European Parkinson Therapy Podcast: Parkinson Podcast network

ENGLISH Newly diagnosed, teaching the teachers

Colin Alexander Reed Season 5 Episode 15

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 19:55

We are about to launch a therapy program for newly diagnosed. This podcast outlines the course and shows how we are training our presenters.

Stiamo per lanciare un programma di terapia per chi ha ricevuto una diagnosi recente. Questo podcast illustra il corso e mostra come stiamo formando i nostri relatori.

SPEAKER_01

Imagine standing in front of a room of, you know, just terrified people who have just been diagnosed with Parkinson's, looking them right in the eye and telling them they can reduce their symptoms by up to 60%.

SPEAKER_00

Right.

SPEAKER_01

And doing that without them taking a single new pill.

SPEAKER_00

Yeah, that is a huge claim.

SPEAKER_01

Welcome to the deep dive. And you know, we are talking to you directly today because you have a really profound responsibility. You are preparing to present the first steps program.

SPEAKER_00

Which uh is also known in some regions as VitaFelice, just to clarify.

SPEAKER_01

Exactly, Vita Felice. It's this really intensive curriculum originally created by the European Parkinson Therapy Center over in Italy, and it's built entirely on their groundbreaking regen protocol.

SPEAKER_00

Right. The regen protocol, which is all about um regenerative neurological rehabilitation.

SPEAKER_01

Yeah. So our mission today is to give you, the presenter, the comprehensive chronological guide on exactly how to deliver this material to your class.

SPEAKER_00

Aaron Powell Because it's a big commitment, right? It's an 11-hour journey spread over four days.

SPEAKER_01

Yeah, four days.

SPEAKER_00

And the overarching goal you have as the presenter is to facilitate this massive psychological and frankly biological shift.

SPEAKER_01

Aaron Powell, which is no small feat.

SPEAKER_00

Aaron Powell No, not at all. You're taking individuals who are currently paralyzed by the shock of what feels like an atomic bomb diagnosis. Trevor Burrus, Jr.

SPEAKER_01

Right. Their whole world just blew up.

SPEAKER_00

Exactly. Right. And you are transitioning them into active, empowered protagonists of their own lives.

SPEAKER_01

Aaron Powell Okay, let's unpack this. Because before you even get to day one, you know, before you hand out a schedule or introduce yourself to the room, there's a core philosophy you just have to completely master. Trevor Burrus, Jr.

SPEAKER_00

Oh, absolutely. The foundational mindset.

SPEAKER_01

Yeah. If you don't get this right, nothing else in those 11 hours will stick. I mean, you have to understand the fundamental paradigm shift from the machine to the garden.

SPEAKER_00

Aaron Powell Right. So for decades, the medical community, and by extension, basically everyone, viewed the human brain as a machine.

SPEAKER_01

Like a literal machine.

SPEAKER_00

Yeah. Like if you picture a really complex Victorian steam engine or um a delicate pocket watch, you kind of understand the classic view of Parkinson's.

SPEAKER_01

Hardware, basically.

SPEAKER_00

Aaron Powell Exactly. It's hardware. Over time, it slows down. A specific gear, which in this case represents the dopamine-producing neural circuits, it just breaks.

SPEAKER_01

Aaron Powell And you can't fix a broken gear naturally.

SPEAKER_00

Right. Because it's a machine, it cannot naturally repair itself. It just, you know, grinds down until one day it simply stops.

SPEAKER_01

Aaron Powell So if I'm a patient in that model, my role is just completely passive.

SPEAKER_00

Rolly passive.

SPEAKER_01

I'm just the owner of a broken machine sitting in a waiting room, hoping a mechanic like a doctor can put some synthetic oil in it.

SPEAKER_00

Give you some pills. Yeah.

SPEAKER_01

Give me some pills and hopefully delay the inevitable.

SPEAKER_00

And that view breeds total despair. I mean total despair. But the modern view, which is heavily backed by neuroscience, throws that outdated model completely out the window.

