Our brains are more powerful than we ever realised.

Too often, we humans tend to assume that nature is fixed, immutable — and this tendency is particularly strong when we think about matters of the mind and behaviour. People just can’t change, we say, so they must somehow be prevented from becoming a burden on society or from hurting themselves and others. Neuroplasticity — the virtually limitless capacity of the brain to remould itself — turns these notions on their heads.

Leading brain researcher Niels Birbaumer brings new hope to those suffering from depression, anxiety, ADHD, addiction, dementia, the effects of a stroke, or even the extremes of locked-in syndrome or psychopathy. Like the fathers and mothers of psychiatry, Birbaumer explores the sometimes-wild frontiers of a new way of thinking about our brains and behaviour. Through actual cases from his research and practice, he shows how we can change through training alone, and without risky drugs. Open your mind to change.

‘A fascinating read and a groundbreaking work on the human condition. Birbaumer shares his insatiable curiosity and gives us a tour of the human brain, the many cases he’s worked on, and the therapies he’s pioneered — some of which are truly radical!’ — David Roland, author of How I Rescued My Brain

Why We Change

Panta rhei. This aphorism was supposedly coined by the ancient Greek philosopher Heraclitus nearly 3,000 years ago. It was his belief that ‘everything flows’ and nothing remains as it is; the only constant is change. Most of us would agree unreservedly with this idea; after all, we see the world changing every day as we go about our lives — and that’s not only true of everything, but of everyone, too. Children become adults, eloquent professors turn into care-dependent dementia patients, liberal democrats develop into dogmatic ultraconservatives, dutiful wives mutate into man-eating seductresses, loving husbands become violent rapists, high-school dropouts transform into dotcom billionaires, and wallflowers grow into showstopping stars, only to end up later as alcoholics. When it comes to the life trajectory of any given individual, anything is possible. It’s sometimes fascinating, sometimes horrifying, but always very interesting.

Nonetheless, we have a tendency to ‘freeze-frame’ our fellow human beings in certain situations. We speak of born orators, artists, or thinkers, but we also identify born losers and born criminals. We are unable to believe hardnosed psychopaths can ever become valuable members of society, and demand they be locked up forever. We call for a ‘humane’ end for bedridden patients with locked-in syndrome or those in a persistent vegetative state; we’d like to put an end to their ‘suffering’ by switching off the machines their lives depend on. We even doubt that people with attention-deficit disorders, chronic depression, or anxiety will ever be able to ‘get their act together’ again. The argument we hear repeatedly, even from medical professionals and therapists, is that it is better to put them on medication for the rest of their lives than risk them throwing themselves off a cliff or, even worse, dragging other people into the maelstrom of their dark destiny.

Panta rhei — that is the philosophy. It may sound logical and reasonable, but Homo sapiens tends very often to assume the precise opposite, and that tendency is particularly strong when we think about matters of the mind and behaviour. It is in precisely that context that we harbour the fatalistic assumption that some people just can’t change, and so there can be only one solution for dealing with them: they must somehow be prevented from becoming a burden on society or from hurting themselves and others. By controlling them, punctiliously isolating them, or even locking them away. Just don’t let them disturb the peace, that’s the main thing.

Friedrich Nietzsche said that, with the conceptual tools available to them, human beings were doomed to fail repeatedly to express the idea of ‘becoming’. He argued that this was the case because, although words could to some extent at least be used to capture that which is, they are not capable of capturing what will be. It may be that this deficiency explains why we repeatedly hear talk of immutable character traits and personal characteristics.

However, if we examine the areas in which it usually occurs, we could just as easily conclude that this attitude towards people stems from fear and laziness. After all, it is easier to lock up psychopaths and throw away the key than to reintegrate them into society and run the risk of them relapsing into their old behaviour patterns. And when locked-in patients are ‘switched off ’, their relatives and friends are spared a great deal of trouble and frustration.

The wife of one of my locked-in patients had to face the fact that the man lying in bed staring at the ceiling and struggling to breathe no longer bore any resemblance to her once-witty and energetic husband. Although he had learned to communicate with his environment via a brain–machine interface (BMI) while in our care, this was not the normality she had expected from him. She told us she would never have agreed to let us attempt to communicate with him if she had known this beforehand. She wrestled with the idea that maybe his life-support measures could still be terminated. Not because she wanted to end her husband’s suffering, but because she wanted to end her own.

