Brain image extraction: Is it metaphysically significant?

Brain image extraction technology has been around for years now: researchers measure brain activity patterns and are then able to translate these measurements into an approximation of the imagery the subject is either seeing or imagining. This way, one can 'read your mind' or 'extract images' from your brain, so to speak: one can make inferences about your first-person visual experience based purely on objective brain activity measurements.

A new study in Russia on brain image extraction may again—understandably, but nonetheless regrettably—lead lay people to the following conjecture: if we are able to translate brain activity measurements into the visual imagery the person is actually experiencing from a first-person perspective, doesn't that mean we have bridged the explanatory gap? Philosophers have maintained for decades now that we cannot deduce the qualities of experience from objective measurements. There is an 'explanatory gap' between these two domains, in that we can't explain qualities in terms of quantities. But if—as shown in the Russian study—technology can translate EEG measurements into visual imagery, surely we have eliminated the gap; haven't we?

Surely we haven't. The conjecture—understandable and forgivable as it may be—is totally wrong; it is based on a deep misunderstanding of what is going on here. This is what I shall attempt to explain in this post.

But before we start, let me clarify first that I won't be judging the quality or accuracy of the Russian study, as reported in this preprint. I will simply assume that it is accurate, as reported. Even if this particular study turns out to be flawed—which I have no reason to believe—something along the same lines is or will surely be possible. In addition, the general public summary prepared by the Moscow Institute of Physics and Technology is quite accurate, level-headed and well written. The popular science media in the West—with some honorable exceptions—could learn a thing or two from them on how to communicate science in an accessible but non-hysterical and non-misleading manner. So you don't really need to read the full technical paper to follow this post; the popular summary will do.

The first thing the researchers did was to train an artificial neural network (ANN) to link certain patterns of brain activity, as measured with an EEG, to certain images. This sounds complicated but it really isn't. All they needed to do was to take EEG readings of a subject as he or she was looking at a known set of images displayed on a screen. Researchers then knew, by construction, what brain activity pattern corresponded to each image, since the subject was actually looking at the image as his or her brain activity was being measured. Next, the researchers provided each EEG measurement as input to the ANN and trained it to produce the corresponding image as output. Again, the latter image was known—it was what the subject was looking at when his or her brain activity was measured—so the trick consists merely in getting the ANN to produce a similar-enough copy of the image. We say that the image is the target output of the ANN during training, which it should produce when given the corresponding EEG data as input.

The ANN's training goes something like this: imagine that the input is just a number—say, 5—and the target output another number—say, 21. What you then want is to configure the ANN such that, when it is given 5 as input, it produces 21 at the output. The function the ANN is configured to perform could be as simple as to multiply the input by 4 and then add 1. In other words, the ANN could simply implement the function f(input) = 4 x input + 1. When the input is 5, we get f(5) = 4 x 5 + 1 = 21. 'Training' the ANN consists in finding this function f(input) through directed trial and error, so the ANN matches the target output. Once it's found, the function constitutes an ad hoc mapping between input and output data. It enriches and processes the input until it adds up to the target output.

In the case of the Russian study, instead of a single number as input, the ANN receives an array of numbers corresponding to each EEG measurement. Instead of a single number as target output, the ANN receives an array of numbers corresponding to the images. And then, instead of just one pair of input / target output, it receives several training pairs—that is, a series of EEG measurements, each with its corresponding image—so the function f(input) generalizes for a variety of inputs. Yet, the essence of what happens during training is what I described in the previous paragraph. The ANN implements an ad hoc mapping between EEG data and target image. It enriches and processes the EEG data until it adds up to the target image.

The figure below, from the Russian paper, illustrates the images the ANN was trained to produce (two upper rows) and the images the ANN actually produced. Notice how training gets the ANN to produce images pretty similar to the target ones.

That the ANN manages to do this is no miracle; it is in fact trivial, the straightforward result of having been trained to do so with actual images. The ANN doesn't magically deduce visual qualities from electrochemical patterns of brain activity; it doesn't bridge the explanatory gap; it already receives images from the researchers to begin with, who knew what the subject was looking at. The ANN outputs images because it was already shown images during its training, so it just learned to copy them when given EEG data as input. That's all. It generates roughly the right images because it has been forced—during training—to find an ad hoc mathematical way to process and enrich EEG data so as to produce certain sequences of numbers that can be visualized, by you and me, as images. As a matter of fact, as far as the ANN is concerned there actually aren't images at all, just sets of numbers that—it so happens—you and I, conscious human beings, can interpret as images.

The next step in the Russian study was to—after training—present the ANN with new EEG patterns that it had not yet seen during training. The idea is to check if the ANN has learned enough to extrapolate from what it has seen and make inferences when it is presented with new inputs—that is, to check if the ad hoc mapping between EEG data and images, produced during training, remains valid for data not used during the training. If the training was effective, the images the ANN will then produce will be similar to the images the subject was actually being shown when the new EEG measurements were taken. If the training was poor, it will produce images that don't correspond to what the subject was experiencing.

In the figure below, also from the Russian paper, we can see how well the ANN managed to infer the new images. The two upper rows show the images the subject was actually looking at when EEG measurements were performed, and the two lower rows show the images the ANN produced in response to these new EEG readings. The match, though still reasonable, isn't as good as that obtained during training, since now the ANN is trying to guess from data it has never before seen.

By explaining how this whole thing works, I hope to have made it clear to you that none of it has anything to do with the explanatory gap or the hard problem of consciousness; the Russian study, in fact, has no new metaphysical relevance. All it establishes is that there are correlations between patterns of brain activity and inner experience, but this we already knew. Such correlations are also entirely consistent with many other metaphysics aside from materialism (e.g. different versions of panpsychism and idealism account for the same correlations; even some versions of dualism do), so it doesn't privilege materialism at all.

The ANN produces images because it was trained with known images to begin with. It succeeds in linking EEG data to images because it was trained on the EEG measurements of subjects who were actually looking at the images. So it merely leverages the fact that the researchers already knew what the subjects were experiencing to begin with. The ANN presupposes the subject's experiences in its training set, it doesn't explain them at all. Do you see the point?

Insofar as it merely assumes the qualities of experience to begin with, brain image extraction technology doesn't explain these qualities. It can't explain that which it presupposes. All it does is to find a mathematical function that links two sets of data (inputs and outputs); it doesn't even begin to explain how qualities can emerge or be produced by quantifiable physical parameters.

Introducing 'Decoding Schopenhauer's Metaphysics'

My new book, Decoding Schopenhauer's Metaphysics (DSM), is now available for pre-ordering from amazon UK and soon from other retailers as well. In this post, I want to give you a brief overview of the book, tell you why I wrote it and why I think it is important.


After I finished The Idea of the World—over a year before the book was actually published—I started an effort to trace my ideas back to their historical predecessors and anchor them in the Western philosophical tradition. In regard to 19th-century philosopher Arthur Schopenhauer, I took it light at first and read Christopher Janaway's little book Schopenhauer: A Very Short Introduction. I describe this experience, and what happened next, in DSM:
In the many quotes of Schopenhauer’s works included in [Janaway's] book, I believed to discern—to my surprise—clear similarities with the metaphysics laid out in my own work. Naturally, I felt his points were compelling. Yet, Janaway peppered his book with criticisms of Schopenhauer’s metaphysics. What he seemed to be making—or failing to make—of Schopenhauer’s words was quite different from what I thought to discern in them. Janaway saw problems and contradictions where I thought to see clarity, elegance and consistency. But since Janaway is the professed expert and I was just perusing quotes out of context, I initially suspected I was reading too much into them.

