Psychology
2012. Vol.3, No.12A, 1110-1115
Published Online December 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.312A164
Copyright © 2012 SciRes.
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Neuroplasticity and Positive Psychology in Clinical Practice:
A Review for Combined Benefits
Joyce Shaffer
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
Email: JShaff@UW.edu
Received September 30th, 2012; revised November 6th, 2012; accepted November 29th, 2012
Research on using positive psychological perspectives to drive brain plasticity in a positive direction is
increasingly encouraging and empowering for clinicians and clients. Increased lifespan with neuroplastic
gains was found by Diamond in lab rats when they were held and spoken to. Improvements in brain
chemistry, architecture and performance associated with lifestyle choices are now being documented in
humans with increasing frequency of reports. Positive psychology can strengthen this trend toward in-
creases in wellbeing by using this evolving research for motivation to increase healthy lifestyle choices,
for reinforcement of successive approximation toward these goals and for the many gains associated with
greater happiness.
Keywords: Neuroplasticity; Brain Plasticity; Neurogenesis; Aging; Cognitive; Cognition; Computerized
Cognitive Training
Introduction
We need not rest “on the cusp of a revolution, which is set to
transform the diagnosis and treatment of mental illness and
reverse the lack of major progress made in curbing associated
ill health and death over the past 100 years” which was des-
cribed by our director of NIMH, Thomas Insel. The British
Medical Journal (White, 2011) reports that he told the Royal
Society in London on 31 August, 2011: “We are at an extraor-
dinary moment when the entire scientific foundation for mental
health is shifting, with the 20th century discipline of psychiatry
becoming the 21st century discipline of clinical neuroscience.”
He recommended brain-plasticity based pre-emptive strategies
that “could include the development of a credible risk score
coupled with some, or all of, cognitive training, psychosocial
approaches, education, and the use of specially designed video
and computer games”. This recommendation finds more than
adequate support in the growing body of research in the fields
of neuroplasticity and positive psychology.
Neuroplasticity can be defined as the natural tendency of the
brain architecture to shift in negative or positive directions in
response to intrinsic and extrinsic influences. Positive psy-
chology strives to achieve “a scientific understanding and ef-
fective interventions to build thriving individuals, families, and
communities” (Seligman & Csikszentmihalyi, 2000). Indeed,
positive psychology “may covertly be a central component of
good psychotherapy as it is done now” (Duckworth, Steen, &
Seligman, 2005). The purpose of the paper is to review recent
research on neuroplasticity with consideration for the several
ways that positive psychologists can facilitate driving brain
plasticity in a positive direction at any age.
The goal of this review is to add dignity to aging, empha-
size science-based ways to enrich heredity, maximize human
potential, and enjoy playing a role in evolving human intel-
ligence. Massive gains in human intelligence that have been
found across time are referred to as the Flynn Effect (Flynn,
1984, 1987). These findings coupled with recent neuroscience
clearly showing the potential for improving brain plasticity
(Goh & Park, 2009) can give humans unprecedented hope for
our future. And neuroplasticity has fleshed out what some of
these chemical, anatomical and performance gains could in-
clude.
Search efforts for this review were primarily focused within
the PubMed database and included animal as well as human
studies. Articles accepted for review met rigorous scientific
standards, almost exclusively were random controlled trials,
and were included without a specified time span. Also, bibliog-
raphies of these articles and related reviews were searched.
Periodic searches of this nature were conducted between 2005
and 2012 using names of prominent researchers in the field as
well as combinations of keywords listed above.
Neuroplasticity and Synaptogenesis:
Enhancements on a Cellular Basis
The discussion of neuroplasticity necessarily begins with the
work of Marian Diamond. Clinicians and consumers can bene-
fit from reading her books, Enriching Heredity as well as Magic
Trees of the Mind.