SPEAKER_01

Thank goodness.

SPEAKER_00

Right. So you have to teach your class that the brain is not a machine, it is a garden.

SPEAKER_01

A garden. I love that imagery. Trevor Burrus, Jr.

SPEAKER_00

It's powerful. It's a living dynamic ecosystem that is constantly growing and adapting. I mean, we typically only use about 10% of our brain's capacity, right?

SPEAKER_01

Wait, really? Only 10%.

SPEAKER_00

Roughly, yeah. The point is there is vast untapped potential in the soil of the mind.

SPEAKER_01

So if we use this analogy in the course, we can tell participants that if a tree falls and blocks a path in a forest.

SPEAKER_00

The forest doesn't die.

SPEAKER_01

Right. The forest doesn't die. You don't stand there trying to glue the dead tree back together.

SPEAKER_00

You'd look ridiculous trying to do that.

SPEAKER_01

You forge a new path around it, you trample down the undergrowth, and you make a new way.

SPEAKER_00

And that analogy perfectly encapsulates the actual science of neuroplasticity. The fallen tree represents the neural circuits damaged by Parkinson's. Okay, got it. But the brain has this remarkable biological ability to reorganize itself. It can physically form entirely new neural connections to bypass the damage.

SPEAKER_01

So we can forge new pathways for voice, balance, posture.

SPEAKER_00

All of it. But, and this is crucial for the presenter to convey a garden doesn't tend itself. It requires an active, sweating gardener.

SPEAKER_01

Which brings us directly to day one. You're standing in front of them, and before you can plant this beautiful new garden, you gotta pull up the weeds of misinformation.

SPEAKER_00

There are so many weeds.

SPEAKER_01

So many. But as a presenter, what do you do if a patient in the room is highly resistant on day one? Like what if they're weeping or angry and they just refuse to engage with this whole garden metaphor?

SPEAKER_00

Well, you start by acknowledging the room. You have to validate their grief, fear, anxiety, depression. These are completely normal responses to hearing the words you have Parkinson's.

SPEAKER_01

It's a trauma.

SPEAKER_00

It is. And if you try to skip over the emotional trauma and just, you know, feed them facts, their brains literally will not process the information.

SPEAKER_01

Because of the stress.

SPEAKER_00

Exactly. High stress means high cortisol, and cortisol actively blocks learning and memory formation.

SPEAKER_01

Oh wow. It biologically blocks it.

SPEAKER_00

Yeah. So you have to let them know that their terror is valid, which chemically lowers their threat response, and that prepares their minds to actually hear you.

SPEAKER_01

That makes a lot of sense. You have to lower the shield before you can offer the sword.

SPEAKER_00

I like that.

SPEAKER_01

Yes. They walk in believing they've been handed a rapid death sentence. So your job on day one is to deliver the real truth, which is that Parkinson's is actually a slow developing condition.

SPEAKER_00

Very slow, yeah.

SPEAKER_01

And then you hit them with that staggering fact we started with. You tell them they can reduce their symptoms by up to 60%.

SPEAKER_00

Improve their medication absorption.

SPEAKER_01

Increase their mobility. And all without any new medicines yet.

SPEAKER_00

That is where the light returns to their eyes. It really is. But um you can't just throw out a statistic. You must provide the research foundation.

SPEAKER_01

You gotta back it up.

SPEAKER_00

Right. You explain neuroprotection. You teach them that high-intensity activity acts as a literal biological shield.

SPEAKER_01

How does that work?

SPEAKER_00

It alters the brain's environment to defend the remaining healthy neurons from degeneration. It actually alters the overall trajectory of the disease.

SPEAKER_01

That's incredible. You also introduced the use it or lose it principle here, right?

SPEAKER_00

Yes, absolutely.