The only way to clarify the issue was to sink my teeth into Schopenhauer’s magnum opus: the two-volume, 1,200-page-long third edition of The World as Will and Representation [1859], in the same translation that Janaway himself used. ... In the ensuing months, I devoured the lengthy two-volume set, reading and re-reading it. I recognized in it numerous echoes and prefigurations of ideas I had labored for a decade to bring into focus. The kinship between my own work and what I was now reading was remarkable, down to details and particulars. Here was a famous 19th century thinker who had already figured out and communicated, in a clear and cogent manner, much of the metaphysics I had been working on. What better ally could I have found? And yet, bewilderingly to me, Schopenhauer’s “metaphysics has had few followers” (Janaway 2002: 40). Its utter failure to impact on our culture for the past 200 years is self-evident to even the most casual observer.
With DSM, I try to change this, for I think there is tremendous value in Schopenhauer's legacy for a 21st century readership, particularly in the modern context of quantum mechanics and the 'hard problem of consciousness':
I believe Schopenhauer’s most valuable legacy is precisely his metaphysical views: they anticipate salient recent developments in analytic philosophy, circumvent the insoluble problems of mainstream physicalism and constitutive panpsychism, and provide an avenue for making sense of the ontological dilemmas of quantum mechanics. ... Had the coherence and cogency of Schopenhauer’s metaphysics been recognized earlier, much of the underlying philosophical malaise that plagues our culture today—with its insidious effects on our science, cultural ethos and way of life—could have been avoided. (emphasis added)
In the book,
I offer a conceptual framework—a decoding key—for interpreting Schopenhauer’s metaphysical arguments in a way that renders them mutually consistent and compelling. With this key in mind, it is my hope that even those who have earlier dismissed Schopenhauer’s metaphysics will be able to return to it with fresh eyes and at last unlock its sense.


A perfectly legitimate and good question that can be asked of a book about someone else's writings has been put forward by a participant of my discussion forum:
I never understood why would anyone read a book about a book wrote by someone else. ... why not just read the original and use your own mind to decide what the author wanted to say? ... why bother with third parties and not just read the original?
I replied to him by stating that, with DSM, I think I can help to

  1. disambiguate Schopenhauer's conceptually-loose terminology usage;
  2. clarify his argument under the light of modern psychology;
  3. place his ideas in the context of quantum mechanics, inexistent at his time;
  4. relate his discourse to modern issues emerging in ontology and philosophy of mind, which were also inexistent at his time;
  5. summarize and bring together his contentions in a coherent framework articulated in modern language, which people today can easily relate to.
All this said, I do think the best is indeed to read Schopenhauer's own words, if people are willing to face them: Schopenhauer's The World as Will and Representation alone has 1,200+ very dense pages in tiny fonts, written in an accessible but old-fashioned style. Because I suspect that most people don't have the time or the interest to plow through that, I felt an alternative would be valuable, for I want to make Schopenhauer's thought available to them too. DSM has only 144 pages and costs a fraction of Schopenhauer's original. After reading it, if their curiosity is piqued, the more interested readers can approach Schopenhauer himself with a solid basis for making sense of his words.


I have two main goals with DSM:
on the one hand, I aim to rehabilitate and promote Schopenhauer’s metaphysics by offering an interpretation of it that resolves its apparent contradictions and unlocks the meaning and coherence of its constituent ideas. On the other hand—and on a more self-serving note—I hope to show that my own metaphysical position, as articulated in my earlier works, isn’t peculiar or merely fashionable, but part instead of an established, robust and evolving chain of thought in Western philosophy.


A key element in achieving both goals is my refutations—elaborated upon in detail in DSM—of present-day criticisms and misrepresentations of Schopenhauer's metaphysics, which unfortunately are rampant in academia. As a philosopher who has produced original work myself, the idea of my own writings being one day subjected to the kind of disfiguration and outright abuse suffered by Schopenhauer, at the hands of presumed experts, makes me sick. My sympathy for Schopenhauer compels me to try and improve the standing of his work.

Unfortunately, instead of producing original work of their own, some scholars in academia choose to make a career out of (mis)representing and criticizing dead philosophers' works. That these philosophers are no longer around to defend themselves seems to give license to the scholars in question to pass their own interpretative difficulties for errors on the part of the late philosophers; errors one wouldn't attribute even to a high-school student today. In other words, some critics seem to mistake their own intellectual obtuseness for (completely implausible) shortcomings in the argument of the philosophers they criticize. By presumptuously portraying themselves as intellectually superior, these critics perhaps feel that the recognition hard-earned by their targets—thanks to the latter's original work—rubs off on them.

Christopher Janaway characterizes Schopenahuer's metaphysical contentions as "something ridiculous" or "merely embarrassing," which should be "dismissed as fanciful" if interpreted in the way Schopenhauer clearly intended them to be. He claims that "Schopenhauer seems to stumble into a quite elementary difficulty" in an important passage of his argument. And so on. The freedom Janaway allows himself to bash Schopenhauer, and the arrogant, disrespectful tone with which he does it, are breathtaking. It is so easy to bash a dead man who can't defend himself, isn't it?

Ironically, all this actually accomplishes is to betray the utter failure of Janaway's attempt to grok Schopenhauer. Indeed, his apparent inability to comprehend even the most basic points Schopenhauer makes, and to think within the logic and premises of Schopenhauer's argument, is nothing short of stunning. Here is someone who just doesn't get it at all, and yet feels entitled not only to write books about Schopenhauer; not only to characterize Schopenhauer's argument as "ridiculous," "embarassing" and "fanciful" (Oh, the irony!); but even to edit Schopenhauer's own works! By now Schopenhauer has not only turned in his grave, but strangled himself to a second death.

Even more peculiar is Janaway's suggestion that it is Schopenhauer who is obtuse, for the "elementary difficulties" Janaway attributes to him couldn't be seriously attributed even to a high-school student today, let alone a renowned philosopher. At no point does Janaway seem to stop, reflect and ponder the glaringly obvious possibility that perhaps Schopenhauer does know what he is talking about and it is him (Janaway) who just doesn't get it. Instead, he portrays Schopenhauer as an idiot; how precarious, silly and conceited. He even accuses Schopenhauer of crass materialism, despite Schopenhauer's repeated ridiculing of materialism and the fact that Schopenhauer's whole argument consistently refutes it in unambiguous terms. I discuss all this in detail in DSM. Here it shall suffice to observe that, to be an expert on anything, it takes more than just study; for if one can't actually understand what one is studying, no amount of scholarly citations will turn vain nonsense into literature.

I richly substantiate my criticism of Janaway in DSM: I carefully take his contentions apart, while clarifying Schopenhauer's points in a way that should be clearly understandable even to Janaway. So if you think I am exaggerating in this post, please peruse DSM: it can be leisurely read in a weekend or, with focus, in a single sitting, so it won't cost you much time at all to see whether I actually have a valid point.

Tackling other misrepresentations

Amazingly, some attribute dual-aspect monism to Schopenhauer. Indeed, as of this writing, Wikipedia listed his metaphysics as an instance thereof. I can only imagine two reasons for such a vulgar misunderstanding: either one has read only the title of Schopenhauer's main work (The World as Will and Representation) and arrived at conclusions from it alone, or one doesn't actually know what dual-aspect monism means. Again, I elaborate much more in DSM.


Despite all this, DSM isn't primarily about polemics and refuting misunderstandings and misrepresentations, even though it is about that too. Primarily, it is about elucidating, in a concise and easily-accessible manner, Schopenhauer's extraordinary and sophisticated ideas on the nature of mind and reality; ideas whose plausibility, explanatory power and importance have only increased over the past two centuries. Schopenhauer's work is a veritable metaphysical treasure that deserves much more recognition than it has gotten. Even more importantly, we, 21st-century readers, deserve the gift Schopenhauer has left us as inheritance.

