Mechanism for Change

Imagine a bowl sitting on a table with a marble inside. No matter where you drop the marble on the inside of the bowl—high up on the rim, halfway down, wherever—it will always roll down and settle at the bottom. The bottom of the bowl is what scientists call an attractor state: where systems naturally settle and stay. Push the marble and it'll roll up the side a bit, but then it comes right back down. This is the key feature of an attractor: the system tends to return to it even after being disturbed. The 'basin of attraction' is the entire inside surface of the bowl, all the places the marble could start from and still end up at that same stable point.

This started as a mathematical concept, formalized in the 1960s for describing how dynamic systems behave, and was popularized by John Hopfield in 1982 when he showed our human neural networks work this way too, for which he won a Nobel Prize in 2024. Since the 80s when it was discovered, researchers have been finding attractor dynamics everywhere in biology, in things like cells, immune responses, and brain states. In 2022, a team at the Kavli Institute in Norway captured this happening in real time; using electrodes they could actually watch the brain settle into stable patterns exactly the way the math predicted.

A small-scale attractor state that most people have probably seen in their own lives is that it’s easier to maintain our weight than to change it. Once we sit at a certain weight for a while, the body treats that as its set point and resists changing it; the marble of that system wants to roll to the bottom of the bowl, maintaining its homeostasis.

This same dynamic plays out at the level of whole-body health. Any given system can have multiple stable states, and which one you end up in at any given moment depends on context, (like with the context based memories) and your reaction to the context. Remember when we talked about how people often feel better on vacation, and then snap back to illness the minute they return home? That’s an example of this in action. You have a healthy attractor state, a stable, maintainable healthy state that can get activated when you get out of the context of your disease. And then another attractor state that contains your disease expression, one with multiple entry points that pull you back in when you return to your normal life. And this is why healing can feel so hard. Why medicine thinks it’s incurable. Because we can never get rid of these attractor states, they are right about that piece. We learned that our brain's wiring works by adding new things, not replacing old things. So if you’ve been cancer free for 5 years and your spouse dies, it’s possible, without conscious awareness, that you fall into that old basin and your cancer returns. Or you haven’t had IBS in years, but something pulls you back in and all of a sudden it’s like your entire symptom symphony has shown back up and started playing the slow march to decline your body knows so well.

And because we haven’t known what this was, we have seen this as “relapse”. It feels helpless and hopeless and crushing. And with what we know about the PAG states, this feeling of helplessness can lead to an immobilization threat response, which then further cements your fate of being stuck in this state. But what is ALSO true is that the healthy bowl you’ve been in for years at that point, that bowl is available too, and you can snap back into the healthy bowl just as quickly with the right approach.

And attractor states aren’t a new concept to us at this point, because they are actually exactly what we walked through in chapter 9 when we talked about neuroplasticity. Think about the Merzenich monkeys. When those monkeys spent weeks spinning discs with their fingertips, the cortical map for those fingers expanded dramatically—it literally overtook neighboring territory. The enlarged map becomes the attractor. The neural real estate dedicated to that activity grows so large that signals naturally flow there. Electricity follows the path of least resistance, and the most-used pathways have the lowest resistance. More synapses, more connections, more myelin wrapping those connections. The signal doesn't have to be "pulled" toward the attractor—it falls there because that's where the infrastructure is. And pathostasis is an attractor state; it’s a bowl your system has settled into. So given that, let’s put together everything we’ve uncovered in the research and see how we can build a new competing bowl.

What doesn’t build a new bowl

Medicine says your disease is caused or worsened by poor diet, lack of exercise, inadequate sleep, and too much ‘stress’. Which means the answer becomes lose weight, eat better, sleep more, reduce stress by changing your lifestyle, and your condition will improve. Wellness says something similar. It says you need to optimize your inputs through clean eating, movement, sleep hygiene, stress management, supplements, and routines. So the message on both sides of the aisle seems to be: the problem is your inputs, and the solution is perfecting them.