SPEAKER_01

I know programs like LSVTLow UD are often cited here, but I want to make sure I really understand the mechanism. I know Parkinson's affects movement, but how exactly does it affect someone's voice volume?

SPEAKER_00

Okay, so it's a sensory scaling glitch. Parkinson's basically alters the brain's internal perception of volume.

SPEAKER_01

Like the internal dial gets messed up.

SPEAKER_00

Exactly. A person with Parkinson's genuinely thinks they are shouting, but they're actually whispering. Their sensory feedback loop is providing false data.

SPEAKER_01

Oh man, that must be so frustrating.

SPEAKER_00

It is. But the LSVT L I U D program proves that through intense repetitive vocal exercises, you can physically rewire the brain to recalibrate that scaling.

SPEAKER_01

So you force it back to normal.

SPEAKER_00

You force the brain to recognize the new louder volume as normal. It's structural, measurable neuroplasticity in action.

SPEAKER_01

So you spend day one just blowing their minds with the science of their own potential.

SPEAKER_00

Setting the stage.

SPEAKER_01

Right. And you end that first day not with another lecture, but with a testimony from a peer or a team member, someone who has been where they are and has fought back.

SPEAKER_00

And what's fascinating here is the biology of why peer testimony works so much better than a clinical lecture.

SPEAKER_01

Wait, there's a biological reason for that too.

SPEAKER_00

Oh yeah. You could have the world's leading neurologist explain the science, but seeing a peer succeed triggers a psychological construct identified by Albert Bandura called self-efficacy.

SPEAKER_01

Self-efficacy, that's like believing you can actually do it.

SPEAKER_00

It's the deeply held belief in your own capability, yeah. And research consistently shows that self-efficacy, not the clinical severity of the disease, is the number one predictor of success in physical therapy.

SPEAKER_01

The number one predictor, wow.

SPEAKER_00

When they see a peer succeeding, their brain reassesses the threat level of the disease. That realization literally reduces the fight or flight response.

SPEAKER_01

Which means less cortisol.

SPEAKER_00

Less cortisol. And it tangibly lowers muscle rigidity right there in the room.

SPEAKER_01

Lowering rigidity through a change in perspective. That is incredible.

SPEAKER_00

It's the mind-body connection in real time.

SPEAKER_01

So day one validates the grief, lowers the cortisol, dispels the myths, and gives them agency. They are primed.

SPEAKER_00

Fully primed.

SPEAKER_01

So day two is where you hand them the actual tools. Yeah. You introduce the regen protocol's four pillars approach.

SPEAKER_00

Right. The four pillars are the structural foundation. You have to explain that if a house has only one wall, it collapses. You teach them that all four are mandatory.

SPEAKER_01

Okay, let's go through them.

SPEAKER_00

Pillar one is medicine. This is the fuel. It's essential for easing symptoms so that movement is possible. But you must be very clear that a neurologist cannot prescribe happiness.

SPEAKER_01

Right. Pills don't give you a good life, just the ability to move.

SPEAKER_00

Exactly. Medicine is the baseline, not the cure.

SPEAKER_01

Got it. Pillar two is physical movement, which we need to dive into heavily in a second because that's the real rewiring process. But pillar three is lifestyle.

SPEAKER_00

The soil of the garden.

SPEAKER_01

Yeah, the soil. You talk to them about the Mediterranean or mind diet and the critical importance of gut health.

SPEAKER_00

And we should pause on lifestyle for a second, actually. Presenters must emphasize strict sleep hygiene here.

SPEAKER_01

Sleep is that important.

SPEAKER_00

Crucial. Sleep is when the brain flushes out metabolic waste. If they aren't sleeping, they're building up the acid rain of cortisol in their system.

SPEAKER_01

Which blocks the learning again.

SPEAKER_00

Exactly. It chemically blocks the formation of those new neural pathways they're working so hard to build.

SPEAKER_01

Yeah, everything connects back to cortisol. Okay, pillar four is psychology, the mindset, rejecting the victim identity.