Showing the role of environmental enrichment in driving
brain plasticity in a positive direction was one of her seminal
contributions (Diamond et al., 1971; Malkasian & Diamond,
1971; Uylings et al., 1978). When twelve rats were housed in
one large cage and given many objects to play with, their brains
were remarkably different from the control group in which each
rat was alone in a simple regular cage. After eighty days in their
environment, the enriched rats as compared to the controls
showed such advantages as a 6% thicker cerebral cortex as well
as dendrites that were longer with more complex branching,
spines and synapses. These plastic changes have been associ-
ated with enhanced intelligence through executive functions
that are faster and more accurate. And offspring of mammals
J. SHAFFER
afforded enriched environments while in utero had larger brains
than their mothers. She also found more glial cells (previously
thought to be primarily supportive) per neuron in the brain of
Einstein (Diamond et al., 1985).
Diamond’s initial assertion that these advantages could be
appreciated even in the elderly was refuted by a claim that her
600-day-old rats didn’t qualify as elderly. In an effort in her lab
to keep rats alive longer, the rats were held and talked to daily
(Diamond et al., 1984). This positive psychological approach
resulted in the rats surviving 904 days, a 50% increase in lon-
gevity. Diamond calculated that this “was equivalent to a
90-year-old person” and the positive impact on neuroplasticity
was still found. Diamond emphasized that stimulation im-
proved brain anatomy of her animals throughout the lifespan
from prenatal to the very elderly. She believed these same
changes could be appreciated at any age by humans as well.
This positive psychological approach yielded so much neuro-
plastic purchase in rats that it can afford a scientific basis for
the positive psychology perspective to counter the myth of “the
normal decline of aging” with optimism about the potential of
aging brain cells and encouragement of continuous active stim-
ulation.
Her research also found importance of stimulating expression
of emotions to engage connections between the cerebral cortex
and the limbic system including activating the amygdala, hy-
pothalamus and hippocampus. She stated that “emotional well-
being may be more essential for survival than intellectual”.
Diamond’s research shows that inheritance does not control
our destiny. Others concur. Genetics road maps do not rule the
road ahead (Kopinsky et al., 2002).
Active participation is essential to observe changes in the
brain. Animals in a separate cage observing the active play of
animals in an enriched environment did not show similar brain
changes. Thus, these findings can influence the work of posi-
tive psychology to emphasize positive emotions and interac-
tions with an enriched environment for everyone “at any age.”
Since enrichment for as little as four days was associated
with these brain changes, subsequent research focused on
changes in the DNA to store new memories when stimulation
was frequent and active. Thus neuroplasticity can be described
on a behavioral, systemic, cellular or molecular basis. We have
the option of active participation to enrich heredity with asso-
ciated improvements in learning and performance. Positive
psychology can emphasize positive emotions and interactions
with an enriched environment for everyone “at any age” be-
cause this response of the nervous system occurs with stimula-
tion that is extrinsic and intrinsic to support learning and as
related to therapy.
Perhaps the world expert on intrinsic neuroplastic impact of
positive emotions is Richard Davidson, one of the world’s
leading neuroscientists.
Impressed by how easily thinking can move a human from
healthy to the depth of depression or the flight of terror, he led
some of the early research on emotional and brain changes
associated with meditation. In collaboration with His Holiness
the Dalai Lama, he studied brain function in Buddhist monks
that had trained in meditation for varying periods of time. The
monks’ brains functioned differently when meditating and dif-
ferently than brains of naïve meditators. With long-term medi-
tation, “tens of thousands of hours,” anatomical and functional
brain plasticity was noted.
The left prefrontal cortex is the brain part that regulates posi-
tive emotions such as happiness. It showed the greatest change
with deep meditation and the greatest increase in volume in
monks with extended experience (Davidson et al., 2003; David-
son & Lutz, 2008).
