In some circles, the term implies optimism, and affected individuals inquire eagerly about its meaning.

It does not quite mean “regenerate” as the popular sense of the word implies but instead “the ability to be deformed or have form applied to change it”. So “neuroplasticity”, if one understands the definition, relates more to a strong imposition of change – “forming”, “deforming” than just the ability of tissue to restore itself.

Brain-injured tissue, or brain-injured networks, are not “regenerated” through neuroplasticity but accomplished by other means. Laborious, repetitive actions build the habits and the networks underlying them.

Catherine Malabou writes about brain injury in a book which should be more widely read: The New Wounded. She speaks of “destructive plasticity”, a violent deformation of matter and circumstance, ¬†as effected by traumatic wounds: a shadow definition of the commonly understood sense of plasticity as benign and enabling.

One does grow through “destructive plasticity” but the plastic patterns can be maladaptive, perpetuating themselves through the individual’s life with stubborn consistency. They are, also, bored into the brain’s networks through repetition. They are, also, reflections of the way the brain re-organizes itself in the face of trauma.

Recovery from coma restores to the world re-awakened individuals, who must now return to the sense of embodiment they lapsed away from, who in the severer cases must be coaxed for hours on end each week on walking, talking, thinking anew. The more severe the wound, the more disoriented the awakened. Persistence is the watchword of rehabilitation, the new habit is the “hook” of coming back into life. Through this persistence one sees the individual adapt in amazing ways.

It is “destructive” plasticity as much as “constructive”, though, the hook of habit in brain injury rehabilitation, and identity regrows alongside of it uneasily.

It is the way that all of us progress through life, in the case of brain injury (and other extreme conditions) expanded powerfully. The responsiveness of the brain: our ability to shape ourselves. It is understandable why the idea inspires admiration, but it should never be seen as an easy process.