SPEAKER_00

Huge part of it.

SPEAKER_01

We know from the Parkinson's Outcomes project that mood and depression actually impact a patient's health status more than their physical motor symptoms do.

SPEAKER_00

Yes. It's staggering but true. But let's go back to pillar two, physical movement, because a massive part of day two's curriculum is explaining the difference between standard exercise and neurological physiotherapy.

SPEAKER_01

Also called neurotherapy, right.

SPEAKER_00

Right, neurotherapy.

SPEAKER_01

Because I can imagine a patient sitting there saying, I already walk on a treadmill for 30 minutes a day, so I'm good. Wait, if getting your heart rate up on a treadmill is good for your body, why isn't that enough to trigger the brain rewiring? What's the biological difference?

SPEAKER_00

Okay, so standard physical therapy or just a casual treadmill walk isn't enough because their body's hardware, like the muscles themselves are generally fine.

SPEAKER_01

No, the muscles aren't the problem.

SPEAKER_00

No, the problem is the software. Specifically, a region deep in the brain called the basal ganglia.

SPEAKER_01

The basal ganglia.

SPEAKER_00

Yeah. It acts as our autopilot for automated movements, like walking or swinging our arms. But because Parkinson's depletes the dopamine that the basal ganglia relies on, the autopilot starts glitching.

SPEAKER_01

So if they just mindlessly walk on a treadmill while watching TV.

SPEAKER_00

They are relying on a broken autopilot. It reinforces bad pathways.

SPEAKER_01

Here's where it gets really interesting. As the presenter, you have to look at your class and tell them they must now think before they move.

SPEAKER_00

Yes. Conscious movement.

SPEAKER_01

You're switching them from automatic transmission to manual. I like to use this analogy for the class. It's like sleeping with a broken rib.

SPEAKER_00

Oh, that's a good one.

SPEAKER_01

Yeah. If you usually sleep on your side and suddenly you have a broken rib, you have to sleep on your back. For the first few nights, it takes immense conscious effort. You have to force yourself to stay on your back.

SPEAKER_00

Right. You can't just relax into it.

SPEAKER_01

No. But eventually the brain adapts, the new pathway is formed, and sleeping on your back becomes the new automatic.

SPEAKER_00

And that conscious manual override is the absolute heart of neurotherapy. They must execute movements that feel massively exaggerated. Big movements. Huge. And to truly force that rewiring, you introduce the concept of forced exercise. This stems from Dr. J. Albert's research on cycling.

SPEAKER_01

I've heard of this cycling study, but I don't really know the mechanics of it. How does riding a bike change the brain?

SPEAKER_00

Okay, so Dr. Alberts found that if you put someone with Parkinson's on a stationary bike and let them pedal at their preferred comfortable rate, say 50 to 60 revolutions per minute.

SPEAKER_01

They burn calories, sure.

SPEAKER_00

Yeah, they burn calories, they get cardiovascular benefits, but there is minimal motor improvement. It does not change the brain.

SPEAKER_01

And what changes the brain?

SPEAKER_00

The magic zone. You have to force the cadence up to 80 to 90 RPM. That's about 30% past their comfort zone.

SPEAKER_01

Wait, what happens chemically at 80 to 90 RPM that doesn't happen at 60?

SPEAKER_00

When you push the brain past the false signals of fatigue and slowness generated by that dopamine-deprived basal ganglia, you induce a highly specific biological stress response.

SPEAKER_01

A good kind of stress.

SPEAKER_00

Exactly. That intense forced effort signals the brain to release a protein called BDNF, brain-derived neurotrophic factor.

SPEAKER_01

BDNF.

SPEAKER_00

BDNF is essentially miracle growth for the brain. It's the exact fertilizer required to grow those new neural pathways around the damaged areas.

SPEAKER_01

Wow.

SPEAKER_00

But if you stay in your comfort zone, the miracle grow stays locked away.

