Why is the problem of obesity so damned tricky?

1. Why is the problem of obesity so damned tricky?

 

A lot of us are fat. Fatness increased dramatically in the 20th century, especially since the 1980's in the US.  We don't like being fat in general.  When it becomes extreme, body fat usually doesn't look good to us and can lead to health problems, diminished longevity, and restricted quality of life.  Some distributions of body fat are worse than others for health or for appearance, but at some point it eventually looks bad to us and detracts from our lives.  

 

1. Just Theories are Well Communicated and Popular but Wrong

 

If we find fat so problematic, why haven't we simply found good solutions for it and begun to apply them?  Most people can lose some body fat temporarily by some combination of depriving themselves of some particular kinds of preferred foods, trying to force themselves to eat less,  and trying to force themselves to be more active.  Most people end up going back to their original body fat levels, or greater, after a few weeks, months, or years of that effort.    There is no lack of simplistic just theories about why this is happening:

 

Fat people are just lazy and not exercising enough self-control over their eating and exercise

Fat people are just gluttons who eat too much

Fat people are just eating too much carbohydrate

Fat people are just eating too much starch

Fat people are just eating too much sugar

Fat people are just eating too much fat

Fat people are just maintaining their weight at a genetic set point

 

Although each of those ideas is wrong in its own particular way, and they are each perhaps partly right in some sense,  it is the just part that is most wrong of all.  The just theory is a special kind of problem in itself that is part of the reason fatness is so difficult to address.

 

Here's my central claim: scientific consensus is not just a matter of certain opinions winning out over others, the problem of obesity is understood in broad form as a scientific consensus even though many the details are complex and some of our knowledge of the factors is undoubtedly incomplete.  There is a rough scientific consensus about various aspects of obesity across fields of physiology, nutrition, psychology, neuroscience, and medicine.  It is not just the confusing mess that appears in popular media.

 

I also claim: this consensus understanding is not what is published in most diet, fitness, and weight control books.  In fact, a sizable number of popular books on diet and weight control conflict dramatically with the scientific consensus, but are marketed as if they were new and revolutionary new findings.    This has contributed heavily to the confusion and so added to the problem. 

 

 

B. The Scientific Consensus is Poorly Communicated

 

In the stories that journalists tell to try to communicate their own interpretations of the obesity and health research, they have often engaged the science compellingly but not faithfully.  We now know some very useful things that are not well communicated, or are even ignored or denied by popular authors with their own agendas, or get lost in the media confusion:

 

1. The theory that people can control their weight by exercising self-control at each eating or activity decision is simply wrong.  

 

No one has that much self-control against an environment that constantly tempts them.  The psychological study of self-control reveals that variation in impulsiveness is indeed a factor in all sorts of problems, including obesity, and that people can often learn skills to compensate for impulsiveness, but these do not rely on individual acts of self-control.  Self-control is always finite, and we successfully compensate for impulsiveness by not just exercising self-control in each decision, but also even more importantly by altering our environment and altering our habits so that we reduce the need to exercise our always finite capacity for self-control.

 

2. All of the theories of specific  macronutrients causing  us to become fat are simply wrong.

 

The theories of metabolic advantages of particular diets (low carb, low fat, vegan, paleo, etc.) have all been falsified scientifically so far.  Obesity is in general at the population level not caused by everyone's metabolism being "broken" by certain foods nor is it "fixed" by eating certain foods. 

 

We know for a fact for example that low carb diets do not cause people to lose weight by any special "fat burning mode" as is often claimed in popular diet books.   We know that simply eating a lot of fat or a lot of sugar while keeping energy intake constant does not cause us to gain more body fat.  We know for a fact that the theory of obesity being caused by insulin levels rising due to eating  too much starch or sugar is simply wrong.  People become fat when they take in too much energy regardless of the source and they lose body fat when they take in less energy regardless of the sources they eat less of. 

