Flashback Fridays – When the light goes on

With the previous post on meaning, this classic noinote from 2010 seemed apt for a Flashback.

When the light goes on

Big brain shifts

Can you recall a time when you have had a sudden and massive shift in thinking ‘when the lights really went on’? We are often asked about the possibility of big learning shifts during one on one therapy sessions (manual or education therapy), or in group education sessions. People ask, “can someone really just get the explain pain message instantly and have a huge cognitive shift with beneficial behavioral changes?” It kind of goes against traditional Hebbian concepts of learning as an incremental event of synapses “firing together and wiring together”. These rapids shifts, if they do occur, are too fast to attribute to wiring changes. Something else is going on!

Reflecting on patients

A patient with a complex and chronic pain state once said after an education session “I don’t need to be here any more, all I wanted to know was that moving, especially gardening won’t cause any damage”. Another chronic pain sufferer, after two sessions including a well explained physical examination said “so I don’t need all my pain, do I?” These are big shifts, often leading to huge behavioral changes.

I am sure our psychology readers will find this all very familiar, but this possible radical cognitive restructuring is worth reflecting on in terms of the new biological education strategies being proposed and possible mechanisms. We are seeking help here with your input and experiences.

It’s not just in the clinic

These sudden and large conceptual shifts happen though our life, mostly when young. I recall my mother saying very offhand to me, “of course you know that Santa Claus is not real”. It just happened that the death of Santa had not yet clicked in my brain, and this startling new knowledge required a massive conceptual shift for me – including the place of the easter bunny, parental lies, and what the other kids must have thought of me. An expert in the conceptual change field, Michelene Chi noted that when you learn that electricity is a process and not a substance, you change a lot of your related thinking. We sampled our office staff about big shifts. One said, “when I realised that being gay is OK and not a disease it changed a lot”. Another said, “I had panic attacks and when my doctor told me it’s nothing harmful and I was panicking about having panic attacks, so much changed in my life.”

Radical and incremental conceptual change

Conceptual change theorists such as Gale Sinatra and Paul Pintrich talk of two kinds of change as we learn – an incremental change with a gradual enrichment of knowledge or a radical change. Radical change means completely replacing an old concept with a new one – there must be an awareness of major anomalies that no longer make sense with existing thoughts and beliefs and it therefore requires considerable questioning of the person views. Nobody knows what happens in the brain – it is unlikely that a module of brain function is suddenly removed. After all, the person may want to revisit the old thoughts to check on the new concept from time to time and in different contexts. Perhaps in our brains with their multiple oscillations, the old cognitive event is no longer coherent with the oscillations and a new memory is rapidly made coherent (Başar 2005).

Perhaps the new brain knowledge can do it

From our own experiences and repeated anecdote, it appears that a radical cognitive restructuring is occurring in some patients via the power of the biological knowledge. There are a number of patient, clinician and contextual variables associated with such a change, but my growing belief is that the power of the neuroscience narrative can do it.Anecdotally, these are particularly powerful…