I do not believe we need to move outside the body to explain meaning.
Not because meaning is unreal.
Not because identity is unreal.
But because identity itself is embodied.
The brain is not separate from the body.
The immune system is not separate from emotion.
The gut is not separate from memory.
Narrative is not separate from physiology.
A story changes the body because the body is the thing telling the story.
~
What I think this physician is correctly observing is that human beings are predictive organisms shaped by meaning, attachment, memory, and perception — and that these processes can profoundly alter autonomic tone, inflammation, endocrine function, immune response, pain perception, digestion, muscular tension, and behavior over long periods of time.
That part is real.
Clinicians absolutely see it.
But I become cautious when metaphor hardens into ontology.
The “green slug.”
The “gremlin.”
The “belief field upstream of matter.”
I understand these phenomenologically.
I understand them symbolically.
I even think altered states can allow parts of the self normally kept outside awareness to become emotionally and imagistically accessible.
But I do not think this requires positing an identity-field existing independently from biology any more than dreaming requires a soul projector. Human beings naturally experience psyche through image, symbol, narrative, sensation, and personification. The nervous system does this constantly.
~
And honestly, I think trauma discourse keeps splitting itself into false binaries:
Either:
“trauma is literally trapped in fascia”
or
“the body is irrelevant and everything is cortical computation.”
Neither is true.
The body keeps patterns.
Not because trauma is stored like poison in tissue,
but because living systems adapt.
Posture adapts.
Hormones adapt.
Immune signaling adapts.
Attention adapts.
Breathing adapts.
Muscles adapt.
Prediction adapts.
Identity adapts.
And identity itself is not floating above the organism.
Identity is an emergent process arising through embodiment, attachment, memory, culture, language, relationship, and nervous system development.
Meaning becomes biology because biology is always already meaning-making.
~
What I do think this piece gets very right is the importance of covert chronic stress.
The slow erosions.
The SCEES events, as he calls them.
Not the car crash —
the decades of emotional unpredictability.
The parent whose love could not be reached.
The marriage where the body never unclenches.
The child adapting so continuously to subtle instability that hypervigilance becomes personality.
That absolutely reorganizes physiology over time.
Not metaphorically.
Biologically.
And healing can absolutely reorganize physiology too.
We should not be embarrassed by that.
Nor should we mystify it beyond recognition.
~
To me, the deeper truth is not that consciousness exists separate from the body.
It is that the body was never merely mechanical to begin with.
A human being is not a machine occasionally interrupted by emotion.
We agree on more than we disagree. The body is not a machine. Meaning becomes biology. Healing reorganizes physiology. Chronic stress carves identity into tissue. All of that is right.
Here is where we part ways.
You are saying identity is emergent from embodiment. I am saying identity is upstream of the brain-body system. Those are not the same claim. “Emergence” sounds humble but it quietly preserves materialism. If identity emerges from biology, biology is still primary. The arrow only points one way.
That model cannot account for what I and many clinicians have actually watched happen. A thirty-year-old story rewritten in a single meditation reorganizing a chronic DNA viral infection that eight years of pharmacology did not touch. Decades of pain dissolving over a weekend. Patterns that change in directions and at speeds that bottom-up emergence does not predict.
You can call the green slug a personification. Fine. But the resolution of the clinical condition that came with meeting it is not a personification. It is data.
I am not asking you to believe in a soul projector. I am asking what kind of system reorganizes itself this fast, this completely, through this specific lever, and whether “emergent from biology” is actually a sufficient description… or whether it has become a placeholder we use to avoid saying we do not know.
I think we do not know. I think honest practice requires saying so.
The body was never merely mechanical. We agree. But neither was identity ever merely emergent.
I have appreciated this article for helping clarify the relationship between chronic illness and identity. But I am having difficulty following the discussion between you and Sarah. I think it’s because we’re using terms that have multiple meanings depending on the philosophical frame being used. No amount of clinical observation or scientific inquiry will resolve the debates between different frames. Can both of you clarify the philosophical frame being used? For “identity”, “upstream”/“prior”, and “belief field”, I see at least 5 possible frames: identity as (1) fully emergent from matter alone (materialism), (2) a complete substance separable from the body (Cartesian Dualism or Platonism), (3) a fundamental feature of reality (panpsychism), (4) something identical with or contained within the Divine (pantheism or panentheism), or (5) the “form” of an embodied organism (Thomistic hylomorphism). I think (5) can hold that “the soul” (the organizing principle of the body, including “identity”) is non-material and causally prior to the body as its “actualizing principle” (rejecting 1), while also stating that it co-exists with the body as a single unified entity, rather than existing outside of or separate from the body (rejecting 2-4).