Advances in technology afford greater diversity of brain
measures (Eyler et al., 2011). For example, tools such as the
MRI have made it possible to observe increased white matter
connecting the prefrontal cortex to the amygdala in highly re-
silient individuals (Kim & Whalen, 2009). The connections
between the hippocampus and other brain structures suggest
avenues used for memory storage and retrieval (Ranganath,
2010). Understanding how humans use stronger signals of de-
sired focus and inhibition of distracting variables to focus atten-
tion (Lutz et al., 2008) can assist in coping with increasing in-
formation overload. The practice of certain forms of meditation
can strengthen abiding attention and selective attention (Slagter
et al., 2009; Lutz et al., 2008). Magnetoencephalography showed
altered brain patterns associated with focused attention after
just eight weeks of mindfulness-based stress reduction (Kerr et
al., 2001).
Well-being therapy (Fava & Tomba, 2009) has enhanced
various aspects of well-being such as “autonomy, environ-
mental mastery, positive interpersonal relationships, personal
growth, purpose in life, and self-acceptance”. Davidson (2012)
considers it “a good bet that well-being therapy strengthens the
prefrontal cortex and its connections with the ventral striatum.”
The anterior cingulate cortex is the part of the brain associ-
ated with resolving conflict as well as exercising control of
cognition and emotion. In research led by Posner (Tang et al.,
2012) neural activity of this part of the brain changed and “im-
proved connectivity” with other regions of the brain. The type
of therapy used in this study was “integrative body-mind train-
ing”. Their results found white brain matter changes associated
with improvements in self-regulation after four weeks of this
training. They believe this greater efficiency of white brain
matter might indicate that this intervention could be beneficial
for treating or preventing several problems that require self-
regulation “including addiction and mental disorders such as
attention-deficit hyperactivity disorder, anxiety, depression,
schizophrenia, and borderline personality disorder”. They posit
that the changes in emotional status and autonomic nervous
system related to this therapy might be related to the improved
white matter efficiency. Thus, short-term meditation can be
beneficial for white brain matter neuroplasticity and be benefi-
cial for prevention and treatment of mental disorders that in-
clude a component of difficulty with self-regulation.
Clinicians continue to teach a specialized form of mental
training with cognitive behavioral techniques (CBT) from a
variety of perspectives (Ellis, 1987, 2005; Ellis & Harper, 1975;
Beck, 2006; Burns, 1992, 1999). CBT-related changes in
thought patterns have been associated with less activity in the
brain’s frontal cortex, increased limbic system activity, and
much lower relapse rates of major depression than with medi-
cations (Goldapple et al., 2004).
That’s particularly important since research has shown that
positive emotions are associated with health (Danner et al.,
2001; Ostir et al., 2000, 2001; Chida & Steptoe, 2008). Selig-
man, Rashid & Parks (2006) found symptomatic improvement
in unipolar depression using positive psychotherapy. Use of the
internet for a random controlled trial has provided empirical
validation of some positive psychology techniques that can in-
crease happiness and decrease depression for as long as six
Copyright © 2012 SciRes. 1111
J. SHAFFER
months (Seligman et al., 2005). Thus, CBT and other positive
psychological interventions are especially significant because
the potential damage of the chemistry of depression and stress
might be avoided by psychotherapy which has been of similar
effect but greater duration than pharmacotherapy (Antonuccio
et al., 1999). Duration of depression has been found to be more
powerful than age in predicting volume loss in the human hip-
pocampus (Sheline et al., 1999).
In a review of studies of neuroplasticity, Cramer (2011)
noted that attention, motivation and activity are essential to
plasticity. Techniques found to be associated with positive
neuroplasticity included antidepressant medications, stress re-
duction, social influences, task-specific training, modifying
“cognitive representations and behavioural responses to dis-
tressing stimuli”, computerized cognitive training that is in-
tensely focused on auditory and verbal processing, and target-
ing a specific brain system. Rabipour & Raz (2012) provide a
review of some cognitive training programs.
Intensive training during adolescence or young adulthood
“re-normalized” enduring deficits in auditory cortex processing
that had been induced in infant rats (Zhou & Merzenich, 2009).