 

That doesn't mean people respond equally to every kind of diet.  It's just that the reasons are not metabolic.  The reasons have to do with reward, satiety, and sometimes individual differences.  But the metabolic differences between different macronutrient strategies is based on thinking that has already been tested and falsified.  

 

Also  this wouldn't have to be true necessarily.  It isn't a logical necessity that foods have no powerful differential effect on absorption and conversion to fat and fat storage.  It's not just a matter of thermodynamics or conversation of mass and energy.  It is possible that our biology might have allowed us to take in some kids of nutrient, extract energy or chemicals from it, and excrete most of it without gaining body fat.  But it turns out to be false.  The reason is not conservation of mass and energy, the reason that our biology is particularly efficient in using nutrients and in storing the surplus energy. 

 

We might truly have discovered some  differential metabolic effects that prevent us from processing certain foods into fat (and that is exactly what many popular authors have claimed) but … it turns out that it doesn't seem to be true in general, and certainly not as a reliable  way to lose body fat permanently.  The small differential effects of nutrients on metabolism are sometimes used to good effect in short term efforts at bodybuilding and fitness, but they are not a reliable approach to obesity in general.

 

3. Consequently, No macronutrient restriction strategy is a best practice diet for everyone. 

 

Framing the problem of fatness as if we  need to choose between popular branded diets is more often part of the problem than part of the solution.  Branded diets are generally based on a particular just theory.  

 

Debates over low carb, low fat, low sugar, low starch, low glycemic, high fiber, vegan, paleo, and so on are mostly based on asking the wrong question: "what specific food is making me fat?" 

 

Cutting out problematic "trigger" foods can be helpful for particular people, but not for metabolic reasons.  Also cutting out entire classes of food can help at least temporarily lose weight.  This is also not for metabolic reasons.  This is because we tend to reduce intake more than we compensate, at least for a while, when we cut out entire classes of food. 

 

Some of those strategies work better than others in the short run.  But it turns out with those macronutrient restriction strategies that it really doesn't matter which class we chose to cut out in the long run. 

 

People who successfully reduce intake by restricting carbohydrates and people who successfully reduce intake by eating vegan or by eating "paleo" are all losing weight because they are taking in less energy, not because of metabolic advantages. 

 

So long as we can sustain the calorie deficit with that strategy, we lose body fat.  That's wonderful for the people who end up with a strategy they can sustain, and we can find some success stories for many different strategies.  Strategies that restrict entire classes of nutrients end up being unsustainable for most people  in the long run though and the claims often made about any of these having unique metabolic advantages for weight control have been soundly falsified.  

 

4. People do not regulate their weight to a particular inherited set point.

 

This is the opposite problem from the panacea solutions.  This one reinforces our tendency to give up.  Fatness and leanness often run in families, but not because our genes have a built in weight that we are fated to maintain.  It is because of all of the various factors that go into activity, reward, impulse control, individual metabolism, and habit formation, how those interact with specific environments, and because we often inherit things in addition to our genes.  Animals in their native ecological niche tend to regulate their weight very tightly and people who try to lose weight often end up back at the same weight.  But these are as much a result of stable aspects of their environments as stability in their weight regulation.  When we re-engineer out environments we end up altering weight regulation.  The efficiency of our biology and the stability of our dispositions are powerful factors in making obesity a difficult problem but they do not  make it impossible to solve. 

 

I'm going to try to do more than just add my own personal just theory to the already confusing and conflicting list.  What I'm going to try to do is navigate the available evidence to show what is going on and make sense of why the problem is so difficult and what people are doing when they do manage to succeed.

 

3. The Backlash Culture Against Obesity Does More Harm Than Good

 

So the "obesity epidemic," as it has often been called, has led to a culture of backlash against fatness.  By that I mean a commonly shared negative attitude toward fatness and toward fat people.  We have mobilized mightily against the problem in all sorts of ways.  Some of those have unfortunately probably made the problem worse. 

