If Evolution Isn't Going to Fix It...

For most of human history, we believed memories were fixed, trapped in amber for the rest of time. Which means we also thought of our memories as a trustworthy and true recall of what actually happened. But in the early 2000s, Karim Nader while working at NYU, discovered that every time you recall a memory, it becomes temporarily moldable, able to be updated and changed, before being saved again. Meaning we are literally rewriting our history every time we remember something.

When Nader proposed that memories could be changed during recall, senior scientists told him he was committing career suicide. The idea that consolidated memories were permanent was dogma. One prominent researcher told him "Don't waste your time, this will ruin you.” Which illustrates again that when people find things that should excite medicine, the things that could rewrite the textbooks, rather than being celebrated and supported, they are cautioned against pursuing the truth.

But Nader persisted anyway. And he figured out that our memory works similarly to how computer memory works. When you open a file on a computer, you're not just reading the saved version - you're actually loading it into working memory where it can be edited before being saved again. And it turns out this is how our brains work too. When we remember something, it’s like pulling up a file from a computer, and what we do with that file changes it, and those changes get saved, which updates the file. For difficult memories like trauma and those surrounding PTSD, this has some really important implications. It means that we are able to update those memory files in our brain, potentially reducing the physical response and making the trauma feel less traumatic. If you recall a fear memory while simultaneously experiencing genuine safety - not just thinking about being safe, but actually feeling safe in your body - the memory gets rewritten to include that safety information. How your past is encoded can be changed, neurologically, through how you meet it in the present.

But the flipside of that is also true. If you recall a memory and add a new lens to it that is not safety but threat, or dysfunction, that also can get encoded into the updated memory file. When we adopt the cultural narratives around having had toxic parents or specific attachment styles or childhood trauma, we're not just reinterpreting our past, we're reconstructing it. Every time you recall a childhood memory through the lens of "that was trauma" or "my parents were narcissists" or "I have anxious attachment," you're encoding that interpretation into the memory itself. It can feel like you're finally seeing what was always there. But it is also very possible that in some real way you could be building a past that matches your current beliefs, making it more true neurologically, emotionally, and psychologically, with each recall.

The story you tell about your history becomes your history more deeply with every retelling.

This is not to say that people didn’t have hard childhoods, or that specific events aren’t traumatic. It is only saying that the way we tell the story to ourselves as we recall those memories becomes part of the memory itself. The way we decide to feel about our history can either help us better respond to our current reality, or it can encode in more trauma and more threat and make us more reactive and stuck.

Exposure therapy

The traditional model says you should go slowly, exposing yourself to less scary or activating things, and building up your tolerance over time. Like if you had a fear of spiders, the traditional model might have you start with pictures of spiders, and then maybe a spider in a jar across the room, then closer, and then eventually you can maybe touch one, or have one on your hand. The idea was that you'd slowly get used to the fear, building tolerance over time until the thing that scared you didn't scare you anymore. The ultimate goal being that you could remain calm in the face of your fears.

In 1989, a Swedish psychologist named Lars-Göran Öst showed that this slow approach wasn't necessary. He developed what he called one-session treatment, where patients would go through their entire fear hierarchy in a single three-hour session. People told him he was traumatizing his patients. And it makes sense why they thought that; he would put spider-phobics face to face with tarantulas, or make claustrophobic patients enter tight confined spaces, all in one sitting. But his data showed 90% of patients were improved or recovered at four-year follow-up. The intense, concentrated approach worked for discrete phobias — fears tied to specific, identifiable triggers. But chronic conditions aren't wired to one trigger. They've been encoded across contexts, states, and situations over months or years. Which is why the context-dependent piece still matters for more complex patterns.

But even for discrete phobias, no one understood why Öst's approach worked; it violated everything the field believed about safe exposure. Michelle Craske at UCLA started looking into why this contrary seeming method was working. The old model said exposure worked through habituation - you slowly got used to the fear until it went away. But Craske researched what was going on and was able to show that wasn't actually what was happening. The key component wasn’t whether your fear went down during the exposure session; that didn't predict your long-term outcomes. People whose fear stayed high throughout exposure did just as well as people whose fear decreased. The ones who were crying, terrified, sweating - they showed good long-term outcomes too. The prevailing wisdom was that this level of activation would retraumatize people, but that's not what the data showed. It turned out what actually mattered was activating the fear circuit while simultaneously showing your threat center that you're okay - that this scary seeming thing is not actually a threat.

