If you are an OT practicing sensory integration then you know Hebb’s Law.

Hebb’s Law states that “neurons that fire together wire together.” When I first began practicing Sensory Integration (SI) this made so much sense to me; pair the sense that isn’t working with the senses that are. Use the strong senses to carry the weaker senses along. I envisioned little tiny but mighty neurons with their little dendrite arms, reaching out on either side of a weak little striving neuron who couldn’t muster up the energy to keep going so was dragged along or hoisted up by his underarms by the mighty neurons coming in to save him! In a practical sense Hebb’s Law also resonated because it explained why I could get a child with tactile defensiveness to engage with messy play simply by turning it into a seek-n-find, i.e. “Let’s search the beans and rice bin to find the race cars” (translation: let’s use our visual system along with a sense of playfulness to dive our hands into a tactile medium that typically you despise). It also helped me treatment plan for kids who wouldn’t even contemplate sitting on a swing, i.e. “Let’s put the toy on the swing and pretend it’s a bad guy, and you can sit or stand in front of it and knock it off like a super-hero!” (translation: let’s use your visual and proprioceptive systems to challenge you just off your center of gravity and get you comfortable enough with a moving object that you at least want to interact with it which means making baby steps toward the input that you would typically avoid like the plague).

However, as I continued to dive deeper into my work in SI, I began to see another side of Hebb’s Law. It was the side that kept a child stuck in their ways, no matter how many positive sensations or associations I set up. I began to see children remain rigid or increase their rigidity upon presentation of supplies. When it comes to treatment, I realized that “neurons that fire together wire together,” is not ONLY about pairing the strong with the weak, it’s about unpairing systems that have fired together for years.

Default stress responses are the explanation AND the pathway for healing.

Deb Dana, when suggesting we “befriend our own nervous systems” (Dana, 2018), talks about knowing your home base. We all have a default set pattern for dealing with stress and so do our clients. As we work in therapy to build new positive associations between sensory inputs we also have to work to “unpair” or weaken established associations and connections.

We all know the brain circuitry works like a matrix, and sensory inputs are the foundation for the messages that get sent and received and the meaning that gets created in our minds, to understand the experiences we have as we go about life. When a message in the limbic system is paired with a sensory input to the motor cortex that wiring of the sensory-affective and motor responses becomes our way of managing in the world (Lamm et al., 2007). Thus Hebb’s Law, to me, becomes not only a way of treatment planning but a means of explaining some of the rigidity and resistance we see in our clients, despite the adaptive responses we also see growing, as a result of therapy.

Two Applications for Intervention
We can unpair old (less adaptive) connections in multiple ways:

  1. Mindful Action & Inter-action – with young children this often means
    1. narrating out loud what you see happening to draw attention to their experience and their response. For example, “Oh, I saw you back away from that swing/bucket of rice/sticky glue/piece of broccoli.”
    2. followed by a “wondering,” “I wonder if that means you don’t like it or if there’s something about it that makes you nervous?”
    3. followed by a pause where you don’t intervene, don’t say anything else, and model taking a deep breath. This gives them time to process, shows them how to respond (breath is the foundation of regulation) and sends the message “there’s nothing to worry about here.” (Hopefully they’ll follow your lead.)
    4. followed by a statement of reassurance that they are in control while also not completely removing the offending stimulus, “You don’t have to touch it if you don’t want to.” And/or an action by you that communicates a reduction in possible threat/imposition of the stimulus, like moving it further away from them, covering it up, or putting a lid on it. This visually signals that the threat is more safe than their body initially interpreted and the verbal statement is an auditory cue that supports a felt sense of safety. Visual and auditory systems work together to interpret cues (I call these first-line safety senses and will write more about that in an upcoming post).
  2. Adding a playful context to the negative sensation/activity. Children learn through play and play is typically experienced as fun. Because a negative sensation is often interpreted as a “serious threat,” we can find ways to diminish the seriousness or perception of threat, when we play fun things. By adding a playful quality to the experience, we are encouraging activation of the parasympathetic nervous system, specifically by way of encouraging ventral vagal activation, which in theory helps to balance out the sympathetic activation caused by the perceived serious threat. Fun, thus encourages a calmer state. Play and fun can sometimes be more meaningful to a child than negative sensory experiences so it’s worth exploring the addition of a playful quality and experimenting with how to be more playful during potentially upsetting daily experiences. We also know that play often involves interaction with peers or significant others and because all humans are ‘wired to connect” (Porges, 2018), when we add play we are adding double the opportunity for positive neurological connections. During play the limbic system and the motor systems are firing together simultaneously and we know there are neurological connections between both of these systems with the frontal lobe, a huge driver of overall planning abilities and regulation…play can become a neurological super-power, and is a practical application of Hebb’s Law.

When we set up treatment sessions, and consider Hebb’s Law, it’s important to remember the formation of new adaptive responses and how we facilitate the modification of pre-existing less adaptive ones as well. Sometimes this happens spontaneously if the new adaptive responses are strong enough but if a child seems stuck, get curious about the patterns that may need a little insertion of mindful interactions and/or play!

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