SPEAKER_01

You're teaching them to be their own pharmacists, dispensing BDNF through intense conscious effort.

SPEAKER_00

That's exactly what it is.

SPEAKER_01

That is such an empowering message to end day two on. So by the time you get to days three and four, they understand the mechanics, the engine is primed.

SPEAKER_00

Yep, they get the why and the how.

SPEAKER_01

Now the final two days of this program are entirely about sustainability. How do they keep this up for the rest of their lives without burning out? That's where you introduce the ACMA protocol.

SPEAKER_00

Right. ACMA is the psychological roadmap you guide them through. It stands for accept, comprehend, motivate, and action.

SPEAKER_01

And it's a strict sequence, right?

SPEAKER_00

Yes. You cannot jump to action without moving through the first three.

SPEAKER_01

The first step, acceptance, is notoriously the hardest. It's easy for people to confuse acceptance with surrender.

SPEAKER_00

Very common mistake.

SPEAKER_01

I tell presenters to give their class a different visual. Imagine you're the captain of a ship that just hit a reef. Acceptance isn't throwing your hands up and letting the ship sink.

SPEAKER_00

Giving up.

SPEAKER_01

Right. Acceptance is taking a flashlight, going down into the dark hull, and taking a brutal, honest inventory of exactly how much water is coming in. You have to look at the damage clearly so you know exactly which holes to patch.

SPEAKER_00

That is the perfect way to frame it. Yeah. Really. And once they take that inventory, they move to comprehend.

SPEAKER_01

Which is understanding the disease.

SPEAKER_00

Gaining health literacy, yeah. Understanding the mechanics of their condition removes the terror of the unknown.

SPEAKER_01

Aaron Powell Because it's not a mystery monster anymore.

SPEAKER_00

Exactly. Then comes motivate. And this is a critical juncture for the presenter. You must explain that motivation isn't just a warm, fuzzy feeling, it has sheer biological power.

SPEAKER_01

Biological power. Okay, you have my attention.

SPEAKER_00

You introduced the expectancy effects, specifically looking at the nocebo and placebo effects in Parkinson's.

SPEAKER_01

Is there actual science behind hope, like hard biological science that you can show a class?

SPEAKER_00

Absolutely there is. You look at the research from neuroscientists like Sarah Lidstone. Her work proves that conviction physically alters brain chemistry.

SPEAKER_01

Conviction.

SPEAKER_00

Yes. When a patient is entirely convinced that an intervention will work when they truly expect a positive outcome, their brain actually releases endogenous dopamine directly into the striatum.

SPEAKER_01

Wait, hold on. Just the pure belief that a therapy is going to work causes the brain to release the exact chemical they are deficient in.

SPEAKER_00

Yes. The expectation of improvement triggers a chemical event that temporarily improves motor function. That is the biological power of hope.

SPEAKER_01

That is mind-blowing.

SPEAKER_00

But you must warn them that the reverse is equally powerful.

SPEAKER_01

The nocebo effect.

SPEAKER_00

Exactly. If they have negative expectations, it activates the stress response. This spikes their cortisol levels, which actively blocks dopamine receptors and actually facilitates pain transmission.

SPEAKER_01

Negative thinking creates a physical barrier to movement.

SPEAKER_00

It literally does, which leads directly into the greatest danger you must warn them about, the vortex of apathy.

SPEAKER_01

Apathy, yeah, you have to be incredibly direct about this. The vortex of apathy is the number one threat to a person with Parkinson's.

SPEAKER_00

More than any physical symptom.

SPEAKER_01

It's not a motor symptom. It's the profound loss of interest in life. If they give in to the grief, if they go home, sit in a dark room, and stop caring about their hobbies or their families, they eliminate all neuroprotection.

SPEAKER_00

Aaron Powell Without engagement, neuroplasticity shuts down entirely. It just stops. If they aren't challenging the brain, the brain stops trying to bypass the damage. The degeneration speeds up exponentially.