 

The backlash against fatness might have been a good thing if it had led to a problem solving culture that recognized the biological, psychological, cultural, and economic dimensions problem realistically, helped us understand it, and began providing realistic solutions.  Obesity researchers have sometimes attempted to offer realistic solutions, especially focusing on preventing obesity in children where we can potentially have the most effect.   

 

But realistic problem solving is definitely not most of what has happened so far.   What we have instead is:

 

1. The problem remains: most people who try to lose body fat end up going from diet to diet or from one exercise program to another , succeed for a while, and then give up.  Eventually many give up on the problem entirely as hopeless.  In effect, we often give up on ourselves.  This is especially true when we buy in to the popular misconception that obesity reflects a simple failure of willpower.  Fat people are often stigmatized as lazy and they feel like failures, which generally makes the problem worse rather than better.

 

2. The food industry exploits the situation by creating and marketing niche "diet" and "health" products that supposedly address the problem but which rely on outdated theories, popular misconceptions, and strategically selective interpretations of research.  The market for high density rewarding "diet" foods for example was created to exploit medical advice to eat less food by eating less fat.  The advice was oversimplified and the new market for diet foods probably added to the problem significantly by exploiting it.  Their goal is selling more food product rather than improving health, which most often turn out to be conflicting priorities.     They become part of the problem by flooding us with false solutions and misleading information. 

 

3. The fitness industry exploits the situation by creating complex dietary and exercise programs that are oriented to short term bodybuilding or fitness goals and then marketing those as solutions to obesity. 

 

4. Popular authors tout their range of idiosyncratic interpretations and solutions, each trying to make sense of the confusion but they mostly end up increasing it.  Popular diet just theories by journalists and doctors very often end up inadvertently creating even more confusion.  

 

So the backlash culture in these various dimensions,  far from helping to lessen the problem, has exacerbated and perpetuated it in several specific ways:

 

• It increases the difficulty of the problem for individuals psychologically, by fostering confusion and then discouragement and self-loathing.  By emphasizing willpower in unrealistic ways, and relying on solutions that require extraordinary short term efforts, we make people less able to succeed rather than more able to succeed in the long run.

 

• It adds to choice confusion when we try to make decisions and are led astray by the marketing of product rather than decisions in our own best interests.  Unless things like "diet foods" and "bootcamps" and "extreme weight loss" are themselves actually viable solutions to obesity (which they are not in general) they become new sources of both confusion and discouragement.

 

• It reinforces the epistemological problem of cynicism.  Thinking we are all scientific experts  who are well situated to simply choose between the popular diets and popular theories that seem most plausible to us prevents us from learning from the actual research and prevents us from moving toward more realistic solutions.  We become easy prey for every scheme that comes along. 

D. Science Cynicism and Overly Broad Mistrust of Expertise

 

Journalists writing about the problem of obesity have responded to this ongoing confusion by either claiming we don't know what causes obesity or by trying to promote a particular new finding.  The problem is very complex in some ways, but it is very misleading to say that we don't know enough about it to move toward better solutions.  The journalists who say we don't know the answer are a minor concern though, they are at least sincerely trying to be good communicators of the science and clear up the confusion.  The ones who are really dangerous are the grandiose prophets of false information. 

 

What we usually have is a theory that catches the interest of the journalist and then they confirm it by gathering information and telling stories that reinforce their own theory.  This is a compelling and powerful way to communicate, but it offers no assurance that they are getting the science right.  And while we sometimes find out about truly revolutionary ideas this way, as it turns out, these "sciencey" storytellers are most often getting as much of the science wrong as they are getting right.   

 

These "sciencey" journalists often end up asking bad questions and then we end up talking about the wrong things.  I think this is a big part of the problem and the reason I have written this book.  I hope to describe what we know about the problem of fatness without falling into the common trap of arrogance and confirmatory bias, but of course I can only argue my own perspective.  I could be wrong about the scientific consensus, but I will do my best to communicate it as faithfully as I can. 