But our ancestors had terrible inputs by these modern standards we have been optimizing for. They didn’t have modern mattresses or shoes or even consistent shelter. They didn’t have consistent food sources. They had actual predators and tribal warfare and high infant mortality rates. Our ancestors’ stress, the lifestyle kind we blame for our poor health, was very high and persistent. But studies of hunter-gatherers show that they don’t have epidemic levels of chronic diseases like we do. Our bodies are actually robust and able to adapt and tolerate extreme levels of imperfect inputs, they had to be. The animals that could handle the stress and imperfect inputs of our ancestors were the ones that survived to pass on their genes. Which means the difference isn’t the inputs. And if you think about this logically, it just makes sense. If optimizing our macronutrients and exercise and sleep were the solution, don’t you think more people would have actually healed using these methods? Even medicine doesn’t seem to think those things will heal us, or they would have a model for curing chronic illness and not just remission. What medicine seems to think is that we are on a death march to dysfunction and disease, and the only way to stave it off is to optimize everything perfectly.

But what we have discovered as we’ve looked across all the research, is that optimizing inputs, when it does help, helps by pushing you up the sides of the bowl for a bit. But ultimately people end up sliding back down and from the outside it may look like you weren’t trying hard enough, but the reality is that it was a losing battle from the beginning. Because the problem was never the inputs, the problem was being stuck in a pathostatic attractor state.

The way all animals' brains work is that they have a threat detector system that is always on. You can think of it like Alexa or Siri waiting for you to say their name. Our brains are scanning for danger in a similar way, it’s a passive system that is always watching, always listening. For 500 million years, this detection system only activated when an actual threat was present or suspected, and when that happened it would fire off your threat response and ready you for the danger it had perceived. But with the cognitive revolution came the ability for our brains to find threat cues through thoughts alone. Which means that we are always looking for danger and threat, and we can always find it. And the threat system can't tell the difference between a real threat and a thought about a threat, it just responds. So we can fire the full physiological cascade sitting safely on our couch, worrying about something that might never happen or that has already happened.

And even that doesn’t keep pathostatic chemicals on, or every single human would be sick. What actually keeps pathostasis running is our ability to have an opinion about our body's signals, emotions, and threat activation, and then our ability to consciously choose to disregard or reject it. When we feel something and resist it, fight it, suppress it, amplify it, narrate it, monitor it. The science shows us that this is what keeps these chemicals that were meant for short term utility stuck on. If the driver is our ability to have an opinion about our emotions or activation, the way to turn it off is to allow those signals to exist without trying to change them, and then to choose from that state how we want to wire in our new bowl.

What the science shows does build a new bowl

We’ve walked through all the learning, behavioral, and neuroscience research, so now let’s put it all together so we can see what it takes to build a new bowl. There are a few key components and taken as a whole it’s actually extremely simple. So simple that it will be tempting to pattern match it to other things that haven’t worked, but stay with me for a second as we walk through this. Based on the science we’ve laid out in the last 3 chapters, let’s summarize the primary pieces we need to both create a new bowl, and augment the threat loop wiring that already exists.

If the driver is our ability to have an opinion about our emotions or activation - which stops the signals from coming in and then moving through our bodies like they have in every animal for 500 million years. The way to turn it off is to allow those signals to exist without trying to change them, and then to choose from that allowed state how we want to wire in our new bowl.

I want you to think about allergies for a minute. No one thinks allergies are just some vague ‘symptoms’; they aren’t “just” stomach upset or fatigue or a headache or the other things people generally dismiss as not that serious. Anaphylactic shock, which is at its core just a really severe allergic reaction, can lead to death. Literal death. And people are having these responses to peanuts, and bee stings, and other things most people can experience with no problem at all. And medicine is actually able to treat these extreme reactions, and get people’s bodies to stop reacting this way to these non-threatening stimuli. Because they are, ultimately, non-threatening. If people were biologically allergic to things, if that were coded into our DNA, then it wouldn’t be something we could train ourselves out of. But it is. It’s done all the time. The way it works is that they give you just a little bit, a trace amount, of the thing your body is reacting to. Then over time they increase the amount, and your body learns to stop mounting a response. This is neuroplastic conditioning in action, and this treatment is used at major medical centers across the country, because they understand that it can help people’s bodies stop reacting. What they may not understand is that all you are doing through this process is teaching the threat response to stand down and stop reacting to things that aren’t dangerous.

