Stroke recovery and rehabilitation. Featuring Professor Leeanne Carey, Florey Institute

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00:00:00 

We acknowledge the Yuggera and Kaurna nations as traditional custodians of the land on which we work, live and learn, and their continuing connection with the land waters and community. 

00:00:09 

We pay our respects to them and their elders, past and present. 

00:00:13 

All content related to this program is for general informational purposes only and contains stories and discussions around mental health that. 

00:00:20 

May be disturbing to some listeners if. 

00:00:22 

Concerned about yourself or someone you know. 

00:00:24 

Please seek professional individual advice and support. 

00:00:27 

More details are contained in our show notes. 

Sketch: Despite all my rage… 

Doco music fades up, Narrator VO narrates for context 
 

Narrator: Every morning in the Praise For Cheeses Laboratory, researchers set up the maze for their two lab rats Fred and Millie, whose purpose is to make the best choice available to them. Let’s peer in on their conversation as Fred returns from his morning run. 
 

FX: Squeaky treadmill/rat wheel, Millie is prepping herself for her run as Fred returns, dry retching as he enters their common are. 
 

Millie: Hey Freddie! How was the cheese this morning? 

Fred: (heaving) Oh, you know. Same same. 

Millie: Where did you go this time? 

Fred: OK, so I go down the corridor and take the first left- 
 

Millie: No, no no!  
 

Fred: What? 

Millie: You’re going to tell me first left, second right second left. 

Fred: But that’s where (heave) the cheese is 
 

Millie: That’s where the bad cheese is Freddy. (steps off treadmill) I’m telling you, there’s better cheese out there, you just need to open yourself to the possibility there’s something else out there and try a different path. Just use your nose. That’s how I found it! If you keep doing the same thing, you’ll keep getting the same result! Oh! They’re raising my barrier, it’s my turn. See you in a bit! 

Narrator: As Millie follows the path she discovered to the good cheese, Fred expels the contents of the bad cheese from his stomach (vomit noise in the background). Millie, indeed has found the bountiful cheese platter and returns completely satisfied. 

Millie: Oh man, did you vomit again?  
 

Fred: I’m sorry! That cheese was rank this morning, you must have noticed that! 
 

Millie: I’m telling you, the cheese I’m finding is way better than the cheese you’re going to. Give it a try tomorrow. 
 

Fred: Maybe 

Narrator: Next morning, Fred and Millie are ready to go again. Millie is first out of the gate this time and returns, triumphant. 

Fred: Good cheese? 

Millie: Oh. My. God. They had tasty, blue vein and camembert this time! 

Fred: Whaaaat? 

Millie: Same place as usual, Freddy. Try this: first on the right, first on the left, third on the right. Go get that tasty cheese! 
 

Fred: Woo hoo! (Scurrying noises) 

Narrator: Here he goes, Fred is making his way down the corridor and, oh, he’s taken the first left instead of the first right. He’s taking the path he always takes and… oh… that’s new… we haven’t seen him vomit on the cheese before. He’s making his way back, quite slowly it seems. 

Millie: How’d you go, Freddy? Wasn’t that blue vein exquisite? I think I tasted a hint of charcoal… Freddy? You did get the good cheese this time, didn’t you? 
 

Fred: (sigh) I remembered what you told me, but I still went first left. 

Millie: On, no! Freddy! 

Fred: And it was the same, old, awful cheese 

Millie: Well at least you not heaving today 

Fred: I vomited as soon as I sniffed it. I couldn’t even stomach a small nibble today. 

Millie: But you threw everything up yesterday, you were running on empty as it was! 
 

Fred: I’m tired. I just want to go to sleep. I mean, I know you say there’s better cheese out there, but the cheese I’m going to was there well before you joined me in this game. It’s all I’ve ever known. 

Millie: But it’s killing you, Freddy! Please! Why do you keep going back there when you  know it’s bad for you? 
 

Fred: I suppose I’m scared if I try somewhere else, there won’t be any cheese at all. 
 

Millie: Just try my way Freddy. I promise you won’t be disappointed 

Narrator: But the next morning, the researchers decided to swap the cheeses around. 
 

Millie: Good morning Freddy! Where are you going this morning? 

Fred: I suppose I can try your way. Looks like I’m first this morning… 
 

Narrator: Indeed, Freddy has decided to try Millie’s route this morning and he’s found the cheese but… wait… he’s sniffing it. Oh… poor Freddy. It’s vomit town for him again, I’m afraid. 
 

Fred: I knew it was too good to be true (sigh) 
 

Millie: Here he is! Now how was that Freddy? 
 

Fred: Millie, I don’t know what you’re on, but I went your way this morning and the cheese was just as rotten as always? 

Millie: I don’t believe it. Are you sure you went first on the right, first on the left, third on the right? 

Fred: Yes! Watch out for my vom. Sorry. Your turn. 
 

Narrator: Millie is out of the gate quite quickly this morning and taking her usual path and… she can smell the bad cheese as soon as she rounds the last corner… but wait a minute, she’s doubling back and trying Fred’s usual pathway. Eureka! The good cheese is hers to enjoy! 
 

Fred: Hope you were able to eat around my vom OK. 

Millie: Now listen here, Freddy, I’m telling you this because I’m concerned about your welfare. Use. Your. Nose! 
 

Fred: What?  

Millie: You have to use all of your senses and trust them. Yes, I went my usual way, but this time they had the bad cheese there, so I doubled back and went the way you normally go and the good cheese was there this time! 

Fred: No (bleep) way! I’m over this, man! I just want some cheese! 

Millie: I’m telling you, it’s out there! You just have to believe it’s there then go out and look for it. Stop taking the first cheese you find, especially if it smells bad! 
 

Fred: I don’t know if I’ve got the energy for this 

Narrator: And indeed, Fred’s energy stores were low. Two days have now passed since he was able to keep even the smallest part of bad cheese down. Time is running our for our poor Freddy. Next morning, the researchers put the cheeses back into their original places. Millie is returning from her run. 
 

Fred: Well? 
 

Millie: OK. So they’ve switched the good cheese back to where it normally is – go get it, Freddy! 

Fred: I dunno, Millie. I mean, I’ve been to both locations now and there’s bad cheese in both places. Maybe I just don’t have the stomach for cheese any more. Maybe there’s no actual difference. 

Millie: Freddy, I’m only going to say this because I love you, but snap the (beep) out of it! Use your nose, and if it smells bad, go to the next place. What harm is there in trying? 
 

Fred: (sigh) OK. One last time. 
 

Narrator: Freddy is moving very slowly this morning. The researchers are furiously taking notes and as wanders down his well trodden path. But as he approaches, something peculiar… he stopped before he got all the way to the chunk of rancid cheese. He’s turning away. He’s back tracking. It looks like Freddy is sniffing his way into the passageways Millie took. Eureka! He’s found the good cheese! And he’s really chomping in. Don’t eat too much, Freddy or you might (vomit noise in background). He’s much more lively now as he turns back to the common area. 
 

Millie: How’d you go, Freddy? 

Fred: I vomited. 

Millie: (disappointed) No! 

Fred: But I found the good cheese, Millie! I used my nose! 

Millie: Thank you Millie 
 

SFX: Clunking noise 

Millie: Freddy? 

SFX: Cat growling 

Narrator: Oh, what luck… bad luck I’m afraid… it appears the researchers other experient, Shroedinger’s Cat, has escaped the box and was indeed alive, and very very hungry. Poor Freddy. 

00:07:39 

Well, the cats out of the bag now Andy. 

00:07:41 

By the sounds of it. 

00:07:41 

Burning his cat of all cats post ready. 

00:07:45 

Despite all his rage, he was. 

00:07:46 

Still just a rat. 

00:07:47 

In a cage. 

00:07:48 

Oh, I can’t believe you finally got. 

00:07:49 

One of my music references. 

00:07:51 

How could I miss it after our music episode a couple of weeks ago them Smashing Pumpkins reference circa what 1995? I’m in there. 

00:07:59 

Somewhere around there. 

00:08:00 

And I think that. 

00:08:00 

Would classify as a heavy metal tracks. 

00:08:02 

So you know. 

00:08:03 

Obviously we do like a bit of heavy metal frames. 

00:08:06 

Look, we’re not going to start the is Silverchair grunge or heavy metal debate again this time maybe. 

00:08:11 

Maybe we can play the heavy metal at poor Freddie Wake. 

00:08:15 

Imagine what could have happened for Freddie if he’d leaned into possibility instead. 

00:08:19 

This is re frame of mind. 

00:08:23 

Where we deep dive into discussions about mental health, joined by some of Australia’s leading lines to expand our understanding of the world and ourselves. 

00:08:31 

Because we don’t exist in a vacuum, and the way we talk about mental health shouldn’t either wear your hosts. 

00:08:35 

Louise bull. 

00:08:36 

And Andy Leroy. 

00:08:38 

Sometimes it feels like our troubleshooting mind gets out of control, and before long we’re down a rabbit hole. 

00:08:43 

Or you know rats maze of limitation, unable to unstick ourselves from a bad situation. 

00:08:48 

Stop priming, it’s not music. 

00:08:50 

Sorry, no more last time. 

00:08:53 

On re frame of mind we met public speaker and entrepreneur Lucy Bloom who shared her secret for getting on with things in the face of adverse. 