 

The unconstrained confirmatory bias by journalists wouldn't be so bad by itself in some cases, since they do sometimes bring information to light that was not previously well known.  At least some people would benefit from some of this information.    But these folks often then read some scientific literature to try to bolster their articles and books and I feel they often do a hatchet job on it.  They can't reconcile their idiosyncratic theories with the existing evidence so they start claiming that the evidence that conflicts with their own theory was due to "corrupt researchers."  This ad hominem strategy has been a highly successful one for some authors, but it is an unfair way to argue and much worse, it plays into general cultural cynicism of science.  That part is extremely bad for the rest us.  It means we perceive the science as arbitrary or a matter of choosing sides based on what sounds plausible or what seems to work for some people.  It feeds the popular trend for imagining that everyone is naturally capable of evaluating scientific evidence by virtue of "common sense." 

 

What often happens, I believe, is that we end up mistrusting expertise, which is in itself a very serious problem.   That fact that we find so many false or misleading claims of expertise makes the problem of finding, trusting, and interpreting legitimate expertise even more of a challenge.    Nutrition and health sometimes involve on complex technical knowledge and interpreting rich patterns of seemingly conflicting evidence.  This kind of interpretative skill and knowledge is not something we possess as part of our "common sense."  It is something that requires not only understanding "critical thinking" in general, but also requires domain-specific knowledge in the specific fields in question. 

 

The backlash culture and especially cynicism of real expertise has fed bias and arrogance by various popular journalists who then set the tone for popular conversations in unproductive ways.  Although they may have a lot of charts and graphs and selectively cite and interpret a lot of research, rarely do journalists engage the research deeply and competently and systematically and put it into context.  Rarely do they make a distinction between different kinds of evidence and different quality of evidence in order to do a skilled job or drawing general conclusions from the existing science. 

 

The biggest problem with many of these popular authors is their grandiosity.  They think they've discovered a pattern that everyone else has missed or they have some limited success with some people and they proclaim to the world that they have the solution.  Grandiosity exploits uncertainty and cynicism to produce cults of misinformation that are self-perpetuating and extremely difficult to address with reasoning and evidence.  

 

 

Summary of Why the Big Fat Problem is So Tricky

 

Summary of broad factors making the Big Fat Problem so nasty:

 

Problem Factor	Class of Factor	Associated Bad Thinking
We tend to think in terms of simple actionable heuristics we can act upon when we make decisions.  What food is causing me to get fat, so I can stop eating it and lose weight?  What foods should I eat to lose weight instead?  Our need for actionable heuristics makes us especially vulnerable to just theories, and just theories of complex outcomes are typically wrong.	Oversimplification	"Obesity is just a matter of eating more of … or eating less of  …"
The science is often distorted into oversimplified advice.  The scientific consensus relies on expertise to understand and is hard to communicate in terms of actionable steps so it gets lost in the confusion of just theories.   We end up systematically asking the wrong questions and arguing without regard to the existing patterns of evidence.	Oversimplification	"One study constantly contradicts the previous one, so it's all really useless information, we should just pick the authors we agree with and follow their advice"
Our collective cultural assault on fatness has led to a backlash culture that makes things worse and leads to additional problems.	Unintended Consequences	"Being fat is really bad, stop being so lazy!  Just do this… "
Journalistic arrogance and widespread science cynicism exploit the problem of ubiquitous expertise	Knowledge Cynicism	"We're all scientific experts, including me!  Forget the scientific consensus, this sounds like a good way, follow me!"
"Sciencey" storytelling journalism	Poor science communication	"Telling stories about research and researchers is a great way to learn the science!  The details of weighing evidence are boring and irrelevant and people aren't able to handle it."
Industry interests driven by economic and business concerns that often end up conflicting with public health or individual interests of consumers	Economically Driven Consumer Culture	"People citing research in their ads and branding their products for health are generally offering valuable new choices for us."

