Recall that we can separate nerves in the nervous system into two fundamental types: sensory (carrying information to the central nervous system), and motor (carrying information from central nervous system to muscles for movement).

Last week we covered the trigeminal nerve, which is the main sensory nerve that carries information from your face to your brain (it does have motor components going to the jaw).

This week let’s talk briefly about the facial nerve and the vestibulocochlear nerves.

The trigeminal nerve carries sensory information.

The facial nerve carries motor information.

Both richly ennervate your face; if you sense your face, you are mostly using the trigeminal nerve. If you scrunch your face up, you are using the facial nerves.

Exercise: FEELING THE FACIAL NERVE

Try slowly smiling, bringing your cheeks out wide. See if you can feel the connection of the cheeks (buccal branch of the facial nerve) to right below the ears (root of the facial nerve). Now try scrunching your forehead. Can you feel a line of connection from your forehead to the base of the ear?

Oh boy, time for the vestibulocochlear nerve.

The whole hearing and balance system is marvelously sophisticated and its own field of study (there are thousands of audiology PhDs each year), but here is the briefest of brief overviews.

The basic anatomy of a sound registering to the central nervous system:

• Air particles vibrate the eardrum, small bones in the middle ear transmit vibration to a shell structure in the inner ear (cochlea),

• Fluids move along the shell structure, and mechanoreceptors (little filament hair cells) get deflected and fire, activating the vestibulocochlear nerve in the brain

Importantly! The sense of sound is constructed. You can experience this in meditation, but also with some simple audio illusions.

The parameters of ‘distance’ (notice the cars on the street may feel further away than the fan in your room) and ‘pleasantness’ (listen to bird song vs construction work) feel ‘baked in’ to the sound, but they are inferences our central nervous system makes. Sound has no inherent distance nor valence.

Out of time to describe a full exercise, here is a fun video that shows how sound is constructed.

Semicircular canals help with orientation (three curls help with x y and z axes! and there is specialized apparatus to detect linear vs nonlinear acceleration) - Very cool stuff. for further rabbit holing, look at the Moro reflex and role of inner ear, and eye tracking reflexes

See you next time!

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The most important nerve cluster in the peripheral nervous system is the cluster of cranial nerves.

Take your three fingers and put them at the back of your head, the ridge where your neck meets your head. Notice the two bumps below your earlobes your mastoid processes.

Everything you see, taste, smell, hear involves a small set of nerves that enter your brain stem there.

These are the 12 CRANIAL NERVES.

—

Here’s another experiment.

Using your fingers, probe just below your eyebrow at the center, around the bridge of your nose. Press around and in towards the little notch and see if you can feel that at some point there’s a light buzzing (maybe slightly uncomfortable sensation). It feels different from pushing on your facial bone.

If you can feel that slight buzzing, you’re pushing on part of your trigeminal nerve. This is a series of sensory (as opposed to motor) nerves that innervate your face.

Now let’s try a more soothing version: trigeminal tapping.

Find the small indentation just in front of your ear where the top of the ear meets the skull — this is your resting place, where the trigeminal nerve divides. Using alternating fingers, tap gently along six pathways: across the eyebrows up to the hairline and back; along the cheekbone in to the nose and around its edge; along the upper jaw toward the center and back; along the lower jaw to the chin and back; around the back of the ear; and up the side of the skull and back down. After each pathway, return to the resting place and pause to feel the resonance. The alternation is what matters — it stimulates the trigeminal nerve roots across the whole face and head.

EFT tapping is a popular technique people use to address headaches, allergies, stress in general. Though I haven’t seen them talk about it like this, it seems like the whole thing involves tapping the trigeminal and vagus nerves while saying soothing things. Even though it initially triggered my ‘woo’ detector, it ends up being quite soothing and a nice easy downregulation tool

If you want a guided version, here is a nice youtube guided video.

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A couple of months ago, I gave a presentation the set point theory of chronic illness, it was an attempt to use a new language, the language of cybernetics to shift out of this mind body duality when talking about illness.

The inspiration for this presentation was a paper by. Dr. Tom Pollock and Mike Levin. fter reading the paper and giving the presentation, I decided to reach out to the lead author, uh, Tom Pollock and have a chat. This conversation was the result. He’s a neuropsychiatrist based in the uk. We talk about his experience with a.

Which doctor and how that partly inspired, uh, section in the paper. And more broadly on the role of, of experience and challenges when wading into this field where there’s a clear interface between the mind and the body. I hope you enjoy.

Dr. Thomas Pollak is a neuropsychiatrist based in the UK who works at the interface of immunology and mental health. We talk about his encounter with a Balinese witch doctor, the cybernetics of chronic illness, and why psychiatry needs a more dynamic model of inflammation.

Episode Outline — Dr. Thomas Pollak: Reboots, Resets, and the Immunopsychiatry of Stuck States

00:00:00 Introduction and the Set Point Theory of Chronic Illness

00:01:30 The Witch Doctor Story

00:08:00 Humiliation, Shame, and One-Pointedness as Therapeutic Tools

00:12:00 A Room With a Dead Body

00:15:30 Meditation Practice and the Constructionist Turn in Neuroscience

00:18:30 The Tantric Phase of Science

00:24:00 Reset vs. Learning vs. Unlearning

00:30:00 Safety Behaviors, Canalization, and Narrowing of State Space

00:37:00 Long COVID, Interface Disorders, and the Two-Camps Problem

00:43:00 The Role of Awareness in Healing

00:45:00 What Kind of Awareness Is Therapeutic?

00:49:00 Neurostimulation and Embodied Experience

00:50:00 Autoimmunity and Psychosis: The Main Research Thread

You can find Dr Pollak’s substack here.

The first distinction to notice is that most of the neurons near the center are encased in bone — the skull and spine. There are also many neurons and nerves wrapped around bone and muscle at the periphery. We can call these two parts of the network of nerves and neurons the central nervous system and the peripheral nervous system.

Practice: Feeling the Difference

Embodying the Central Nervous System

Stand up and feel the shape of your skull, including the small bumps and asymmetries. Breathe into the skull, letting your breath be like air in a large cathedral — feeling the depth and space within. Now feel the weight of all the neurons, tissue, and connective matter in the skull, and let gravity begin to pull your skull down toward the earth. Feel the neurons inside the spine and their weight too. Let yourself come to lie on the ground so your skull is touching the floor.