My view is something closer to panpsychism. Or as Kastrup would say analytic idealism. Materialism can't explain this IMO. I also think Sarah is using her AI... which made it a bit difficult for me to follow
Thank you for clarifying! I would agree that materialism is incomplete; I personally lean toward 5, though it’s been a while since I’ve thought deeply about it (“nose to the grindstone” as a relatively new practitioner, as it were). What do you think of the other non-material frames, particularly Thomistic hylomorphism? I acknowledge that’s a huge question not easily answered in a comment section, so feel free to decline.
I dont think I am familiar with thomistic hylomorphism... but I think this is referring to Thomas Aquinas? The view that we are a body and a soul or the body is just a material expression of the soul? For me I dont really like the idea of seperation that this implies (if I am getting it right). I think it is all consciouness or mind in different forms. The way kastrup might call it "mind at large." I see it more like the "source field" is like vapor. The subconscious/biofield is water and the physical body is ice. Just different expressions of the same substance. But I don't waste a whole lot of time with these thoughts. I simply try to ask what is the most useful story for my clients/patients that gives them some type pf agency and meaing? To me that orientation is that we are energetic or spiritual beings in a human avatar he to learn and have experiences that grow or spiritual selves and evolve source itself. I don't necessarily believe this literally.... I just see it as the philosophical orientation most helpful to dealing with the beauty and horror of being human. We are meaning making machines so why not make meaning that is useful
The radio/song metaphor is the most interesting thing in your piece, and I want to sit with it rather than move past it.
Because I think it’s doing more work than you’ve named.
When you say the song uses the radio but is not the radio — where is the song before the radio comes on? Where does it go when the radio breaks? You don’t say. And I don’t think that’s an oversight. I think that’s the actual claim underneath the claim, and it’s a significant one.
If the belief field exists upstream of biology in any meaningful sense — not just functionally upstream, but ontologically upstream — then we’re talking about something that doesn’t require a nervous system to exist. That’s not a clinical claim anymore. That’s a metaphysical one. And I want to ask you directly: is that what you mean? Because your clinical observations don’t actually require it.
Naomi’s story is remarkable. I’m not explaining it away. But what it demonstrates is that identity-level reorganization can produce measurable biological change at speed and depth that bottom-up models don’t predict well. That’s true. That’s important. That’s worth taking seriously.
What it doesn’t demonstrate is that the belief field exists independently of the organism that holds it.
~
Here’s where I think I was wrong in my earlier response, or at least incomplete.
Emergence may be the wrong frame. Not because you’re right that identity is upstream — but because emergence implies something thin and accidental, a byproduct, a foam on the surface of neural activity. That’s not what identity is. Identity is the organizing principle of the whole system. It’s not generated by the system the way heat is generated by friction. It’s more like the shape the system takes when it becomes coherent enough to have a perspective.
Maybe the question isn’t upstream or downstream. Maybe it’s whether identity is the kind of thing that can be located in a direction at all.
~
What I’m genuinely curious about: when you say identity wrote the score — do you mean that functionally, as the highest-order prior in a nested predictive system? Or do you mean it metaphysically, as something that exists prior to and independent of embodiment?
Because those are very different claims, and I think you’re moving between them in a way that makes the argument harder to hold.
The clinical case is strong. The ontological leap may not need to be taken to make it.
Brilliant. Thank you for sharing. I think we are past the magic of " emergence" from matter as an explanation for what is clearly psychic. And to say that matter and psyche are two sides of the same coin is wordplay. There are converging lines of research and philosophy (eg Michael Levin and Bernardo Kastrup) that ressurect the ancient intuition that there are other spaces or realms besides those familiar to us.