Book Review: "The Hypnotist" by Jake Shannon

"The Hypnotist: Healer, Head-Hacker, & Headliner"

by Jake Shannon

https://www.createspace.com/3623853

Jake Shannon is a fascinating multi-talented man with a rich and partly enviable life experience. He has also lived through extraordinary pain and illness which were a big part of his initial inspiration for his deep study of hypnosis. As in the life story Dan Ariely, whose life with severe burns helped shape his fascination with psychology, Jake turned to the study of the mind for healing and pain relief. Hypnosis served Jake, as it has served many, as a way to alter the way they experience pain and discomfort.

If "hypnosis" simply referred to a straightforward technique for altering our perception, and that were the end of the story, then Jake's book would have been much more narrow in scope. The intentional structure of the human mind as we understand it pretty much ensures that any any discussion of perception also overlaps with a discussion of beliefs, behavior, communication, and social interaction. This network of concepts has far reaching implications in areas that fascinate all reflective people.

Topics as deep and diverse as the nature of "free will" and responsibility, the sources of extraordinary (and ordinary) human abilities, the role of social compliance in human life, and the malleability of perception all have some meaningful dependence on the ideas that underlie contemporary theories of hypnosis in terms of things like suggestion and expectancy. That interaction, and those dependences, are where the story gets really interesting, and Jake stands out to me in the broad way he has captured them.

Jake surveys the key concepts from a wide range of hypnosis theories, but he does not stop there. He also explores their use in daily life and their implications for social and political issues. When we extend our scientific theories to less directly empirical questions like the implications for social and political issues, of course we tend to incorporate our own distinctive leanings along the way.

Jake's distinctive leanings are strongly libertarian, and libertarian philosophy does not map neatly onto the usual political spectrum but has its own distinct principles. In his book "Justice," Michael Sandel argues that libertarian philosophy revolves crucially on the idea of self-ownership, and I think this is borne out in Jake's perspective on hypnosis. Jake is starting with the central notion that we own the stories we tell ourselves about the world and our role in it, and that we can and should take responsibility for guiding our own self-talk and for filtering the inevitable influences that impinge on it.

For Jake, the crux of hypnosis is entering into and redirecting the conversation we all have with ourselves in our own thoughts, thus shaping the inner stories we tell ourselves. This emphasis on the language aspects of hypnosis are particularly complementary with the communications theories of hypnosis, such as the ideas derived from the studies of Milton Erickson's hypnotherapeutic methods. Jake wants to tie the concept of hypnosis together with a host of other phenomena of importance to self-ownership, particularly social compliance phenomena, so the emphasis on communications and language seems to be strategic.

Hypnotic phenomena are all about changes in our perception as a result of "suggestion," and it is notoriously difficult to distinguish changes in perception from their related mutual influences on belief, behavior, attitude, and emotional associations. So Jake is working from very fertile ground in adopting the broad view of hypnosis as a class of psychological phenomena with interesting social implications. The question that arises about the role of "hypnosis" (in the broad sense Jake uses the term) in human life is whether the sorts of focused suggestions we associate with hypnotism really have a lasting and systematic effect. This is where the topic has historically gone astry in the public mind, with many people attributing much greater and more mysterious power to hypnosis than it deserves, and others attempting to debunk it out of existence as a distinctive class of phenomena of any importance.

Jake would seemingly focus on hypnotic suggestion as a situation where the someone's existing inner conversation is entered into and guided or redirected by the voice of the hypnotist. In the communications view, the explanation for what is going on in the situation (our self-talk about the situation) seems to be a driver for what will follow. We explain the situation to ourself in a particular way, and as a result we act in the situation as if that explanation were true. I think this primacy of the role of explanation in behavior in Jake's thesis is tied tightly to his committment to libertarian self-ownership. It provides a focus point where we can more clearly see how we can influence our own behavior, and how we influence each other. In psychological terms, it centers around *compliance* rather than the _experience_ we have from hypnosis.