This finding started to make more sense as researchers looked at what was happening in the brain during these updates. In 2004, Phelps and colleagues looked at what was happening in the brain during fear extinction. What they found was that successful updates required two things firing simultaneously: the fear center, where the automatic threat response lives, and the prefrontal region responsible for conscious processing and safety learning. The prefrontal cortex forms the new 'this is safe' memory and actively inhibits the fear response, but only if the fear memory is active at the same time. The strength of connection between these two regions predicted how well the extinction stuck. Knowing this, that we need the fear center activated while the conscious safety-learning center is online and communicating with it, helps explain what the trauma therapy field got right, and what they missed.

Bessel van der Kolk and others established what is now known as trauma therapy because they noticed that trauma showed up in body sensations: people would have full physiological reactions, racing heart, shallow breathing, the whole cascade, even when they consciously knew they were safe. They could tell you "I know I'm not in danger right now," and their body would be acting like a tiger was in the room. Seeing this, they assumed that meant that trauma was "stored in the body" and needed to be released or processed through the body. Which was revolutionary at the time, and brought a lot of much needed attention and research to what else was happening with trauma aside from just the thought piece. But since then we’ve learned a lot more about what’s actually going on, and it turns out that interpretation wasn’t quite right either.

Remember that the implicit system encodes threat responses that fire automatically, before conscious thought even comes online. And the explicit system that encodes the narrative, the conscious story of what happened. And because these two systems can encode separately, store separately, and retrieve separately, they also can fire completely independently. Which is why as we said above, you can know intellectually that you're safe, while your body is in full terror. The explicit system has the information: "this is my living room, there's no danger here." But the implicit system has different information, encoded through different pathways: "this sensation pattern means danger, this sound means threat, this body position means brace for impact." And though most of the time these two systems encode information together and get retrieved together, if the situation was too scary or your brain decided to help you check out, they can be encoded separately. These systems activate physical responses, but that doesn't mean trauma is stored in the body, the way van der Kolk and others claimed. The body sensations aren't where the trauma 'lives.' They're the output of the implicit system, which is in your brain, firing its learned pattern.

Which means the update doesn't happen by "getting into the body" or "releasing stored trauma." There's nothing stored in your tissues that needs to be released. The update happens when you get both systems online at the same time, and you update the prediction algorithm of your threat center. When you're actually feeling the sensations, which is the implicit system's output, while also consciously present and aware that you're safe, which is the explicit system doing its job. The two systems that were encoded separately have to fire together, integrated, for the learning to update.

And for complex threat responses that have been encoded throughout many instances in your life, this can't just happen once, in a therapy room, under special conditions. The research on context-dependent learning that we covered earlier showed that updates made in one setting don't automatically transfer to other settings. If you only practice being calm in your therapist's office, you've taught your brain to be calm in your therapist's office. The pattern that fires when you're at home, or at work, or in the middle of the night, that pattern hasn't been touched. You need the new integrated experience to happen across contexts. Across different moods and times of day and situations, in the actual moments where life activates the old pattern. Each time you meet the activation with both systems online, feeling it while staying present, you're building the new wiring in that specific context. Do it enough times, in enough different situations, and the new pattern starts to become the default.

This dual requirement explains why so many interventions have failed to create lasting change. Cognitive approaches that help people understand their patterns intellectually don't reach the implicit, somatic encoding. Body-based approaches that release tension or create calm states don't necessarily update the cognitive piece. Meditation might create a calm state, but without the fear memory active, there’s nothing to update. Exposure might activate the fear, but without the felt sense of safety, your body still thinks this is dangerous, but we averted disaster this time. And all of them typically happen in isolated contexts, like the therapy room or retreat, which means the pattern that fires at home, at work, or in bed at 3am, remains intact.

The research has mapped out exactly what the brain needs to update patterns that seem fixed. Scientists have discovered the lock and the key. They just haven't quite realized that chronic illness patterns are locks that can be opened with these same keys.