Thanks. A brilliant explanation. As Sarah rightly puts it, we are an amorphous whole, but we can target a specific area, identity, in this case for clarity and healing through deep work. Very revealing. Thanks once again Doc. 🙏
Thank you, my friend. That is exactly it… amorphous whole, specific entry point. The body is the player, the brain reads, identity is where the leverage is. Glad it landed. 🙏
I love how you bring science and .......whatever that is......together and question. I have seen and experienced that which can't be explained, doesn't mean it doesn't happen. This is where knowing comes in and it doesn't matter what anyone thinks. Let's keep talking about this and changing stories
Great piece thank you. Just a casual observer in all this but one thought came to mind as I was reading, how does this work with dementia and Alzheimer’s patients? My father had both and I wonder what priors his brain was trying to predict, or is this not relevant to his case? Was the dementia the score the identity was writing? Has me thinking 🤔
Thank you for this, and I’m sorry about your father.
Honest answer: the framework has real limits with neurodegeneration. Dementia damages the instrument itself. The reader loses the ability to read, and that isn’t a problem of priors or identity. It’s tissue breakdown.
But here’s what hospice workers and dementia caregivers notice all the time: as the cognitive scaffolding falls away, what’s often left is the deeper identity layer. The unhealed grief. The unresolved relationship. The thing the person spent a lifetime not feeling. The disease didn’t write that. It just stopped your father from being able to hide it.
There’s also real research linking lifelong chronic stress and isolation to dementia risk… not as cause, but as contributor. So the identity layer probably interacts with neurodegenerative risk at a population level. Whether it shaped your father’s case, none of us can know.
What I would say is this. Meeting what surfaces in those moments with as much compassion as you can muster, even when the person can no longer meet you back the same way, is its own form of the work.
Thank you so much for this very clear explanation. My father passed in 2004 and it was diagnosed late, 1999. Chronic stress was definitely part of my dad’s life for over 40 years. He was an only child growing up in the depression era in a very middle class family. He did have 7 kids so that might have helped with isolation 😉. Thanks so much for this, it’s having a very cathartic effect on me as I write to you. 🙌
I think where I diverge is this:
I do not believe we need to move outside the body to explain meaning.
Not because meaning is unreal.
Not because identity is unreal.
But because identity itself is embodied.
The brain is not separate from the body.
The immune system is not separate from emotion.
The gut is not separate from memory.
Narrative is not separate from physiology.
A story changes the body because the body is the thing telling the story.
~
What I think this physician is correctly observing is that human beings are predictive organisms shaped by meaning, attachment, memory, and perception — and that these processes can profoundly alter autonomic tone, inflammation, endocrine function, immune response, pain perception, digestion, muscular tension, and behavior over long periods of time.
That part is real.
Clinicians absolutely see it.
But I become cautious when metaphor hardens into ontology.
The “green slug.”
The “gremlin.”
The “belief field upstream of matter.”
I understand these phenomenologically.
I understand them symbolically.
I even think altered states can allow parts of the self normally kept outside awareness to become emotionally and imagistically accessible.
But I do not think this requires positing an identity-field existing independently from biology any more than dreaming requires a soul projector. Human beings naturally experience psyche through image, symbol, narrative, sensation, and personification. The nervous system does this constantly.
~
And honestly, I think trauma discourse keeps splitting itself into false binaries:
Either:
“trauma is literally trapped in fascia”
or
“the body is irrelevant and everything is cortical computation.”
Neither is true.
The body keeps patterns.
Not because trauma is stored like poison in tissue,
but because living systems adapt.
Posture adapts.
Hormones adapt.
Immune signaling adapts.
Attention adapts.
Breathing adapts.
Muscles adapt.
Prediction adapts.
Identity adapts.
And identity itself is not floating above the organism.
Identity is an emergent process arising through embodiment, attachment, memory, culture, language, relationship, and nervous system development.
Meaning becomes biology because biology is always already meaning-making.
~
What I do think this piece gets very right is the importance of covert chronic stress.
The slow erosions.
The SCEES events, as he calls them.
Not the car crash —
the decades of emotional unpredictability.
The parent whose love could not be reached.
The marriage where the body never unclenches.
The child adapting so continuously to subtle instability that hypervigilance becomes personality.
That absolutely reorganizes physiology over time.
Not metaphorically.
Biologically.
And healing can absolutely reorganize physiology too.