Merzenich and colleagues (Mahncke et al., 2006) believe that
declines in adult human functioning can be reversed, stopped,
or reduced. They developed a “brain-plasticity-based training
program”.
Using this computer-based program that includes positive
reinforcement of speed and accuracy (Mahncke et al., 2006a),
they conducted a random controlled trial. Eight to ten weeks of
training resulted in significant improvement in memory that
generalized to other tasks. Some of these gains in verbal mem-
ory were still apparent after three months without further train-
ing with 182 participants from ages sixty to eighty-seven.
A subsequent trial (Smith et al., 2009) found memory, speed
and accuracy gains that generalized to tests on which they re-
ceived no training. Speed of processing improved from 118
down to 51 milliseconds in this program with individuals be-
tween the age of sixty-five and ninety-three.
Their later study (Berry et al., 2010) used visual discrimina-
tion with healthy individuals between the ages of sixty and
eighty-nine. After ten one-hour sessions using computer soft-
ware, improvements in working memory for untrained tasks
were significant.
Software with similar features as described by Smith (2009)
also found benefits of clinical significance (Jobe et al., 2001).
The Advanced Cognitive Training for Independent and Vital
Elderly (ACTIVE) study (Ball et al., 2002) focused on 2853
participants in diverse settings. This and multiple subsequent
studies have found benefits in a variety of realms such as in-
creased useful field of view (Edwards et al., 2006), driving
(Roenker et al., 2003; Ball et al., 2006) and health related qual-
ity of life as well as depression (Wolinsky et al., 2006).
Cognitive improvements associated with increased focal
brain volume have also been found in women “with amnestic
mild cognitive impairment” (Baker et al., 2010). Participants
between the ages of fifty-five and eighty-five that maintained
45 to 60 minutes of aerobic activities four times a week for six
months appreciated improved “executive control processes.
Numerous other studies have also found brain volume changes
associated with cognitive gains after aerobic exercise (Erickson
et al., 2009, 2010, 2011; Heo et al., 2009; Flicker et al., 2010;
Prakash et al., 2011).
One research study found good results using this combina-
tion brilliantly in a concept they call “exergaming” (Anderson-
Hanley et al., 2012). This random controlled clinical trial stud-
ied the impact of three months of traditional exercise versus
stationary cycling with virtual reality tours (“cybercycle”) on
executive function in 102 older adults with mild cognitive im-
pairment. Since the cybercyclists showed greater cognitive
improvement, the researchers suggest that “simultaneous cogni-
tive and physical exercise has greater potential for preventing
cognitive decline”. It would have added interest if assessments
of brain changes were also reported.
Neurogenesis: A Special Form of Neuroplasticity
Proof of neurogenesis in humans (Eriksson et al., 1998) at
any age marked a milestone in brain plasticity (Gage, 2002).
Gage and colleagues (Pereira et al., 2007) found evidence of
increased neurogenesis in eleven human beings that were below
average in aerobic fitness prior to the study. Participants were
aerobic four times a week for twelve weeks. The increase in
neurogenesis was noted in the part of the hippocampus that is
associated with learning and memory as well as age-related
cognitive decline. Participants showed improved performance
on the Rey Auditory Verbal Learning Test that was correlated
with improvements in VO2Max, the gold standard measure of
aerobic fitness.
Making maximum purchase of neuroplasticity is “one prom-
ising avenue to reach the goal of successful aging” (Jessberger
& Gage, 2008). Since “approximately 30% - 40%” of new
neurons survive to integrate, simply increasing the birth rate
may under-realize this neuroplastic potential. While aerobic
exercise increases the number of new neurons in humans and
other animals, survival and stable integration is dependent on
other factors (Snyder et al., 2009).
Gage and colleagues (Kempermann et al., 2002) corroborated
plasticity in elderly rats. Rats from the age of ten to twenty
months were already middle-aged at the beginning of the study
and elderly by its completion. Enrichment included complex
inanimate as well as social stimulation. Rats in an enriched
environment increased sustained neurogenesis fivefold in com-
parison to the control group that was housed in standard cages.