Jake's summary illustrates this focus on compliance very clearly: "The hypnotist accesses the subject’s self-conversation through specific rhetorical techniques and subject similar-body language while leveraging the effects of expectation and authority in the subject’s mind in order to achieve compliance."

Explanation is just one albeit critical aspect of human mind, but it clearly isn't the primary driver of behavior in a wide range of situations. Jake refers to the work of John Bargh and others who have demonstrated this experimentally. Jake seems to give the non-language aspects of hypnotic phenomena a secondary role as influencers on our inner dialog. Importantly, he sees hypnosis as "leveraging the effects ..." of expectancy rather than expectancy being the central distinction of effective suggestion.

A less communications-oriented view might see the same situation as if our expectations were altered first, through various language and non-language means, and then our experience and behavior followed our expectations, followed at last by some explanation. In the expectancy view promoted by Irving Kirsch (for example), the explanation for why we responded to a suggestion is an artifact, not a driver of the behavior. We follow a suggestion, and then explain why we followed it. Experiments have sometimes deliberately imposed a conflict between an explicit suggestion and an implicit expectancy, and Kirsch interprets those as demonstrating that the expectancy (rather than the language per se) is what drives the resulting behavior. Jake sees automaticity as "the ability to do habitual tasks with little active thought." Kirsch, in his writings on automaticity, has gone much farther and described it as the default state for daily life, where active thought arises only under limited conditions. The non-communications views tend to focus more on the _experience_ of hypnosis and especially why **our experience of control** differs from situation to situation.

This is to some extent a chicken and egg problem, since we can find circumstances where behavior is more clearly driven by the (potentially) self-owned stories we tell ourselves, and also circumstances where our explanations for our own behavior are completely at odds with a more compelling cause. The stronger-self-ownership view of the mind will of course tend to emphasize the role that we play in guiding it. The stronger-automaticity view emphasizes the small, critical windows where active guidance actually takes place. These are not mutually exclusive ideas, something that I think Jake does manage to get across in his book. Again, though, there is that important difference in emphasis, and the different role of language in the human mind that this difference in emphasis represents.

It seems plausible that we can reconcile these different views by seeing the mind as having multiple different parallel systems, perhaps one speciallized for explanations, and others speciallized for motivating and guiding behavior as such. This is part of the role that Jake seems to attribute to bicameral theories of mind. As good promoters of natural science, we want to somehow try to map the features of the mind onto the brain, and bicameral theories take a big swing at that. I think the process of mapping mind onto brain is, while laudable, problematic in practice for various reasons perhaps better identified by philosophers than scientists. Also I don't personally step onto the train of thought that views the anatomical division of many of the brain's "higher" structures as also being a fundamental infrastructure of psychology, nor do I think it plays a particularly fundamental role in explanations of hypnosis, but I do think it is likely that it plays at least some secondary role. My difference with Jake here seems to be mostly one of emphasis.

I don't criticize Jake for taking on the language-focused view of hypnosis here, and I understand how compellingly it fits into the bigger picture of ownership for our own thinking and behavior. In various notable attempts to naturallize consciousness, various reflective thinkers such as Daniel C. Dennett have also described the meaning-making function of the mind largely in terms of stories we tell ourselves, and this does seem to imply a huge role for language as well.

The remaining question is the relationship between language and experience, and in the case of Jake's thesis in this book, especially the experience of *control* and its relationship to compliance. Understanding the phenomena of hypnosis (broadly defined), Jake empahsizes, can help us gain better control of our own mind, and better understand the influences that others are having. I would say that compliance and self-ownership of our mind is a larger topic than is hypnosis, but that Jake is right on target in pointing out the crucial importance of understanding how our mind is shaped and influenced, and how much we can learn about this from the phenomena of hypnosis.