00:09:01 

Confront the worst case scenario and then scrunch it up in a ball. 

00:09:05 

Flush it down the loo and then start focusing on the best case scenario. 

00:09:09 

That’s what I do when things are a bit out of my control and I can’t control the worst case scenario happening. 

00:09:15 

I almost fantasize about the best case scenario ’cause I have just as much control over that. 

00:09:20 

I had a really serious motorcycle. 

00:09:22 

Accident and it like I was. 

00:09:23 

Going to lose. 

00:09:23 

My leg, but the care of my leg was out of my hands. 

00:09:26 

It wasn’t up to me to. 

00:09:28 

Make the decisions. 

00:09:29 

Or perform the surgery that would or wouldn’t save. 

00:09:32 

My leg that’s really hard to surrender to to just go under a general anesthetic. 

00:09:37 

Not sure if you’re gonna wake up with one leg or two is true surrender, so because that was all out of my control. 

00:09:43 

It took a year a week and a day to save my leg. 

00:09:47 

I found myself consciously taking my thoughts out of. 

00:09:52 

The worry, the anxiety and the worst case scenarios and pushing them towards not even the best case. 

00:09:58 

Total fantasy land and that’s because it feels better. 

00:10:02 

That’s where I find myself always seeking what feels better. 

00:10:05 

It felt limited. 

00:10:05 

It’s better to fantasize and plan. 

00:10:08 

On the surface of things that have been really easy to read, this as a hollow platitude, best friend of toxic positivity. 

00:10:14 

But we do not like toxic positivity in re frame of mind or no, no, no, they are no friend of. 

00:10:19 

Ours, so Lucy Active pursuit is fantasizing about the positive. 

00:10:24 

Instead of dwelling on the negative, it came with an important distinction in some cases. 

00:10:28 

We have just as much control of things going right as going wrong, so we might as well fantasize about what could go right instead. 

00:10:35 

Yeah, you know I’m looking at both of our stories so far. You know we’re now 29 episodes into the first season of re frame of mind. 

00:10:42 

Is that last time? 

00:10:42 

And yeah, I know right? You’ve been dealing with the with leaving your career or 26 years in radio and the implications of that psychologically and emotionally for you. I’ve been dealing with the emotional trauma of a really. 

00:10:55 

Huge change in family dynamics. 

00:10:57 

So we’ve been talking all about emotional well-being. 

00:11:00 

Which is obviously what we. 

00:11:02 

Set out to do, but what happens when something? 

00:11:04 

Physical is linked. 

00:11:05 

To that outside of those psychological impacts, you know, so we’ve had. 

00:11:09 

Mental health is not just in our mind, it’s in the world around us, including our body. 

00:11:12 

I know. 

00:11:14 

2nd, so let’s just focus back on Lucy for a second. 

00:11:15 

So what? 

00:11:20 

When she was thinking this about the cheap, there’s just as much control over what could go right as we could go wrong. 

00:11:25 

She didn’t know whether she’d have to have a foot amputated, yeah, and she didn’t know that. 

00:11:29 

If she didn’t have to have the foot amputated. 

00:11:32 

How, if at all, that was going to impact on her future mobility? 

00:11:35 

We’ve had other guests who have had limbs amputated. 

00:11:38 

You’ve lost mobility completely during McManus was shot 14 times in under a minute. 

00:11:42 

There’s a lot of physical stuff going on there that you know is woven into a psychological or emotional or mental outcome for all these guests. 

00:11:52 

For us as well. 

00:11:53 

As much as it was a little joke before about our mental health, existing outside of our minds, it’s true we cannot get around in this world and not be influenced by the rest of the world around us. 

00:12:03 

In terms of mental health and the thing that we’re carrying with. 

00:12:06 

Everywhere we go is our body. 

00:12:08 

So if something you feel like, there’s a physicality about you that is affecting you. 

00:12:14 

Whether it’s a chronic pain or a disability or a condition that’s happened to you, of course it’s going to affect your mental health. 

00:12:21 

So as we put together our conversation with Lucy against some of the other people we’ve spoken to. 

00:12:27 

Particularly from a scientific background, and it really made us look at how the physical implication. 

00:12:31 

Does affect our mental health and vice versa? 

00:12:33 

Yeah, and as. 

00:12:34 

We started putting this series together. 

00:12:35 

We actually noticed that there was some conversation starting to emerge around the subject of stroke and stroke recovery. 

00:12:42 

So what we’ve done this time around is brought together 2 perspectives for this episode. 

00:12:46 

Firstly, from someone who has first hand experience helping her mum recover from the damaging effects of stroke and a brain aneurysm. 

00:12:53 

Elite marathon runner Lisa Tamati, who recounted the impact of dealing with a raft of negative prognosis. 

00:12:59 

Five years ago. 

00:13:00 

My mum had a mess of aneurysm. I don’t know if you know that story or not, but so she was left at the age of 74 were fighting for a life. 

00:13:08 

For starters, they didn’t think she would survive when she did she, she was in and out of coma for a number of weeks. 

00:13:14 

And when she did survive and come out the other end of the coma, she had massive brain damage. 

00:13:19 

And hardly any higher function mentali, so she had no control over their body or anything. 

00:13:23 

Now on suddenly confronted, you know, I’ve been up. 

00:13:26 

To that point, this you know selfish goal orientated athlete Mum was always supporting me and you know looking out for me and helping me. 

00:13:34 

I was running my businesses and so on, but I was very much I could do what I wanted and and then this situation happened and we were left. 

00:13:42 

You know, being told that she would never do anything again that the brain damage was so massive. 

00:13:46 

She would never have any quality of life or do anything and to put her in an institution and I was just like no, that’s not happening and so at that point I had to stop. 

00:13:54 

Training and running. Obviously in doing long stuff I still looked after myself self-care wise, but I put all of my energy’s in focus and to her rehabilitation. 

00:14:06 

And even though I was told there was my hope and there is no way forward and just forget it, make it comfortable. 

00:14:11 

Why don’t do comfortable for start? 

00:14:13 

And if if that’s the option. 

00:14:15 

Then I’d rather go down fighting if I’m going to go down, so I started to research and study and I came across something called hyperbaric oxygen therapy, which was hugely beneficial when who case with a brain injury and a very underrated therapy in general, and I got her access to. 

00:14:29 

To this, and like she couldn’t even set or put food in their mouth or chew or or speak or know who I am. 

00:14:36 

She had nothing I I spent. I spent now it’s 5 1/2 years it took Me 2 1/2 years basically to get her back to normal. Thousands and thousands of hours of retraining your brain studying neuroplasticity, epigenetics. 

00:14:49 

Functional neurology physio you name and I studied it and stayed one step ahead of her and her rehabilitation process and or with every step of the way, especially in the early stage. 

00:15:00 

As I would get criticised to help by people telling me like why are you putting it through such an arduous, torturous regime? 

00:15:06 

Because what I was doing was quite difficult. 

00:15:08 

You know it was harsh and it was, and it was a, you know she had to relearn things from scratch. 

00:15:15 

So it was just absolutely sometimes really really tough to watch the stuff I had to put her through. 

00:15:20 

But I knew that the alternative was death, and so that for me was. 

00:15:23 

Just would you know? 

00:15:25 

That’s not an option, I’m I’m I’m I’m. 

00:15:27 

I’m gonna throw everything at at this thing or I’m going to get it back or die. 

00:15:31 

Trying was my attitude. 

00:15:32 

So I went all then. 

00:15:34 

And Professor Leanne Kerry is a world leading Australian neuroscientist in occupational therapy and stroke, rehabilitation and recovery research, she sent out with a mission to bust some commonly held beliefs about brain function and its capacity to recover. 

00:15:48 

Very early in the piece is an occupational therapist and I was working with a young stroke survivor who was a dental nurse. 

00:15:58 

She had great mood. 

00:15:59 

That had little or no sensation and so for her to be able to go back to work or engage or even to wear slightly high schoo shoes or something like that. 

00:16:10 

There’s just an impossibility meeting trying to hold the dental tools and pass them across to the dentist, and at that time basically was. 

00:16:19 

The belief that the brain was. 

00:16:21 

Some are hard wired and there was little or no change and that if you had us in through loss she just had a poor. 

00:16:29 

Outcome and I didn’t think that was putting hot, and so you know I’d seen changes in the movement and things like that, and so I really thought that this was a limitation for many people that should have potential for change. 

00:16:47 

So basically. 

00:16:49 

I did verify include take myself across to the states for a six month study tour. 

00:16:55 

Talked with all the people that had Norman Dirge talks about him. 

00:16:59 

His brain that changes itself as I did that back in the 80s and and then just continue to use it and see how I could hands on apply it to this situation. 

00:17:09 

So if no one heard of neuroplasticity before, how would you explain? 

00:17:13 

It to them. 

00:17:14 

Nor plasticity, it’s about that ability of the nervous system to respond to stimuli. 

00:17:21 

By reorganizing its structure function and collection, so it’s essentially that underlying phenomenon that allows us to change, adapt, and learn. 

00:17:33 

So it’s it’s one thing to like. 

00:17:36 

It’s important to remember in this is that. 

00:17:39 

It’s the changes are experience and learning dependent. 

00:17:44 

They occur during development throughout the normal lifespan and actually in response to injury. 

