Radical remission from cancer graphic 1356 x 1384

No, I haven’t become a “new age”, “positive thinking”, “psychic energy” guy. I have seen a lot of willpower, grit, and optimism overcome physical limitations—but that does not correct a physical limitation. Wouldn’t a way to change the brain’s perception of pain, or alter the brain’s pathways that determine an addictive behavior be a better solution than the panoply of drugs that we addle our brain with?


Technology to the rescue

One of the advantages of living in Northern California is being plugged into the new and emergent technologies that are all around us. Superb universities that are incubators of revolutionary ideas, startup companies budding all over the place like mushrooms after the rain, many of them folding, others going on to do great and wonderful things (heard about the latest one? It has a funny name, something like Google)—what an exciting time and place to live in.

So, it was really just a question of time before somebody took a stab at exploiting the brain’s plasticity (its adaptability or capacity to change) in order to deal with medical and psychiatric problems. Indeed, several startups are already hard at work doing just that.


How do they do it?

The technique of fMRI or functional MRI measures the blood flow in different regions of the brain and displays it on a screen. This is how radiologists can determine areas in the brain that are metabolically hyperactive (pain perception, hunger, thinking) or hypoactive (stroke, some tumors). But now, a few companies are developing “real-time fMRI”, which means that you can view your own brain MRI in, well, real time. And that opens up some exciting possibilities.

Remember the old EEG (electroencephalogram) biofeedback technology? Subjects would be hooked up with electrodes which measure electrical feedback across the brain. They would then use a visual representation of the brain waves to control their blood pressure, for instance, using techniques of biofeedback such as meditation or visualization. The results were encouraging but were not translated to clinical use.

The new fMRI technique actually shows the subject which areas of the brain have increased blood flow if they suffer from chronic pain, for instance. The patient lies inside the scanner and watches a computer-generated flame projected on the screen of virtual-reality goggles; the flame’s intensity reflects the neural activity of regions of the brain involved in the perception of pain. Most people can control the flame’s intensity by concentrating and using visualization techniques. One could imagine bathing the neurally active region with a soothing drug, or dousing the area with a cold liquid—the flame would wane and the patient would feel relief of the pain. Amazing but true.

This is actually an old concept. Paul Eckman, a professor of psychiatry at UCSF, wrote extensively about the mutual interaction between the body and the brain. We know, for instance, that a happy thought brings a smile to our face. But he showed that conversely using the facial muscles involved in smiling activates the pleasure/reward centers in the brain. The result? You feel happy for no reason at all. Just try smiling every morning, or singing “Oh, what a beautiful morning” when you get out of bed, and you’d be amazed at the results. I read a few years ago about an Indian man who would go out to the park and would laugh out loud without any reason. He claimed that it put him in a happy frame of mind for the rest of the day. Soon, other people joined him. They formed a laughing club, meeting daily in the park. This laughter became infectious, and thousands of people around the globe formed their own clubs. Sounds wacky, but it works, and it has a neurobiological basis. Try it!


The possibilities are mind boggling

What else can be controlled?

  • I already mentioned the craving for drugs; addiction should be eminently amenable to this technique since it is restricted to distinct brain regions.
  • Hunger and feeding control.
  • Psychiatric diseases such as depression.
  • Behavioral disorders, such as uncontrolled anger, fear, phobias.
  • How about stroke? Recent experiments have shown that by forcing stroke patients to use their paralyzed limb rather than the functional one, they begin to regain function. Underlying this “miracle” is the capacity of the brain to adapt and generate new pathways to serve the functions of the damaged ones. One problem with these experiments is that improvement is painfully slow and uneven. It is quite plausible the visualization of the new areas, which should have increased blood flow, could improve the outcome of these experiments.

I am sure that assorted libertarians and privacy watchdogs will warn about the sinister possibilities of this kind of brain control. Frankly, my dear reader, I don’t… Just smile and be happy.

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. Great entry, Dov. And it’s especially good to see someone working in the biotech industry on pain medications expand the horizon for treatment of chronic pain beyond pill popping.Thanks, Ellen

    • To deny the connection between the mind and body is to deny reality. It also makes it easier to think drugs are the only answer. Most docs are taught to force pills on their patients, and those who don’t are labelled quacks. But patients who use CBT, biofeedback or other mind/body techniques to control their pain, will have the last word. Thanks for the post,

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