I would actually go farther and say that I think the phenomena of hypnosis have potentially much more to tell us about the nature of the mind than just about the issues pertaining to compliance and influence. I wouldn't entirely define hypnosis in terms of compliance or language, I would define it more primarily in terms of expectancies, and in revisioning the workings of the mind in terms of expectancies I would expand Jake's thesis to include even broader implications of our shifting sense of control for law, medicine, philosophy, economics, and so on. Still, this is a great start and a very worthwhile research effort with both a depth and breadth of ideas you won't easily find elsewhere and which most people will find surprising, fascinating, often troubling, and most importantly, useful in understanding ourselves. I urge you to learn from Jake's experiences and reflections.

"Evolving Your Brain" some interesting and inspiring science with an unneccessary spin

My review of "Evolving Your Brain: The Science of Changing Your Mind", (author Joe Dispenza).

Interesting neuroscience, inspiring message, and some old philosophy in new clothes

Overall I enjoyed reading this book, although I did find it somewhat misleading regarding the scientific "paradigm" it offers and the minority philosophical points underlying it, and I was disappointed that there was not more practical applications of the author's interesting model.

My take on this book was almost the opposite of many of the other reviewers here who were either so impressed by the fact that someone would try to sue use science to support "free will" or so dismayed by the amount neuroscience in this book. Neither of those things seems that impressive to me. There *is* a lot of neuroscience here, and much of it is better than average (for a popular non-technical book anyway), but there is also some crude and I think poorly thought out philosophy as well. And the ironic thing for me was that the principles the author espouses for change are pretty mundane and don't really require either the neuroscience or the "consciousness precedes matter" philosophy.

The reasonable principles include such straightforward suggestions as envisioning your end point to organize action, using deliberate shifts of attention to change direction, using rehearsal to change habits, identifying destructive habits of thought, take responsibility for change, and make well-being a priority. Great ideas, but they don't really need the intro to neurosci or quantum physics in my opinion.

Brain science would have been more appropriate if the author had gone into more details about how we make decisions, showing how to influence the thinking process (e.g. see The Owner's Manual for the Brain: Everyday Applications from Mind-Brain Research 3rd Edition, (Howard)), but he avoids *that* sort of research, probably because it would dilute the philosophical message of "free will" that the author seems very concerned with promoting. If there are causal influences on thought, then it doesn't seem so free afterall, the opposite of the rhetorical message of this book.

The author does a pretty good job most of the time selecting and deriving pertinent lessons from neuroscience data and he gives some optimistic and realistic applications for how we can and do change ourselves sometimes. Where there is practical advice given, most of it seems very good to me, which is why I like this book overall and gave it a fairly good rating as inspirational self-help that tries hard to be scientific. As such it may for many people turn out to be a nice corrective to the scientific pessimism they find from many old school medical and psychological experts who are overly deterministic in their prognoses. I guess that's why so many reviewers seem so taken with this book, it does have an element of hope in it dressed in science, and we are more used to getting skepticism or pessimism in scientific treatments.

The author and I both seem to agree that we *can* change ourselves and influence our healing processes deliberately to some degree by rewiring our own nervous system in places, and we both also respect and commit ourselves to scientific causal models. We also both seem to be "compatibilists," people who beleive that our sense of free will and scientific determinism can be adequately reconciled. That far, I liked this book. We may disagree on the limits of self-change in practice in some specific spots, but I think the basic concept of self-healing and self-change is sound and welcome.

However the author also seems to have struggled with the philosophical problem of "top-down causation" at some point and I don't agree with or like the resolution he came up with. The whole concept from the start begins with the idea that thoughts trigger all sorts of physical things that have lasting effects. The author spends a lot of time in the book giving detailed examples of this. I have no problem with that, although it should be mentioned that this is not something new, it has been pretty well documented for decades by other authors, e.g. The Healer Within: The New Medicine of Mind and Body (Locke) and Psychobiology of Mind-Body Healing: New Concepts of Therapeutic Hypnosis (Rossi).

