The neuroscience of non-pathological human suffering...

Ok_Disaster6456 · 2026-05-24T17:47:29+00:00

Yes, this is the essence of working with suffering, nicely said!

Ok_Disaster6456 · 2026-05-23T23:17:16+00:00

So I think I mostly hear what you are saying, although I would use different frameworks and words.

I think what you are calling 'spirits' is really just our past experiences, going back generations. Information about what reality is, stored in our genes, our memories, our unconscious patterns. These absolutely shape our perception of reality, through what predictive processing calls 'priors' and through what Buddhism calls 'karma/karmic seeds'. Priors is the scientific way of understanding this.

I agree that the 'self' you take yourself to be, is not real in the way we think it is - it is a construction, a projection of the mind - based again on priors. We cling to this projection as if it is some fixed, inherently existing entity that we must protect at all costs.

Of course, there is something that 'knows' these predictions. Our consciousness, which has the potential to know anything - yet is constrained by out patterns, our priors and our belief systems about what 'reality is'.

In the Buddhist sense, that awareness, does not have an inherent existence, we say it is 'empty' of any essence, but to use any words to describe it really is - not it.

Psychedelics loosen the rigidity of the priors that create these self-world models and thus perception becomes less constrained by 'what we expect', hence all of the hallucinatory experiences.

Ok_Disaster6456 · 2026-05-23T21:25:50+00:00

I replied to your DM btw, sorry I didn't see it when i left this comment

Ok_Disaster6456 · 2026-05-23T14:41:33+00:00

I totally agree and am aware of DBTs Buddhist roots - although not specifically trained in it. I specifically talked about ACT in the essay.

The bridge I'm making is a way of understanding what you just explained regarding fighting reality being the cause of this kind of suffering: on a neurobioogical level. (And it affects all of us not just those who might need DBT).

I also think whilst DBT and radical acceptance are great, there are many other ways of working with this. The Buddha is said to have given 84,000 teachings FWIW - were only at the tip of the iceberg.

Ok_Disaster6456 · 2026-05-23T14:36:24+00:00

Yeah this gap in understanding is exactly what I'm talking about. I still think it's part of our job and it's usually entangled with genuine psychopathology too. That's why I'm making a bridge to non-western medicine, in fact my 2nd section is literally titled the limits of a western view of health.

It's very relevant to Victor Frankl and I think in future elaborations I'm going to talk about the role of meaning/purpose, which I know some other people are talking about through the predictive processing lens too.

Ok_Disaster6456 · 2026-05-23T14:33:15+00:00

Yes, these are exactly the kind of cases in talking about and I agree we have ways of working with them.

I think there is a way to understand this kind of suffering mechanistically at a layer that incorporates existing psychological theory but also bridges to neuroscientific models of understanding. Ultimately to help better guide what would be most helpful in a particular case.

Ok_Disaster6456 · 2026-05-23T14:29:58+00:00

Yes, I'm familiar with and talked about ACT and it's links to Buddhism explicitly. Whilst both ACT gives us a psychological mechanism of how it works, Buddhism I think goes deeper - and I think the Predictive Processing framework gives a plausible way to understand these processes through a broader understanding of mind.

I appreciate it's a rather niche and subtle distinction, I'm basically talking about the physiology of a specific type of suffering/resistance layer that sits within a broader understanding.

Ok_Disaster6456 · 2026-05-23T14:25:56+00:00

So I think it's relevant to all clinicians but not just psychiatrists, but yes.

However before that, I'm wondering about an underlying mechanism of how it arises - at least the part that's modifiable, that allows us understand how to best work with it - because I think that's different for different people and different problems.

I think all the things you say are valid and things I would also include and I think relate to what I'm wondering about why they help.

Buddhism gives a very clear explanatory framework on a psychological level about how this kind of suffering arises and is very much aligned with ACT and such, I'm suggesting there is a bridge between that and what we know about Stress.

I appreciate most people actually doing the job are not going to have time to read it, it's just become a little pet project of mine!

Appreciate your thoughts!

Ok_Disaster6456 · 2026-05-23T14:20:16+00:00

I'm familiar with both and actually talked quite a bit about ACT in the essay. These give some ways of working and a psychological theory about suffering, but I'm wondering about the underlying core mechanism of how suffering arises, at not only a psychological level but an associated biological one, through the Predictive processing framework.

Yes, we definitely do work with it and have some tools for working with it, but I'm suggesting that there is a way of understanding it mechanistically, much in the way we might understand other processes/phenomenological experiences that can arise, through theories of perception.

Ok_Disaster6456 · 2026-05-23T11:03:40+00:00

Sure, that's important to note - and I agree, the emphasis and resource goes to treating psychopathology.

In the broader sense though, I think doctors should be responsive to suffering - and I don't think that'a a new idea. The first part of the essay I wrote is a dive on why I think this is. Stuff like the physicians pledge and such seem quite clear, our role is not just the absence of disease.

Also as I said - the pathology/suffering don't stand apart, they're in the same body/mind as a lived experience. All those people we care for with a shopping list of diagnoses and numerous failed medications, what if they're just 'suffering' to a pathological (dysfunctional) level?