Even more encouraging, this “neuroplasticity in old age” was
associated with “significant improvements of learning parame-
ters, exploratory behavior, and locomotor activity.” For exam-
ple, their spatial memory improved. Perhaps best of all, reduced
amounts of lipofuscin in their hippocampal neurons indicated
“decreased nonspecific age-dependent degeneration” of their
brain cells! In essence, their activity demonstrated not just im-
mediate “but also a sustained effect on brain plasticity”.
Taken together, we have a human model for increasing neu-
rogenesis with aerobic activity (Pereira et al., 2007). Rats give
us an animal model for sustained neurogenesis that increased
fivefold with complex stimulation that is both social and in-
animate. These and other studies provide additional encour-
agement for positive lifestyle choices by also showing cognitive
gains with this plastic response (Audiffren et al., 2008). And
the rat study can add the motivation of “decreased nonspecific
age-dependent degeneration” as measured by less accumulation
of lipofuscin in hippocampal neurons.
Sleep deprivation and untreated depression in animals
(Guzman-Marin et al., 2006) have been shown to decrease neu-
rogenesis. However, depressed people can experience an ele-
vated mood for at least one day after missing one night of sleep.
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J. SHAFFER
Antidepressants restored neurogenesis in lab animals. To study
this interesting complex of data further, rats were kept awake
while being handled gently during the twelve hours they would
normally sleep (Zucconi et al., 2006). In comparison to the con-
trol group of rats that were permitted to sleep, rats with gentle
handling in one night of sleep deprivation had significantly
increased neurogenesis in the hippocampus as well as increased
survival of these new neurons fifteen and even thirty days after
their sleepless night. No differences were noted in their sub-
ventricular zone of the lateral ventricles, the other identified site
of neurogenesis in mammalian brains.
The immune response can have a negative or positive influ-
ence on neurogenesis (Kohman & Rhodes, 2012; Sartori et al.,
2012). While inflammation, an immune response, can reduce
neuron birth, survival, function and integration, in a healthy
brain it can enhance these stages of neurogenesis by being a
brief healing response to infection or cerebral insult. However,
inflammation has been found to increase with age. Neuroin-
flammation and impaired learning memory were found in ro-
dents when their sleep was disturbed (Zhu et al., 2012). Since
chronic inflammation is a risk factor for dementia, monitoring
for it could assist in maintaining brain health (Rosano et al.,
2012).
Discussion
In keeping with the recommendations of Thomas Insel, these
and other studies can be used in clinical practice to educate,
motivate and reinforce consumers in efforts to “build thriving
individuals, families and communities” as is the goal of posi-
tive psychology (Seligman & Csikszentmihalyi, 2000). Adding
new brain cells by virtue of one’s own lifestyle choices could
be a more powerful incentive than we often have to offer.
That’s especially true when these findings have been associated
with improved cognition in animals and in humans; with con-
tinued neuroplastic as well as cognitive gains across the lifeline
of rats that lived fifty percent longer in enrichment; and with
fivefold increase in neurogenesis associated with significant
cognitive gains in rats afforded enriched environments.
A review and meta-analysis (Colcombe & Kramer, 2003) of
eighteen intervention studies found robust but selective cogni-
tive benefits with fitness training. Of these fitness-induced
gains, “executive-control processes” showed the largest bene-
fits. Included in this are planning, inhibition and scheduling of
mental procedures. Their answer to the question of whether
“aerobic fitness training can have a robust and beneficial influ-
ence on cognition of sedentary older adults” was “an un-
equivocal yes”. Individuals who had maintained a high level of
fitness across time showed better performance than older indi-
viduals that had a low level of fitness. A later review supports
this (Angevaren et al., 2008). However, very few people main-
tain even this minimum amount of aerobic activity. This is also
important since chronic inflammation is a risk factor for de-
mentia and aerobic exercise can help reduce inflammation.