We should not be embarrassed by that.
Nor should we mystify it beyond recognition.
~
To me, the deeper truth is not that consciousness exists separate from the body.
It is that the body was never merely mechanical to begin with.
A human being is not a machine occasionally interrupted by emotion.
A human being is a living interpretive system.
An animal made of memory.
Prediction.
Attachment.
Symbol.
Story.
Hormones.
Touch.
Language.
Immune response.
Relationship.
Time.
And all of it is happening together.
We agree on more than we disagree. The body is not a machine. Meaning becomes biology. Healing reorganizes physiology. Chronic stress carves identity into tissue. All of that is right.
Here is where we part ways.
You are saying identity is emergent from embodiment. I am saying identity is upstream of the brain-body system. Those are not the same claim. “Emergence” sounds humble but it quietly preserves materialism. If identity emerges from biology, biology is still primary. The arrow only points one way.
That model cannot account for what I and many clinicians have actually watched happen. A thirty-year-old story rewritten in a single meditation reorganizing a chronic DNA viral infection that eight years of pharmacology did not touch. Decades of pain dissolving over a weekend. Patterns that change in directions and at speeds that bottom-up emergence does not predict.
You can call the green slug a personification. Fine. But the resolution of the clinical condition that came with meeting it is not a personification. It is data.
I am not asking you to believe in a soul projector. I am asking what kind of system reorganizes itself this fast, this completely, through this specific lever, and whether “emergent from biology” is actually a sufficient description… or whether it has become a placeholder we use to avoid saying we do not know.
I think we do not know. I think honest practice requires saying so.
The body was never merely mechanical. We agree. But neither was identity ever merely emergent.
I have appreciated this article for helping clarify the relationship between chronic illness and identity. But I am having difficulty following the discussion between you and Sarah. I think it’s because we’re using terms that have multiple meanings depending on the philosophical frame being used. No amount of clinical observation or scientific inquiry will resolve the debates between different frames. Can both of you clarify the philosophical frame being used? For “identity”, “upstream”/“prior”, and “belief field”, I see at least 5 possible frames: identity as (1) fully emergent from matter alone (materialism), (2) a complete substance separable from the body (Cartesian Dualism or Platonism), (3) a fundamental feature of reality (panpsychism), (4) something identical with or contained within the Divine (pantheism or panentheism), or (5) the “form” of an embodied organism (Thomistic hylomorphism). I think (5) can hold that “the soul” (the organizing principle of the body, including “identity”) is non-material and causally prior to the body as its “actualizing principle” (rejecting 1), while also stating that it co-exists with the body as a single unified entity, rather than existing outside of or separate from the body (rejecting 2-4).
My view is something closer to panpsychism. Or as Kastrup would say analytic idealism. Materialism can't explain this IMO. I also think Sarah is using her AI... which made it a bit difficult for me to follow
Thank you for clarifying! I would agree that materialism is incomplete; I personally lean toward 5, though it’s been a while since I’ve thought deeply about it (“nose to the grindstone” as a relatively new practitioner, as it were). What do you think of the other non-material frames, particularly Thomistic hylomorphism? I acknowledge that’s a huge question not easily answered in a comment section, so feel free to decline.
I dont think I am familiar with thomistic hylomorphism... but I think this is referring to Thomas Aquinas? The view that we are a body and a soul or the body is just a material expression of the soul? For me I dont really like the idea of seperation that this implies (if I am getting it right). I think it is all consciouness or mind in different forms. The way kastrup might call it "mind at large." I see it more like the "source field" is like vapor. The subconscious/biofield is water and the physical body is ice. Just different expressions of the same substance. But I don't waste a whole lot of time with these thoughts. I simply try to ask what is the most useful story for my clients/patients that gives them some type pf agency and meaing? To me that orientation is that we are energetic or spiritual beings in a human avatar he to learn and have experiences that grow or spiritual selves and evolve source itself. I don't necessarily believe this literally.... I just see it as the philosophical orientation most helpful to dealing with the beauty and horror of being human. We are meaning making machines so why not make meaning that is useful
The radio/song metaphor is the most interesting thing in your piece, and I want to sit with it rather than move past it.
Because I think it’s doing more work than you’ve named.