Let the weight of your brain and spine initiate movement, and slowly roll on the ground. Notice that in each position there is a slight settling as the meninges — the membrane between the skull and the brain — shift slightly, and the skull itself moves and settles in response. After doing this, you may begin to feel like a brain and spine with limbs attached. This is embodying the central nervous system.

Embodying the Peripheral Nervous System

Pat the entire surface of your body, including your inner thighs, midsection, and back. Feel the slight vibration or buzzing in your skin. Try to breathe into the vibration at the surface of your skin and let your body move from that awareness. This is the most direct way to feel the peripheral nervous system.

We can also get more precise and actually feel specific parts of our central nervous system. Let’s explore the brainstem.

Practice: Breathing in the Brainstem

Bring your middle fingers to the bony ridge just below each ear — not the jaw, but the mastoid process on the skull. Find the midpoint between your fingers in your awareness. This is the approximate location of the brainstem. Don’t strain to find it. You may feel a slight buzzing or tingling when you locate the spot.

Bring your breath into that point and allow yourself to breathe from there. It may help to begin with your eyes closed and breathe for a minute or two. As you do this, notice what other sensations arise.

We can do this with other regions of the brain, which we’ll explore in future editions.

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Let's say you have an illness no one seems to fully understand. The surgeon proclaims that cutting you open will help, but with significant risk of complications. The pharmacist shrugs and hands you depressants to take your mind off the discomfort — but she doesn't even pretend that the drugs can resolve the pain.

Saddened, you find yourself at a bus stop one day recounting your woes to a friendly stranger. He nods with sympathy, and then gives you a closer glance.

He looks around before leaning in, voice barely above a whisper.

Can I tell you something strange that might help?

Of course, you nod.

To be completely honest, there’s this method I know that can cure you. No surgery, no drugs, and it can be mostly done in a single afternoon.

Your eyebrows raise. And what is the price of this method? You ask.

If you don’t mind waiting a bit, it can be free. Otherwise, it costs less than the price of a restaurant meal.

Would you believe this stranger?

What if he showed you dozens of people who swear that it worked for them?

Scroll down the reviews for John Sarno’s Healing Back Pain, and you’ll find about 2 in 5 claiming that the book greatly reduced or eliminated their pain. If you total the number of reviews for his books across Goodreads and Amazon, and use some publishing heuristics, the number of book cures is likely between 100k and 1 million1.

Having personally experienced a major reduction in my pain after reading the book, I am very familiar with the mechanism that Sarno proposes.

Yet there’s still something fascinating here that I believe no one is paying attention to.

How does reading a book fundamentally change your bodily experience?

When it works for people, how does it work?

That’s why I’m running a qualitative study to look more closely at what’s going on.

If you or someone you know has had this experience, please reach out to maxkshen@gmail.com

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Thank you to Sebastien Ehmann and Zoran Josipovic for support

In your skull, there is a large organ that we call the brain. For the last hundred years, we have privileged it as the focal point for investigation into human nature and behavior.

Exercise

If you close your eyes, and point to where you feel you are in your body, where do you point? Do you have a focal point?

Most of us locate ourselves in our head, somewhere behind the eyes.

Much of the neuro-centric cognitive revolution that started with Minsky and Chomsky with the first ENIAC still dominates many of the human sciences. Cognitive Behavioral Therapy, Melzack’s neuromatrix model of pain, even Pain Reprocessing Therapy — all have this (in my view undue) emphasis on the brain.

Is human consciousness in the brain? We may also ask: Is flight in the wings of the bird?

Yet if you look closely at our nervous system, you’ll see that there are neuronal clusters distributed throughout the body. Human computation is better understood as distributed than centralized.

The gut has 500 million neurons1, which is about the same count as a dog’s brain. This is only connected to the brain through roughly 30,000 fibers, most of which lead from gut to head.

The gut has its own sensory apparatus — chemoreceptors in the small intestine to ‘taste’ the digested food, stretch receptors in the stomach wall, and its own advanced immune system.

From the head-brain’s perspective, it’s as though there is a separate intelligent organism, with the complexity of a mammal, living in us, coordinating our digestive behavior. From the whole-being perspective: we often forget that our gut-brain is us.

The heart has 50,000 neurons, which is on the same order of magnitude as a filter feeding lancelet. JA Armour (1991) found that the heart has its own nervous system — sensory neurons to detect what’s happening locally, motor neurons to speed up or slow down heartbeats, and crucially, interneurons that communicate locally before reaching the brain (which is relatively far away). A heart can keep beating separately from the body — heart transplants can now work with a new heart that is still beating(!). In several cases, memories of the old heart’s host seem to become accessible to the recipient2.

The spinal cord contains about 15 million neurons. In addition to local reflex arcs and movement patterns, we know that the neurons in the spine have a huge role to play in sensing pain. Melzack and Wall’s gate control theory of pain (1965) was that the dorsal horn in the spine would amplify or suppress signals from our pain receptors before they would ever reach the brain, acting as a ‘pain gate’. They were right about the local computation, but wrong to assume that pain was the same as the firing of a pain receptor3.

These clusters of neurons allow the organs independent activity.

Exercise

Take a breath, and feel your feet on the ground.

Bring your hands to your head, feel the weight and depth of your skull, the mass of the brain inside. Let yourself move from this position for a couple of minutes.

Bring your hands to your chest, feel the structure of your ribcage, sense the lungs inside, and your heartbeat. Feel into the back of the ribs, any sensations or emotions there. Let yourself move from this position for a couple of minutes.

Bring your hands to your midsection, feel underneath the abdomen to your viscera. Softly feel your stomach on the left side below your heart, the intestines below your stomach. Rest your hand there and feel the weight of all the organs.

Bring to mind someone you have had a simple, loving relationship with. A childhood pet, close friend, or perhaps a character in a movie or TV show you feel resonance with. Remember a specific situation involving this figure.

Where do you notice sensations in the body?

Now bring to mind a scene where you felt particularly safe and relaxed. Maybe: a sunny beach near a calm ocean with a gentle sea breeze; a blanket around your shoulders as you huddle before a fire; an field of grass.

Where do you notice sensations in the body?

As I continue to explore my internal landscape, I get more and more precise on the ‘location of feelings’. Anxiety is around the front of the lower left rib, right around the middle of the stomach — it feels like my midsection wants to fold inwards, like the invagination of a cell. The left side of my throat tightens at the same time, as if to pull me inside.