We may speculate about why we have this tendency to attribute such immutability to our brain and our behaviour when it suits us. But I am more interested in demonstrating how wrongheaded that idea is. This book is about neuroplasticity — the virtually limitless capacity of the brain to remould itself. This book explains why neither locked-in patients nor those with depression, addictions, or anxiety disorders and neither hyperactive fidgets nor ruthless psychopaths are frozen forever in their behaviour patterns, immune to any attempt to influence them. It describes how we can change into a compassionate ‘character’ within a very short time, but it also shows how we can just as quickly go from being a loving family man to an inconceivably cruel mass murderer and then back again to an upstanding citizen. People often like to reinterpret excrescences such as Nazism, and the subsequent attempts to trivialise it, as ‘exceptional cases’ in world history, when in fact they are nothing other than ‘perfectly normal’ products of the enormous plasticity of our brains. Humans have been both blessed and cursed with an almost limitless willingness to learn — it is both a boon and our doom.

Whether a better understanding of the brain processes associated with learning really does make them easier to control is something we do not know. But if it weren’t for the hope that that is the case, many of the experiments described in this book would never have been carried out. Most of the research activities reported here come from my scientific ‘workshop’, the Institute of Medical Psychology and Behavioural Neurobiology, in Tübingen, since those are the ones from which I can draw first-hand knowledge and experience.

Looking at the course of history, we see that the increase in our knowledge of the development of human behaviour since the Renaissance and the Enlightenment has not done much to advance self-control or humanisation. Nonetheless, various experiments have shown that ‘observational learning’, i.e. learning that occurs through observing the behaviour of others, controls one of the most efficient learning processes, and that observational learning is firmly embedded in specialised cells in the cerebrum, which have recently become known by the rather vague term ‘mirror neurons’.

There is one problem with this mechanism: our brains ‘mindlessly’ copy anything that promises success and effect. This is why we must strive to maintain a democratic context to our lives and social living conditions, so that our plastic brains do not seduce us into acts of denunciation, murder, and slaughter as has so often been the case in history. When such behaviours are rewarded — as they usually are in undemocratic, dictatorial systems — the brain will principally conform to those patterns.

Conversely, how can such values as respect, empathy, and tolerance be established? Research into the psychology of learning has shown that this becomes more successful the more we know about the aim and purpose of the behaviour to be learned. This does not mean an ideological or moral superstructure such as is sought not only by democracies, but also by dictatorships. What is meant is rather the conscious creation of a memory of the consequences of a certain behaviour. If we experience a positive effect achieved through compassion and respect — and this is more likely to happen in a democracy than in a dictatorship — those behaviour patterns will become stabilised within us and will recur again and again.

This book is about the brain processes involved in learning, but also about loss of self-control; its individual sections outline which people and situations we must pay particular attention to in that context. Each chapter covers one of the topics and issues in human behaviour I have studied with my collaborators over the decades.

I begin in Chapters 1 and 2 with the self-regulation of the brain, using the example of schizophrenia before moving on to the effect neuroplasticity has on the way we behave, think, and feel. Next, I explore what then remains of our so-called character and whether we can even consider it anything more than a more-or-less-random pattern of habits.

Chapters 3 and 4 consider how it is possible to communicate with completely locked-in, paralysed patients by teaching them how they can use their brains to talk by means of state-of-the-art imaging techniques — and the way in which such interaction repeatedly reveals that these supposedly moribund individuals can indeed experience a very high quality of life. This culminates not only in a plea against the ever louder and hastier demands for such patients to be ‘switched off ’ or to be assisted in dying, but also in a warning about the continued rampant trend for advance healthcare directives, often known as ‘living wills’.

Chapter 5 explores the brain’s ability to repair itself, as in the case of epilepsy or following a stroke. The German actor Peer Augustinski, for example, was almost completely paralysed on one side of his body after suffering a stroke — but was able to return to the stage after treatment.

Chapter 6 shows that anxieties can largely be neutralised using training techniques; usually, a course of confrontation therapy is all it takes. Neither highly problematical medicinal drugs nor expensive technical equipment are necessary — although it may sometimes be helpful for the therapist to chain herself to the bed with her client, or to go out scooping up dog poop in the park with him.