The problem with this particular book that I didn't have with those others is: where did the thought itself come from and what is its manifestation in the brain? That's where the author mostly just hand waves the brain mechanisms and defers to the ancient archaic version of "free will" as something that floats free of physical reality through some obscure unspecified quantum mechanical rationale. Why does he need this stretch to point out that we can change ourselves? I don't think he does.

The way thoughts themselves arise is one of the most important and interesting aspects of brain science, and still largely a mystery. The author's good but selective review of neuroscience mentions "free will" a lot but never all the wonderful data that has been accumulated regarding how we make decisions or where our perceptions and misperceptions of "free will" come from. Free will, in the sense that it actually exists and is worth seeking, is not something that escapes the brain and then reprograms it as the author claims, it is a result of that same remarkable brain, even if not entirely understood. At least that is a more interesting and promising line scientifically than hand waving about quantum weirdness and how "thoughts" as disembodied entities cause things to happen in the body. From my perspective, the illusion that makes us feel as if thought has to be non-physical is addressed well in: The Illusion of Conscious Will (Wegner) and Freedom Evolves (Dennett).

This "new paradigm" of the author is actually more philosophy and pop science speculation than hard science I think. It isn't terrible by any means, or impossible, and he isn't alone in considering it, but it is not really a new scientific model at all in any interesting experimental sense. It has been around for a while and has had a small, marginal, but dedicated following outside of mainstream science (and more broadly in popular media).

The author applies the problematic "consciousness is prior to matter" philosophical stance and then at the end of the book he throws in the traditional idiosyncratic interpretation of quantum physics to make the point more "scientific." To be fair, this view is reasonable philosophically and more to the point, I suppose may help non-scientists better appreciate human potential for change, which seems to be the author's primary overriding goal. But personally I think it is a technically completely unneccessary and misleading way to resolve the issue raised by top-down causation. For details on the philsophical issues, Jaegwon Kim's books are particularly helpful, such as: Mind in a Physical World: An Essay on the Mind-Body Problem and Mental Causation (Kim).

"Top-down causation," is the problem of how the mind, as a product of the brain, can then turn around and influence the body. I would say that this is a problem of how some aspects of brain function can influence others. The author instead joins those modern day Cartesians who evade the scientific problem with philosophy by making "thought" something outside of the physical world that causes things to happen in the physical world. Yes, I agree with the author that whatever a thought is in the brain does cause other things to happen in the body, but I disagree with him that it requires a weird non-physicalist take on consciousness and quantum mechanics to achieve this in principle. I particularly don't like that he claims this is some sort of new scientific paradigm. It is an old philosophical idea. There's a nice account of the difference between this intuitive view and the scientific worldview in: The Problem of the Soul: Two Visions of Mind and How to Reconcile Them (Flanagan).

This idea is certainly considered seriously by some philosophers, especially those who feel it is impossible to solve "hard problems" like qualia with physical explanations. But there is very little science here that applies to these ideas unless you really stretch and squint an awful lot at a few marginal experiments that could just as well be interpreted in other ways.

More importantly, the book doesn't really have as much in the way of practical ideas as I would have liked. The "science of changing your mind" should actually have a lot in it about changing your mind, rather than just explaining why it should be possible to change your mind.

So I don't think this was pioneering science because of its unneccessary odd digressions of philosophy and quantum physics, and I don't think it is a good how-to book, but I think the author makes a good case from neuroscience for the possibility of changing ourselves. I did find some value in the author's general model of how we change, but that would have made a better article than a book.

If the author had taken his model of change and neuroscience references and applied them to many practical examples rather than using them to promote an idiosyncratic underlying theory, this would have been a superb book in my opinion.

As it is, it is a better than average "alternative science" book. A worthwhile spiritual and also practical message combined with a mixture of real scientific and also very idiosyncratic models.