00:17:53 

And actually there’s probably already a number of your listeners that might have heard about the concept. 

00:18:00 

Plasticity and it’s in things like the book the brain that changes itself down. 

00:18:06 

Norman Doidge and yeah and on the television series for example. 

00:18:07 

Yeah, that was the 1st place I heard it. 

00:18:13 

Redesign my brain by Todd Sampson. 

00:18:16 

So I think the knowledge that the brain can change. 

00:18:20 

This concept of neuroplasticity is now becoming mainstream. 

00:18:25 

It’s important for us all to know that the brains changing it. 

00:18:29 

Function and networks constantly. 

00:18:32 

Whatever we do even now. 

00:18:34 

How much does our brain have the ability to change at different life points? 

00:18:38 

Is my brain more neuroplastic now than it was ten years ago, or am I getting worse? 

00:18:43 

Look, I think The thing is that we we this really compelling evidence now that the brain can change that has this new plastic capacity throughout the last. 

00:18:54 

Ben, so whilst the person is younger, there might be more rapid changes we can still change throughout the lifespan, and I think this is really so crucial when we’re working with different people at different life stages to to know that there’s this possibility and for people, for example, that I work. 

00:19:14 

If you have a stroke that it. 

00:19:16 

Really provides a hope for change. 

00:19:19 

In reply to help her mum, Lisa also set out to challenge some commonly held opinions. 

00:19:24 

You have to be willing to put the hard yards in in risk risk failure despite all that, but have you got any other alternatives? 

00:19:32 

If you don’t, then this is the only way forward. 

00:19:35 

If you’re willing to go through and sacrifice what it will take to do this. 

00:19:39 

And that’s the conversations that I, you know, that I find really difficult when people don’t have what it takes to push through those barriers. 

00:19:47 

And it makes me so sad. 

00:19:48 

You know, because there are, you know, especially in in a rehabilitation space, there are people that could have come back that could have survived that could have maybe had a chance had there been given the right resources or right information and a lot of that information is already out in the world is not like we’re waiting for stuff. 

00:20:05 

This is, this is stuff that’s already known, but not necessarily. 

00:20:08 

Available in your local, you know hospital. 

00:20:12 

Or your local. 

00:20:12 

Doctors, and that’s not their fault. 

00:20:14 

It’s just that the world is changing so rapidly. 

00:20:17 

The research is going so fast that we no one person can keep up with it, but if you’re willing to put in the hard yards, you might have a chance of finding someone in the world. 

00:20:26 

He’s fixed us before or helped with this. 

00:20:29 

So talking about stroke recovery and rehabilitation, it’s very specific and it’s not something that I don’t think Andy or I can personally relate to in terms of having been through an event like that where we have to go through such a long process of rehabilitation and relearning. 

00:20:47 

Look, I think you know and we don’t want to draw too long about here. 

00:20:50 

But when we’re talking about brain plasticity, let’s talk about our friend Freddie from the sketch for a second. 

00:20:56 

Because Friday was really ingrained in those behaviors, wasn’t he was actually no matter what anybody said he would just automatically go down that pathway and then eventually he tried a new pathway, but it took some effort to actually go on to that, so his brain needed to make the link to go somewhere else, even though his automatic sensors were saying go this way. 

00:21:15 

So I don’t know. 

00:21:16 

For me it seems like brain plasticity comes into the mental health conversation. 

00:21:20 

In saying that if we are open to the possibility of something different then we might try it and it might actually have a. 

00:21:27 

Different outcome, I think there’s so many amazing insights that we can gain from Lisa, Tom, Eddie, and LeAnn carries. 

00:21:32 

Work for ourselves for our own mental health and and the mental health of people around us. 

00:21:37 

Because yes, we’re talking about an extreme and specific incident, but that research at the basis of it, that underpins it about our ability to change and create those new pathways and leave behind the things that. 

00:21:52 

Didn’t work and really learn something new is something that’s really valuable to everybody. 

00:21:57 

And this isn’t just about making a choice, so. 

00:22:00 

If you know something that might be more useful to think, this is actually a physical representation or a physical proof of the brain actually being able to make new neural pathways, and to actually do something different and to relearn so. 

00:22:13 

Think it’s actually quite exciting around when you’re thinking about depression. 

00:22:17 

For example, like what are the implications there? 

00:22:19 

What are the the ways that this research can be transferred across to chronic illnesses like depression and anxiety? 

00:22:26 

Is our brain capable of reloading a different way to not do those things that it does? 

00:22:31 

I hope so. 

00:22:33 

I would love to think that my brain could learn another way of being. 

00:22:38 

For all the things that I’ve done in the past or thought in the past that haven’t been particularly helpful or healthy for me, I, I think that the possibility to use the Lucy Blumenthal to lean into the possibility to fantasize that there is a better solution. 

00:22:53 

That we won’t always be trapped in those patterns of thought and those core beliefs that we’ve held. 

00:22:59 

That it’s not just toxic positivity. 

00:23:01 

If if we start telling different stories about ourselves, if we try to look for the good in things that there’s actually scientific evidence that backs up that it can change incrementally, it can lead to us being who we want to be. 

00:23:16 

And I think importantly as well. 

00:23:17 

You know when it comes to toxic positivity, you’ll generally find that there is no changed outcome that things are just the same as just somebody sitting amongst. 

00:23:24 

Us saying, oh. 

00:23:25 

Well, it could be worse. 

00:23:26 

But what we saw here out here is actually making a change in deciding to entertain the idea, at least in the beginning, that something could be different if we try something diff. 

00:23:37 

So the proof is always going to be in the pudding, isn’t it? 

00:23:40 

You know if you try something different and it still doesn’t work, then try something else. 

00:23:44 

I think that phrase is now the proof is. 

00:23:45 

In the cheats. 

00:23:46 

I think so. 

00:23:49 

If he’s still vomiting by the end of the second choice, try something else. 

00:23:54 

Another flavor 

00:23:57 

Uhm, so relating this research to my mental health journey. 

00:24:01 

There’s a lot. 

00:24:02 

Of things that stand out that Leanne is said about paving those new path. 

00:24:06 

Ways I remember when and you know we are 29 episodes in and I feel like it’s been a while since we we touched on depression. 

00:24:14 

We’ve been having a bit of. 

00:24:15 

Fun with music. 

00:24:16 

In fact, we kind of lost the plot with. 

00:24:18 

Music lovely diversion. 

00:24:20 

We have been having a bit of fun. 

00:24:22 

Not the depression is not, uh, riotously. 

00:24:24 

Fun thing of course. 

00:24:26 

Ah, but when we? 

00:24:28 

Started the series. 

00:24:29 

I was in a place where I’ve been suffering from many periods of debilitating depression and. 

00:24:36 

And then at the one where we. 

00:24:37 

Started the series. 

00:24:38 

It came around a time where I also walked away from my former career as a radio announcer radio person. 

00:24:45 

My career in. 

00:24:46 

The media life. 

00:24:47 

Out of 26 years that I had built my identity around. 

00:24:50 

Now it’s a little bit of a shock, isn’t it? 

00:24:51 

Because you do something for so long and suddenly we start to? 

00:24:54 

Enter this load of. 

00:24:56 

Automatic pilot. 

00:24:57 

Yeah, and so without reactivating the drama. 

00:25:02 

Roma, of the the those first few episodes which I found myself describing is quite dark to somebody who was starting the podcast the other day thing you know. 

00:25:11 

The first Rep is quite dark, just I mean we get lighter and then darker and then lighter but. 

00:25:16 

The first one is quite dark. 

00:25:18 

It was a quite tough. 

00:25:18 

First ones are quite dark because I was feeling quite dark. 

00:25:22 

And I can say that I’m not in the same place now that I was. 

00:25:25 

At that period of time. 

00:25:27 

There was this great this book I saw once and it had illustrations in it of emotions. 

00:25:33 

Maybe it’s like the visual representation of the sketches that we do at the front and it had a cartoon and it said this is what depression feels like and it was basically a really really long hole in the ground like a long shaft and there was. 

00:25:47 

A person in the bottom and it was just all darkness. 

00:25:52 

And someone up the top just reaching out a hand and all around the top. 

00:25:56 

There was light but it was too far to reach. 

00:25:59 

There was too much darkness to to climb from where they were, so really the lights not that far away, but that that tunnel of the darkness feels very very long and and so when we’re talking about the stuff that happened. 

00:26:12 

In you know those early episodes of the series. 

00:26:14 

We’re talking about me feeling like I was down the bottom of that. 

00:26:17 

Dark tunnel before I ended that career and also after in trying to reevaluate and trying to work out who I was. 

00:26:26 

So even though some of those actions like deciding that I had more value and wanting to live authentically, were things that I wanted and resulted in me making decisions that ended that. 

00:26:37 

Radio career, even though sometimes that felt empowering ’cause I was finally standing up for myself, finally making that change that I wanted to change. 

00:26:46 

It was also dark and depressing, and it wasn’t always empowering, especially afterwards. 

00:26:53 

We’ve spoken before about feeling like I couldn’t leave the house. 

00:26:55 

US, UM, like I couldn’t leave the yard about literally, not going beyond the gate. 

00:27:02 

There were some things that went on during that time that actually called back to my previous experiences and things that were said. 

00:27:11 

That were and are being very vague, but horrible. 