That which anxiety patients have too much of is lacking in sufficient quantities in psychopaths: activation of the areas of the brain that cause them to vacillate. Psychopaths also lack compassion and empathy. Which, however, does not stop them from pursuing successful careers. Certainly, many psychopaths can be found in prisons, but they are also often to be found in company boardrooms and in the upper echelons of political parties. On the bright side, Chapter 7 shows that their brains are open for change. This means even psychopaths can learn to empathise and develop a necessary measure of fear.

Even senile dementia — which the pharmaceutical industry and therapists connected with it like to pathologise, for their own financial gain, under the general heading of ‘Alzheimer’s disease’ — can be influenced by teaching patients how to control the processes of their own brains. As described in Chapter 8, music can be a valuable aid to this. Just as it can act generally as a phenomenal force for shaping our plastic brains. Imaging techniques do not necessarily enable us to identify the profession of a brain’s owner, but the brain of a musician is almost always recognisable.

Chapter 9 deals with another important issue of our time: attention-deficit hyperactivity disorder (ADHD) in children. This problem can also be controlled using braintraining techniques (such as so-called neurofeedback) without recourse to tranquilisers like Ritalin.

The right training methods can also awaken in any one of us a so-called savant ability — that is, a specialised, exceptional talent — by enabling us to unconsciously control our unconscious mind. That might sound paradoxical at first, but it can work — and Chapter 10 describes how.

Neuroplasticity opens up endless possibilities. But let’s not get carried away. Not everything is curable, or possible, and the same is true in the context of the brain. Worse, the brain’s enormous plasticity has its dark side: the fact that anything that gratifies, stimulates, delights, rewards, or relaxes our brain — in short, anything that makes us feel good — can become addictive. In principle, we are all potential addicts. Chapter 11 explains the mechanisms in the brain that underlie this, and describes how healthy wishes and desires can metamorphose into relentless compulsion and insatiable craving.

Conversely, understanding the greed mechanisms of the brain can help to release an addict from the cycle of wanting more and ever more, although that may not be enough to attain the state of nirvana, which is the focus of the book’s conclusion.

The foundation of each chapter is neuroscientific research carried out by my associates and myself. However, I also refer to the work of other scientists and — no less importantly — to philosophers such as Ludwig Hohl, Friedrich Nietzsche, and, in particular, Arthur Schopenhauer. This is because, throughout my many years of working as a researcher in brain science, I have been struck by the fact that much of what we have discovered in our scientific research was already ‘pre-thought’ centuries ago by philosophers. Sometimes the novelty of a scientific finding consists in nothing more than providing scientific confirmation of ancient knowledge, and thereby attracting to it the attention it deserves.

I was assisted in connecting the results of brain research and philosophical enquiry, and in formulating and explaining my research work, by the philosopher and science journalist Jörg Zittlau. We both hope that, in reading this book, people will gain a new insight into the amazing organ nestling inside their skull. My late friend, the Italian brain anatomist, who later also worked in Tübingen, Valentino Braitenberg, dubbed that organ a ‘thought pump’. This may sound mechanistic, but it wonderfully expresses the fact that, on the one hand, the brain is merely a vehicle of transportation, while, on the other hand, it transports something to the surface that would never have emerged if it weren’t for the pump. Or, to express it in Schopenhauer’s words: the brain is not all, but without the brain, all is nothing.

Of course, we can stretch the metaphor of the pump as far as we like. But, at this stage, let’s be content with one hope: that Jörg and I manage to activate the thought pumps of our readers, and in doing so, that we cause a surprise or two to emerge.

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Niels Birbaumer is a psychologist and neurobiologist. He is a leading figure in the development of brain–computer interfaces, a field he has researched for 40 years, with a focus on treating brain disturbances. He has been awarded numerous international honours and prizes, including the Gottfried Wilhelm Leibniz Prize and the Albert Einstein World Award of Science. Professor Birbaumer is co-director of the Institute of Behavioural Neurobiology at the University of Tübingen in Germany, and senior researcher at the Wyss Centre for Bio- and Neuro-engineering in Switzerland.