Thus, it bears repeating that this might be an ideal place for the
application of positive psychological techniques to increase
frequency of this lifestyle choice.
Sleep is another critical brain variable. It can be improved by
cognitive behavioral techniques (Gregg et al., 2004), can en-
hance inspired insight (Wagner, 2004) and is necessary for
memory consolidation (Stickgold, 2005).
When they learn that lifestyle choices can enhance their brain
function as well as prolong their life, many people are more
inclined to do at least some of those things that can make the
combined purchase. Thus, this education coupled with strategic
positive psychological practices including reinforcement, cele-
bration and increasing happiness could address the essential
goal of changing the field of mental health in ways that can
reduce the related healthcare burden (Lojovich, 2010).
It is significant that exercise and some forms of cognitive
training target the brain sites considered most vulnerable to the
so-called “normal decline of aging”. Since these types of inter-
vention have shown gains in the chemistry, architecture and
performance of human and other animal brains, the call of
Thomas Insel to facilitate the profound shift in how we promote
enhancing mental health is timely, perhaps even urgent with the
global trend of humans living longer.
Advantages of computer based programs include the greater
accuracy and efficiency of positive reinforcements for succes-
sive approximations than could ever be applied by even the best
and brightest humans. Use of software programs that were de-
signed to be sensitive to level of functioning and to reinforce
memory, speed and accuracy have resulted in enduring cogni-
tive gains. This fits well with the positive psychology finding
(Abuhamden & Csikszentmihalyi, 2012) that challenges that are
neither too difficult nor too easy enhance enjoyment, particu-
larly when the competition between relatively balanced oppo-
nents in an endeavor lend an element of suspense about out-
come.
In positive psychotherapy we also need to include biblio-
therapy. In addition to books mentioned above, Davidson’s
breakthrough research is delightfully presented in his superb
book (2012) The Emotional Life of Your Brain. This book is an
invaluable source for clinicians and consumers as a primer on
the growing field of affective neuroscience. Begley’s book
(2007), Train Your Mind Change Your Brain, can also help
educate on neuroplasticity. To be entertained plus educated,
Why Zebras Dont Get Ulcers by Sapolsky can increase moti-
vation to maximize psychotherapy to master stress. Also valu-
able in positive psychotherapy are: Good Business by Csik-
szentmihalyi; Social Intelligence by Goleman; and Authentic
Happiness by Seligman.
In summary, positive psychologists need to encourage and
empower people to use powerful non-pharmacological inter-
ventions that are associated with positive neuroplasticity. These
include but may not be limited to aerobic exercise; combining
aerobic and cognitive exercises; restorative sleep; adequate
treatment of depression; stress reduction; techniques that pro-
mote enduring happiness; reducing inflammation; social influ-
ences; task specific training; cognitive behavioral techniques;
meditation; and computerized cognitive training that reinforces
memory and speed, is intensely focused on auditory and verbal
processing and targets a specific brain system. As positive psy-
chologists we need to motivate, educate and empower our peo-
ple to drive neuroplasticity in a positive direction. Using evi-
dence-based efforts we can help strengthen trends toward in-
creases in wellbeing.
We are privileged that we are able to appreciate the gains
reported in human intelligence across the centuries. And we’re
gifted to see the human lifespan extend beyond what might
have been anticipated. Still, the increase in the aged with the
ages has included a raft of lifestyle illnesses that could take us
down like a house of cards. As positive psychologists, we need
to use the encouraging and empowering evolving affective
Copyright © 2012 SciRes. 1113
J. SHAFFER
neuroscience to reinforce awareness, efforts and successive
approximations in healthy lifestyle choices so that we are in-
formed participants that facilitate the growth of human intelli-
gence along with vigorous longevity. Let us unite in the mar-
riage of neuroplastic potential and positive psychology to
maximize human potential at any age with dignity, health and
joie de vivre for everyone in ways that can simultaneously im-
prove our collective economic welfare.
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