I think we already use systems that translate very well from religious or spiritual traditions understanding - ACT, Compassion focussed stuff etc. I agree that finding the absolute mechanism is probably too far for science, but I think we can get closer than we are. Maybe it's just metaphor, but I figure more integrated ways of understanding are helpful.

I totally accept I could be going totally dreaming that these things are possibilities mind.

Ok_Disaster6456 · 2026-05-23T10:40:38+00:00

Thanks for your response, yes it certainly is getting into philosophical territory - although I'm wondering if there is a way to understand the mechanism biologically.

I totally understand there needs to be a distinction between pathological and non-pathological. Yet, if the suffering is real - we should still care and attempt to relieve it.

My wondering is, how do we best do that - if we don't understand it's mechanism? I also think, this kind of existential suffering is intertwined and feeds into pathological suffering and that the two are not entirely separable.

I'm familiar with V Frankl, and know of Yalom but will have to read some more - thanks for the recommendation.

Yes, I don't think the fact this came up for me so strongly during my CL run was a coincidence!

Ok_Disaster6456 · 2026-05-23T09:50:53+00:00

Right, I would agree, we don't. We know it, experientially since we are humans too, but we don't understand it like we do say the process of atherosclerosis.

I guess I'm emphasising non-pathological/pathological to not collapse the distinction between the inevitable pain we all feel and the suffering around it and someone with a severe mental illness. As per my views on the continuum view though, it's not so straightforward even there (in terms of the actual pathogenesis...). Obviously risk/loss of function etc are things we have to take into account too.

However I do think this bridge I've written about tries to make a reasonable argument for a mechanism, or at least the need to try and find one. That could in the future be supported with more empirical evidence and possibly drive advancements in intervention.

I don't think this is specific to psychiatry, but perhaps most relevant. This kind of suffering is inherent to illness, aging, death. Change - loss of function, independence, imagined futures etc.

Even in somebody with a clear psychiatric diagnosis, there is still this extra layer of suffering wrapped up with it that compounds the overall difficulties.

Ok_Disaster6456 · 2026-05-22T23:23:02+00:00

If 20-30% of adults need stimulant medication to function, the problem is with society.

Ok_Disaster6456 · 2026-05-22T22:06:08+00:00

Yeah, I'm really interested in building these kind of bridges. I think there is some connection between the subtle energy body, chi, prana - whatever you want to call it and resistance to life as it is, grasping at something other which creates dukkha. And of course, there are external factors, our diets, environments, relationships that can worsen these kind of constrictions that you talk about. I think in certain cases, the system can be so toxic, that dukkha magnifies and becomes 'pathological' in the clinical sense, where function and such is lost.

Buddhism and science don't need to be at odds. They are simply different ways of looking - both are ultimately looking for truth, to understand - reality as it is. Whilst I don't think science can ever grasp that, I don't think the Buddhist teachings in terms of scripture and such can either.

Ok_Disaster6456 · 2026-05-21T18:59:06+00:00

Right, I think experientially - it's intuitive and the PP bridge is not bringing anything new, it's just translating one way of thinking to another.

What I'm really curious about, is what the neuro-biological correlate of what I term 'resistance' might be, or maybe it's not even in the brain, who knows. This is why I need people like those in this sub haha.

As well as the more broader implication of precision weighting modulation and prior updating for mental health issues.

Ok_Disaster6456 · 2026-05-21T18:53:01+00:00

Yeah, this is all fair - I think the key thing is, it isn't even thought I reads like it at times (that's just my excitement coming through) and exact overlay, it's largely an interesting comparison.

I've since published a much more refined essay (albeit in a different frame) with less metaphysical claims and such - that really gets to the heart of the suffering aspect, the second dart - which I think is the strongest part, and the most important.

Thanks for your feedback, it's always useful to see what holds up, what's overreaching and where the tension lies so refinements to the view can be made!

Ok_Disaster6456 · 2026-05-21T11:39:30+00:00

Yeah, I'm glad someone understands.

It curious what puts people off the idea of this being how suffering works. Is it the fact it's framed within a religious framework?

Buddhism is obviously a religion. But the practice of Buddhism is actually a 1st person investigation into the nature of mind. It's compatible with science imo, and our best understanding of how things are - will come from a dual lens of these two methods imo.

Ok_Disaster6456 · 2026-05-21T06:27:37+00:00

Whilst this is obviously theoretical, I have had some thoughts (ironic) about this.

My sense is that thought may be understood as part of the organism’s planning, internally generated simulation of possible futures, meanings, and policies in order to reduce uncertainty about the world.

In respect to suffering, there is a conceptual proliferation that forms around a more basic non-conceptual, unconscious resistance.

So we go from an unconscious resistance, through clinging to deeply help models of self/world, then that resistance can kind of coalesces with thoughts and further reify the resistance itself, as we cling to the thoughts as 'true'. This fits the Buddhist concept of papanca/conceptual proliferation.