Sometimes, those who preceded us weren't just naive and ignorant, 'primitive' versions of ourselves—as some scholars conceitedly seem to think—but in fact saw farther than most of us do today (including scholars). We ignore and dismiss them at our own peril.

The many in our dreams

Giotto di Bondone's Joachim's Dream (1303-1305). Source: Wikimedia Commons.
As I posted on social media recently, a critical essay of my work has been published, a few days ago, in a Russian newspaper. I know a few words in Russian but can't really read an essay. Yet, Russian-speaking readers told me that one of the criticisms made in it is the following: whereas we can see an interact directly with other people and animals, the different alters of a patient with dissociative identity disorder (DID) can't see or interact directly with each other. Therefore—or so the argument goes—my stating that life, biology, is the image of dissociation in universal consciousness is incoherent.

It so happens that, in my upcoming book on Schopenhauer's metaphysics, I tackle precisely this criticism in the passage reproduced below. In it, by 'universal will' I mean universal consciousness. Since I offer this as a defense of Schopenhauer's metaphysics, the implication is that, in my view, Schopenhauer, too, explains personal identity and life in terms of universal dissociation. I make this case quite extensively in the book, which will very soon be available for pre-ordering.

Soon available for pre-ordering.
Long quote from Decoding Schopenhauer's Metaphysics

A criticism that could be offered at this point is this: whereas we can perceive and interact directly with other individual subjects in ordinary waking life—after all, I can surely see and interact with other people and animals—an alter of a human DID [Dissociative Identity Disorder] patient cannot perceive and interact directly with another alter of the same patient; there is nothing the second alter looks like from the point of view of the first; the first alter cannot reach out and touch the second. So how is it that I can reach out and touch other people and animals if they, like me, are analogous to alters of the universal will?

The key to making sense of this is rigor in interpreting the analogy: we are likening (a) a person with DID to (b) the universal will with something analogous to DID. But remember, unlike the case of the person, there is no external world from the point of view of the universal will. The latter is, ex hypothesi, all there is, all phenomena being internal to it. So we are comparing apples to bananas when we relate the person’s life in the outside world to the entirely endogenous inner life of the universal will. It is much more apt to compare the latter with the person’s dream life, for only then all experiential states in both cases are internally generated, without the influence of an outside world. This, and only this, is a fair analogy.

So what do we know about the dream life of a human DID patient? Can the patient’s different alters share a dream, taking different co-conscious points of view within the dream, just like you and I share a world? Can they perceive and interact with one another within their shared dream, just as people can perceive and interact with one another within their shared environment? As it turns out, there is evidence that this is precisely what happens, as research has shown (Barrett 1994: 170-171). Here is an illustrative case from the literature:
The host personality, Sarah, remembered only that her dream from the previous night involved hearing a girl screaming for help. Alter Annie, age four, remembered a nightmare of being tied down naked and unable to cry out as a man began to cut her vagina. Ann, age nine, dreamed of watching this scene and screaming desperately for help (apparently the voice in the host’s dream). Teenage Jo dreamed of coming upon this scene and clubbing the little girl’s attacker over the head; in her dream he fell to the ground dead and she left. In the dreams of Ann and Annie, the teenager with the club appeared, struck the man to the ground but he arose and renewed his attack again. Four year old Sally dreamed of playing with her dolls happily and nothing else. Both Annie and Ann reported a little girl playing obliviously in the corner of the room in their dreams. Although there was no definite abuser-identified alter manifesting at this time, the presence at times of a hallucinated voice similar to Sarah’s uncle suggested there might be yet another alter experiencing the dream from the attacker’s vantage. (Barrett 1994: 171)
Taking this at face value, what it shows is that, while dreaming, a dissociated human mind can manifest multiple, concurrently conscious alters that experience each other from second- and third-person perspectives, just as you and I can shake hands with one another in ordinary waking life. The alters’ experiences are also mutually consistent, in the sense that the alters all seem to perceive the same series of events, each alter from its own individual subjective perspective. The correspondences with the experiences of individual people sharing an outside world are self-evident and require no further commentary.

Clearly, our empirical grasp of extreme forms of dissociation shows that a DID-like process at a universal scale is, at least in principle, a viable explanation for how individual subjects arise within the universal will. Whether the cognitive mechanisms underlying dissociation are also conceptually understood today is but a secondary question: whatever these mechanisms may be, we know empirically that they do exist in nature and produce precisely the right effects to explain the illusion of individuality posited by Schopenhauer. In this regard—and in many others as well—Schopenhauer’s metaphysics is empirically plausible.

The sincere art of obfuscation: A rebuttal of Keith Frankish

Vassily Kandinsky's 'segment blue,' 1921 (cropped).
Could it be that your experience of seeing these rich colors doesn't actually exist?
After my publication of a rebuttal of Michael Graziano's latest essay yesterday, a Twitter exchange followed with philosopher Keith Frankish. It turns out that Frankish holds a very similar position to Graziano's: he, too, argues that subjective experience, phenomenality, is an illusion. This is called the 'illusionist' position in philosophy of mind. In the online exchange, Keith invited me to point out what is wrong with his ideas, as expressed in an online essay on aeon Magazine:

As most of you know, I have little respect for the illusionist view, considering it self-evidently absurd. Well, in all honesty, I actually don't have any respect at all for it. But it is legitimate for Frankish to ask me to point out, explicitly, where I think his argument goes wrong. After all, having criticized his position publicly, I feel obliged now to be quite specific and explicit about my points. Moreover, Frankish writes in a sober tone and articulates his argument fairly carefully. The attitude he brings to the debate renders his work deserving of careful consideration, at least one time. So here we go.


While setting up the context of his argument, Frankish correctly highlights a premise of the physicalist metaphysics, but incorrectly conflates it with science:
For science tells us that objects don’t have such qualitative properties, just complex physical ones of the sort described by physics and chemistry. The atoms that make up the skin of the apple aren’t red.
I don't think science says this at all. Instead, it studies and describes the behavior of nature. As such, it doesn't make—and fundamentally cannot make, as its empirical methodology cannot address such questions—assertions about the metaphysical status of any properties. Science simply describes the behavior of objects and phenomena as they appear to our observation. Such descriptions entail measurable physical and chemical quantities, but that doesn't entail or imply a metaphysical exclusion of qualities from nature.

Having said that, it is entirely true that the metaphysics of physicalism is premised on the notion that all qualities are generated by the brain and, as such, cannot exist out there in objects, but only inside our heads. Frankish's assertion quoted above is consistent with his physicalism, but it illegitimately co-opts the success of science as if physicalism were implied by it. While a common move, this is wrong.


Insisting on his conflation of physicalism with science, Frankish claims:
It is phenomenal consciousness that I believe is illusory. For science finds nothing qualitative in our brains, any more than in the world outside. The atoms in your brain aren’t coloured and they don’t compose a colourful inner image.
He elaborates beyond the quote above, but the complete essence of his point is already captured in it. The argument structure is this:

  1. Physical things, in themselves, have no qualitative properties (like color, flavor, tone, etc.). Only our perceptions of them do;
  2. The brain is a physical thing;
  3. From (1) and (2), the brain has no qualitative properties;
  4. Our experiences are reducible to our brain;
  5. From (3) and (4), our experiences cannot entail qualitative properties.
Ergo, qualitative properties—phenomenality, subjective experiences—cannot exist; they must, instead, be an illusion. The question-begging here is rather obvious: step (4) in the argument structure above presupposes the metaphysics of physicalism, which is precisely the point in contention.