00:27:15 

Literally I could not get them out of my head and I laid in iron be laying in bed one week not being able to get certain words and phrases out of my head because they just kept playing on a loop and it wouldn’t stop and that’s debilitating. 

00:27:30 

Yeah, it is completely, you know, from my perspective with you know I talk about this change in family dynamics. 

00:27:36 

There’s a relative. 

00:27:37 

That said, some pretty awful things to me and different to you. 

00:27:41 

Where you know for you those words rang through you ahead and wouldn’t leave you alone. 

00:27:45 

For me it was less about that and more about if I actually reject those comments in the way. 

00:27:52 

The only way that I know how which is to cut them off then what was playing through my mind was all of the expectations around how families should be and how families. 

00:28:00 

Train each other and yet within that twisted kind of year, that kind of Disney finding must have a happy ending. 

00:28:06 

Tour of this kind of. 

00:28:08 

Ideal, the only way that I could actually achieve that would be if I gave away my power and said OK, I forgive you whatever, but don’t do it. 

00:28:16 

Again, it would happen. 

00:28:17 

Again, and you know, as Joe Focus has pointed out to us before in an episode way back, we can stop people from saying things, but it doesn’t stop them from thinking yet. 

00:28:27 

So if they’re going to think. 

00:28:28 

Care about me anyway? 

00:28:29 

How valuable is that relationship? 

00:28:31 

What value does it give me to have somebody who thinks so poorly of me? 

00:28:35 

Why should I actually make the effort to try and heal that? 

00:28:40 

Because it takes two, I can’t go and fix that and the only way I think in their mind that is going to be fixed as if I say yes I am the ******* Yes, I did say those things. 

00:28:49 

Yes, whatever. 

00:28:50 

But that doesn’t. 

00:28:50 

Work for me either I. 

00:28:51 

I I really had to come to change my beliefs around what was acceptable as far as family relations go and for me it’s not acceptable beta. 

00:29:00 

Treated like that, it’s not acceptable for anybody to treat or talk to anybody like that, and if they want to be a part of my life, then they need to treat them with respect. 

00:29:08 

So from my perspective, brain plasticity comes into that because I need to teach my brain to think in a different way when it comes to family. 

00:29:18 

Because my default is to say. 

00:29:21 

Look OK. 

00:29:21 

Now the heat out of it we just need. 

00:29:23 

To go back, say. 

00:29:23 

Sorry and move on, but there’s a lot within that story that needs to happen. 

00:29:27 

And I need to know. 

00:29:29 

For one, treat myself better and stop defaulting to that position that I’m to blame. 

00:29:34 

And I also need to change my position in my brain expecting things to resolve expecting things to actually just go back to the set point because realistically they can’t, you know. 

00:29:45 

And that’s not an easy. 

00:29:46 

Thing like I. 

00:29:47 

Talked about how I would journal every morning. 

00:29:49 

And I was journaling about these issues and these problems and finding ways and trying to find ways to actually help myself through it. 

00:29:56 

And I think part of that was actually changing the way I think about it, because while I was doing that, I was actually coming to an agreement with myself that I wasn’t gonna go back and I was going to fight because a fight wasn’t going to achieve anything for me, nor were going to go back and. 

00:30:09 

Just pretend things didn’t happen because dismissing things or not acknowledging things or what’s the word I’m looking for. 

00:30:16 

Just brushing things off doesn’t work either, so I need to find a different way I will need to find another way to respond, which I didn’t know how. 

00:30:25 

Honestly, I put my hand up and say no one told me that I don’t know how I’ve learned the best. 

00:30:29 

I can from what I’ve observed, growing up and from the relationships I’ve had, but I need to do something differently. 

00:30:35 

Yeah, ’cause if we keep doing the same thing we keep getting the same result. 

00:30:39 

You bet. 

00:30:40 

It’s it’s a hard conversation ’cause from I mean, from my depressive point at that time, there’s the element of the physicality and the the chemical imbalance that goes on in your body. 

00:30:51 

When you’re experiencing those extreme emotions, so why I’m always happy to chat toxic positivity out is because you can’t give enough platitude. 

00:31:00 

Needs to cover up the way that you really feel and the way that your body is reacting and and all those things like you know, sticking up latitude over it doesn’t change the fact that your dopamine deficient. 

00:31:10 

So when I think about those times of being down the dark hole, I don’t know that there’s there’s not a big recognition, like if someone said. 

00:31:20 

Me if if we had had a conversation with Lee Anne Carey at that point and she’d said, you know, the brain plasticity is incredible and you can save yourself a new pathway. 

00:31:29 

I don’t know if I would have believed it was possible because it. 

00:31:33 

That’s that’s a big that’s a. 

00:31:35 

Big jump to make. 

00:31:37 

Think leap yeah. 

00:31:38 

Big Big leap the. 

00:31:39 

We’re not suggesting that anybody goes off their meds and just goes. 

00:31:42 

I’ll just create a new pathway. 

00:31:43 

No no, no. 

00:31:43 

That will be sent. 

00:31:44 

Don’t be here. 

00:31:44 

I I was actually going to say that it’s actually the opposite to that because I I would say it’s glimmers when you’re in the dark place. 

00:31:52 

There might be the. 

00:31:53 

The TNC IST faintest bit of refracted light as a passing glimmer, or a shadow on the wall or something. 

00:32:00 

And if you can do your best to hold that, maybe you can slowly find more and more light, and so in that context, some of those things for me for changing the brain involved changing the thoughts I had around medication around my resistance to medication too, because I said before that I had a number of depressive. 

00:32:20 

Episodes in my life and I never medicated for any of them. 

00:32:23 

I just I think I just packed up my life, moved it somewhere else and. 

00:32:27 

And put it in a box under the bed until little came back again, which it does if you don’t. 

00:32:31 

Look at things. 

00:32:32 

But I think that some of the first movements I made in terms of changing the pathways in my brain was saying it’s OK to try medication. 

00:32:41 

It might work. 

00:32:42 

There’s a possibility that this could make it better, and there’s a possibility that it might not. 

00:32:47 

But what if it helped? 

00:32:49 

What if it made it slightly better and then that pathway leads to another pathway where, OK, that did help. 

00:32:55 

A little bit. 

00:32:56 

Is there something else I can do? 

00:32:58 

Because if that helped, maybe something? 

00:33:00 

Else will help. 

00:33:00 

Maybe there’s a different medication. 

00:33:02 

May be a change in the dose, maybe it can help me get some space to work on some other things. 

00:33:08 

Maybe some of the other techniques that are being suggested to me by people who know about this stuff will have experience and have lived down here before. 

00:33:18 

Maybe some of those might work. 

00:33:20 

All of them might not be. 

00:33:21 

Some of them right? 

00:33:22 

And it kind of slowly carves out a new pathway from that, so you don’t get too. 

00:33:26 

I’m, you know, on the floor of the shower with a razor blade in one day to let’s make a new breed. 

00:33:32 

Then the next day it’s those small incremental changes to build a new pathway and it is possible. 

00:33:33 

Hum, hum. 

00:33:39 

Oh yeah, right. 

00:33:40 

Like Nathan Parker told us, you’d take one small step. 

00:33:43 

You take one small thing that you can achieve and then you can build on it. 

00:33:47 

Yeah, like those months after I left that job lets the end of 2020, which is when this was so I left that job in August 2020 and we. 

00:33:56 

Decided to start the business and welcome change media. Our business between Andy and I at the start of 2021 have I got the timelines right? I do, don’t I? 

00:34:04 

You do you do? 

00:34:05 

In that time we were talking about before we decided to turn it into a business. 

00:34:09 

I, you know, I left that job. 

00:34:11 

I had absolutely no plan. 

00:34:12 

I didn’t have a business. 

00:34:13 

I had a whole heap of bad mental health and are feeling like I just ******* couldn’t anymore and had to dissolve the situation that I was in. 

00:34:21 

But I we’re having those conversations. 

00:34:23 

We were going. 

00:34:24 

What could we make together? 

00:34:26 

We haven’t made anything together in a long time and and those conversations. 

00:34:29 

Came up for us with you and ’cause it hasn’t been that long since your dad died and so we would. 

00:34:34 

We were talking a lot about the grief of that and I was feeling definitely that grief at the loss of a career. 

00:34:40 

There was a sense that I think for me. 

00:34:42 

When we’re talking. 

00:34:42 

About grief as well that there’s a sense that, OK, there’s this grief, period. 

00:34:46 

And then we can sort of look at how was the taste retention normal like this is some kind of magic endpoints. 

00:34:51 

Never happens. 

00:34:52 

Seeing this and slow. 

00:34:53 

Spoiler alert. 

00:34:55 

I think we’ve kind of grown a bit since then. 

00:34:57 

I think we’ve kind. 

00:34:58 

Of come with utilizations in between. 

00:35:00 

Yeah, those first few moments. 

00:35:01 

Those are the those are the glimmers as well. 

00:35:03 

Before we had a business before we have this podcast. 

00:35:05 

That we have. 

00:35:06 

Now those were the glimmers that paved that way in the plasticity, because that six month period of time I. 

00:35:13 

We we would have a chat. 

00:35:14 

Actually, Andy and I would have a chat most Sundays about what we want to do with the podcast, and we’d start to plan out our episodes and what kind of things that we might like to have. 

00:35:22 

And we give each other some tasks we. 