What does it mean that that I feel my anxiety in my gut? And that I clearly feel when I’m speaking from my head or my heart (or both)?

The neuro-reductionist story is that the feeling of location is downstream of some brain region — maybe the somatosensory cortex firing in a certain way. (Yet I can also feel if I’m more inside my prefrontal cortex versus more in the cerebellum — you can try this quickly yourself by feeling the back of your skull and finding yourself there). Why should we privilege the neuron cluster in a patch in our cortex over the cluster in our gut, or our heart?

I find it more plausible that the feeling of speaking from the gut is akin to allowing that center of intelligence coordinate the rest of our body. Sometimes our ‘gut feelings’ become so strong they are impossible to ignore, but it is also possible to live in more harmonious relation between the head, heart, and gut — all the intelligence centers.

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The traditional way anatomy is taught is through a textbook where you memorize various parts: organs, muscles and bones (usually ignoring the fascia) to then answer questions like “identify the ligaments in the lateral collateral ligament complex of the ankle that may be involved in a common ankle strain.“

I want to be able to feel the structures inside my body — I don’t care much about learning all the names.

It turns out there’s an inspiring community around doing just this. I’ve been learning from a senior teacher, Mark Chandlee Taylor, who has been excellent.

The Nervous System

First topic is the nervous system.

Mark suggests approaching it from six angles:

I. Micro-mapping - nerves, neurons, glia

II. Three Brains - neuron clusters around brain, heart, gut

III. Location - Central vs peripheral

IV. Inflow/outflow - Sensory vs motor neurons

V. Somatic vs Autonomic

VI. Levels of engagement - Sympathetic/Parasympathetic balance

The exercise involve touch, movement, visualization which then becomes embodiment.

I. Micro-mapping

Prompts:

Neurons

Recall the cell body of a neuron, its axon which projects outward to other neurons, its dendrites which connect to other cells’ axons.

Your torso is the soma of a neuron, your left arm is the axon, and your other limbs are dendrites. Floating in a sea of liquid, you can sense keenly but you cannot move. At some point, like the beginning of a sneeze, you feel an impulse that travels all along your body towards your left arm. Building, and building, until it bursts through your left arm like a sneeze. ACHOO!

Note: contrary to the standard visualizations that depicted neurons as basically static wires, neurons literally bulge as the action potential happens, like a tube of toothpaste being squeezed. It is fluid and electrical.

Glial cells are crucial supporting structures in the brain. The fatty myelin sheath

Warm your hands and apply a thin layer of oil around a willing partner’s hand. Their hand is a nerve — a bundle of parallel axons, live, pulsing, moving, and your hand is the outer layer of myelin, covering the bundle of axons. Feel the fluid, fatty nature of the myelin. Then swap, and feel what it is to be wrapped with a myelin sheath as an action potential fires.

Neurotransmitters

Acetylcholine - sitting in a field, watching wind blow through the grass. You see a pattern appear between the grasses of different heights. The short grasses flicker then are still, the taller grasses sway for a little longer before subsiding, like a deep wave in the sea. You watch this pattern, focused calm inside.

Dopamine - you’re hunting at the edge of a forest clearing, waiting for the animal to appear. You lean forwards, anticipation raising — ready to go but not yet. Just, almost, ready, almost. You can feel it’s close, rustling nearby. Your hairs raise.

Norepinephrine - the animal appears, and to your surprise, it turns towards you, staring you down. It begins to charge. You feel heat spreading in your chest, time thickens as your eyes widen. Baring your teeth, you raise the spear, ready to plunge it forwards.

GABA - the fight is over. you are back at the camp, staring into a warm fire. You rest back into your chair, surrounded by the others. Taking a breath, you toss a friend some meat.

Serotonin - as you settle, you feel a deeper relief — you survived, and you are now safe. A pleasant warmth fills your face

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Before starting, a heuristic that is useful for any type of challenging sensation1:

You can’t let your arm relax if you don’t realize that your fist is clenched. Similarly, you can’t move to accept or transform a sensation if you don’t have basic awareness of its dimensions (e.g. shape, location).

Once you’re aware of the pain, acceptance becomes easier. Acceptance means allowing enough internal relaxation for the sensation to move through you. After it has largely moved through, you can examine and transform the underlying patterns generating the pain.

If pain >8/10:

(e.g. it is difficult to talk)

It’s likely too intense to even maintain awareness of the sensation.

• Basic box breathing (2m) can be helpful.

• Mantra or prayer can still work at this stage.

• Skilfully dissociation (distraction, painkillers) may be appropriate

In the moment, you might invite someone to help you find ways to take the pain down just 1 level. Afterwards, brainstorm some options for the future.

Aware (pain <8/10):

(uncomfortably distracting, but you can still mostly function):

Grounding and Tracking2.

Accept (pain <6/10):

Shinzen Young’s guided pain meditation.

Transform (pain <3/10):

Gendlin-style Focusing in dialogue pain. [pure audio]

Note: Many people struggle to fully benefit from accept- or transform-type practices on their own. This often reflects current limits in emotional/attentional capacity — don’t take it as a personal failure. If you’re feeling frustrated, try involving another person (peer, coach, therapist) to expand your capacity.

It’s important to approach all of this with patience and kindness toward yourself. Even the gentlest practices can become self-punishment if done from internal criticism.

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Elena Lake was a math major at MIT who later transitioned from her software engineering career into bodywork. We talk about her journey, and the role of perception in bodywork.

Episode Outline — Elena Lake: From Engineering to Regenerative Touch

00:00:00 Introduction and Early Background
00:01:00 Trauma, Mental Health, and Limits of Talk Therapy
00:02:00 First Encounters with Touch and Somatic Relief
00:03:30 Massage School as a Foundation, Not a Revelation
00:10:00 Qualities of Touch, Trance States, and Sensory Depth
00:12:00 Advanced Touch Perception
00:14:00 Lineages of Somatics and Extreme Sensitivity
00:18:00 Developing “Regenerative Touch”
00:21:00 Awareness, Attention, and Where People Live in Their Bodies
00:23:00 Practice as Research and the Role of Presence
00:25:00 Models of Pain: Continuity, Tangles, and the Camel’s Back

You can find out more about Elena through her website.

