolog- attention and controlling impulses later in childhood. For every
ical statements. In some cases, this process can actually lead them to hour of TV the toddlers watched each day, their chances of develop-
"unlearn" their preexisting mental structures, as Walter Freeman has · ing serious attentional difficulties at age seven increased by 10 per-
observed. These unpleasant outcomes would not be possible if the cent. This study, as psychologist Joel T. Nigg argues, did not perfectly
adult brain were not plastic. control for other possible factors influencing the correlation between
TV watching and later attentional problems. It might be argued that
parents of children with more attentional difficulties deal with them
A Vulnerable Brain-How the Media Reorganize It . by putting them in front of television sets. Still, the study's findings
The Internet is just one of those things that contemporary are extremely suggestive and, given the rise in television watching,
humans can spend millions of "practice" events at, that the demand further investigation. Forty-three percent of U.S. children
average human a thousand years ago had absolutely no expo- two years or younger watch television daily, and a quarter have TVs
sure to. Our brains are massively remodeled by this exposure- in their bedrooms.About twenty years after the spread of TV, teach-
but so, too, by reading, by television, by video games, by ers of young children began to notice that their students had be-
modern electronics, by contemporary music, by contemporary come more restless and had increasing difficulty paying attention.
"tools," etc. The educator Jane Healy documented these changes in her book En-
MICHAEL MERZENICH, 2005 dangered Minds, speculating they were the product of plastic
changes in the children's brains. When those children entered col-
We have discussed several reasons plasticity was not discovered .. lege, professors complained of having to "dumb down" their courses
sooner-such as the lack of a window into the living brain, and the each new year, for students who were increasingly interested in
more simplistic versions of localizationism. But there is another reasou "sound bites" and intimidated by reading of any length. Meanwhile,
we did not recognize it, one that is particularly relevant to the cul-. the problem was buried by "grade inflation" and accelerated by
turally modified brain. Almost all neuroscientists, as Merlin Donald ,,' pushes for "computers in every classroom;' which aimed to increase
writes, had a view of the brain as an isolated organ, almost as though, \ the RAM and gigabytes in the class comp~ters rather than the atten-
it were contained in a box, and they believed that "the mind existt Ltion spans and memories of the students. The Harvard psychiatrist
and develops entirely in the head, and that its basic structure is a .]:Edward Hallowell, an expert on attention deficit disorder (ADD),
biological given." The behaviorists and many biologists championed iwhich is genetic, has linked the electronic media to the rise of atten- ·
this view. Among those who rejected it were developmental psycho!..; ·t tion deficit traits, which are not genetic, in much of the population.
i

j
308 Appendix 1
The Culturally Modified Brain
309
Ian H. Robertson and Redmond O'Connell have had promising re-
literate man from a ~orld of sound to a visual world, by switching
sults using brain exercises to treat attention deficit disorder, and if
from speech to readmg; type and the printing press hastened that
that can be. done, we have reason to hope that mere traits can be
process. Now the electronic media are bringing sound back and, in
treated as well.
some ways, restoring the original balance. Each new medium creates
Most people think that the dangers created by the media are a re-
a unique form of awareness, in which some senses are "stepped up"
sult of content. But Marshall McLuhan, the Canadian who founded
and others "stepped down." McLuhan said, "The ratio among our
media studies in the 1950s and predicted the Internet twenty years
senses is altered." We know from Pascual-Leone's work with blind-
before it was invented, was the first to intuit that the media change
fol~ed people (stepping down sight) how quickly sensory reorgani-
our brains irrespective of content, and he famously said, "The zations can take place.
medium is the message." McLuhan was arguing that each medium
To say that a cultural medium, such as television, radio, or the
reorganizes our mind and brain in its own unique way and that the
Internet, alters the balance of senses does not prove it is harmful.
consequences of these reorganizations are far more significant than
Much of the harm from television and other electronic media, such as
the effects of the content or "message:'
music videos and computer games, comes from their effect on atten-
Erica Michael and Marcel Just of Carnegie Mellon University did a• tion. Children and teenagers who sit in front of fighting games are en-
brain scan study to test whether the medium is indeed the message;".
gaged in massed practice and are incrementally rewarded. Video
They showed that different brain areas are involved in hearing speech
games, like Internet porn, meet all the conditions for plastic brain map
and reading it, and different comprehension centers in hearing wo~ds
cha~ges._A team at the Hammersmith Hospital in London designed a
and reading them. As Just put it, "The brain constructs the message .. ~
typical VIdeo game in which a tank commander shoots the enemy and
differentlj for reading and listening. The pragmatic implication is that '
dodges enemy fire. The experiment showed that dopamine-the re-
the medium is part of the message. Listening to an audio book leaves a
ward neurotransmitter, also triggered by addictive drugs-is released
different set of memories than reading does. A newscast heard on \fle ·
·~· in the brain during these games. People who are addicted to computer
radio is processed differently from the same words read in a newspa- ;-
:'.; .games show all the signs of other addictions: cravings when they stop,
per." This finding refutes the conventional theory of comprehension.