00:35:24 

Designed some tasks throughout the week and. 

00:35:26 

Do you know what Andy do, his tasks and you know what I would do? 

00:35:29 

Is I would sit in bed all week upset and not do anything and then Sunday would come along and we’d. 

00:35:34 

Have a chat and I’d be like. 

00:35:36 

But I didn’t get to it, but. 

00:35:38 

The truth is our, you know. 

00:35:38 

Move them with tasks. 

00:35:40 

It didn’t, I didn’t. 

00:35:41 

I didn’t do them because that was the the depressive knice of it. 

00:35:46 

So those small conversations that lead to bigger ideas that led to us putting this project where we both put our mental health. 

00:35:56 

And healing at the heart of our business model and at the heart of the. 

00:36:00 

Content that we produce for ourselves and making it important to us that when we work with other people that they’re also making content that we believe will help make the world better and improve. 

00:36:09 

People’s lives, those incremental moments all up really helped pave that pathway to, you know, like we hadn’t even considered talking to Leanne carry about stroke rehabilitation. 

00:36:20 

And brain plasticity and changing and on a big subject like that when we were making those small decisions we were just going to make our little podcast and it will. 

00:36:29 

Just like that little pod carves. 

00:36:29 

It’s a side. 

00:36:30 

There’s a side hustle on a Sunday. 

00:36:32 

We were just going to make our little podcast. 

00:36:34 

Yeah, and then I thought I’m gonna leave the bank. 

00:36:37 

I’m a. 

00:36:37 

Bit more control. 

00:36:38 

Over my life and here we are. 

00:36:41 

And all. 

00:36:42 

And I thought. 

00:36:42 

Oh, he’s going to make me put on. 

00:36:43 

Pants and work. 

00:36:44 

Every day you know what? 

00:36:45 

That still hasn’t happened. 

00:36:46 

Hasn’t happened story put on pants. 

00:36:50 

Still have to put on pads. 

00:36:53 

But you know so. 

00:36:54 

So those kind of changes. 

00:36:56 

They happen this small, there’s that potential of possibility, and it it creates that new pathway where it gets easier and it gets easier. 

00:37:03 

And it gets a little easier, and it’s not always easy when I say easier because for many many many, many months into us starting the. 

00:37:11 

The business in this podcast I would say to Andy, one of the things that I’m really afraid of, is that I just think that depression is lurking around the corner, that I might be OK now, but something is going to happen soon or something gonna trip me and it’s gonna send me back down that path and I don’t want to be there. 

00:37:29 

’cause it’s a ******* horrible place to be. 

00:37:31 

Hey yeah. 

00:37:31 

Yeah it is, and it’s a ******* horrible place to be and you know you talk about those incremental changes and I think in any circumstance I think it’s those incremental changes when you’re trying to battle something so big. 

00:37:42 

It’s those little changes, small steps at a time that actually you can start to build into that roadway of recovery as well, yeah? 

00:37:49 

Like we celebrated the first time that I left the house. 

00:37:52 

We did that was a big thing. 

00:37:52 

The first, the first time that I went back into the city after you know having not been in the city for so long, and I know we’ve celebrated before as well. 

00:38:00 

When you’ve received letters from people and it’s not affected you emotionally like you. 

00:38:05 

Yeah, that’s true. 

00:38:06 

Like early on I was getting communication from people related to the relative. 

00:38:12 

I don’t know. 

00:38:12 

Isn’t it funny like talking about all this sort of shift and not actually naming people, but I’d get letters and they weren’t particularly good and going through me. 

00:38:22 

But then, as time went on I would get letters. 

00:38:25 

From her and there came a point where I. 

00:38:29 

Didn’t get triggered anymore because I’d made that change. 

00:38:31 

Within my own. 

00:38:32 

Mind as to what was acceptable and I wasn’t about to be manipulated down the same path way of being hurt or being convinced that I was to blame for everything because I saw that happen far too many times with other people in my life and I was going to be party chat. 

00:38:49 

You know what I say? 

00:38:50 

Trauma strong. 

00:38:51 

Right, whether it’s an envelope full of cutlery or an end of a career, whatever, whatever has affected you, has affected you. 

00:38:59 

Yeah, trauma instrument. 

00:39:00 

And yeah, I wonder whether from a brain perspective where the physical trauma is similar in some ways to psychological trauma. 

00:39:09 

Yeah, one of those things that Professor Leanne Kerry spoke to us about was that as counter intuitive as it sounds, people who have suffered stroke or actually in a prime position to recover because their brain plasticity is improved following the trauma of stroke. 

00:39:23 

The plasticity is enhanced by an injury like that, so it does have a special significance for a person who’s had had a stroke, they sort of challenged to move and think and feel with an altered brain and body. 

00:39:39 

And this phenomenon really opens a window to change. 

00:39:44 

And adaptation really. 

00:39:46 

In the days, weeks, months and even years after stroke, I often say to the people with stroke that I work with. 

00:39:54 

They actually have an even greater capacity for change and adaption because of that injury. 

00:40:00 

And they can learn new skills on a day-to-day basis like we can. But we have to also be aware that they could learn habits and movements that are not so helpful, such as they might learn not to use that Len. So whilst there’s a greater capacity is also important that we really worked. 

00:40:20 

Harness that capacity for a positive change. 

00:40:23 

It really does seem counter intuitive that the brain becomes more plastic. 

00:40:28 

More more able to cope with learning and change after an injury, like strokes so. 

00:40:34 

How do you help people? 

00:40:34 

Not only the people who have suffered the stroke themselves, but the people who are supporting them to accept the possibility of recovery in place of being resigned to that permanent disability. 

00:40:43 

Well, I think if. 

00:40:44 

We think about how the brain works. 

00:40:47 

It works in networks and in an interconnected way. 

00:40:52 

So if part of that network has been damaged by the stroke, then other parts of the network that need to reconnect. 

00:41:03 

To make up for that loss, and that’s I suppose, where. 

00:41:08 

That readiness and the presence of neuroplastic change is intensified after a stroke because we know that that plasticity is linked with experience and learning. 

00:41:22 

So then, whilst there has been damaged somewhere, if you can see that you can put to the person. 

00:41:28 

To the brain. 

00:41:29 

I mean, has this capacity for change, but it’s ongoing the whole time. 

00:41:34 

And really what we need to come together about is how we can shape the change in a way that meets the goals and new challenges that that person is being presented with. 

00:41:49 

So it really is being very concrete that there is hope because of this phenomenon of neural plasticity of the brain, and because. 

00:42:00 

It’s the fact that the brain isn’t our ability to do things is not just linked with one area of the brain, it’s linked with networks and there’s redundancies and capacities to reconnect and reorganize those networks to achieve a better outcome might not be exactly the same. 

00:42:20 

As it was before. But to achieve the goal that the person’s aiming for. 

00:42:27 

Lisa Tom barely managed to lose some other vector from health after she suffered a brain aneurysm and then. 

00:42:32 

A stroke while. 

00:42:32 

On the operating table to address the aneurysm. 

00:42:35 

When you’re up against all the odds, and when everybody is telling you there is no way forward, you know they’re not always right, and that if you’re up against it and you have no other options, why not throw the bus at this, you know, and go all in, and that was, you know, especially when you love somebody you know there’s a pretty big motivating factor there, and so that’s what I did. 

00:42:54 

And and now. 

00:42:55 

You know, and my mum is just loving life again and I think that’s an example of resilience and an example of being able to adapt to change, you know ahead to be relentless. 

00:43:06 

And I’m still relentless like she has never had a day off train. 

00:43:11 

Never, you know. She you know birthdays, Christmas whatever. She’s training everyday and she has to because she’s now 79 and I need to keep her there and I’m determined to keep her there and there’s healthy for as long as I possibly can because I selfishly want my mum around, you know. 

00:43:27 

Was it the case here that you felt like you wanted to prove them wrong as well? 

00:43:31 

Did it come back to that attitude for you, or was there something else there that helped? 

00:43:34 

To drive you in your mind. 

00:43:35 

I mean like the main driver was love and that my mum and my family and my always my. 

00:43:41 

Number one priority and. 

00:43:42 

Everything I do, but there’s definitely, you know. 

00:43:44 

When I was told there is no way I’ve been told my entire life that you can’t do that, and that’s impossible. 

00:43:50 

And who the hell do you think you are and you don’t know? 

00:43:52 

And so I just don’t even listen to naysayers. 

00:43:55 

I just I just chewed all that out and I I think I definitely have a rebel spirit. 

00:44:00 

I do like proving people wrong and. 

00:44:02 

And I use that as a motivating force some. 

00:44:04 

Comes when I’m in despair and when I don’t think I can carry on, I think of that person who just told me I couldn’t. 

00:44:11 

And I go. 

00:44:11 

Where you gonna let them preview them, right? 

00:44:13 

You know? 

00:44:14 

Or are you gonna keep going with mom? 

00:44:16 

It was easily easy to be motivated because you know, I was just desperate and she’s she was, you know, just an amazing mother. 

00:44:23 

You know just. 

00:44:25 

Phenomenal mother. 

00:44:26 

And Lyons work as we discovered in episode 22 of re frame of mind, the science of changing our thinking has resulted in some groundbreaking therapeutic treatment for stroke survivors called sense therapy. 

