How to Practise When You Can’t Practise (On Focal Dystonia – final)

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Re-learning and Recovery

(*My apologies for not writing sooner, it has been a very busy time at Uni with many assessments due recently!)

There are some words which (bad) writers of popular science like to throw around in order to sound impressive. Quantum is perhaps among the most frequently abused terms, for instance. Another would be statistically speaking. (Did you really analyse the sample distributions, and compute the variance and correlation coefficients? Didn’t think so). Another buzzword, and the one pertinent to our discussion here, is neuroplasticity. Fortunately, unlike quantum field theory and statistics, we don’t have to pretend to understand neuroplasticity, since there are many cases where it is clearly visible, and I believe its core concepts are readily grasped by the general public. In addition, popular science titles like The Brain That Changes Itself by the neuroscientist Norman Doidge certainly increase public awareness and understanding of this issue. We can observe directly that the brain is capable of remarkable change and adaptation.  One of the most dramatic and convincing examples of this is the phenomenon of “phantom limbs” — the ability to feel pain or itching or other sensations in missing limbs. If you are interested, I will save you from googling for unreliable sources, and link this journal article by Ramachandran & Ramachandran (2000). The important and (at the time) revolutionary idea is that the brain is not a static organ. The brain map can be reorganised — new neural networks can be created, and the physical topography of the brain is susceptible to change. This is reassuring for those with dystonia. It means that there is a possibility of “unlearning” the dystonic movements, and creating new neural pathways to replace the old, misbehaving ones. Many dystonia researchers now recognise re-training as a viable treatment option, and from a musician’s point of view, I believe it is also the most useful and least harmful. Medical treatments can work very well for some individuals — and depending on the severity of the symptoms, may even be essential — but the prospect of taking botox injections several times a year, for example, is not exactly pretty. However, re-training requires considerable time investment and dedication… then again, isn’t this exactly like learning a musical instrument!

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On Focal Dystonia (3b)

<— back to part 3a

Psychological Aspects of FD

Many recent studies on musician’s dystonia now acknowledge the role of psychological and emotional factors contributing to the emergence or persistence of the disorder. In the previous section, I have already alluded to one of these psychological pressures: the need or expectation for perfection in classical music training. Indeed, this point has been emphasised many times across many research papers, including several by Altenmüller and his colleagues. For example, Altenmüller & Jabusch (2009) is a noteworthy paper, as it compares psychological profiles (“personality structures” is one of the terms used in the paper) of patients with FD and those without. Interestingly, a group of patients suffering from chronic pain was also examined, with the aim of “detect[ing] unspecific secondary psychological reactions in diseased musicians.” I object slightly to the use of the term “diseased”, but you get the idea!

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