neglect of other activities, euphoria when on the computer, and a ten-
which argues that a single center in the brain understands word~ ~ ···.·.dency to deny or minimize their actual involvement.
it doesn't really matter how. (by what sense or medium) infonn.ation
,,,. . . Television, music videos, and video games, all of which use tele-
enters the brain, because it will be processed in the same way '
:" vision techniques, unfold at a much faster pace than real life, and
place. Michael and Just's experiment shows that each mediUlil ere# ':flier are getting faster, which causes people to develop an increased
a different sensory and semantic experience-and, we might add1 ~
.· appetite for high-speed transitions in those media. It is the form
velops different circuits in the brain. . .
i of the television medium--cuts, edits, zooms, pans, and sudden
Each medium leads to a change in the balance of our ind.Md-:
f.noises--that alters the brain, by activating what Pavlov called the
ual senses, increasing some at the expense of others. According q>:
\"orienting response,'' which occurs whenever we sense a sudden
McLuhan, preliterate man lived with a "natural" balance ofhearin.,
: change in the world around us, especially a sudden movement. We
seeing, feeling, smelling, and tasting. The written word moved p .
~tinctively interrupt whatever we are doing to turn, pay attention,
310 Appendix l
The Culturally Modified Brain 311
and get our bearings. The orientation response evolved, no doubt, people to a camera, and they were able to perceive shapes, faces, and
because our forebears were both predators and prey and needed to perspective, he demonstrated that the nervous system can become
react to situations that could be dangerous or could provide sudden·.
part of a larger electronic system. All electronic devices rewire the
opportunities for such things as food or sex, or simply to novel situ-
brain. People who write on a computer are often at a loss when they
ations. The response is physiological: the heart rate decreases for four
. have to write by hand or dictate, because their brains are not wired
to six seconds. Television triggers this response at a far more rapid
to translate thoughts into cursive writing or speech at high speed.
rate than we experience it in life, which is why we can't keep our eyes
When computers crash and people have mini-nervous breakdowns,
off the TV screen, even in the middle of an intimate conversatio14 there is more than a little truth in their cry, "I feel like I've lost my
and why people watch TV a lot longer than they intend. Because
mind!" As we use an electronic medium, our nervous system extends
typical music videos, action sequences, and commercials trigger ori- . outward, and the medium extends inward.
enting responses at a rate of one per second, watching them puts us .
Electronic media are so effective at altering the nervous system
into continuous orienting response with no recovery. No wonder because they both work in similar ways and are basically compatible
people report feeling drained from watching TY. Yet we acquire a and thus easily linked. Both involve the instantaneous transmission
taste for it and find slower changes boring. The cost is that such ac'.'.' of electric signals to make linkages. Because our nervous system is
tivities as reading, complex conversation, and listening to lectures plastic, it can take advantage of this compatibility and merge with
become more difficult.
the electronic media, making a single, larger system. Indeed, it is the
McLuhan's insight was that the communications media both ex~-,.,~ nature of such systems to merge whether they are biological or man-
tend our range and implode into us. His first law of media is that all the :'(
made. The nervous system is an internal medium, communicating
media are extensions of aspects of man. Writing extends memory, wheli?l
messages from one area of the body to another, and it evolved to do,
we use a paper and pen to record our thoughts; the car extends the f~?t:; "' for multicelled organisms such as ourselves, what the electronic me~
clothing the skin. Electronic media are extensions of our nervous sy~-
" dia· do for humanity-connect disparate parts. McLuhan expressed
tems: the telegraph, radio, and telephone extend the range of the hu-
this electronic extension of the nervous system and the self in comic
man ear, the television camera extends the eye and sight, the computer ·
terms: "Now man is beginning to wear his brain outside his skull,
extends the processing capacities of our central nervous system. He ar-
and his nerves outside his skin." In a famous formulation, he said,
gued that the process of extending our nervous system also alters it_ ·. "Today, after more than a century of electric technology, we have ex-
The implosion of the media into us, affecting our brains, is less
tended our central nervous system itself in a global embrace, abol-
obvious, but we have seen many examples already. When Merzenicb. ·, ,
ishing both space and time as far as our planet is concerned:' Space
and colleagues devised the cochlear implant, a medium that trans~ t and time are abolished because electronic media link faraway places
lates sound waves into electrical impulses, the brain of an implant.)):(
instantaneously, giving rise to what he c~lled the "global village."
patient rewired itself to read those impulses.
.This extension is possible because our plastic nervous system can in-
Fast ForWord is a medium that, like radio or an interactive com- tegrate itself with an electronic system.
puter game, conveys language, sounds, and images and radically re~ ·
wires the brain in the process. When Bach-y-Rita attached ~~nd