00:44:37 

It’s tried, tested and widely available, and Leanne walked us through exactly how it. 

00:44:42 

Works I’m. 

00:44:42 

Really curious about the process involved with bringing back sensation. 

00:44:47 

And movement. 

00:44:47 

Because for me, my experience of knowing people. 

00:44:51 

Who have suffered stroke and. 

00:44:53 

And working with them, they don’t have that movement in their in their limbs. 

00:44:57 

So there was one. 

00:44:58 

Lady I worked with who didn’t have. 

00:45:00 

Any movement in the left arm, so the therapy was more based around trying to compensate for that and give her mobility in other ways, but what they seem to be suggesting is that this person you know with the right kind of therapy and attention might have been able to regain the. 

00:45:14 

It’s a touch and some using that link. 

00:45:15 

How does that? 

00:45:16 

How do you go from zero? 

00:45:17 

Movements to being able to have a functioning again. 

00:45:19 

Well pets, if I can give the example in sensation peel, which is particularly where we’re looking at, so the question is how can you go from something? 

00:45:29 

It’s almost not there to be able to restore function and then use it, and that’s often the case for a person who has loss of sensation. 

00:45:43 

It’s like the hands blind that can hardly feel all tune into the sensation. 

00:45:50 

Or make sense of that altered information. So what we do is we can set-up very special learning situations too. 

00:46:00 

Help them to go to tune into some sensation that’s there and to make sense of it. 

00:46:08 

So for example, even in the beginning person might only just feel that there’s something there rather than nothing, so then we use the knowledge. 

00:46:20 

The network that supports the processing of sensation to help enhance that experience. 

00:46:28 

So one example might be we use anticipation. 

00:46:32 

So in this way we use deliberate anticipation to help ready the person to know what to expect to feel from priming them or helping them to tune into that sensation. 

00:46:47 

And often they’ll then get. 

00:46:48 

Is a hard moment are there’s something there and then we’ll go through the process with them to help make sense of that altered information that might be where we. 

00:46:57 

A concept called calibration. 

00:47:02 

Where we help the person to experience that altered sensation by reference to a more normal sensation that they can experience with the other hand and with vision so they get a chance to directly match what the feeling is compared with the other hand and with vision. 

00:47:23 

And we know that when we normally experience the sensation, all those types of information come to. 

00:47:32 

Together and it. 

00:47:33 

Increases the signal input and the intensity so the person can learn to make sense of that altered information so they just. 

00:47:43 

2 features of seven principles of sense training that we use and each of the principles are very directly linked or mapped to this knowledge of how the brain can learn and adapt. 

00:48:01 

And change it’s important to know that the sensors in their fingertips are still working. 

00:48:09 

It’s just the direct out the area of the brain that problem with the brain making sense of that. 

00:48:17 

And whilst there might have been damaged to a particular region. 

00:48:21 

The brain that that’s occurred with there are supporting areas and networks in the brain that we. 

00:48:29 

Can help the person to learn to make sense to tune into the altered sensation by priming it and then to help make sense of that altered information so very much. 

00:48:43 

Aiming to take a more learning or restorative rather than compensation. 

00:48:50 

And unfortunately, compensation has been there. 

00:48:55 

Approach for many people today’s. 

00:48:57 

I think that’s a really interesting distinction right there, between it being an issue with the brain will be able to interpret something that’s still working, because perhaps, you know, in our best intentions we may be confuse this type of damage with something like nerve damage or some other kind of cognitive issue that that can happen. 

00:49:17 

Along the way. 

00:49:18 

That’s a really important distinction, and when we work with clients where this is a challenge, we make some of those distinctions very clear for them, so they they’ve got a basis to really have a buy in. 

00:49:32 

To be involved in an approach to training that will help them to regain the sensor touch and then use it and that there’s very real capability. 

00:49:44 

This is the neurobiology of how our brain works and it does work. 

00:49:48 

We see those changes. 

00:49:50 

We see the improvements. 

00:49:52 

Not only in the persons ability to discriminate textures or objects, or know. 

00:49:58 

Where their hands? 

00:49:59 

And are in space on quite standard and formal tests. 

00:50:04 

But also then how they can use that in the context of everyday tasks and market worth at that point. 

00:50:12 

Just to mention this, different types of neural plasticity that we can tap into in stroke rehab. 

00:50:19 

One would be. 

00:50:20 

Often think of his experienced dependent and that’s their thinking more enriched environments and spontaneous changes in plasticity of the brain. 

00:50:31 

But what we’re really targeting and therapy and two others one is learning independent, and that’s where we’re focusing on skill. 

00:50:40 

Training so that might be learning to pick up differences in textures like I mentioned or learning to grasp the cup in the more normal manner following that loss of movement. 

00:50:51 

And here we’re looking at the relatively large lasting changes in both knowledge and skill and the second level that sometimes people forget. 

00:51:00 

And that is what we call activity dependent plasticity, and this involves sort of more strategy learning and what they call metacognitive strategies. 

00:51:12 

And this is where the person can. 

00:51:14 

Would they apply the new skill to their everyday task? 

00:51:19 

Really go through the. 

00:51:20 

Discovery process of how to use that skill and how to perform it in the task. 

00:51:26 

And then they’ve got this new capability, which they can bring into novel tasks. 

00:51:33 

But it’s not just about Rd exercises. 

00:51:35 

Leanne pointed out the importance of a good relationship between the patient and the therapist. 

00:51:40 

How important is the concept of being able to? 

00:51:42 

Encourage yourself through all. 

00:51:44 

Of this so I can imagine you know there must be quite a few barriers with someone who’s experiencing this type of some limitation. 

00:51:50 

How how do we? 

00:51:51 

Go about helping them to encourage. 

00:51:53 

I think that’s a really important part, and I think there’s also encourage themselves, but there’s also. 

00:52:00 

With a partnership that stormed in in this train and a lot of people are really challenged by a sensory loss in some of the cognitive and emotional challenges and go with it. 

00:52:13 

So perhaps if we think about where it starts it, it’s actually hard to imagine what it might be like if you can’t. 

00:52:20 

Field on one side of your body. 

00:52:22 

If you can’t feel living objects in your hand and you can’t feel where your arm is if it’s behind. 

00:52:29 

The back were. 

00:52:30 

Able to reach into your pocket etc. 

00:52:32 

So with that people can often refer, you know, it can be quite distressing, and yet it’s a hidden problem and they lose that sort of connection. 

00:52:42 

So one big step of the way is for the person to feel safe and supportive in that first phase. 

00:52:49 

And to acknowledge some of those demands and perhaps even those emotional problems with the experience of the altered. 

00:53:00 

Sensation we’ve also heard from these people is that they report that harnessing the positivity in the relationship is important. 

00:53:11 

And seeing the specialized therapy is a vehicle to help make that change. 

00:53:18 

When people come in with a more open mind set to the treatment that the recovery time is faster. 

00:53:24 

We don’t know that we’ve sort of directly had an opportunity to. 

00:53:29 

Tips that yeah, but we do take time in the beginning to really work with the person to understand where they’re at. 

00:53:39 

To understand this capability for change and to really look at getting that buying, and I think that’s important. 

00:53:49 

And so people engage really intensively in it, and they’ve often said, you know, it’s hard work and and you know they’re quite tired afterwards, but they’re prepared to do it because they can. 

00:54:04 

See some some of the challenges some have talked about. 

00:54:07 

It feels like I’m. 

00:54:08 

You know, going back. 

00:54:09 

To school and you fit. 

00:54:11 

At school and everything still so hard. 

00:54:13 

I mean, maybe that’s that’s some of the occasion. 

00:54:17 

One of the comments that say that was challenging, but I wouldn’t have changed and I knew then it was working that same person saying it’s. 

00:54:24 

Like we’re wiring your brain. 

00:54:26 

Sort of thing. 

00:54:26 

Does depression play a role in the? 

00:54:29 

Very plasticity. 

00:54:30 

We do actually measure people depression and such along the way. 

00:54:35 

The extent to which it directly impacts the neuroplasticity and probably not in a position to really give you a very clear background on that. 

00:54:45 

But I think that the emotional part directly. 

00:54:50 

Impacts on obviously how the person engaged. 

00:54:53 

We also know that mood and cognition are very distributed parts of the. 

00:54:59 

Same that support learning and engagement. 

00:55:02 

So from that point of view they can. 

00:55:05 

They can contribute to the extent to which the neuroplasticity might play out, but I think that the the other thing is that people, then who might. 

00:55:19 

They’ve had some emotional problems and some anxiety associated with it can definitely still benefit from the therapy. 

00:55:30 

And I’m thinking as I’m talking some people involved that have really made a very. 

00:55:36 

Important gains from that that part of it, and even again I I’ve picked out a couple of comments here. 

00:55:45 

You know with that shared vision resident change where someone said we both worked so hard so so hard like we really gave it our. 

00:55:56 

For another person who said look, we all done it, the help of the therapist. 

00:56:02 

Because if by themselves forget it. 

00:56:04 

So maybe sometimes those people will need to set extra scaffolding earlier, because there can be quite a brief in the sadness, sort of. 

00:56:16 

Thinking with the loss, but then when they’re showing, they often have also reported the positive emotions and when they see the improvements associated with the training and that they can connect back with their and happy with some confidence and being able to. 

00:56:36 

Take back some of that choice in how they use their arm in daily activities. 