When you say the song uses the radio but is not the radio — where is the song before the radio comes on? Where does it go when the radio breaks? You don’t say. And I don’t think that’s an oversight. I think that’s the actual claim underneath the claim, and it’s a significant one.
If the belief field exists upstream of biology in any meaningful sense — not just functionally upstream, but ontologically upstream — then we’re talking about something that doesn’t require a nervous system to exist. That’s not a clinical claim anymore. That’s a metaphysical one. And I want to ask you directly: is that what you mean? Because your clinical observations don’t actually require it.
Naomi’s story is remarkable. I’m not explaining it away. But what it demonstrates is that identity-level reorganization can produce measurable biological change at speed and depth that bottom-up models don’t predict well. That’s true. That’s important. That’s worth taking seriously.
What it doesn’t demonstrate is that the belief field exists independently of the organism that holds it.
~
Here’s where I think I was wrong in my earlier response, or at least incomplete.
Emergence may be the wrong frame. Not because you’re right that identity is upstream — but because emergence implies something thin and accidental, a byproduct, a foam on the surface of neural activity. That’s not what identity is. Identity is the organizing principle of the whole system. It’s not generated by the system the way heat is generated by friction. It’s more like the shape the system takes when it becomes coherent enough to have a perspective.
Maybe the question isn’t upstream or downstream. Maybe it’s whether identity is the kind of thing that can be located in a direction at all.
~
What I’m genuinely curious about: when you say identity wrote the score — do you mean that functionally, as the highest-order prior in a nested predictive system? Or do you mean it metaphysically, as something that exists prior to and independent of embodiment?
Because those are very different claims, and I think you’re moving between them in a way that makes the argument harder to hold.
The clinical case is strong. The ontological leap may not need to be taken to make it.
Brilliant. Thank you for sharing. I think we are past the magic of " emergence" from matter as an explanation for what is clearly psychic. And to say that matter and psyche are two sides of the same coin is wordplay. There are converging lines of research and philosophy (eg Michael Levin and Bernardo Kastrup) that ressurect the ancient intuition that there are other spaces or realms besides those familiar to us.
Thanks. A brilliant explanation. As Sarah rightly puts it, we are an amorphous whole, but we can target a specific area, identity, in this case for clarity and healing through deep work. Very revealing. Thanks once again Doc. 🙏
Thank you, my friend. That is exactly it… amorphous whole, specific entry point. The body is the player, the brain reads, identity is where the leverage is. Glad it landed. 🙏
— Jade
I love how you bring science and .......whatever that is......together and question. I have seen and experienced that which can't be explained, doesn't mean it doesn't happen. This is where knowing comes in and it doesn't matter what anyone thinks. Let's keep talking about this and changing stories
💪🏽❤️
Great piece thank you. Just a casual observer in all this but one thought came to mind as I was reading, how does this work with dementia and Alzheimer’s patients? My father had both and I wonder what priors his brain was trying to predict, or is this not relevant to his case? Was the dementia the score the identity was writing? Has me thinking 🤔
Thank you for this, and I’m sorry about your father.
Honest answer: the framework has real limits with neurodegeneration. Dementia damages the instrument itself. The reader loses the ability to read, and that isn’t a problem of priors or identity. It’s tissue breakdown.
But here’s what hospice workers and dementia caregivers notice all the time: as the cognitive scaffolding falls away, what’s often left is the deeper identity layer. The unhealed grief. The unresolved relationship. The thing the person spent a lifetime not feeling. The disease didn’t write that. It just stopped your father from being able to hide it.
There’s also real research linking lifelong chronic stress and isolation to dementia risk… not as cause, but as contributor. So the identity layer probably interacts with neurodegenerative risk at a population level. Whether it shaped your father’s case, none of us can know.
What I would say is this. Meeting what surfaces in those moments with as much compassion as you can muster, even when the person can no longer meet you back the same way, is its own form of the work.
Thank you so much for this very clear explanation. My father passed in 2004 and it was diagnosed late, 1999. Chronic stress was definitely part of my dad’s life for over 40 years. He was an only child growing up in the depression era in a very middle class family. He did have 7 kids so that might have helped with isolation 😉. Thanks so much for this, it’s having a very cathartic effect on me as I write to you. 🙌