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neuroplasticity: rewiring the brain


Can changing your outlook really change the world? Does “reframing” really work, or is it just wishful thinking?

This week, I had the pleasure of speaking at the International Meeting for Simulation in Healthcare. One of my sessions was about handling difficult situations, and using cognitive techniques to literally change one’s own reality, allowing for more effective leadership and decision making.

You may have read about memory reconstruction error previously on this blog or during my recent Stanford Medicine X presentation. In the context of medical error and availability bias, the ongoing neuroplasticity that accompanies retrieval of both semantic (i.e. facts, common knowledge, imagination) and episodic memory (i.e. prior experiences) may lead to inadvertent incorporation of details that were not present at the time the memory was formed (sometimes called “recall intrusions”). These intrusions are below the surface of consciousness, and are therefore indistinguishable from the original memory. We literally do not know that our brain is supplying details that weren’t there, either because those details are known now, or those details seem like they fit, and the brain hates incomplete incoherent memory gists.

On the other side of this neuroplasticity coin, however, is the good news that we can modulate our perceptions of events and their associated emotions, and that with the proper attention to our chosen modulation, the new perception and emotional combination actually become our reality. We have the power to choose to disconnect neuronal circuits that are currently linked, and deliberately sync a new interpretation and emotion into our neuronal circuits. Then, we really can view something as exciting that was previously scary, or view difficult challenges positively, instead of with anxiety.

We can do this is in a retroactive fashion for our episodic memories. For example, pharmacologic modulation during recall training has been shown to successfully treat PTSD such that the recall of the previously traumatic event is now emotionally neutral. We can also do it in an anticipatory fashion by calling on semantic memory (facts and ideas) to prevent ourselves from associating paralyzing negative emotions with events yet to come, such as tough conversation with a boss, or public speaking (the #1 fear for most people).

This process of modulating our perceptions is called “reframing”. It consists of recognizing the current frame and emotional association, and then selecting a different, more effective frame/emotion. Unfortunately, the new association is not automatic. It requires sustained and deliberate effort to focus attention on the new association. With time and attention, however, new brain circuitry is formed, and the more desirable new connection replaces the old frame, and eventually becomes the stronger and perhaps only apparent frame.

A variety of methods have been proposed for reframing, and I find the work of Anette Prehn and the Framestorm group to be especially compelling. Here’s a link to her work, which describes more scientific detail about neuroplasticity and the “Framestorm” – her proprietary formula for reframing.


Have you had a tough situation in which you wish you could have changed your reaction? Did negative emotions get in the way of moving forward effectively?


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