00:56:42 

One of the first things that in is involved in the process is focusing on tuning in to the sensations that you still have. 

00:56:50 

How does that go when as humans we have, I suppose, spend a lot of time not focusing on things, especially listening to our own bodies. 

00:57:00 

What’s what is that process like in actually breaching that gap? 

00:57:03 

Yeah, and that it’s a really good point. 

00:57:05 

And Louise and one that a lot of people who are involved in the program comment on there. 

00:57:13 

Say, ah, I hadn’t realized how my sensors work before or how important the sensation is and how they can tune into it. 

00:57:23 

So we we have very specialized training sorts of tasks and activities. 

00:57:28 

So for example, from feeling different textures to even knowing where your limbs in space. 

00:57:34 

So for example, we have an apparatus with. 

00:57:37 

We can hold their hand in a comfortable position and move it back and forward and then they can get feedback from a protractor to know and understand better where they’re limousine space, and then they connect with that and then sort of internalize that knowledge. 

00:57:57 

But they they limit is sort of like. 

00:58:00 

The new internal scale of that sensation and people get incredibly engaged in that, and we we. 

00:58:08 

We’ve actually had the opportunity to get some input from people who have been involved in it, and one person said it was from a completely different type. 

00:58:20 

Of thinking and processing than I’d ever been used to, it was always a positive thing. 

00:58:26 

It was challenging, but I wouldn’t have changed it. 

00:58:29 

New was working there or this other one from a young gentleman who was a Carpenter. He said, yeah, 100%. 

00:58:38 

It’s just like when I didn’t have the retraining to when I done. 

00:58:41 

It’s like chalk and cheese. 

00:58:43 

Just chalk and cheese. 

00:58:44 

It done wonders for me like in sensation so it actually helps. 

00:58:50 

Two people to reconnect to something that perhaps they hadn’t needed or are to be so conscious of. 

00:58:59 

I understand that the research that you’ve been involved with has been really focused primarily on use of upper limbs. 

00:59:06 

Is is that right? 

00:59:08 

Yeah, would it? 

00:59:08 

Be fair to to say that there’s a possibility that this is also transferable to. 

00:59:14 

You know other parts of the lower limbs to just speech are the functions of the brain as well, or is it too early to? 

00:59:21 

To comment on that type of thing. 

00:59:22 

There’s no, I think, because the principles. 

00:59:26 

Strongly and robustly centered in the science of neural plasticity and the science of learning, they they actually come from those fields in, in, and of themselves, and have now been applied to the sensation through what we’ve done. 

00:59:43 

Others have used some of those techniques. 

00:59:46 

And principles to apply it to loss of sensation. 

00:59:49 

For example, in the lower limb with positive outcomes. 

00:59:54 

Many of the principles of perceptual learning and the context of neuroplasticity are also directly relevant for retraining of movement, as it would also be for learning a skill such as articulation in speech. 

01:00:12 

How long does? 

01:00:13 

It take on average for somebody to be able to start to see the effects of this kind of retraining. 

01:00:19 

Well, we do quite intensive training. 

01:00:22 

Oh, and over a period of 10 sessions, each of those sessions being one hour each, usually it. 

01:00:29 

Around two or three times a week, with practice in between is the period in duration of time that we’ve seen clinically significant and statistically significant improvements in change. 

01:00:44 

So when when you pointing to something clinically significant, so would that be, say, over the course of a. 

01:00:50 

Couple of months, six months. 

01:00:51 

Somebody might start to feel the sensation back in. 

01:00:54 

In that area or. 

01:00:56 

Notice having patients. 

01:00:56 

You’re probably standing, so if we’ve got 10 sessions. 

01:01:00 

It’s often over a period of four to six weeks at that rate of two or three times a week, and in that time we can see improvement in standardized assessments of sensations that might be touch, sensation or texture. 

01:01:16 

Knowing where their limits in space and their ability to. 

01:01:20 

Recognize if we die. 

01:01:21 

Objects also within that time we can see improvement in the particular tasks that we’ve been involved with training on. 

01:01:30 

So what we do is we go through person daily activities and we identify 5 activities that they feel are directly impacted. 

01:01:41 

By this sensory less and we train on two of those with them. 

01:01:46 

And so we see what we call as clinically significant improvement in those where on on the scale. 

01:01:53 

It’s been shown to be clinically significant in terms of the amount of improvement in. 

01:02:00 

Performance and it’s important to know, particularly the one which applies to the persons everyday activities that’s actually self rated by the individual as well. 

01:02:10 

I’m guessing that that the feedback through this process is probably vital, because I can imagine if I was in this situation, I’d probably myself grow quite impatient and maybe need to to know that change is happening and that I need to maybe balance out my expectations against the progress, yeah? 

01:02:18 

Right? 

01:02:27 

I think that’s one thing, the Pepsi. 

01:02:29 

Maps back to what we’re saying before about how a person engages is once they start to see those sorts of changes which they can see quite readily within the first couple of weeks, and that actually then really is positive and they engage in it and they talk. 

01:02:49 

About that, that’s part of them helping to, you know, get back to the positive side. 

01:02:56 

Even though they recognize that there’s challenges and. 

01:03:00 

Man’s and they’ve gotta work hard with it. 

01:03:02 

One of the things I I noticed you say I think in the same presentation I was watching is that so much of the rehabilitation that people are trying with people with strokes, it’s still compensatory. 

01:03:13 

It’s not. 

01:03:13 

Doing this, how do you kind of spread that message out further? 

01:03:17 

Because it’s almost like people need to advocate for themselves too and and their families to make sure that. 

01:03:22 

They are getting the treatment that can help them. 

01:03:25 

If they’re particularly if the immediacy of when you start the treatment is important. 

01:03:29 

No, I think that you are very right with flash on on on 2 counts. 

01:03:34 

One if we know that there is this ability to aim for a more restorative to approach to rehabilitation, this is compensation. 

01:03:43 

We just have to get it out there because the compensation this is not just compensating. 

01:03:50 

They’re actually learning non use of that in if they’re not using the link, so it’s actually really scary. 

01:03:58 

In some way you know. 

01:03:59 

And then. 

01:04:00 

On the second part of it, we need to make sure that therapists can also have the skills and capabilities to it, so we’ve actually been working on this in that what we call a a partnership project to really work with clinicians, health providers, consumers. 

01:04:20 

Reset and research. 

01:04:21 

With the aim to increase access to more science based stroke, rehab of the arm so that we can achieve these better outcomes, we’ve developed up some specialist therapy centers as well as also upskilling therapists in existing health care centers. 

01:04:41 

But this this the two sides to it then needs to be their beliefs and the knowledge that there is this pathway. 

01:04:49 

There needs to alongside that the the hands on therapies and protocols that a therapist can learn and feel confident. 

01:05:00 

And skill to deliver. 

01:05:02 

And I think that’s where we’re looking. 

01:05:05 

Obviously at trying to advance off and to bring them together, but but unfortunately the plasticity with knowledge of this plasticity unfortunately still is in part in its infancy in stroke rehab. 

01:05:20 

There’s certainly it’s probably, or whether I’d say exponential or not, but there’s certainly a growing realization from the stroke rehab area that to achieve better outcomes, we need to start a new. 

01:05:34 

Are these more restorative approaches to rehabilitation? 

01:05:38 

We’re linking with the knowledge and the science of motor learning, sexual learning, as well as the neural plasticity to apply that to some interventions, and we’re making steps, but I think there’s many people in the partnership. 

01:05:57 

Many stakeholders that we. 

01:06:00 

Need to draw on both from an efficacy point of view, but also from the skill and development point of view to try and escalate this as rapidly as we can. 

01:06:11 

Are there learnings or techniques or anything that has come from this process working with stroke survivors that we can take out and apply to ourselves as normal stroke survivors to increase our capacities to learn and grow and change. 

01:06:17 

Earth the virus. 

01:06:26 

Perhaps behaviors that we need to change? 

01:06:29 

Well, I I think there. 

01:06:30 

Are and again just going back to the idea that because this is so strongly founded on robust put principles of neuroplasticity and learning, and many of these principles actually came originally from looking at normal motor learning normal perceptual learning? 

01:06:50 

And then crossed calibrating that which we need to do with the brain following injury and. 

01:06:57 

I suppose if. 

01:06:58 

We think about it, even with some of the questions that you’ve asked, which I think are really important, perhaps even at that first level with. 

01:07:06 

Making sure we have a. 

01:07:08 

Select tasks that are meaningful and graded and varied. 

01:07:13 

That’ll help you transfer, and when you’re engaged in the task, make sure that you’ve got a very clear goal in the task and it could be a subgoal or it could be a task goal along the way, because that will make sure that. 

01:07:31 

Direct your attention in a meaningful way because there’s this self organizing capacity as well within the brain. 

01:07:38 

So it’s really about if you get to the goal and let the brain do what it needs to do a little bit behind. 

01:07:45 

That’s important. 

01:07:46 

Then you want to. 

01:07:47 

If we think about how the brain works, you know in networks. 

01:07:50 

And things think about how we can. 

01:07:52 

Use feedback and maybe even that calibration to match the experience. 

01:07:58 

I think the anticipation is another key goal that we could use and I know what to expect to feel. 

01:08:05 

Tune into it. 

01:08:06 

So ready yourself for what it is, that’s your goal for learning and then. 