Ironically, what Frankish actually accomplishes in his argument structure is to highlight an implication of physicalism that reduces it to absurdity.

More question-begging

Frankish proceeds to argue against two alternative metaphysics: property dualism—the view that the brain has both physical and qualitative properties—and the view that qualitative properties are merely how physical properties present themselves to introspection, being, therefore, ultimately just physical.

He rejects property dualism by arguing that the physical world is causally-closed and, therefore, the additional qualitative properties are useless and can presumably be dismissed on parsimony grounds. Then he rejects that qualitative properties are merely appearances of physical properties because
it is not just that introspection fails to present sensations as brain states; it positively presents them as utterly unlike brain states
I concur with Frankish's conclusion that both alternatives are incorrect, even though I'd be a lot more cautious than him about claiming that the physical world is causally-closed. At a microscopic level, all quantum mechanical events are undetermined. Only at a macroscopic, statistical level do regularities emerge that allow us to speak of causality. Moreover, laboratory experiments, by virtue of their very need to isolate experimental conditions from unknown factors, may exclude non-local organizing principles in nature that may not be describable as physical causality (cf. e.g. this).

Be that as it may, my point here is different: all alternatives considered by Frankish assume physical realism; that is, the notion that there are non-experiential things out there. This is a premise of physicalism and certain variants of panpsychism, but not of other metaphysics. Objective idealism, for instance, while granting that there is indeed a world out there, maintains that such a world is itself constituted by transpersonal phenomenal states. These transpersonal states simply present themselves to us as the qualities on the screen of perception, in a qualitative transition that occurs for reasons I've discussed on Scientific American. This completely avoids the impossible transition from one ontological category to another, as the fact that certain qualities of experience modulate other qualities of experience is empirically trivial (it happens e.g. every time your thoughts affect your emotions, or the other way around). Finally, a very strong case can be made that physical realism has already been refuted by experimental physics anyway, as I've discussed also on Scientific American here and here.

Whatever the case, Frankish's argument begs the question of metaphysics by simply assuming a key premise of physicalism contested by other metaphysics. At best, his argument refutes other variations of physicalism, but says nothing about e.g. objective idealism.

Internal inconsistency

By rejecting that qualitative properties are introspective appearances of the physical brain and taking physical realism as a given, Frankish concludes that only illusionism can be true: introspection misrepresents the physical states of the brain, thereby generating the illusion of qualitative properties. We've already seen above how the path he took to arrive at this conclusion begs the question in more than one way. I shall argue now that, in addition to this, Frankish's elaboration is also internally inconsistent.

To begin with, I can't resist pointing something out that has already been pointed out by many others. Consider this passage by Frankish:
Think of watching a movie. What your eyes are actually witnessing is a series of still images rapidly succeeding each other. But your visual system represents these images as a single fluid moving image. The motion is an illusion. Similarly, illusionists argue, your introspective system misrepresents complex patterns of brain activity as simple phenomenal properties. The phenomenality is an illusion.
Frankish is very clear that what his argument tries to deny is the very existence of qualities, experience, phenomenal states. But since illusions are themselves phenomenal states—after all, they are experienced—they are already instances of the very thing whose existence Frankish is trying to deny. The appeal to illusions immediately disproves Frankish's whole point. He explicitly addresses this objection towards the end of his essay, and I will deal with his answer towards the end of mine, in the last section below.

For now, though, let us charitably interpret the reference to illusions as a metaphorical effort to evoke a certain familiar intuition, and see where Frankish goes with it:
it is useful to us to have an overview or ‘edited digest’ (Dennett’s phrase) of [our brain] processes – a sense of the overall shape of our complex, dynamic interaction with the world. When we speak of what our experiences are like, we are referring to this sense, this edited digest.
The point here is that, when we introspect, what we experience aren't the original brain processes as they are in themselves, but an inaccurate, distorted, "edited digest" of these processes. This is the basis for Frankish's claim that experiences are illusions: they are misportrayals of that which they represent, i.e. physical brain states.

There is at least one obvious problem with this, though. Misportrayals as they may be, since Frankish's basic premise is that only physical states exist, these 'edited digests' must themselves consist of physical states; what else could they be? And so we end up with the exact same question we started with: How is it that these latter physical states—i.e. the brain states corresponding to the misportrayals—are presented as something utterly unlike brain states?

It seems to me that, to answer this question within Frankish's own logic, we need to postulate a meta-introspective system that misportrays the misportrayals. But then such meta-misportrayals will also necessarily consist of physical brain states, for there is nothing else they can consist of under Frankish's premises. So we need a meta-meta-introspective system that misportrays the misportrayals of the misportrayals... Well, you get the picture.

Frankish's effort to add a physical layer of indirection to explain how presumably physical states can present themselves as qualitative properties is like trying to pull yourself up by your own bootstraps; it just can't do the magic Frankish wants it to do. Adding the indirection brings things no closer to a solution; it merely ends up confronting the exact same problem—intact—that it started with.

No amount of physical indirection can make the physical seem phenomenal, just as no amount of extra speakers can make a stereo seem like television; these two domains are incommensurable. All Frankish accomplishes with his step of indirection is to postpone the inevitable, final confrontation with the real problem at hand. Yet, by obfuscating the innate simplicity of the issue, these indirections can create the impression that some profound, penetrating philosophical insight lies hidden behind them. But none does; it's all smoke and mirrors, as I shall argue in more detail below.

More internal inconsistency

Even Frankish's chosen metaphor actually illustrates no more than the untenability of his thesis:
In Consciousness Explained (1991), Dennett draws a comparison with a computer’s user interface, with its icons for files, folders, waste basket and so on. This is a fiction created for the benefit of the user (a ‘user illusion’). By manipulating the icons, we can easily control the computer without knowing anything about its programming or hardware. Similarly, representations of phenomenal properties are simplified, schematic representations of the underlying reality, which we can use for the purposes of self-control. We should no more expect to find phenomenal properties in our brains than to find folders and waste baskets inside our laptops.
Let us interpret this strictly according to Frankish's own premises and logic, so as not to misrepresent his case: the user interface (UI) is a fiction that (mis)represents e.g. computer files. The latter are patterns of open and closed microelectronic switches in a silicon memory chip inside the computer. But they are presented to the user, through the UI, in the convenient form of little icons. The files aren't icons—they are patterns of open and closed microelectronic switches—yet the UI's (mis)representation is convenient for the user.

So far so good. One can go further down this line of reasoning and observe that, just as the actual computer files, the UI, too, is purely physical: the pattern of pixels that makes up the icons on the screen also consists of open and closed microelectronic switches in both a memory chip inside the computer and the LCD screen that displays the icons to the user. In other words, the UI example shows that a first set of physical states (the actual files) is (mis)represented by a second set of physical states. The states in the second set are different from the states in the first set, which accounts for the fact that icons are different from the actual computer files; but all states are physical and will never look like anything other than physicality.

Transposing this to our problem, a first set of brain states—corresponding to e.g. brain signals processing visual information—is (mis)represented by a second set of brain states, the latter playing the role of UI. These sets differ in that the brain states comprised in them differ. But they are all still brain states; they are all still physical. There is nothing in Frankish's metaphor that provides any intuition for how something physical can end up looking like something phenomenal.

Indeed, the metaphor only seems cogent because it cheats: its evocative power rests in the transition from abstract physical states hidden inside a computer chip to the experience of seeing the computer screen with its icons. But by visualizing this transition we are already using that which Frankish claims not to exist: phenomenal states, qualitative properties, experiences. To be strictly consistent with Frankish's logic, we must imagine that no one is there to look at the computer screen. Then, we are left only with the physical states inside the computer chip and those of the LCD screen. There are no qualitative properties anywhere, only physical states. Now, without someone to look at the screen, does the metaphor do what Frankish wants it to do?