SPEAKER_01

And this is exactly why days three and four involve intense group discussions. And crucially, they must involve the family.

SPEAKER_00

Aaron Powell Well, the family's role is massive.

SPEAKER_01

You must speak directly to the partners and adult children in the room. The family members are not just observers, they are co-therapists.

SPEAKER_00

Co-therapists, I like that term.

SPEAKER_01

They have to provide that continuous positive reinforcement to keep the dopamine loops active.

SPEAKER_00

However, you also have to caution the families about the caregiver trap.

SPEAKER_01

The caregiver trap. Yeah, this is so common.

SPEAKER_00

It is. A well-meaning spouse, acting out of pure love and fear, will suddenly start doing everything for the person with Parkinson's. They button their shirts, they cut their food, they help them out of chairs.

SPEAKER_01

You treat them like a helpless victim.

SPEAKER_00

And by doing that, they strip the person of their identity and their autonomy.

SPEAKER_01

But connecting it back to the science we talked about on day two, if the caregiver removes all the physical struggle, they are removing the trigger for BDNF.

SPEAKER_00

Yes. You nailed it.

SPEAKER_01

Struggle is what releases the miracle grow. The family has to let them struggle. They have to push them to reach that 80 to 90 RPM magic zone in their daily lives, whether that's getting dressed or going for a walk.

SPEAKER_00

The family has to be cheerleaders, not servants. The entire four-day course culminates in a profound recalibration of what the future holds.

SPEAKER_01

Recalibrating.

SPEAKER_00

You're ending the program not by teaching them how to manage a steady decline, but by planning for the years ahead. You ask the room, what are we doing next year? Where are we traveling? What new skills are we learning?

SPEAKER_01

And you teach them to answer with absolute conviction. Because you can.

SPEAKER_00

Because you can. That's it.

SPEAKER_01

That is the note you end on. So what does this all mean for you, the presenter, getting ready to walk into that room?

SPEAKER_00

It means everything.

SPEAKER_01

It means your mission over these 11 hours is nothing short of transformative. You are taking people paralyzed by the shock of a broken machine, and you are handing them the tools to tend a living, growing garden. Right. You are teaching them to dispel the myths, to embrace the rigorous manual control of neurotherapy, to build their lives on the four pillars, and to lean on their families to fight the vortex of apathy. You are giving them their lives back.

SPEAKER_00

It's a remarkable protocol, and mastering it will truly change the lives of the people in your classroom.

SPEAKER_01

It really will.

SPEAKER_00

But you know, it also raises an important question that extends far beyond the walls of the European Parkinson Therapy Center.

SPEAKER_01

Oh, how so?

SPEAKER_00

Well, while this course is meticulously designed to save the quality of life for those facing Parkinson's, the reality is that every single one of us is dealing with a neurodegenerative condition.

SPEAKER_01

Right. What do you mean?

SPEAKER_00

It's called aging.

SPEAKER_01

Oh. Wow. Okay.

SPEAKER_00

Right. If the garden metaphor and the intense conscious application of neuroplasticity can physically rebuild a brain navigating a disease like Parkinson's, we kind of have to ask ourselves a question. How many weeds are we letting grow in our own minds simply because we've gotten comfortable? Because we've stopped forcing ourselves into the magic zone of intense effort and stopped doing the hard work of learning new things.

SPEAKER_01

That is a fascinating thought to leave on because you can always build a better garden.

Podcasts we love

Check out these other fine podcasts recommended by us, not an algorithm.

The Michael J. Fox Foundation Parkinson's Podcast Artwork

The Michael J. Fox Foundation Parkinson's Podcast

The Michael J. Fox Foundation for Parkinson’s Research
The Parkinson’s Research Podcast: New Discoveries in Neuroscience Artwork

The Parkinson’s Research Podcast: New Discoveries in Neuroscience

The Michael J. Fox Foundation for Parkinson’s Research