Anyone reading this book is not going to be around long enough to see a time where our ancient and cognitive brains evolve to sync up more seamlessly. Evolution needs hundreds of thousands of years to create that kind of integration. Maybe even millions of years. So we need solutions now; we can't wait around hoping for natural selection to fix a mismatch that's making millions of people sick today. Luckily, the same neuroplasticity that allows pathostatic loops to form in the first place also gives us the means to consciously wire them differently, and wire in alternate pathways.

Everything we've learned about how patterns get encoded tells us how they can be re-encoded differently. But before we can use these keys, we need to understand one more piece of learning research.

Pattern matching

In 1935, a German psychologist named Karl Duncker developed an experiment where he gave people a candle, a box of thumbtacks, and a book of matches, and then asked them to attach the candle to the wall so the wax wouldn't drip on the floor. The simple solution was to empty the box, tack it to the wall, and use it as a platform for the candle. But because people first saw the box as a container for tacks, they struggled to see it as a platform. That first association as a container blocked the perception of other possibilities, demonstrating that the first version of something that we encounter and believe persists in our minds unless we consciously work to challenge those assumptions and associations. And this quick pattern matching is really evolutionarily useful and efficient. We don't want to have to evaluate every object from scratch every time we encounter one. This allows us to move through our complex world much more quickly and adeptly. But it can also limit us and keep us stuck when it inhibits our ability to assess information in a novel way. Ultimately what Duncker was showing was that once you have decided what something is for or what a concept means, you are far less likely to be able to see it a different way.

Not long after Duncker’s experiment, in the 1940s, Abraham Luchins took it a step further. He studied our brains' tendency to get locked into the thinking and problem solving strategies that we learn first. He developed what came to be known as the water jug problem. He'd give people a series of puzzles where they had to measure out specific amounts of water using three jugs of different sizes. The first several puzzles all required the same somewhat complex solution - fill jug B, pour from it into jug A twice, then pour from it into jug C twice. People would solve puzzle after puzzle using this method until it became automatic. Then Luchins would give them a puzzle where this method still worked, but there was now a much simpler solution - just fill jug B and pour once into jug C. But over 80% of people stuck with the complicated method they'd learned. They couldn't see the simpler solution even when it was right there, because their brains had locked onto the established pattern.

This phenomenon, called the Einstellung effect, showed how practiced solutions actively block novel approaches. And it gets stronger with expertise. Later chess studies revealed that when expert players encountered problems with a familiar-looking pattern that required an unconventional solution, their performance dropped dramatically - to the level of players three standard deviations below them in skill. The expert sees the board, recognizes a pattern, and applies the sophisticated response they've developed over decades, completely missing that this particular configuration needs something different. Their expertise becomes their blindspot.

Luchins later tried telling some of his subjects, before introducing the puzzle with the simpler solution, “don’t be blind”. And more than 50% of these prompted students found the simpler solution on the remaining problems. Which illustrates that we have the capacity to see what we could be missing when we consciously bring into awareness our pattern matching tendencies.

By the late 20th century, neuroscience research on the hippocampus and cortex showed that the reason this becomes so powerfully entrenched is because we make these associations before our thinking brain has had time to process at all. It happens automatically, in the blink of an eye. When your brain gets partial information matching a known pattern, it literally fills in the "expected" rest without waiting for you to think about it. And this served us evolutionarily - if you see stripes in the tall grass, your brain completes the pattern to "tiger" and gets you moving before you've consciously processed what you're seeing. This kept us safe and alive, but in our modern world, with our conscious brain slapped on top, it can become a bug when the automatic completion blocks you from seeing what's actually there. Like if your partner or friend is trying to grow and change, and you can’t stop seeing them through the old lens of how they used to be. Our old perceptions pattern match before we even think about it, and then we get stuck, seeing them through the automatic pattern instead of noticing what's different. And this can also get in the way of learning something new, or seeing an old problem through a new lens.

There’s another theory that takes this further by demonstrating how this plays out with complex knowledge. Schema theory shows that once you have a mental model for understanding something - a schema - your brain preferentially notices information that fits that schema, and dismisses or reinterprets evidence that doesn’t fit it. The researcher who developed Schema theory, a British psychologist named Frederic Bartlett, had British people read a Native American folk tale and then retell it. And he documented that on each retelling it became more "British," the participants replacing unfamiliar details with more familiar ones. They weren’t intentionally changing the story; their brains were automatically reconstructing the memory to fit their existing schemas.