Allergies are unique because the threat is “external”, at least in part. Not for the paper rose lady, since that rose wasn’t real, but in the sense that you can say ‘I’m going to inject you with this threat and show your body that it’s not actually dangerous.’ We can’t do that with internal processes, internal symptoms, thoughts, feelings, emotions - the things we are reacting to most of the time throughout our days as threats. So we have to show our body the same thing from the inside. Just like medicine does with these allergens, we have to show our body that these things aren’t a threat and that it can stop mounting the response it has gotten so good at mounting.

In allergy desensitization, the steps are clear. Expose to a small amount of the threat, body reacts, body learns it's safe, increase exposure, repeat over time. With internal signals the steps are the same but they look different because the "allergen" is your own activation, feelings, and symptoms. So taking those steps and applying them to pathostasis, this is what falls out:

Notice: you can’t expose yourself to something if you don’t even know it’s happening. If you don’t know it’s happening you’ll just do the same thing you’ve always done.

Map: get to know what your activation looks like. How you respond to symptoms. How you relate to your emotional world. Are you a suppressor or a ruminator more often? Knowing this will make notice easier.

Allow: this is the core work. This is the exposure to the allergen. When you expose someone to an allergen, the actual neuroplastic work that is happening is the body is experiencing the thing, maybe peanuts, WITHOUT mounting a response. This is the thing that is changing their physiology. So allowing your activation without bracing, ruminating, suppressing, distracting etc. This is the part where you expose yourself to the thing and change the outcome.

Choose: this is where you titrate in exposure at the level at which you can allow the activation. Just like they do at the doctor. They aren’t giving you a full allergic reaction, they’re giving you just enough that your body doesn’t mount the response. So here, it doesn’t help if you are white knuckling it, so you have to titrate it in over time, stretching your capacity. So if you have a symptom and you normally lay in bed, if you can sit on the couch this time and actually allow the symptom for example, that shows your body something different. Then eventually you can get up and do the dishes. And eventually you can still go out with your friends even though your back is screaming or whatever your symptom is. But the allowing piece has to be there or your body still sees it as a threat and it’s not actually rewiring it. Without allowing it, you're just pushing through, which is necessary sometimes, a lot of the time probably, but is also a version of suppression, and we know what that does to your chemistry.

And this is true with our emotions too. The rumination and suppression research was about how people managed their emotions, and there was a clear dose response from how much you did these things to how likely you were to get sick. Because what is happening when you ruminate? You’re trying to resolve a feeling by reasoning your way out of it. What is happening when you suppress? You’re trying to resolve a feeling by shoving it aside. A deer hears a rustling in the bush next to it and what does it do? It feels something first, the threat response creates an emotional response, and then it orients toward the threat, and chooses how to act. We have built a world with way more rustling bushes than we evolved for. On their face, the threats we are encountering aren’t as bad, an email from your boss, a news story about people across the world, betsy694 saying something rude on your social media. But to our amygdala they all feel the same. And in our modern world there are a lot more signals than there were evolutionarily. And because our cognitive brains, the new part, understands these aren’t REAL threats, we treat them differently than we would a tiger running toward us. But because our 500 million year old brain doesn’t see the difference, these new modes of managing this input aren't working, and it’s keeping us sick.

So we need to do those steps above to basically play out the threat resolution our brain is looking for, so we can stop running the threat chemistry and get our body back to baseline. And this does two things: it stops the engine of pathostasis from continuing to run AND it rewires the automatic pathways we’ve built so THEY stop running the engine too.

Why this is hard

We have 500 million years of evolution telling our threat detectors to do exactly what we’ve been doing. The neuroplasticity that changes our brains and helps get us stuck? That exists in animals too, as evidenced by the Merzenich monkeys and decades of other neuroplasticity research. The reason we are able to use animals to test drugs and reactions is because they are so similar to us. If rats were fundamentally different from humans they would have no utility as our test subjects.