If you’re convinced of the role of the nervous system in perpetuating pain and other symptoms but are having weak results pursuing it on your own, feel free to reach out to maxkshen@gmail.com.

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This past weekend, inspired by a recent preprint from Thomas Pollak, Mike Levin, et al, I gave a talk on how cybernetic models (predictive processing, dynamical systems, homeostasis/allostasis) are a hugely powerful lens to understate the current epidemic of the recent rise in chronic illness.

You can watch the video while looking at the slides here, or read the essay version below:

Here’s the essay version (generated by Claude from my transcript). It is less good than the talk, but faster to read:

Chronic Illness as a Stuck Set Point

In 1910s Vienna, one in five young men had syphilis. The medical community was helpless—a deep nihilism pervaded as they watched patients die from this bacterial infection that would spread across the body with devastating mortality rates.

Then a German psychiatrist noticed something strange: some of his late-stage syphilis patients got better after getting more sick. Specifically, after contracting malaria.

In what seems like utter insanity in hindsight, Julius Wagner-Jauregg began drawing blood from his malaria patients and injecting it into those dying from syphilis. There was even a criminal investigation involved.

But here’s the thing—it worked. Even though 10-15% died from the malaria, a larger fraction survived what was previously a death sentence. Wagner-Jauregg won the Nobel Prize in 1927.

Nobody could explain why it worked. Medical research today still does not have a biomechanistic account. But it clearly worked.

The Wrong Level of Abstraction

This shouldn’t make sense within the biomedical model that dominated (and still dominates) medicine. How do you give someone something that makes them more sick, yet they become better?

The biomedical reasoning is straightforward: diseases have specific causes, specific dysfunctions. Diphtheria —> Kill the bacterium. Clogged arteries —> Widen them. We find and fix the broken part of our biomechanical bodies.

But the malaria example isn’t unique. If you look at long COVID and other post-viral syndromes, there are well-documented cases of secondary infections leading to resolution.

In the case of MDMA trials for PTSD, the drug doesn’t remove some “PTSD toxin” but somehow resets the entire system.

In my own research, we have increasingly hard to ignore evidence about the widespread efficacy of nervous system reprocessing resolving chronic pain.

This is still the dominant approach

In 2021, Congress gave NIH $1.5 billion to research long COVID—all focused on biochemical pathology, systematically excluding researchers studying nervous system approaches.

Bodies as Problem-Solvers

What if we stopped seeing the body as a collection of chemical pathways and started seeing it as a multi-scale collective intelligence solving problems at different layers—from cell to organ to your whole being?

Your body wants to keep you in a range of safe values. Try this experiment—on your next exhale, stop yourself from inhaling. Feel that rising tension, that panic. Your throat tightens, blood vessels dilate, emotional systems activate. That’s the homeostatic impulse, happening across multiple scales simultaneously.

Normally, you breathe at 13-15 breaths per minute. If you start jogging, that set point shifts higher.

If you work a chronically stressful job, your breathing becomes shallow and fast, and paradoxically, tissue oxygen can decrease over time.

The key insight here is that sometimes our bodies get stuck in these maladaptive states.

Try clenching your abs like you’re bracing for impact. Notice how hard it is to breathe? Now relax.

Feel the difference—the ease, the fuller breath, the sense that more of your body is available.

If you walked around with clenched abs all the time (as many do under chronic stress), your breathing would be persistently altered. You might even forget you’re clenching at all.

The Reset Mechanism

Remember when your computer freezes and nothing works except turning it off and on again? That’s the metaphor driving this new understanding of chronic illness.

We already use resets in medicine without calling them that. During a heart attack, emergency responders shock the heart with high voltage—not to teach it the proper rhythm, but to create a perturbation that allows the tissue to recalibrate. Fecal transplants work similarly—overwhelming the sick person’s microbiome with healthy bacteria, then allowing repopulation in better proportions.

Think of it like this: imagine illness and health as valleys in a landscape. In chronic illness, the valley walls are steep—it takes enormous energy to climb out. But during a reset, those valleys flatten temporarily. The body can move between states with less resistance.

Maybe that’s what happened with Wagner-Jauregg’s malaria cure. Maybe that’s what’s happening when a secondary infection resolves long COVID, or when MDMA allows PTSD to lift, or when nervous system work dissolves chronic pain. The perturbation creates a window of plasticity where the system can reconfigure.

What This Changes

This isn’t just semantic reshuffling. If our bodies are intelligent problem-solving systems that can get stuck, then treatment becomes about creating the right conditions for reset—understanding not just the magnitude of perturbation needed, but the context before and after.

The questions now are practical: What variables actually define these states? How does conscious attention affect plasticity? (There’s something here about how becoming aware of your body’s defensive patterns might itself flatten the landscape.) What makes a helpful reset versus a harmful one?

We’re at the beginning of something. The patterns are here for us to explore. And for someone who spent months unable to type, watching my own pain system reset through understanding and careful perturbation, I can tell you—this paradigm shift matters.

In four images:

We’ve known for decades about culture-bound syndromes that just seem so weird and only occur in a small subculture. Like men in South Central Asia who get the idea that they have semen loss and their semen loss is making them weak and tired... and we go ‘that’s crazy’. But how do we know that back pain isn’t our culture-bound syndrome?

Today I’m talking with Dr. Howard Schubiner, who’s one of the creators of Pain Reprocessing Therapy (one of the most important and exciting new modalities for addressing chronic pain). We met at a conference in Boulder, and this conversation was a chance for us to explore how he got into this space and his stance on where it’s going.

Dr Schubiner is one of the pioneers of modern pain science. After being a professor at Wayne State University for 18 years, he now directs, advises, and supports many of the key initiatives around understanding pain through this neuroplastic lens.

Timestamps

00:00:00 – Intro

00:02:00 – Meeting Dr. John Sarno

00:06:00 – From MBSR to Mind-Body Medicine

00:13:00 – The Evolution of Somatic Tracking

00:21:00 – Predictive Processing and the Brain’s Need for Certainty

00:35:00 – The Cultural Epidemic of Pain Syndromes

00:38:00 – Long COVID and Neuroplastic Conditions

00:43:00 – Healthcare System Reform Vision

00:47:00 – The Future of Neuroplastic Research

Resources:

• Howard’s book, Unlearn Your Pain, just had a Fourth Edition update.

• Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain.

• Correction: I mentioned anorexia and The Geography of Madness, but the correct book is Crazy Like Us. Here is a good book review.