You see, the unintended cheat—for I believe Frankish is cheating himself too, insofar as he sincerely believes his own argument—is that the metaphor implicitly appeals precisely to the very thing whose existence Frankish wants to deny. Therein resides its entire evocative power. Once you see it, the metaphor not only collapses, but its meaning also reverses: no amount of physical representation of the physical can create the appearance of phenomenality.

Some more commentary

Frankish begins now to conclude his argument:
If we observe something science can’t explain, then the simplest hypothesis is that it’s an illusion, especially if it can be observed only from one particular angle. This is exactly the case with phenomenal consciousness.
Except that, in the case of phenomenal consciousness, an illusion is already an instance of phenomenal consciousness, the very thing Frankish denies. Moreover, there are other metaphysics that place the observable dynamisms, patterns and regularities of phenomenal consciousness firmly within the framework of science (see e.g. my own work here, which has been summarized in a popular essay on Scientific American). Therefore, the claim that we have to deny phenomenality because "science can't explain" it is completely bogus; it arises merely from an apparent inability to look at the problem from a different angle, with at least fewer unexamined assumptions.

Frankish seems to be so closed up in his box of implicit assumptions he can't see any alternative but to deny the most obvious. Consider this long paragraph, which Frankish presents as a reason to believe in illusionism. I will quote it in full because I find it so remarkable:
A second argument concerns our awareness of phenomenal properties. We are aware of features of the natural world only if we have a sensory system that can detect them and generate representations of them for use by other mental systems. This applies equally to features of our own minds (which are parts of the natural world), and it would apply to phenomenal properties too, if they were real. We would need an introspective system that could detect them and produce representations of them. Without that, we would have no more awareness of our brains’ phenomenal properties than we do of their magnetic properties. In short, if we were aware of phenomenal properties, it would be by virtue of having mental representations of them. But then it would make no difference whether these representations were accurate. Illusory representations would have the same effects as veridical ones. If introspection misrepresents us as having phenomenal properties then, subjectively, that’s as good as actually having them. Since science indicates that our brains don’t have phenomenal properties, the obvious inference is that our introspective representations of them are illusory.
For all I know our phenomenal properties—i.e. our subjective experiences—indeed do misrepresent something, either physical states or other phenomenal states corresponding to the world outside or certain aspects of our body. But even then they are still phenomenal. One can't deny phenomenality merely by arguing that phenomenality misrepresents something, for this presupposes the phenomenality that misrepresents something.

Rebutting rebuttals

Frankish then begins to preemptively answer possible objections to his thesis. He starts with the objection that our knowledge of the world begins with consciousness, and so consciousness cannot be an illusion. He argues against this by saying that a simple robot would have only sensors and actuators, and only more sophisticated robots, evolved from the simple one, would develop a meta-cognitive introspective system like consciousness. He claims that the same applies to us, so consciousness is not primary but evolved.

One of many problems with this hand-waving argument is that phenomenal consciousness does not need introspection to exist; by assuming that phenomenal consciousness is restricted to its introspective mode, Frankish already makes a mistake. I elaborated on this in both a technical paper and, in summarized form, in Scientific American essay.

The gist of the point is this: introspection—our ability to know and report that  we have an experience—is a metacognitive configuration on top of phenomenal consciousness proper. We know through e.g. the no-report paradigms of modern neuroscience that there can be phenomenal states beyond the field of metacognitive introspection. These states are experienced, even though subjects do not know that they experience them, and so cannot report them; not even to themselves. Once one sees that phenomenal consciousness is in fact more basic than introspection, Frankish's argument here, which is already hand-waving to begin with, collapses.

The grand finale

In answer to the objection that phenomenal states cannot be illusions insofar as illusions are themselves phenomenal states, Frankish has this to say, as a kind of grand closure of this argument:
This looks like a serious objection, but in fact it is easily dealt with. Properties of experiences themselves cannot be illusory in the sense described, but they can be illusory in a very similar one. When illusionists say that phenomenal properties are illusory, they mean that we have introspective representations like those that we would have if our experiences had phenomenal properties. And we can have such representations even if our experiences don’t have phenomenal properties. Of course, this assumes that the representations themselves don’t have phenomenal properties. But, as I noted, representations needn’t possess the properties they represent. Representations of redness needn’t be red, and representations of phenomenal properties needn’t be phenomenal.
I find this passage truly remarkable, but not for the reasons Frankish would presumably like me to. Let's dissect it: Frankish begins by acknowledging that "properties of experiences themselves cannot be illusory in the sense described." This seems quite final to me: the sense described suffices to prove that experiences themselves exist, even if "they can be illusory in a very similar" but other sense. If the sense in which experiences themselves must exist suffices to show that they do exist, whatever other sense in which they may be said to not exist is irrelevant to the point in contention. But let's proceed and see where Frankish takes us.

The sentences that follow are an unsurpassed accomplishment in presumably well-meaning, sincere, but tortuous obfuscation and confused thinking. You should not feel bad if you can't make heads or tails of them, for I had to re-read them several times to see where Frankish is trying to go. What he is saying is that, whether we have actual experiences—phenomenal properties—or not, everything happens as if we had them. That he thinks this answers the objection baffles me, for it in fact succumbs to the exact same objection: for things to happen as if we had experiences, it must seem to us as though we did have them, even if we don't. But Good Lord, the seeming is already an experience. The introspective representations must themselves be phenomenal, otherwise there would be no seeming. Yet there obviously is seeming, for what is an illusion but a factually wrong seeming? If he thinks there is no seeming, why is Frankish trying so hard to convince you that what seems to be the case actually isn't?

Frankish is tying himself up in knots to somehow avoid what is obvious to just about everyone else. It is remarkable and at the same time painful to follow his argument as he buries himself in conceptual confusion. That he claims that the original objection has been "easily dealt with" in this manner is ironic to say the least.

And then he admits:
But how does a brain state represent a phenomenal property? This is a tough question.
Oh! All right!

You see, under Frankish's premises, the question isn't "tough;" it is by construction impossible: for him there are no real phenomenal properties; it just seems as though there were. This seeming is created by said brain representation or state, which misportrays other brain states. Now, how can a brain state create the seeming if seeming—i.e. phenomenality—is not allowed to begin with?  Talk about internal contradictions and conceptual confusion...

Frankish's entire case rests on at least a tentative answer to the question above; without it, there is nothing, just smoke and mirrors. But he just says it is "a tough question"... Oh well.

Undeterred, as if he had accomplished anything at all with everything he has said thus far, Frankish continues:
I think the answer should focus on the state’s effects. A brain state represents a certain property if it causes thoughts and reactions that would be appropriate if the property were present.
Blatant question-begging again. Only under physicalist premises could effects sufficiently account for the question Frankish is leaving open. What defines phenomenal states is precisely that, regardless of their effects, there is something it is like to be in them. By claiming the above Frankish is arguing circularly. But he goes on:
I won’t try to develop this answer here.
Only the answer to this question is substantive for the argument he is trying to make. By not even trying to answer it, Frankish rests his entire case on pure hand-waving. He argues that
it is not only illusionists who must address this problem. The notion of mental representation is a central one in modern cognitive science, and explaining how the brain represents things is a task on which all sides are engaged. ... There is a challenge here for illusionism but not an objection.
I find this nonsensical for a very simple reason: yes, everybody has to account for representation; but only illusionists have to account for it by acknowledging that we seem to have experience while denying experience. How can a physical state be 'seeming' when there is no seeming?

