2011年12月4日 星期日

Mentally Created Neuroplasticity


In prior articles my focus has been on how neuroplasticity follows sensory-deprivation or changes in how the senses are used. Findings derived from his work with Obsessive Compulsive Disorder (OCD) patients led Jeffry Schwartz, MD, (2002) a University of California - Los Angeles Medical School neuropsychiatrist to the realization that the signals capable of creating neural reorganization can also come from the mind. His analysis of the causes and treatment for OCD focuses on a small handful of neural substrates. These include the right orbitofrontal cortex (R-OFC), the striatum [i.e. the region of dopamine receptors to include the anterior cingulate cortex (ACC)], the limbic system's amygdala, and the caudate nucleus. Together he calls them the "OCD circuit."

His conclusions concerning the triggering and treatment of an OCD reaction starts with the function of the R-OFC. As the substrate most involved with anticipation, this totally mental - rather than sensory - perception event causes the executive - or thought-switching - function of the ACC to begin searching for answers (or patterns). This signal is correlated with simultaneous input from the amygdala, which is the limbic system's emotional center. Normally, the caudate nucleus would generate a dopanergic signal that the crisis is over. However, if this "switch" is not functioning, the ACC continues working harder, using more cerebral energy, and creating an imbalance - thereby withdrawing energy and function from nearby substrates - to include the right prefrontal cortex that is vital to the maintenance of inhibitions. Considering Hebbian Learning, the repeated firing of this circuit strengthens the related neural pathways and weakens others. This further exacerbates the problem.

Apparently such pathologies then become "learned responses." Therefore, Schwartz feels that they can be unlearned. His treatment for OCD includes teaching sufferers to trigger a dissociative awareness when an event onsets. Also he works with them to develop an alternate response. This newly learned pattern is then further strengthened with practice. Note that the neurological changes sought by Schwartz originate with the deliberate instigation of mental inputs. This begs the question as to whether deliberate mental inputs (i.e. suggestion and imagination provided by hypnotherapy) can serve as effective interventions in stress or anxiety-related mental pathologies.




Tim Brunson, PhD

The International Hypnosis Research Institute is a member supported project involving integrative health care specialists from around the world. We provide information and educational resources to clinicians. Dr. Brunson is the author of over 150 self-help and clinical CD's and MP3's.





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