• All the Rage (Saved by Sarno) - documentary featuring Dr. Sarno

• ATNS (Association for the Treatment of Neuroplastic Symptoms)

Questions and comments welcome!

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How do scientific paradigms change?

The Structure of Scientific Revolutions, Thomas Kuhn. Beyond the simple ‘normal’ vs ‘revolutionary’ science distinction, Kuhn is so knowledgeable and such a clear thinker that my own perspective broadens hours after I read Kuhn. At David Chapman’s suggestion, I’m also considering his previous book The Copernican Revolution which goes into detail at how a bunch of scientists in the 17th century grappled with the realization that it is the earth that rotates around the sun and not vice versa.

A Feeling for the Organism, Fox Keller. This a biography of the Barbara McClintock, badass yogi / Nobel prize winning discoverer of jumping genes. Her discovery deeply challenged the entrenched dogma that DNA → proteins was a one way street, and she was shunned by much of the biology community for decades. McClintock, among other things could reach a deep meditative absorption while running and significantly reduce pain.

Does Science Advance One Funeral At a Time?, Azoulay et al.

We examine how the premature death of eminent life scientists alters the vitality of their fields. While the flow of articles by collaborators into affected fields decreases after the death of a star scientist, the flow of articles by non-collaborators increases markedly. This surge in contributions from outsiders draws upon a different scientific corpus and is disproportionately likely to be highly cited. While outsiders appear reluctant to challenge leadership within a field when the star is alive, the loss of a luminary provides an opportunity for fields to evolve in new directions that advance the frontier of knowledge.

Azoulay was my professor during graduate school and I am trying to think through how he would understand pain science.

What type of information processing do biological systems perform?

Evolution of the Sensitive Soul, Eva Jablonka.

What marked the evolutionary transition from organisms that lacked consciousness to those with consciousness—to minimal subjective experiencing, or, as Aristotle described it, “the sensitive soul”? In this book, Simona Ginsburg and Eva Jablonka propose a new theory about the origin of consciousness that finds learning to be the driving force in the transition to basic consciousness. Using a methodology similar to that used by scientists when they identified the transition from non-life to life, Ginsburg and Jablonka suggest a set of criteria, identify a marker for the transition to minimal consciousness, and explore the far-reaching biological, psychological, and philosophical implications.

This book has provided the best history of cognitive science I’ve come across anywhere.

Wetware: A Computer in Every Living Cell, Dennis Bray

In clear, jargon-free language, Dennis Bray taps the findings of the new discipline of systems biology to show that the internal chemistry of living cells is a form of computation. Cells are built out of molecular circuits that perform logical operations, as electronic devices do, but with unique properties. Bray argues that the computational juice of cells provides the basis of all the distinctive properties of living systems: it allows organisms to embody in their internal structure an image of the world, and this accounts for their adaptability, responsiveness, and intelligence.

Introduction to Information Theory, JR Pierce.

Beginning with the origins of this burgeoning field, Dr. Pierce follows the brilliant formulations of Claude Shannon and describes such aspects of the subject as encoding and binary digits, entropy, language and meaning, efficient encoding, and the noisy channel. He then goes beyond the strict confines of the topic to explore the ways in which information theory relates to physics, cybernetics, psychology, and art. Mathematical formulas are introduced at the appropriate points for the benefit of serious students.

Soon: Ashby’s Design for a Brain.

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This was a time-boxed writing challenge. I may do more of these, given interest.

If there is a sharp knife pressing into my hand, and let’s call it pain, if I resist, resist it, and hate it and want it gone, I stick the knife deeper in my hand.

Try to push it away, okay. Deeper. Now if I relax my hand, okay, it’s a totally different experience. Now, this is like the ABC of dealing with pain. Not focusing on the pain, but focusing what you do against the pain.

Because the general attitude of people is pain is the enemy. Pain is bad. Pain is the devil. When people are experiencing pain, they immediately contract and stop breathing. Those two actions push the knife more into the body because you take away the respiration, the person doesn’t breathe, or his body doesn’t have enough energy to deal with the pain.

He contracts muscles, he blocks the energy flow in the body. Now the pain can only accumulate.”

 My guest today, Avi Grinberg, is a deep practitioner. He started out as a paramedic and traveled around the world to learn from different indigenous heals. I was particularly excited to talk to Avi because, in my own journey of exploring pain, I’ve come to a set of intuitions that’s hard to articulate about the role of awareness and how we generate the pain in our own way.

When I saw Avi speak, I felt there was a deep connection that we were coming from the same place and seeing things, and so naturally I reached out to have a conversation. While I might not agree with all of Avi’s conclusions. I found a lot to learn from him in this conversation and I hope you will too.

00:00:00 Introduction and Early Encounters with Healing

00:04:00 “Most People Don’t Know How to Experience Pain”

00:08:00 Pain Is Energy Seeking Completion

00:12:00 Indigenous Healers in the Middle East and South America

00:36:00 Demonstration of the Exercise: Relaxing Into Pain

00:44:00 Trying Hard Breeds Chronic Tension

01:04:00 The Danger of “Easy Healing”

01:17:00 Closing Reflections

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Grinberg method website

http://www.grinbergmethod.com/

YouTube channel: https://www.youtube.com/@GrinbergMethod

This map of bottlenecks comes from years of self-experimentation, and the dozens of people I’ve since helped. It is not medical advice.

Note: This applies to chronic pain where the central nervous system is heavily involved. It doesn’t cover the minority of cases driven by clear local injury — like tumors pressing on nerves, broken bones, or other obvious tissue damage1.

Starting out

Before seriously attempting any work, there are three common bottlenecks I’ve observed.

1. Belief that pain = damage

If you believe chronic pain is just a sign of tissue damage, you won’t look closely at your inner experience. You won’t notice how pain can be learned, how it is heavily tied to your emotions, and how — if you look close enough — it is generated by your nervous system.

Most people I meet with chronic pain are stuck here. They focus on biomechanical fixes — painkillers, surgery, physical therapy. When they work, the pain may still linger in the background as a dull drag on your experience, or it may transfer to different parts of your body.

2. Life on fire

When you are overworked, dealing with other health issues, or worrying about how you’ll pay rent next month, you won’t have the slack needed to engage in the process.

Often people will see that their emotional state heavily influences their pain, but do not actually make the slack needed for deep change.