This is what makes their case impossible. Nobody else faces the same problem. An objective idealist, for instance, must account simply for how certain phenomenal states represent other phenomenal states. There is no ontological bridge to be crossed and thus nothing fundamentally difficult about it: our thoughts can trivially represent our emotions by e.g. naming and describing them. An eliminativist—i.e. one who denies experience without even bothering to account for some kind of 'illusion of experience'—only has to show how some physical states represent other, different physical states, which computers do all the time by the use of variables and pointers. The claim that everybody faces the same challenge here is simply untrue, and rather obviously so.

Frankish has accomplished precisely nothing in his long essay; at least nothing more than tortuous obfuscation and hand-waving.

Final thoughts

I started writing this essay with the sincere intention to be charitable, open and understanding. But I finish it now with the overwhelming impression that I have been commenting on a charade. Quite honestly, sincere as Frankish's effort may be, I do think the whole thing is indeed an outright charade, a farce, veiled in conceptual complexity and obfuscation.

Yet I don't think Frankish and other illusionists are malicious about it (perhaps it would do them less dishonor if I thought they were). I think they themselves are caught up in their own charade, drinking their own Kool-Aid to a degree they don't even suspect. Illusionism and eliminativism, in my view, are veritable psychological case-studies on how the human mind finds baffling ways to deceive itself so to defend its own prejudices. I say this with absolute sincerity, in that I truly believe it; it's not to sarcastically deride anyone. I just can't, for the life of me, fathom how otherwise intelligent and educated people can tie themselves up into so much sheer nonsense.

Trying to elucidate this psychological conundrum is, perhaps, the real discussion to be had, after all.

The desperate art of obfuscation: A rebuttal of Michael Graziano

The ‘hard problem of consciousness’ is a well-acknowledged roadblock in efforts to explain subjective experience in terms of brain function: there is nothing about physical things in terms of which we could deduce the qualities of experience. More specifically, nothing we can observe about the arrangement of atoms constituting the brain reveals what it feels like to see red, to fall in love or to have a belly ache.

Whereas neuroscience has been able to pin down correlations between brain function and reported experience, the hypothesized causal link between the two remains elusive. This has turned the solution to the hard problem—if there is one—into the most coveted trophy in neuroscience. As argued in my book Brief Peeks Beyond, the intractability of the problem has even led some to resort to semantic games and claim that consciousness doesn’t really exist.

The absurdity of the notion that consciousness is an illusion—after all, illusions are experiences too, thus presupposing consciousness—has been recently chronicled by Galen Strawson and, more colorfully, David Bentley Hart. So one would have hoped that the time has finally come to move the debate forward along productive lines. Yet the appeal of the trophy seems too irresistible to some. And so it is that neuroscientist Michael Graziano, having not so long ago proclaimed that “consciousness doesn’t happen. It is a mistaken construct,” is at it again.

Graziano starts his latest narrative by correctly defining what is meant by ‘consciousness’ in the context of the hard problem: “it isn’t just the stuff in your head. It is the subjective experience of some of that stuff.” Exactly. Consciousness entails the subjective experiences that somehow accompany the physical stuff going on in your head. So if he is going to claim a solution to the hard problem, Graziano has to explain how these experiences arise from the stuff.

His argument rests on the idea that consciousness is adaptive, that it performs a function useful for survival. Indeed, it is undoubtedly beneficial to recognize and understand ourselves as agents in our environment—i.e. to have a model of ourselves—if we are to thrive. Graziano then argues that consciousness is one such a model the brain constructs of itself, so it can “monitor and control itself.” Consciousness seems immaterial simply because, in order to focus attention on survival-relevant tasks, this model fails to incorporate any detail of brain anatomy and physiology. In his words, “the brain describes a simplified version of itself, then reports this as a ghostly, non-physical essence.”

This sounds very cogent, an impression that is only reinforced by Graziano’s persuasive writing. The problem is that it is all a smokescreen.

The seemingly authoritative argumentation disguises a deceptive sleight of hand: Graziano implicitly changes the meaning he attributes to the word ‘consciousness’ as he develops his argument. He starts by talking about subjective experience—which philosophers call ‘phenomenal consciousness’—just to end up explaining something else entirely: our ability to cognize ourselves as subjects and re-represent our own mental contents. His initial definition of consciousness is relevant to the hard problem, but the one he actually uses isn’t. Creating a model of our own minds and enabling re-representation are ‘easy problems,’ which can be tackled with recursive information processing architectures. Graziano has provided us with exactly nothing as far as the “true nature of consciousness” is concerned.

Indeed, tackling the easy problems has already been done, for instance, by Pentti Haikonen at Nokia Research as early as in 2003. Haikonen’s and Graziano’s approaches merely presuppose phenomenal consciousness; they don’t explain it at all. Once raw experience is assumed to be in place, then—and only then—do their theories help make sense of how such experience can be configured so to enable reflective introspection and a felt conception of itself.

What Graziano describes as an “ethereal essence”—and then proceeds to explain in neuroscientific terms—is merely a colloquial definition of ‘consciousness,’ one that regards it as some kind of non-physical personal entity akin to a ‘soul.’ But this, of course, is not what is meant by ‘consciousness’ in the technical context of the hard problem. There, ‘consciousness’ refers to what it feels like to taste strawberries, lift a heavy bag or hit your head against a wall. These qualities aren’t “ethereal” (try the wall if you doubt me), but the very embodiment of concreteness.

What Graziano tentatively solves isn’t the hard problem, but something relatively trivial. Yet it is doubtful he would have gotten as much press as he does had he not positioned his work as tackling the hard problem. The grandiose claim in the title of his essay—“solving the biggest mystery of your mind”—is a charade.

You see, a model of one’s own mind—which relies on metacognition—is by no means equivalent to phenomenal consciousness. As I’ve discussed earlier, experience can happen without metacognition and metacognition can happen without experience. Philosophers call the latter ‘access consciousness’ and there is no hard problem about it.

It is entirely plausible, for instance, that lower animals experience the qualities of seeing, touching, etc., without metacognition. I don’t think my cats walk around pondering the inexplicable mystery of their ethereal self. Yet, if I step on their tail by accident, I am inclined to believe they actually experience something unpleasant. Therefore, by tackling metacognition and self-referential mental models, Graziano’s argument says nothing about how my cats’ experiences could possibly arise from brain function. His claims in this regard are “smoke and mirrors,” as he—ironically enough—characterizes other approaches to consciousness.

And as if this weren’t enough, Graziano goes on to argue, “a major advantage of this [i.e. his] idea is that it gives a simple reason … for why the trait of consciousness would evolve in the first place.” But insofar as what he means by ‘consciousness’ is phenomenal consciousness, the claim is nonsensical. Evolution is about structure and function: organisms evolve certain structures because the functions they perform increase the organisms’ chances of surviving and reproducing in their environment. None of these structures and functions needs to be accompanied by experience to be effective. From an evolutionary standpoint—and under physicalist premises—all functions could be performed ‘in the dark;' for since the environment and other living beings can't discern a conscious agent from a philosophical zombie, inner experience is always superfluous as far as adaptation is concerned.

If, on the other hand, what Graziano means by ‘consciousness’ is metacognition, attention, symbolic thinking or any high-level cognitive function, the appeal to evolutionary advantages is legitimate. But then his point is unrelated to the hard problem. He can’t have it both ways. Whatever appeal Graziano’s argument may have, it relies on conceptual confusion.

Perhaps because the hard problem renders the mainstream physicalist narrative untenable, when it comes to attempts to solve it scholars and the media alike seem to tolerateand even cheerfully rave abouta level of thinking that in other fields would be ridiculed instead of published; end careers instead of progressing them. What passes for sophisticated, erudite but difficult-to-understand theories are often simply what they seem to be: pitiful amalgamations of obfuscation, bad logic, linguistic sleights of hand and conceptual muddle. If so, we owe ourselves the decency of calling them what they are: baloney.