This concept alone explains some of why medicine is where it is today. Imagine the amount of learning and encoding that happens over the course of a 12 to 15 year education? Doctors are taught in an almost boot camp-like system for over a decade of their lives, training them to see patterns in a very specific way. Of course this would lead to a brain that reinforces what they were taught and rejects anything that doesn’t seem to fit what they think they know.

Schema theory was largely ignored until the 1970s, when computer scientist Marvin Minsky rediscovered Bartlett's work while trying to build AI that could understand the world like humans do. He realized that humans were using stored knowledge frameworks to perceive and understand the world around them, and he modeled AI on exactly that. AI has a bank of knowledge just like human brains, and it makes sense of new inputs by synthesizing its existing information. You might have noticed it can be really frustrating if you are trying to hash through a new or novel context with AI, because the pull of the programming is so strong to repeat what it already knows, even when that's not what you need. This is how our brains work.

And you've seen this in action if you've ever been sick. If you talk to a psychologist about your fatigue and low mood, they will have one interpretation, maybe depression, but if you talk to a cardiologist, they may look at that and see signs of an overworked heart. A pulmonologist might think you have reduced airflow causing those symptoms. And because each specialist has spent years honing their knowledge of this one particular piece of human physiology, it's really easy to pattern match to that knowledge base, and really hard to try to synthesize that across the systems that they aren't as familiar with.

This matters for what comes next because almost everyone has tried calming strategies or various therapy techniques (CBT, EMDR, ACT, ERP, and many more), or wellness hacks, breathing exercises, tapping, or yoga, or any number of other interventions over the years. And we’ve all formed schemas about them - what they are, what they do, whether they work (or don't). Those schemas will now be activated as we think through what we are learning here about updating our pathostatic conditioning. Our brains will attempt pattern completion such as: "This sounds like meditation" or "I tried something similar with my therapist" or "So you mean like CBT?"

And the research shows really clearly that this is most pronounced in people who've tried a lot of these things, because now there aren't just individual things to pattern match to, but a GROUP of things. Similarly to the chess master not being able to see the novel solution on the board. Once we have a "wellness" or "therapy" schema, and none of them produced results, then our brains are really quick to dump it into that schema bucket to save us time and energy. And again, this is super advantageous evolutionarily. If you kept trying to find food in similar looking forests, and every time you came up empty handed, it would be really helpful if your brain tipped you off and said, hey, how about we don't waste our time here again, there's never any food. And because the pattern completion happens fast - often in the first few sentences, before you've actually encountered the full information, it means we don't engage with the nuances that may be there that could show your brain this time is different.

The reason wellness practices, meditation, or the therapy processes we laid out in the last chapter often don't work for pathostasis specifically or fully is that while these approaches might have one or two pieces of what's needed, they are only implemented partially and almost always in isolated contexts. Which means they often function as state changers, not trait changers. And our brains will want to pattern match to those things. But this is like being told you need to do specific physical therapy exercises every day in a specific order and with the proper technique to recover from a broken arm, and listening to our brain when it says “oh yeah well I've tried push ups and lifted weights before so I'll just do that again I guess”. Or worse, “oh well I actually tried pushups already and that didn't work so I don't think this will work for me either.”

And all of these things we are pattern matching to, they weren’t wrong, they were just missing the unifying throughline. It's like discovering that willow bark helps headaches but not knowing it's the salicylic acid, so you create a protocol where people have to: chew the bark, while standing by a river, wearing natural fibers, during the full moon, after journaling about their relationship with trees. Creating complex associations like Skinner’s pigeons showed in the last chapter. And then there are people who are like "I tried it at home without the river and it didn't work!" "You have to be barefoot ON the riverbank, the negative ions are crucial!" "Actually, it only works if you journal about your ANCESTRAL relationship with trees." And then someone creates a certification program for "Integrated Willow Bark Healing Practitioners" with 500 hours of training.

And doing this makes tons of sense if you really want to help people and you’ve seen that doing all this stuff is truly getting results. It’s not the fault of the program, they are just trying to systematize something that is bringing people results. Which brings us back to: everyone is doing the best they can with the knowledge they have, and then once we know better, we can do better. This is that moment.

So we now have all the pieces of the instruction manual for healing, mapped for us across the last century by dozens of learning and brain researchers. It’s time to put it all together.