Processing

Once people make space to do the work, there are still a few common bottlenecks they might face.

3. Poor emotional attuning

Much like recognizing a piano chord, sensing emotions is a skill that can be learned.

Often this skill is largely absent in people with pain. Symptoms of this include: emotions feel highly conceptual (felt ‘in the head’, or similar to thoughts), your chest or midsection feels like one vague blob “my body just feels tension when I’m anxious — it’s hard to be more specific”.

Example of clearly described interoception: “anxiety shows up as this band of tightness especially around the top of my left diaphragm. I notice the back of my right neck is also tight especially as I breathe and there’s definitely some fear there too”

If you can’t clearly feel an emotion in your body, the underlying emotional beliefs tend to remain stuck below conscious awareness — and the mind keeps looping in a catastrophizing cycle.

4. Bad body map

Imagine keeping your hands in thick gloves for five years, and one day taking them off to play the violin. Your fingers might be strong, but they’d feel clumsy. You’d struggle to sense each individual string and apply way more force than is needed.

Something similar often happens with chronic pain.

The pain is coupled with poor sensorimotor discernment. Because you can’t sense that the mid-low back tenses unnecessarily hard every time you stand up, you can’t let it go, and a day full of sitting and standing has your left lower back feeling sore2.

5. Self-attacking perfectionism

Imagine that the next presentation you give is going to determine whether you succeed or fail for the rest of your life. Everything, all your dreams and wishes, your family’s hopes, all hinge on how good the presentation is. As you walk up, with your slides prepared, what would it feel like? How easily could you breathe? How much could you sense your whole body? Now what if this were true for every presentation for the rest of your life?

Having very high personal standards is often linked with self-punishment and catastrophizing. The stakes feel very high, and the intensity of focus leads to a tension to ‘do everything right’. This is paradoxically the opposite of the internal movement of accepting and relaxing — the ‘unlearning’ of self-tension.

Integrating

Even as interoception improves and self-acceptance grows, there may still be situations that feel awkward. Part of developing the better body map also means learning to move with ease.

At this stage, there is a baseline comfort — still, some situations reliably trigger pain. Family gatherings, performance reviews — these can all be worked with.

Lack of progress is often due to working on the wrong bottleneck

Early on, Tanner and I took on people who were excited to work with us, but who seemed to be mysteriously stuck. On closer examination, they weren’t doing any of the practices in between sessions and seemed to be generally overwhelmed, even as there would be progress during the sessions.

For a while we thought it reflected our lack of skill or clarity in explanation. After seeing the same approach work very rapidly for others, it’s made more sense to see that certain clients were bottlenecked on the pre-requisites, which we had little ability to affect.

Bottlenecks are not stages of progression

Although I’ve ordered it roughly chronologically from what I’ve observed, pain is the output of a complex system. You do not need to ‘complete’ one bottleneck to advance to the next. Since our sensations are heavily bundled with our thoughts and emotions, working deeply with one bottleneck can often unravel and resolve many others. Many people find rapid resolution once they meet the prerequisites.

Pain is workable

The father of modern human anatomy, Andreas Vesalius, made the first clear map of the human body. Above, you can see an example of how the human body was illustrated prior to Vesalius. Our conceptual tools begin as blurry, gross things that become refined over time.

Vesalius’ maps were brilliant innovations at an external map of the human body. I’m interested in internal, subjective maps of human experience3.

What I’ve illustrated here is vague, impressionistic. Yet I’m convinced it’s clear enough to be directly helpful for making progress on chronic pain.

Pain is complex, but noticing these patterns gives me the conviction that most people with chronic pain can experience lasting relief. In many cases, this relief can take much less time.

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Thank you to Chris Lakin for inspiring the ‘bottlenecks’ framing. Also to Orpheas, Agi, Misha for feedback, and to Olivia for the illustrations.

In this episode of Pain Points, I’m speaking with David Chapman, a writer and thinker whose work on meaning, meta-rationality, and science has been the most important education I received outside of MIT.

David was a prominent AI researcher in the late 1980s and later a startup founder, but for decades he has written deeply about philosophy, systems, and what he calls “meta-rationality.” In this conversation, we explore how that lens applies to healthcare and chronic illness.

David shares his own story of navigating years of debilitating fatigue and food intolerance, how the medical system failed him, and the experiment he devised that restored his health. He also describes his experience with long COVID, and how a six-mile run cured his fatigue.

We also discuss: why debugging is inherently meta-rational, how most medical science may be false, and why bright lights—not antidepressants—end up curing decades of seasonal depression.

“I could barely stand up. So I drove myself to the trailhead, ran six miles, and by the end…the fatigue was gone.”

“Popper spent his life trying to solve the question: what separates science from non-science? He failed. Everyone has failed.”

Episode Outline

[00:00 – 08:00] Meta-Rationality and Debugging

• Rationality vs. reasonableness vs. meta-rationality

• Debugging as paradigmatic example of meta-rational thinking

• Chronic illness is necessarily metarational

[08:00 – 14:00] Failures of the American Healthcare System

• Patchwork of semi-systems that don’t communicate

• Anecdotes of bureaucratic breakdown (insurance snafus, mis-sent faxes)

• Emergence of the communal mode: relying on personal networks instead of systems

[14:00 – 19:00] Medical Interventions and Their Limits

• Treatments are often presented as “fixes,” but the body still does the healing

[24:00 – 33:00] Fatigue, Food Intolerance, and Experimentation

• Years of symptoms: fatigue, brain fog, GI distress

• Multiple doctors, useless tests, failed elimination diets

• Breakthrough: reducing diet to three foods, symptoms vanish in a week

[47:00 – 49:00] Mislearned Associations

• Pesto and cheesecake stories as examples of the body “wrongly” learning aversions

[53:00 – 59:00] Long COVID and the Six-Mile Cure

• Fatigue relapse after a hike

• Experiment: pushing through with a six-mile run

[60:00 – 72:00] Somatic Practices and Newtonian Mechanics

• Alexander Technique and Feldenkrais as non-woo somatic methods

• Health as alignment, awareness, and agency

[74:00 – 79:00] The Demarcation Problem and Medical Science

• Why the line between science and non-science can’t be drawn

• Why most medical research may be false

[87:00 – 92:00] Bright Light Therapy and Seasonal Depression

• Curing decades of winter depression

• How breakthroughs often come from outside the medical system

[92:00 – End] Closing Reflections

• Health as agency and experimentation

• The need for communities that avoid both scientism and woo

• Restoring agency to people dealing with chronic illness

Links

• You can find David’s writing at meaningness.substack.com

  Thanks for reading Debug Your Pain! Subscribe for free to receive new posts and support my work.