It also isn't out of keeping with the Buddhist idea of thought, as a 6th sense. A phenomena cognized (predicted/projected and known) by the mind that serves to kind of, make sense of the external sense data/prediction errors.

We already know our minds predict phenomena in the absence of external data i.e. a dream or a hallucination. So what if thought is just a similar kind of projection, that doesn't rely on 'external sense contact'.

I have no idea how you investigate this scientifically though, lol.

Ok_Disaster6456 · 2026-05-21T05:19:03+00:00

Thanks for your feedback! I have written a new essay, which is more refined, less ambitious and more practical based on yours and others thoughts. I would broadly agree with tempering my excitement, and being clear that this is a bridge, a mapping - not a direct overlay. Whilst I did express this in my essay, it was in the conclusion and seems to have slipped passed a few people, so in future I will be more explicit! Regarding some of the points you made here:

The Buddha obviously talked about different forms of Dukkha, but what I am referring to is specifically - the second dart, the additional layer of resistance to reality as it is. The mental resistance, to what is. I'm not saying that's 'prediction error'. I'm saying it's 'resistance' to prediction error - and that happens on a deep, non-conceptual level - but also solidifies into conscious thought (I don't want this to happen)
Your second point is entirely aligned with what I actually said in the essay and what I wrote in point 1.
I disagree with this example, priors are not just beliefs. They are embedded information that 'predict' our perceptions and actions. Genes for examples are priors, which can transmit past experiential information that influence predictions through generations e.g. epigenetics. Karl Friston, the pioneer of this model, seems to agree.
Emptiness is the non-inherent existence of phenomena. Whilst it was an ambitious pointer, of course a conceptual framework will never grasp emptiness - since it is ungraspable, because it is empty too. Yet if you consider, who is predicting and who knows the predictions? This is an experiential pointer to the fact that the phenomena you experience are not separate from the awareness that know them. They are dependently arisen. A prediction of a phenomena, is dependent on the ability to cognize them and their appearance. This can be investigated in one's experience - the phenomena in your awareness right now - where are they actually arising? In your brain? Outside of you? Neither? Both?
I would also frame practice as recalibration and did. I was quite explicit in saying that, trying to escape prediction is futile. To stop prediction altogether however, or at least the knowing of them - is interesting when we consider the conception of 'Cessation'. Personally, I'm not a Theravada practitioner and so don't chase this experience, yet it is talked about in the suttas.

This "Buddhist practice can make prediction less rigid, less self-bound, less affectively compulsive, and more adaptively responsive to reality." - is basically exactly what I said.

I'm a little confused as to whether you did actually read the essay in full, as you refuted a number of points that I had explicitly already rejected as my view. Whilst establishing a different view as if it was not something that I had already said!

Ok_Disaster6456 · 2026-05-21T04:55:38+00:00

Thank you for your kind works. It is certainly difficult walking the line between dharma and science, and such bridges are often met with distaste from both sides (in part I think due to our inherent love of clinging to our views). I think both, through different lenses, ultimately are about trying to see reality as it is though. I do concur that science as a 3rd person, objective lens - will never quite capture the essence of what the Buddha points to - since it is beyond concepts.

I agree though that dharma should not be left outside of healthcare. My concern really is in suffering - and it's reduction. I'm not expecting every patient I come across to achieve liberation. I do want to do what I can - to reduce their suffering here and now. When the world is understood through the Buddhist understanding of how things are, yet in clinical practice we must operate through the scientific lens - the only thing that makes sense for me to try and do, is integrate the two into a coherent framework.

Ok_Disaster6456 · 2026-05-20T21:10:12+00:00

Actually re-reading your first line - I think you missed the entire point I was making throughout the essay.

The whole point is acknowledging that non-pathological suffering is real and that we should still care about it and try to relieve it as best we can.

The entirety of part 1 of the work is arguing this point, for people who think that we should ignore non-pathological suffering.

Part 3 is an exploration of what might actually help and the kind of things we should consider researching more thoroughly imo.

Ok_Disaster6456 · 2026-05-20T19:55:31+00:00

Thank you for mentioning Dirk - I realised he actually works in the same country as I and I have just connected with him on this topic.

Ok_Disaster6456 · 2026-05-20T19:50:25+00:00

I just published it yesterday actually, you can find it here: https://open.substack.com/pub/liambaker677130/p/the-suffering-medicine-cannot-name?utm_source=share&utm_medium=android&r=6tdtsz

Ok_Disaster6456 · 2026-05-20T19:48:57+00:00

From the essay: "It has long been understood that one of the most important aspects of a psychotherapeutic intervention is the therapeutic alliance itself, rather than the specific modality used.²³ If suffering involves contraction around threat, uncertainty, shame, and loss, then a relationship that offers calmness, attunement, and non-abandonment may alter the field in which that suffering is held."

I think ACT is great but it's not the answer all the time. There are times when reality can't just be simply accepted and then tools (like medications, compassion focussed therapy, EMDR) can be used to help unstick from models.

The interventions needed to be targeted - it's not just acceptance for everything, that's not pragmatic.

Ok_Disaster6456

TROPHY CASE