01:08:12 

The other thing is you know the repeat and progress. 

01:08:16 

So to bring that into the task, and I suppose, really one of the one that for us if things are working well, that really might be the as important or more important is that strategy. 

01:08:30 

Learning like to really go in with it to discover what? 

01:08:36 

The task is presenting to you and how you can work with that task and manipulate. 

01:08:42 

To achieve the goal, the outcome that works for you so that metacognition for the strategy learning as well. 

01:08:50 

I also picked up in in the reading that we’ve been doing with researching before. 

01:08:55 

We had a chat this morning, so the concept of spontaneity and it seems to me that when it comes to spontaneous use of a luminary training, there really does need to be some focused attention placed on that limb, and it’s used to work it back into spontaneous. 

01:09:10 

Movement Sarah yeah yeah, even to move one limb or to feel as one is very much processed by both sides of the brain and is ones being damaged. 

01:09:22 

So by the stroke person will may even well won’t necessarily spontaneously use that limb, but then. 

01:09:30 

A person who’s trying to use that lead would can even report that they have to consciously stop the other limb coming into doing it to doing the task. 

01:09:42 

So to see if that is very much a balance of tasks. 

01:09:48 

And maybe why it is so important that we have some specially designed tasks and maybe feedback and this belief that you can go on to use that limb. 

01:10:00 

That all coming together are going to be so important to achieve that change. 

01:10:07 

Some conversations I hear around. 

01:10:08 

And being able to implement some kind of restorative therapy. 

01:10:12 

People are very quick to judge and say we shouldn’t actually give people false hopes. 

01:10:17 

So what do you think is the best ammunition against that argument to help fight against that? 

01:10:22 

Pushback that sometimes you can find even in professional circles of clinicians? 

01:10:26 

I think that people experience it. 

01:10:29 

I mean, I’ve had unfortunately. 

01:10:31 

Seeing some of the stroke survivors who come in, they said there were no. 

01:10:35 

After three months I can’t expect any more improvements and so I’m not sure if I should do this or not and I said well, if you want to give it and and then they sort of thought, OK, we’ll give it a go. 

01:10:48 

And then in part it’s because of that very. 

01:10:51 

Expectation that we’re we’re even more determined just to give people that opportunity and that person is an ongoing advocate to say, OK, well, I can actually improve. 

01:11:03 

I can. 

01:11:04 

Change it’s after three months and now I’ve got a completely new way that I can use my hand. It might not be 100% of the sensation it was before. 

01:11:15 

We would be very sort of clear about those sorts of expectations, but as one person says, even if the sensations not there, they. 

01:11:24 

Recognize that their brain is making sense of the altered sensation and the. 

01:11:29 

They enable them to use it in everyday tasks and as they say, perform things you know quite competently in that way, so I think we’ve got to break down those barriers. 

01:11:42 

It’s happening, but not accept it. 

01:11:45 

How have you? 

01:11:46 

Applied what you’ve learned to your own life. 

01:11:49 

How has that made? 

01:11:49 

A difference to you? 

01:11:50 

Yeah, I, I think there’s there’s there’s many elements over Patrick and the partnership way of it. 

01:12:00 

The coaching is quite import. 

01:12:03 

And I suppose more. 

01:12:05 

Personally, you know, it’s always taking that discovery approach to learning to look beyond what’s just close to you to see how the other parts working in in conjunction with it to strengthen that to be open to those different. 

01:12:22 

Ideas and senses and to. 

01:12:26 

To really see how the jigsaw comes together and to be very positive and goal oriented with your approach. 

01:12:38 

And I think both as a therapist and researcher. 

01:12:42 

Really having that belief in the change and. 

01:12:47 

Really, the power of positive thinking and to know that you can work with a person being the moment with them as they’re exploring and discovering a new way of sensing and feeling. 

01:13:01 

That makes sense for them and then can take them to do what they need and want to be able to do. 

01:13:08 

I think a very common thing we here throughout societies that you can’t teach an old dog new tricks. 

01:13:14 

But it seems that any dog, if willing, myself included. 

01:13:17 

I think this dog is kind of learned that I can learn. 

01:13:20 

Anything right up until. 

01:13:21 

The time I leave the earth. 

01:13:23 

So the teacher and all those new tricks is not right. 

01:13:29 

So you can teach an old dog new tricks, something the sayings not right. 

01:13:33 

You can’t teach an old dog new tricks, but even better than teaching the old dog new tricks. 

01:13:38 

Is to teach the dog how to discover new ways of doing things and and to me this is when I hear feedback from stroke survivors. 

01:13:43 

Love it. 

01:13:50 

That, to me, is mostly of enforcing of this therapy. 

01:13:54 

They actually learn the how to do it and so then. 

01:13:58 

When I hear that there. 

01:14:00 

Using it in everyday activities and I catch up with them years later. 

01:14:04 

They said I’m still using their. 

01:14:05 

Compared with this they do there and such and such. 

01:14:08 

They had a problem. 

01:14:09 

I told them how to do. 

01:14:10 

It, and then it’s. 

01:14:12 

So it’s being open and believing in that discovery of learning it, but also having ways that you can bring it together with principles such as this which are very robust in neuroscience to actually start on that pathway and continue on it to change. 

01:14:33 

You know it comes back to what we started with. 

01:14:35 

I mean if you think about reframe the mind, it’s about adapting and learning neural plasticity of the brain is the mechanism or the phenomenon that supports that adaptation and learning. 

01:14:48 

And if we engage in the tasks and we believe in this. 

01:14:53 

And we’ve got a little bit of that know how how to do it. 

01:14:56 

Then we can achieve that change with both the discovery and the knowledge. 

01:15:02 

One of the things I wrote down today. 

01:15:04 

That is going to. 

01:15:05 

Be my big take away is change your behavior, change the brain and I would have actually always put it as the other way around, so that’s an eye opener. 

01:15:12 

Umm the eddies and eye opener, and I think it does challenge, is to recognize the reciprocal nature, but also to realize that the control is back with us in terms of what we can do, not only what. 

01:15:29 

We can do to challenge and make that change, but also how we experience what we do in terms of making that change. 

01:15:40 

So the locus is back with us. 

01:15:43 

I just think there’s so much significance in that change your behavior, change your brain and the reciprocal nature of it. 

01:15:50 

Yeah, you want something I remember from. 

01:15:52 

When we spoke to later, Tommy was that she said that behavior creates motivation and I think we often think of it the other way around that we need to get. 

01:16:00 

Innovators take action, but some of these things that Leanne talking about and even guests prior. 

01:16:05 

Really kind of starting to make us think about how we think about things. 

01:16:10 

I bloody love Liang. 

01:16:11 

She’s filled up my brain with lots of things and stuff and that. 

01:16:18 

Gonna need some sites. 

01:16:18 

But how plastic is it? 

01:16:20 

Or it’s it’s play-doh at the moment? 

01:16:22 

Or or maybe one of those kids slime things that I’ve seen on tick tock. 

01:16:26 

That’s what my brains like. 

01:16:27 

Yeah, right? 

01:16:28 

But still multiple. 

01:16:29 

Oh so should. 

01:16:30 

We go explore our own brain plasticity. 

01:16:32 

Now after filling our heads with all those wonderful tidbits. 

01:16:35 

Yeah, look, I think it’s a great opportunity for us to unlearn some bad habits and implants and good ones. 

01:16:40 

One small change at a time. 

01:16:42 

You know what? 

01:16:43 

I really do think we need to start putting together a toolkit from everything that we’ve actually been talking out across the series. 

01:16:48 

I think with some great advice. 

01:16:49 

The re frame of mind tool catch him and the one that we’ve been talking about for ages that we’re going to do. 

01:16:55 

Yeah, if. 

01:16:56 

One small step at a time. 

01:16:58 

That’s right, definitely more to come. 

01:17:02 

Next time on re frame. 

01:17:03 

Of mind will dive deeper into thinking about thinking as we have a look at positive psychology and see how this differs from the platitudes of toxic positivity with Australia own Dr. 

01:17:13 

Happy Tim sharp. 

01:17:15 

It’s OK not to be OK. 

01:17:17 

Sadness and grief and anxiety and frustration and. 

01:17:20 

Even even anger, or is it? 

01:17:22 

Normal human emotions. 

01:17:24 

We all experience them and there are usually good reasons for experiencing them. 

01:17:28 

You’ve been hearing our story. 

01:17:30 

Now we really want to hear. 

01:17:31 

Connect with that re frame of mind or Instagram? 

01:17:34 

Facebook tik? 

01:17:35 

T.O.K and Twitter. 

01:17:36 

We’ll connect with add welcome, change Media or LinkedIn. 

01:17:39 

You can also contact us via re frame of mind.com dot AU with your stories or suggestions for future topics. 

01:17:45 

We’d like to. 

01:17:45 

Thank today’s guests for sharing their personal stories and insights and For more information on any of the subjects guests. 

01:17:51 

All references used in this episode please see. 

01:17:53 

Our show notes. 

01:17:54 

Or reframeofmind.com dot AU. 

01:17:57 

Re frame of mind is a welcome change media production. 

01:18:12 

Now just do some random. 

01:18:15 

Yeah, yeah. 

01:18:19 

Do it. 

01:18:22 

I’ve been a former 15 more. 

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