He uses embodied cognition to combine ideas from Tai Chi, wrestling, and physical theater to create a wholly unique approach to movement that he calls the Fighting Monkey Practice. We recently finished a paper called Beyond Biomechanics, Fighting Monkey and the Enactive Inference Approach to Health and Movement.

I'm really excited about this interview today because Jozef is, as you'll hear, an incredible storyteller. But more importantly, through his work he is articulating one of the most inspiring visions of health, which of course relates to my own work on pain. We begin by discussing his background, learning Tai Chi for 20 years in an experimental slovakian movement community before explicitly discussing our paper.

(You can read the transcript online)

“ Health is not absence of illness. Health may be described as your capacity to be connected to people . That's also being healthy, right? That's very important. I think we are too obsessed by staying healthy, trying to do everything right. We force our bodies and we stress our bodies enormously. We constantly follow some sort of protocol. We are constantly hearing what we should be, what exercise we should be doing, but we really forget how to listen to ourselves.

We rarely find our authentic voice. We only follow ideas of others, but we do not sense what actually is happening in our physiology.”

[00:00:00 - 08:00] Origins and Early Movement Journey

• Transition from basketball to acting

• Discovery of movement community in Slovakia

• Meeting Tai Chi masters and the 20-year journey with Ming Wong

[08:00 - 14:00] Philosophy of Teaching and Permission

• The importance of teacher permission vs. open learning

• "Stray dogs" approach to students

• Evolution doesn't create solutions, it creates problem-solving

[14:00 - 22:00] Theater, Sports, and Asian Philosophy

• How Tai Chi informed theatrical practice

• Table tennis and father-son relationship

• Journey through Taoism, Zen Buddhism, and Korean traditions

[22:00 - 33:00] Existential Pain and Storytelling

• Childhood encounters with mortality and darkness

• Theater as simulation and agency creation

• "I have something and I'm afraid of losing it" - the core of suffering

[33:00 - 45:00] The Question Dance

• Interactive dialogue experiment

• Exploring meaning, perception, and embodied understanding

• The power of questions over answers

[45:00 - 58:00] Scientific Philosophy and Embodied Practice

• Active inference and nested agency

• Extended mind and embedded cognition

• Breathing as autonomous intelligence

[58:00 - End] Health, Agency, and Creative Healing

• Health as agency rather than absence of disease

• Joy and pleasure as guides to healing

• The vision for more accessible creative movement practice

Links

Shen, Max, and Jozef Frucek. "Beyond Biomechanics: Fighting Monkey and the Enactive Inference Approach to Health and Movement." (2025). Link

Fighting Monkey website, IG

About the Host

Max Shen is a former machine learning researcher turned pain and cognition researcher. After facing chronic pain in grad school, he now uses computational tools at MIT to explore pain from a systems and somatic lens.

🎧 Listen to all episodes:

• Substack: essays.debugyourpain.com
  

📬 Get in touch:

• Email: maxkshen@gmail.com
  

• Twitter: @maxkshen

I think of all of these things as a continuum, [William James] said that ‘thoughts are thinkers too’, and it's a spectrum. We are also patterns, and we spawn off other patterns and there's a continuum... there’re fleeting thoughts and then persistent, intrusive thoughts that are a little harder to get rid of. Maybe they do a little niche construction in your nervous system to keep themselves around longer. And then, much larger things like personality fragments, like in dissociative identity disorder, and then full human personalities, and then maybe some sort of transpersonal bigger things after that.”

 Professor Michael Levin is the director of the Allen Discovery Institute at Tufts, and in my opinion, the most interesting scientist alive. He's created devices to regenerate limbs in animals that are non regenerative, made tadpoles grow working eyeballs out of their tails, and created other novel self-healing microscale life forms.

I am joined also by Adam Safron, who is a brilliant postdoc-collaborator with Mike Levin and who is a good friend of mine.

I start with a concise overview of Levin’s work and we get into rich territory about pain. I hope you enjoy the interview as much as I did.

More on health, movement, and becoming the whole collective intelligence you are: essays.debugyourpain.com

You can also listen on Apple Podcasts

Timestamps

00:00:00 – Regeneration, Bioelectricity, and Cellular Agency
Levin introduces frog limb regeneration and the surprising effects of an empty biodome—suggesting even cells can experience agency and respond to protected environments.

00:02:00 – The TAME Framework: Every Living System as Nested Intelligence
Max explains Michael Levin’s worldview: living organisms are composed of goal-directed agents across scales, from organs to organelles.

00:06:00 – Chronic Pain as a Persistent Pattern with Agency
Exploring the provocative idea that pain can act as an agent with its own goals—akin to false beliefs that persist within tissue systems.

00:09:00 – Personal Narrative: Reorienting Research Through Pain
Max shares his journey through unexplained chronic pain, and how it led to a shift toward somatic cognition and predictive processing.

00:13:00 – Patterns as Thinkers: From Thoughts to Dissociative Agents
Levin discusses how persistent cognitive patterns—like chronic pain or trauma—may act as semi-autonomous agents within the system.

00:18:00 – Social Contagion, Morphogenetic Cohesion, and Cellular Belief
How embryonic cells reinforce each other’s development plans, resist defects together, and what this implies for physiological and social healing.

00:21:00 – Messaging the Collective: Bioelectric Signals and Organ-Level Intelligence
Discussion of how regenerative signals work at the tissue or organ level, rather than with individual cells—emphasizing the importance of scale in intervention.

00:27:00 – Rethinking Pain: Language, Valence, and Non-Neural Embodiments
Challenging assumptions that affect or pain require a nervous system—suggesting even transcriptional states can have “preferences.”

00:34:00 – Therapeutic Alliance and Molecular Placebos
Exploring the parallels between psychotherapy, placebo effects, and associative learning in gene regulatory networks.

00:40:00 – High-Level Healing: Letting Systems Solve Their Own Problems
How interventions like biodomes or somatic practices (e.g., Feldenkrais) can empower cellular or bodily systems to rejoin the collective intelligence of the organism.