So our threat detection is doing exactly what it evolved to do over 500 million years; of course trying to get it to function differently is going to feel not just hard, but wrong. It IS wrong, evolutionarily. Our brain is trying to keep us safe from threats. Telling it to stand down, that’s unnatural. If you’re running toward a fire, your brain is going to tell you to stop. That’s normal. But firefighters are able to tell their brains: I have protective gear on, and I have a good reason to do this. I’m going to do it and it’s safe and ok. They learn to run into a fire. We can learn to change our patterns. It’s not easy but neuroplasticity and our human cognition make it possible.

Entrenchment

While everyone can do this work, it’s important to acknowledge a few things. One is that the longer you’ve been sick and stuck, the harder it is. If you remember from chapter 9, the longer you’re in pathostasis, the more your brain remodels to encourage those same patterns. Not only do you build Merzenich maps from practicing the same symptoms and conditions over and over, but under these conditions the research shows your amygdala grows bigger and more connected, more sensitized and ready to trigger your threat response, and the brakes of this response, the prefrontal cortex and the hippocampus shrink and become less connected. Which means that it’s easier to maintain pathostasis and far harder to reverse it. This is why long covid isn’t considered long covid until 3 months have passed, because until that point spontaneous recovery is still possible. Your attractor state of covid symptoms isn’t so entrenched that you can’t just jump out of it into another bowl. It’s why depression shows better treatment outcomes the earlier you get treatment; patients who get treated early have nearly four times better odds of achieving remission than those who wait. Because the longer we are wiring in these reaction patterns and the more our brain is getting physically remodelled to promote these states, the harder it is. This is not to say that people who have been sick a long time can’t get better, they have and can. It’s just important to acknowledge that the timeline may be longer and the work may feel harder.

And the other big consideration that deserves being addressed is that healing isn’t equal opportunity for everyone. If someone is living in constant stress, working three jobs to make ends meet, has abusive bosses, or is living in unsafe conditions etc, healing will just be harder for them. If your life circumstances are contributing to your pathostatic load, and they are unchangeable, then this gets way way harder. Sometimes when there is a solution like this that requires individual action, it can lead to blaming people for being sick, or people feeling like they are being blamed. We want to avoid the trap of becoming unfalsifiable like Freud and saying if you heal it proves the model and if you don’t you weren’t trying hard enough. This is not easy and it requires a certain amount of space to be able to do. Not everyone has that space. But for those who do, or who can create even a little, the path is clear.

Unnecessary complexity

Similar to how medicine saw the complex outputs of chronic diseases and assumed the mechanism needed to be equally complex, we have seen the complex output of our disease and suffering on an individual level and it can seem like it should require an equally complex solution. That if it took years to wound us, it should take years to recover. The complexity of the healing process can feel like it validates the significance of the pain.

But now with the science laid out for us, we can see what the active ingredients are, and we can simplify and speed up the healing process. And having the science also validates our suffering in a way we’ve never before been able to see clearly. Whether you have a “real” disease, a “psychological” disease, a “functional disorder” or something completely unnamed, we can now see that it’s all the same process: pathostatic chemicals changing your brain and your chemical composition and your physiology at a full body scale. Those changes causing predictable downstream dysfunction like vasoconstriction and glucose elevation and clearance failures that lead to all of the diseases that we have defined. This then creates attractor states that can run for years or decades. All of this is expected given our 500 million year old threat detection system as it’s now paired up with our human cognition. It’s all the same thing, and it’s no one’s fault. And now we have the simple map to what actually works to address it, rather than complex rituals or external optimization.

With all of this knowledge, it becomes clear that addressing illness and suffering demands a reframe. That healing is not, can not be, a destination. It is lifelong. We build a new bowl one moment at a time, over time. But with each momentary change, the load gets easier, the bowl gets stronger, and the work becomes more automatic. So maybe lifelong can be ok, now that we have the answer.