Within the paradigm of the Practices of the Healthcare Athlete, we need to develop and learn new skills and habits and, perhaps, stop using older skills and habits that no longer serve our goals.  What does it actually mean to do this?  How does this actually happen within our brain?

All of our thoughts, actions, and behaviors are the end result of the function of nerve cells in the neural pathway that leads to that outcome.  The process of learning new skills leads to changes in the neural pathways in our brain.  This is called neuroplasticity.  This refers to the ability of our brain to, effectively, change the existing neural networks and pathways, thereby leading to changes in thoughts and actions. 

Neuroplasticity occurs whether we choose to be cognizant of the process or not.  Whether or not the direction of change is in a positive or negative direction is not the objective of the process, rather it is the result of whatever thoughts and actions are being performed regularly and repeatedly.  This apparent lack of consideration towards positive and negative changes is best summed up in the saying, “neurons that fire together wire together”.  As with other skills and habits within the Practices of the Healthcare Athlete, it is best to understand the underlying biology of this process and learn to work with it, rather than trying to overcome it.  We aren’t able to override our biology and, in this instance, our nervous system.  Rather we are best off trying to work with it to our advantage and in alignment with pursuit of our purpose.

Just as we develop proficiency with physical skills through repetition, the actions and thoughts that we tend towards most frequently will become more ‘proficient’ irrespective of whether or not they are positive or negative.  This occurs through the process of neuroplasticity.  The neural pathways for our thoughts and behaviors can be changed through this process.  Rick Hanson, PhD describes four stages in the evolution from an undesired action to a preferred one.  Using frustration or agitation at an external event as an example, the first stage would be our typical gut reaction to the stimulus.  An external event occurs and we may become angry or frustrated or anxious.  We have this response without conscious consideration.  It is essentially reflexive.  In the second phase, there is recognition of the thoughts and emotions associated with our typical reaction, although the reaction still occurs.  In the third stage, there is a milder version of the typical reaction which is frequently internal only.  In the fourth and final stage, the external event is the same, however there is no external or internal reaction. 

The stages that Hanson describe is the result of the process of neuroplasticity.  But how does this occur and, more importantly, how can we work with our biology in order to stop unwanted thoughts and actions and develop desired skills and habits? 

Dr. Andrew Huberman has distilled the scientific evidence on neuroplasticity for day to day application.  As he describes, the physiologic processes of our neurons lead to our thoughts and actions.  This occurs due to the neural networks that are formed and the neurochemicals that are released at the junctions between the nerve cells.  In order to change our thoughts and actions, we need to change the physiology of what is occurring at the level of the neurons and, in particular, at the connection between the cells.  Following the well used quote that “neurons that fire together, wire together”, we can accomplish this change in neurophysiology by repeatedly performing the desired actions and stopping the undesired action.  Over time, this will lead to changes in the neural pathways and physiology at the connections between cells.  This process can be difficult and associated with frustration and agitation.  Persevering through these challenging sensations, however, leads to the desired change.

The requirements for neuroplasticity, according to by Dr. Huberman, are focus during the desired activities and rest following the activities.  Without this combination of factors, the desired skills and habits will not be fully developed and neuroplasticity will not occur to allow them to become the new reflexive action in response to a given stimulus.  Focus on the action of interest requires awareness of our attention so that it can be redirected as necessary.  Rest following the activity requires both adequate and sufficient sleep as well as non-sleep deep relaxation.

The process of neuroplasticity is always occurring, beneath our conscious awareness and without regard for whether the action is desired or undesired; positive or negative.  Essentially, the actions we undertake on a regular basis can become reflexive and automated as a result of neuroplasticity.  The choice become ours: do we want to acknowledge that this is continually occurring and deliberately and intentionally perform desired actions to influence the process of neuroplasticity towards our chosen actions in alignment with our passion and purpose?  Or do we choose to allow the process to occur randomly and without intention?

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