GUEST ESSAY: The metaphysical rubber meets the road in healthcare reform

By Rogier Fentener van Vlissingen

(This is a guest essay submitted to the Metaphysical Speculations Discussion Forum, reviewed and commented on by forum members. The opinions expressed are those of its author. For my own views on the subject of this essay, see my recently revised book Brief Peeks Beyond.)

The problem in healthcare today is not access (but of course some form of universal access would be better, if only “healthcare” worked). Nor is it that some people cannot afford it—nobody can. Rather, the core problem is the uncontrollably spiraling healthcare inflation that has US healthcare spending at $10K per person—almost 20% of GDP (145% higher than the OECD median) with no end in sight and yet, in terms of health outcomes, we rank #48 in the world anyway!

Merely spreading healthcare costs out over more people does not solve that problem, nor does controlling the cost of pharmaceuticals. Access to healthcare and escalating costs, including drugs, are purely red-herring issues in a system that so clearly does not work. I develop the case here that this phenomenon of out-of-control healthcare inflation and the concomitant failure in health outcomes ultimately result directly from the materialist worldview that continues stubbornly to be embraced by medicine—in spite of all we have learned from quantum physics and depth psychology, elaborated so clearly in Bernardo Kastrup’s work, which expresses the value and the necessity of the idealist view of our living experience. In particular, his essay on integrative medicine, which was published first online and then revised in his book Brief Peeks Beyond, is very helpful in this regard and forms the backdrop for my comments here.

The failing healthcare paradigm

It is not just that books could be written about the failings of Western medicine—they have been. There are a few in particular that I want to mention, for they directly inform these comments and might be helpful to readers. My comments reflect today’s reading strictly for the purpose of this article.

  1. Ivan Illich, Medical Nemesis: The Expropriation of Health (1976). Philosopher and cultural critic Illich gives a devastating critique of how modern medicine devalues the body to mere machinery and how its priesthood – the medical profession - usurps individual responsibility for our own health and so expropriates health from all of us by means of modern medical protocols, often with enthusiastic encouragement from patients who don’t know any better.
  2. Seamus O’Mahony, Can Medicine be Cured? The Corruption of a Profession (2019). Here’s the MD who sees how medicine is past its prime and has arrogated omniscience, based on victories over infectious diseases (the last war) and is really ineffective beyond the limits of the germ-theory of disease. In this book, he is not (yet?) aware of the budding paradigm shift to prevention and reversal, by diet and other lifestyle changes, of the degenerative diseases of which people overwhelmingly die today.
  3. Jacob Stegenga, Medical Nihilism (2019). Philosopher of science Stegenga analyzes why the current “scientific” method of the biosciences—reductionist analysis—for the validation of medical treatment protocols tends to overestimate the benefits and underestimate the side effects. Vide, e.g., the current statin crisis.
  4. Dean and Anne Ornish, Undo It! (2019). One of the pioneers of Lifestyle Medicine and probably his magnum opus. He has been instrumental in the acceptance of the new nutrition/lifestyle paradigm, specifically in getting Medicare/Medicaid and other insurers to support it. Ornish says that all these diseases have one common cause: nutritional deprivation resulting from our industrial processed-food system. He proposes a unified theory of disease for all of the degenerative illnesses of which people die today, since they have a single cause: diet (and lifestyle in general), so we are wasting our time with chasing symptoms as in the heyday of the germ-theory of disease.
  5. T. Colin Campbell, Whole (2014). The pioneer of Whole Foods, Plant-Based nutrition (see The China Study (2004)) explains the holistic nutritional paradigm (as in Whole Foods, not isolated nutrients) as a necessary advance over the accepted reductionist paradigm, which of necessity leads to nonsensical conclusions. The upshot is this: 100% of RDA for all nutrients does not healthy nutrition make. A Whole Foods, Plant-Based diet does. A simple example shows this: Vitamin C is absorbed 265x better from food than from supplements. Both nutritional research and drug research will need to be controlled for diet by having groups of standard eaters, with control groups of Whole Foods, Plant-Based eaters.
Besides my own lifelong interest in the metaphysics of medicine, another good recent source for me has been Amit Goswami's The Quantum Doctor, which argues the idealist worldview. He speaks of downward causation (or, as Bernardo puts it, the body is in the mind, not the other way around) as opposed to the materialist (Newtonian/Darwinian) model of upward causation of the universe, where the mind is an epiphenomenon of the body. Whoever wants to understand the political history of the monopolistic, allopathic healthcare system, which gained its status based on its successes in the last war, I refer you to E. Richard Brown’s Rockefeller Medicine Men. A more current analysis of the disastrous state of affairs is Elisabeth Rosenthal’s An American Sickness: How Healthcare Became Big Business and How You Can Take It Back (2018).

My MD father (psychiatrist) in Holland saw, even in the 50s and 60s, the coming of what I now call ‘Pharmageddon.’ He would hold “salon” at our dining-room table with colleagues from a variety of specialties. One key issue that I would often hear and always stays with me, was the growing awareness that the pharmaceutical industry was usurping the doctor-patient relationship and the healing process, including promoting the notion that a doctor’s job was to prescribe medications. My father and many of his colleagues were put off by that. The central concern in those discussions—and this goes straight to Bernardo’s emphasis on the centrality of the relationship between healer and patient—was that the big-pharma style of medicine reduced the physician to the status of a car mechanic and excluded the patient from his own healing process by its very focus on medical intervention (mostly pharmaceutical), as if you were dropping off your body for service and picking it up at the end of the day, fixed. Needless to say, patients bought into the idea and their very expectations reinforced the problem.

My father's way of dealing with pharmageddon was outright rejection, for he saw it innately as a confusion of cause and effect. His practice evolved more towards Jungian psychotherapy than traditional psychiatry. Psychopharmaca, he felt, put him on a path that erroneously placed the cause of illness in the body when his premise was that the cause was in the mind. Not that he was always consistent in every way. I remember a conversation I had with him when I was in my early teens (I was studying Advaita Vedanta at the time) about psychosomatic illness, as if it were a special case, as medicine tends to view it. My question to him was: "But is there any other [than psychosomatic illness]?" He reflected for a moment and then said: "I guess you may have a point."

A few years later, in my late teens, I had an experience with a spiritual teacher I had from about age 15 until nearly 40, when he died, that was a perfect corollary to this. My teacher asked me if I believed in reincarnation. I responded that I did not have any particular quarrel with it, except that I did not think it was a necessary explanation. Apparently, I already had a taste for parsimonious explanations at the time, although I could not have put the argument together clearly. He responded with: “You may have a point.”

The bottom line is that the materialistic model of our lived experience, in conjunction with the period of fighting infectious diseases, created the illusion of grand success of “modern medicine” and reinforced the materialist worldview by virtue of that seeming success, helped by the reductionist model of the validation of supplements and drugs.

The Lifestyle Medicine Revolution

Campbell’s work on nutrition, popularized in his The China Study, has become the definitive anchor for the entire field of Lifestyle Medicine. It offers a unified theory of nutrition and represents a complete paradigm change. It is gaining wide acceptance, now reinforced more and more with the expanding list of stories of clinical success with many of the most difficult systemic, degenerative illnesses from which people die today. In Campbell’s work, we have a completely coherent nutritional paradigm that has been meticulously peer reviewed and has demonstrated to represent optimal human nutrition. With that firm foundation, many clinicians who had advocated plant-based nutrition to one degree or another now had a cohesive foundation in nutritional science. All the pioneers in the field gathered around: Dean Ornish, Caldwell Esselstyn, Neal Barnard, John McDougall, and many others. We are on the threshold of seeing the professionalization of this rapidly growing new trend by such organizations as the Plantrician Project and the American College of Lifestyle Medicine (ACLM).

