Wednesday, January 10, 2007

The Biology of Change (Part II)

In part I of this discussion we talked about the role of dopamine in the formation and continuation of pathways in the brain. This is the time of year that people make resolutions, usually with good intentions of following through. Unfortunately, changing the habit is harder than just producing the thought. After all, if it were easy, we’d all be skinny and rich.

According to Dr Bruce Wexler, leading neuroscientist and author of the book Brain and Culture, the plasticity of the brain is a key factor in the ability to sustain change. Young children are highly adaptable to changing cultures, and easily pick up second and third languages. As people age, that adaptability (plasticity) gradually declines. By age 20, most people have lost that plasticity. Compare the human mind to a computer. A child’s brain is like a software program that can still be edited and refined. Adults are all hard drive. Changing the hard drive requires compressing files, deleting unneeded files, copying, reinstalling….you get the picture.

So, is it possible to make lasting changes?

The answer is YES, but simply declaring a resolution on January 1st is not enough. Even the old adage about repeating a behavior for 21 days until it becomes a habit is not enough. Starting an exercise program, losing weight and other New Year’s resolutions should be approached the same way as learning to play the violin or learning a new language. You wouldn’t expect to be a violin virtuoso or to speak fluent Italian after 21 days. Real change, like the acquisition of any skill, requires abnormally intense concentration, periods of uninterrupted attention, and repetition.

To begin, the habitual pathway must be replaced with a new pathway. To establish a new pathway, you must identify something that triggers the same type of dopamine release. Since a great many pleasurable activities will work, use your conscious brain to select something that is legal, healthy, and available. This may take some experimentation and some time. (I haven’t found the substitute for Blue Bell Homemade Vanilla ice cream yet.)

After finding a substitute object or behavior and establishing a new neural pathway, the next phase is to strengthen the new pathway and extinguish the old. Now this is not rocket science. This is how dogs have been trained for a very long time. When the dog wets the floor, immediately firmly say “NO!” and take the dog outside. When the dog wets outside, reward immediately with hugs and treats. This works. Ask the millions of dog owners.
There is just one catch. To be effective, the rewards must be immediate and salient. (See Part I.) Then the process must be repeated, reinforcing the “good” behavior pathway and extinguishing the “bad” behavior pathway. This may take some time, since the brain will tend to take the easier, long-established pathway, but patience and persistence pay off.

When my children were small, my pediatrician’s favorite saying was, “Don’t worry. They’ll __________(walk, talk, be potty trained) before they’re married.” His humor gave me a laugh and a wise perspective on the time it takes to learn something new. So, have another look at those New Year’s resolutions and treat yourself with the same love and patience that you would give a child learning to walk. After all, it’s only biology.


Anonymous said...

This is very compelling. Quitting smoking is an overwhelming job and I've been counting cigarettes and kicking myself for three weeks now. But this has the air of a good and useful tool to incorporate into my bag of tricks. Especially the Blue Bell vanilla ice cream part. Thank you - I'll let you know how I make out.

Angela Gardner, MD, FACEP said...

Best of luck with your goal. Keep me posted.