In my previous articles The Neurological Causes of Musician´s Focal Dystonia and Causes of the Neurological Changes Found in Musicians with Focal Dystonia I described the research on what occurs at the neurological level in Musician´s with Focal Dystonia. In this article I will explain the research on the Neuroplasticity and Neurogenesis techniques that I use to reverse these erroneous neurological changes.

To summarise the previous articles, the research has demonstrated that there is a direct connection between Musician´s Focal Dystonia, perfectionism and stress. (Altenmüller E, 2010). Investigations have also shown that these types of emotional and social stresses stimulate the visual receptors (superior colliculus) in the midbrain which create involuntary gaze fixation and muscle activation in the brainstem and in the central nervous system found in the neck. They also show how this muscle activation becomes trapped in the nervous system and in the body and it is unable to be effectively released. It seems that one of the principal causes of Musician´s Focal Dystonia is this trapped muscle activation.

Micic, Ehrlichman and colleagues have extensively studied how the eyes are spontaneously activated to move to specific locations and become fixed on them in order to locate and retrieve memories and past information. (Micic D, 2010) Their findings are explained in the journal Brain Cognition, in their article: Why Do We Move Our Eyes While Trying to Remember? The Relationship Between Non-Visual Gaze Patterns and Memory. It is as if we need to look outwards to a specific gaze fixation point in order to look inwards and recall memories and information from past events. In their research they have identified the movement of the eyes during the “search” for long-term memory, which is followed by gaze fixation when the information is “located”. In Causes of the Neurological Changes Found in Musicians with Focal Dystonia I described how when we have a stressful experience there is an automatic movement of the eyes to fix our gaze on what is causing the stress. It seems that later on when we try to remember what happened it is as if we directly mimic the gaze fixation that occurred back then. Furthermore, Micic, Ehrlichman and colleagues have observed how these eye movements which occur in a succession of discontinuous individual movements are connected with memory through the medial temporal regions of the brain and the basal ganglia (the region that produce automated responses and behaviours). From there, they express themselves in the visual receptors (superior colliculus) to create the gaze fixation. The intervention of the basal ganglia in this process is especially meaningful as an erroneous functioning of the messages sent from the basal ganglia have been shown to be one of the primary causes of Musician´s Focal Dystonia (Avanzino L, 2012).

We could describe it in the following way; our memories have a fixed gaze position that David Grand calls a Brainspot, which provides a bookmark or tag on the appropriate information file (Grand, 2013). I support my clients to discover the Brainspots that enable their brain to connect to the memories that left the underlying physiological activation in their nervous system and body. As they do so their brain “rewrites the neural pathways which were previously entrenched in maladaptive and dysfunctional loops” (Corrigan F, 2013). In practice they experience a direct release of the muscle tensions and spasms that are the symptoms of their Focal Dystonia. This release begins to occur instantly and during the session. The memory fragment which provided access to the events which created the blocked physical activation in the nervous system and body becomes integrated into a smoothly functioning system (Lane Rd, 2014).

One of the functions of the basal ganglia is to create the huge number of automated actions that we do every day in order to free up the higher functions of the brain to focus on more important tasks. This means that when movements, including complex sequences, are repeated sufficiently, they may be performed automatically (Squire LR, 2009). This is the reason why fine technical abilities on a musical instrument require thousands of hours of repeated practice.

However, for a musician with Focal Dystonia these movements have been caught in an erroneous message from the basal ganglia which leads to inappropriate muscle contractions or spasms. Therefore, in addition to resolving the cause of this erroneous message we need to simultaneously locate a Brainspot from where we can completely eliminate the Focal Dystonia symptoms whilst they are playing their instrument. In this way we are building a new memory loop into the brain and the basal ganglia´s control of the automatic muscle movements that are used to play the instrument. Once this is achieved the client completes a daily repetitive practice free of the Dystonia symptoms until this becomes the automated muscle movement from their basal ganglia.

Therefore the core of my treatment to enable clients to cure their Focal Dystonia is:

· Releasing the physiological activation that has become blocked in the nervous system and body of the Musician with Focal Dystonia, which creates and immediate release of muscle tensions.

· Creating new automated muscle movements from the basal ganglia which are free of the Dystonic symptoms.

However, I have discovered that it is essential for them to be supported by certain Kundalini Yoga physical and breathing exercises. These have been shown to make direct changes on the brains hormones and neurotransmitters such as dopamine, epinephrine and norepinephrine as well as balancing the sympathetic and parasympathetic nervous system (Khalsa DS M.D., 2001). These are essential elements of the stress reaction that underpins the development of Musician´s Focal Dystonia and therefore, is important to reverse them.

The final and equally vital element of the Focal Dystonia Cure is to ensure that the musician prevents the reoccurrence of Focal Dystonia in the future. This is achieved by building on the relaxed automated movements from the basal ganglia that we have installed. I guide the musician to develop high level Flow Performance States using the corresponding Brainspots. Once they have mastered these states through the exercises that I give them in their home practice, we use the sessions to progressively work through the Brainspots that are associated with feelings of stress and self-demanding in all aspects of their musical career and we anchor them to the Flow State Brainspots. With sufficient practice and repetition the Flow State becomes the automated emotional response from the basal ganglia in what they would have previously experienced as common high stress situations.

What is interesting is that as we perfect this last part of the process, the musician develops a higher level of performance than they had previously. Several of my clients have commented that in hindsight they feel like the Focal Dystonia had been a gift that enabled them to return to their deep and relaxed joy of performing music and that it has taken them to a greater emotional expression and technical performance than ever before.

References

Altenmüller E, J. H. (2010). Focal Dystonia in musicians: phenomenology, pathophysiology, triggering factors, and treatment. Med Probl Perform Art., 25(1):3-9.
Avanzino L, A. G. (2012). How does the cerebellum contribute to the pathophysiology of dystonia. Basal Ganglia, 2, 231-235.
Corrigan F, G. D. (2013). Brainspotting: Recruiting the midbrain for accessing and healing sensorimotor memories of traumatic activation. Medical Hypotheses, 80: 759-766.
Grand, D. (2013). Brainspotting: The Revolutionary New Therapy for Rapid and Effective Change. Louiseville: Sounds True.
Khalsa DS M.D., S. C. (2001). Meditation as Medicine. New York: Fireside.
Lane Rd, R. L. (2014). Memory reconsolidation, emotional arousal and the process of change in psychotherapy: new insights from brain science. Behavioural Brain Science, 15:1-80.
Micic D, E. H. (2010). Why do we move our eyes while trying to remember? The relationship between non-visual gaze patterns and memory. Brain Cogn, 74: 210-24.
Squire LR. (2009). Encyclopedia of Neuroscience (Vol 1). Academic Press.