Besides these emerging professional organizations, and with their help, we are seeing a growing number of medical organizations and single practitioners adopting a Lifestyle Medicine focus (and getting appropriately certified) along with a growing body of literature, both scientific articles and popular books. Some folks are educating their doctors with the idea that Type 2 Diabetes is not incurable after all, but can in fact be prevented and/or reversed with diet. Many doctors see this development as an opportunity to finally get to practice medicine as it was meant to be and really help their patients to be healthy. Others may resist it, for the threat to their paradigm is too much for them. Adoption of it, however, is picking up speed and there can be little doubt that the healthcare paradigm is shifting. The old mechanistic one, with the doctor as the magician, is losing ground to a new lifestyle model with the focus on prevention, and where the patient is in charge. Clearly, the patient controls what is at the end of his fork. Even if some will appreciate the empowerment, others will resist it tooth and nail.

Waiting for the other shoe to drop

Lifestyle Medicine, now the most important healthcare reform nobody knows about, risks missing the boat all over again as long as it clings to the materialist worldview, in which Whole Foods, Plant-Based nutrition is viewed as merely a better alternative to pharmaceuticals. Whole Foods, Plant-Based (#WFPB) nutrition is a holistic concept and an extraordinarily powerful healing modality and it represents a paradigm shift in nutrition and in medicine. Before, there had never been a coherent nutritional paradigm—nutrition was an agglomeration of seemingly reasonable assumptions predicated on the historical accident of the discovery of nutrients, lacking any form of organization per se. But T. Colin Campbell has changed all that, which explains why he is about as popular with traditional nutritionists and the food industry as Galileo Galilei was with the Roman Catholic Church in his lifetime. But the real paradigm change has only just begun, and it rests in the empowerment of the patient, which will forever change the doctor-patient relationship. The predominant focus will now be a partnership for prevention and disease reversal, driven by the actions of the patient and, most importantly, by the mind of the patient.

The psychological supports that ACLM embraces, which are mostly the work Doug Lisle, are helpful because they provide an understanding of the neuropsychological dynamics of diet failure. However, merely understanding the physiological drivers for why we like the wrong foods, is not enough. The neuropsychological understanding risks reducing the issue to a matter of willpower, which does not do anything to resolve the patient’s inner conflict and accomplish any healing. Secondarily, ACLM has recently taken to embracing something it calls positive psychology, which seems to be an updated version of New Age ideas like the power of positive thinking and The Secret (Rhonda Byrne), which do not transcend ego-centrism and therefore never resolve our inner conflict that guarantees continued failure.

A paradigm change cannot be complete without its metaphysical foundation, and I have been arguing for some time that the fundamental part is to understand that, first of all, Whole foods, Plant-Based nutrition (based on T. Colin Campbell's The China Study and Whole) is an instrument of healing and is very powerful at that because it empowers the patient to take responsibility for his own healing, health, and wholeness. The #WFPB diet is not merely better than medical intervention, but if we do not change the medical paradigm we are still lost at sea. It is a tool for health and healing if the patient becomes willing to take responsibility for his/her own health. That is a giant step, for the favorite position of the ego is to see itself as a separate individual and a victim of an outside world, elevating that belief to gospel truth, whereby it escapes responsibility for sickness and healing.

It is not safe to assume that people want to be healthy without consciously assuming that responsibility and resolving the inner conflicts around it. Among other things, there are such things as secondary gain: it “pays” to be sick, because it gets you lots of attention, as Freud well understood.

There is an old adage in psychotherapy that therapy is hopeless until the person is willing and able to take responsibility for their condition. This is different from saying they “attracted it,” as New Agers tend to say, but it does entail a willingness to examine their own role in it. A typical example is the abused woman who cannot even begin successful therapy until she realizes that she has responsibility, not for what occurred, but in how she deals with it. As long as she gets no further than blaming her abusers, no therapists can help her. Therapy begins when she questions her habitual assumptions and is willing to explore her own emotional role in the situation, for that empowers her to change the things she can actually change – her own thoughts and behavior. Of course an abusive boyfriend or a virus or an avalanche all come from the unconscious in the same sense that the whole world does, taking responsibility in that sense means she would be ready to look at her own role and reactions and emotions, including the need to see “bastards.” With regard to diet, accepting that what you put at the end of your fork either heals you or makes you sick(er) is a responsibility that many try to avoid—they prefer to be “a helpless victim” and have the doctor be their legal drug dealer, where they can pick up a fix at will.

We are getting into territory here where the very concrete and practical meaning of the idealist worldview, the world of downward causation (Goswami's favorite term), which sees the cause of illness in the mind and the effects in the body, becomes clear. I wrote about this recently in a blogpost on the drivers of healthcare inflation, where I argued that the physicalist worldview that medicine has clung to for so long is the reason why.

The reductionist approach of functional decomposition of a disease experience into symptoms that need medical treatment is arguably more profitable. Various specialists will see various issues and hence polypharmacy has become a widespread problem in its own right, especially with older people. Medicine with its physicalist worldview is like the proverbial blind men describing the elephant, in this case selling the elephant’s driver medications to treat all the symptoms they see, without ever realizing that they are treating an elephant. In the meantime, they are exposing patients to numerous risks of drug interaction and side effects, not to mention they are not halting the disease process in the first place. In a popular saying in the Lifestyle Medicine field: they are mopping up the floor without turning off the faucet that is causing the flood.

Dean Ornish increasingly speaks instead of the ‘unified theory of disease’ (see his recent book Undo It!) because nearly all of the causes of premature death are diet related and can be prevented or reversed (partially or wholly) with a single method: a #WFPB diet. His recommendations include some other lifestyle changes (loving relationships, sleep hygiene, reasonable exercise), but undoubtedly better nutrition is the predominant factor in the solution. Lifestyle Medicine is doomed until we get the paradigm right, in two steps: first, to incorporate prevention or disease reversal with a whole foods, plant-based diet; and, second, to realize that the mind of the patient is in charge of the process of healing and that, without it, nothing changes. Allopathic medicine’s acceptance of its limitations will inevitably lead to leveling the playing field for all credible healing modalities. Healthcare reform without changing the paradigm is tantamount to moving the deckchairs on the Titanic. The cost of our failure to integrate the meaning of the idealist worldview, which might have been brought back from oblivion by quantum physics, is truly staggering, and spiraling healthcare inflation will not be stopped unless we come to grips with it.


Healthcare needs to deal with several paradigm changes at once. The first is a transition from treatment to prevention and reversal with food, which is embodied in Lifestyle Medicine. The second is understanding the idealist model and realizing that the mind of the patient is in charge of sickness and healing and that the (lifestyle medicine) physician is there as a health coach and a subject-matter expert to assist. The third, not discussed here, will have to be an economic paradigm shift from outside ‘authorities’ profiteering from disease towards the patient taking charge of his own disease prevention and health maintenance. The doctor’s relationship should be with the patient directly, probably through a mutual society, where specialty care and hospitalization are dealt with through reinsurance, resulting in a more results focused and cost-effective care system.

The outcome is a new model in which the mind of the patient is the locus of the healing and the lifestyle physician plays a supporting role and is the subject matter expert to help the patient maximize the results he or she can achieve with lifestyle changes, supporting those efforts very sparingly with medical interventions, which might include specialist care and medication when unavoidable.

Copyright © 2019 by Rogier Fentener van Vlissingen. Published with permission.