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Natasha Mitchell: Norman Doidge, let's come to your therapeutic setting, you're a psychiatrist and psychoanalyst. What would Freud have thoughtof all this, this idea that the brain is a profoundly plastic organ?

Norman Doidge: Well it's funny you should say that because in this certain sense Freud did think of all of this. In the 1880s he was one of thevery first people to propose that when we think and learn we change the connections between nerve cells. He was very, very prescient on this point and modern day neuroplasticians, which is a term I have for people who have helped further our understanding of neuroplasticity, often talk about a basic law of plasticity that states neurons that fire together, wire together and neurons that fire apart wire apart. This is a very monumentaldiscovery. This is how connections are formed in the brain. Sometimes they attributed that to a Canadian, a Canadian, Donald Hebb, and called it Hebbian plasticity. But in fact Freud proposed that idea in the 1880s and 90s and he called it the law of association by simultaneity—it's beautifully named and it just meant that when you put two things together in consciousness they get associated in the neuronal connections in the brain.

And if you hear the word 'association' with respect to Freud you think of free association and you know saying everything that comes to mind and Freud's emphasis that you could find important links and in fact it was related to his work as a neurologist. You know he was never a psychiatrist, he was a neuroscience researcher before he turned to treating patients. Psychoanalysis grew out of these neuroplastic insights, and many of the other therapies that have grown out of psychoanalysis bear that heritage. And one of the most exciting and important things about this work is people have often thought that real treatments are always biological and involve drugs etc, and that talk therapy is just that—just talk, mere talk. But we now have really important work of psychoanalytic therapies, cognitive behaviour therapy, inter-personal therapy which kind of grows out of psychoanalytic therapy which shows that patients come in with brains in certain states of wiring and after these interventions their brains are rewired.

So psychotherapy is every bit as biological as the use of medicines and I would say in a certain respect more precise at times. Now look I use medications from time to time, I never give medication without giving psychotherapy. The Canadian health care system allows me to do that but I think that's really, really important because medications basically bathe every cell in your brain at once. And in that sense, on that level they're a blunt instrument. Now there are times when they have very, very important results, I'm not saying that anyone should go off their medication and all that kind of thing, the reductionist approach... but one of the things we've learnt is that if you look at the letter A and then you close your eyes and think of the letter A, many of the same circuits are activated. And if you're hurting and talking with your therapist about that, those circuits are activated at that point and that provides a point of entry. And when therapy is working it's like a microsurgical intervention on precisely the circuits that have to be changed.


Natasha Mitchell: You've provocatively called psychoanalysis the new neuroplastic therapy. That's quite a claim given that I guess today psychoanalysis is a bit on the nose in neuroscience circles.

Norman Doidge: Well actually at the heights of neuroscience it's actually treated with great respect. Eric Kandel who won the Nobel Prize in the year 2000 and is a great neuroplastician for actually showing how learning changes, turns on genes and changes structures, has written a whole book on psychoanalysis and neurobiology.

Natasha Mitchell: And his key field is of course memory which is the great example of plasticity.

Norman Doidge: He went into it actually, he was a Viennese person who went into psychiatry to become and analyst and wanted to understand more about how learning works because learning is essential to psychotherapy. Gerald Edelman who won the Nobel Prize was interested in it, Antonio Damasio is. At the highest levels I think there is a tremendous amount of respect for the integrative work that Freud did, not for every little detail of what he did. No one is making that claim, he was always revising his work, but on this particular point about neuroplasticity, psychoanalysis gave us a much more plastic understanding of how memory works, a much more plastic understanding of how emotion works, and that change was possible later in life.