Resources

Levin, Michael. "A Technological Approach to Mind Everywhere: an experimentally-grounded framework for understanding diverse bodies and minds." Frontiers in systems neuroscience 16 (2022): 768201.

“Beyond Biomechanics: The Enactive Inference Approach to Health and Movement” Shen & Frucek (2025)

Contact

• Email: max@debugyourpain.com

• Twitter: @mxslk

Watch here

More on health, movement, and becoming the whole collective intelligence you are: essays.debugyourpain.com

⏱ Timestamps

00:00:00 – Introduction: Movement Without Reductionism
00:01:00 – From Stanford Biochemistry to Movement Coaching
00:03:00 – Traditional Training: Isolate, Integrate, Improvise
00:06:00 – Why Transfer Fails in Traditional Models
00:09:00 – Ecological Dynamics in Combat Sports
00:18:00 – Constraints-Led Approach and Skill Transfer
00:21:00 – Enactivism vs. Ecological Dynamics
00:26:00 – The Role of Intention and Meaning in Movement
00:31:00 – What Is Beautiful Movement?
00:35:00 – Movement and Evolutionary Mismatch
00:41:00 – Nested Agency and Biological Intelligence
00:47:00 – Rehabilitating Without Rest: A Proactive View on Pain
00:56:00 – Changing Paradigms in BJJ and Movement Instruction
01:01:00 – Teaching With Tasks, Not Moves
01:07:00 – From Theory to Practice: Bringing CLA to New Disciplines
01:12:00 – Workshops, Collaborations, and What’s Next

📚 Resources

• Beyond Biomechanics: The Enactive Inference Approach to Health and Movement – Shen & Frucek

• Ramstead, M., et al. A Tale of Two Densities: Active Inference is Enactive Inference.
  Adaptive Behavior, 2019

• Varela, F., Thompson, E., & Rosch, E. The Embodied Mind. MIT Press, 2016

• Lehman, G. Recovery Strategies — Greg Lehman’s Website

• Fighting Monkey Practice

🎙 About the Guests

Bren Veziroglu studied biochemistry at Stanford and worked in molecular imaging before pivoting to the world of movement and rehabilitation. He now teaches and practices using the constraints-led approach, integrating ecological dynamics, somatics, and martial arts to train human beings — not just athletes.

Max Shen is a former machine learning researcher turned pain and cognition scientist. After facing chronic pain in grad school, he now uses computational tools at MIT to explore pain from a systems and somatic lens.

🎧 Listen to All Episodes

Substack: debugyourpain.com

📬 Get in Touch

• Email: maxkshen@gmail.com

• Twitter: @mxslk

In this first episode of our new podcast, Pain Points, I talk about the dominant perspective in biology and medical sciences, how it leads to misunderstanding pain, and how the work of people like Michael Levin and Karl Friston heralds a new paradigm for pain treatment, medicine, and biology writ large.

You can listen on Apple Podcasts:

Spotify:

Or watch on YouTube:

Time stamps

00:00:00 Introduction - The Coming Paradigm Change in Biology
00:02:00 The Biomedical Paradigm: Materialism, Reductionism, and Dualism
00:05:00 How Pain Is Usually Explained (And Why It's Wrong)
00:06:00 Challenges with Materialism, Reductionism, and Dualism
00:12:00 Pain Without Damage, Damage Without Pain
00:15:00 The Alternative: Biological Computation and Collective Intelligence
00:21:00 Nested Agency Across Scales - You Are Many Selves
00:24:00 Health as Problem-Solving Ability, Not Statistical Norms
00:27:00 Pain as a Control Signal
00:29:00 The Somatic Scientists - Ida Rolf, Moshe Feldenkrais, FM Alexander
00:33:00 Why RCTs Don't Work for Complex Therapies
00:36:00 Bridging Science and Practice - The Future of Pain Treatment

Resources mentioned

• Ashar, Yoni K., et al. "Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: a randomized clinical trial." JAMA psychiatry 79.1 (2022): 13-23.

• Noble, Denis. "A theory of biological relativity: no privileged level of causation." Interface focus 2.1 (2012): 55-64.

• Wampold, Bruce E., and Zac E. Imel. The great psychotherapy debate: The evidence for what makes psychotherapy work. Routledge, 2015.

• Beyond Biomechanics: The Enactive Inference Approach to Health and Movement: https://osf.io/preprints/psyarxiv/uqc...

⏱ Timestamps

00:00:00 – Introduction: The Coming Paradigm Change in Biology
00:02:00 – The Biomedical Paradigm: Materialism, Reductionism, and Dualism
00:05:00 – How Pain Is Usually Explained (And Why It's Wrong)
00:07:00 – Problems with Materialism, Reductionism, Dualism
00:12:00 – Pain Without Damage, Damage Without Pain
00:15:00 – The Alternative: Biological Computation and Collective Intelligence
00:26:00 – Health as Problem-Solving Ability, Not Statistical Norms
00:30:00 – Pain as a Control Signal and Skill
00:32:00 – The Somatic Scientists: Ida Rolf, Moshe Feldenkrais, F.M. Alexander
00:37:00 – Why RCTs Don't Work for Complex Therapies
00:42:00 – Bridging Science and Practice

🔬 Key Figures Mentioned

• Michael Levin (Tufts) — Biological computation and collective intelligence

• Karl Friston (University College London) — Active inference and free energy principle

• Denis Noble (Oxford) — Biological relativity and heart pacemaker cells

• Ida Rolf — Developed Rolfing, emphasized fascia connections

• Moshe Feldenkrais — Physicist turned movement therapist

• F.M. Alexander — Alexander Technique founder

📚 Resources

• Ashar, Yoni K., et al. Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: a randomized clinical trial.
  JAMA Psychiatry, 79(1), 13–23 (2022)

• Noble, Denis. A theory of biological relativity: no privileged level of causation.
  Interface Focus, 2(1), 55–64 (2012)

• Wampold, Bruce E., and Zac E. Imel. The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work.
  Routledge, 2015

• Beyond Biomechanics: The Enactive Inference Approach to Health and Movement
  Read on PsyArXiv

🎙 About the Host

Max is a former machine learning researcher who pivoted to studying pain and cognition after experiencing chronic pain during graduate school. He now uses computational tools to study chronic pain at MIT.

📬 Get in Touch

• Email: maxkshen@gmail.com

• Twitter: @mxslk

• Substack: debugyourpain.substack.com