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Epistemic Closure, Carbon Cycle Feedbacks, and Mitochondrial Illness

Published on March 14, 2022

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Patterns in life repeat across all ecosystems. We are nothing but circles upon circles of iterative patterns. It does not matter whether we are contemplating patterns of intellectual thought, behavior, or biology, the pattern and cycles of growth and implosion remain. When one circle collapses, another emerges, a little different but similar enough to be recognizable. In the early stages of a cycle, feedback loops are common, but in the latter stages and before collapsing, they become feedforward, endlessly escalating until collapse.

In feedback systems, inputs induce adaptive changes of accommodation. Think of how a thermostat controls heat. When the temperature rises, the thermostat feedbacks to the furnace to turn it off. Similarly, when the temperature cools, it signals the furnace to turn on. In a feedforward loop, there is nothing to regulate the temperature, so as the temperature rises, it would signal the furnace even higher. Most biological systems, excluding some hormonal cues, operate as feedback loops, up until a point. Feedback systems require energy to maintain; feedforward systems, not so much. When the energy runs out, input feeds forward and adaptive changes of accommodation escalate until the last and bitter end.

I was reminded of these patterns a few months back by two seemingly disparate observations: a twitter thread on the closed intellectual systems that feed upon themselves in political social media and a scientific article warning that the threshold for environmental carbon cycles where damage enters a feedforward loop is fast approaching. These, of course, come against the backdrop of my work on mitochondrial illness; perhaps among the clearest examples of cycles gone awry. Mitochondria, the comptrollers of cellular energy, are exceeding adaptable to existential threat. So long as the accounts are balanced favorably towards energy availability, systems keep running. When the energy runs out, however, what are meant as temporary adaptations with clear feedback mechanisms, become more permanent, forever escalating ill-health until the tissue, organ, and eventually the human in which they reside, collapse. Mitochondrial collapse, at its most basic level, is death. For without energy, not even breath is possible. Both the twitter thread and the Nature article reminded me of how perilously close we are to that collapse ideologically and biologically.

Of Collapsing Epistemes and Ecosystems

Some months ago, I stumbled upon a particularly prescient twitter thread that used the term ‘epistemic closure‘ to describe political social media. Briefly, an episteme is a Greek philosophical term that refers to the rules by which knowledge is determined and accepted e.g. how we know what we think we know. From a paper I wrote last year.

An episteme refers to a system of understanding that is, in many regards, codified culturally by the acceptance of others. Those who study epistemology are interested in understanding the conditions for, and structures of, knowledge as it applies to systems of thought like those employed in science, politics, or culture. In general, epistemology ask questions about how ‘truth’ is defined, who is allowed to speak about truth, and how these truths are disseminated. The how and the who of epistemic knowledge are important considerations when evaluating systems of thought as they are often deeply entangled in webs of influence that may or may not be clear to those operating within that system.

The gist: An episteme is like a circle; an open circle when it is healthy and a closed and shrinking one when it approaches collapse. Its rules define what those within that circle consider knowledge or truth, as well as by whom and how truth can be determined. It is important to note that each of us operates under these dictates of epistemic knowledge. We exist in these circles of cultural, religious, political, and other norms. In many regards, these circles provide the heuristic that allows us to navigate informational or belief systems by caveat and without thinking through the problems ourselves. The epistemic circle serves a biasing function that guides decision-making and it is a necessary survival mechanism. Success and even survival within a particular episteme requires us to abide by these rules.

Consider each of the groups that you belong to beginning with macro groups like country and religion down to the smaller groups like work and family. Notice that there are rules, some spoken, others not, about what each group considers acceptable knowledge or behavior; rules that if you want to succeed or survive, you must abide. Many of these rules are so entrenched that we have internalized them and no longer pay them any heed. They are there though and they mark the boundaries of the epistemes under which you live. Now consider whether those rules are healthy, whether there are mechanisms of feedback in place, of dissent or correction, or whether they are feeding forward and simply amplifying a particular power structure or ideology. With the former, there is opportunity for evolution. There are still rules and power structures, but dissent and growth are possible. With the latter, there is not. The episteme is approaching implosion.

Epistemic Closure and Feedforward Loops

If an episteme determines the rules by which truth and understanding are deemed acceptable, then epistemic closure would indicate a closed system of understanding; a closed circle. In the thread I mentioned above, the author was referring to a particular type of political media and to an ideological ecosystem that was not necessarily closed off from dissenting views but one with mechanisms in place that would not only allow for the active rejection of any and all contrary evidence or views, but demanded it. Within this system of epistemic closure, no matter what was presented there were mechanisms in place to ensure that rightness of one’s views could never be challenged, only magnified and reinforced. In this regard, all contrary evidence or ideas become proof supporting the certainty of a particular perspective. It was a feedforward loop. While this gentleman was referring to political ideology, it is difficult not to see the same processes involved in pharmaceutical marketing. Indeed, I would argue that the mechanisms of maintaining epistemic closure have a long and entrenched history in the pharmaceutical and chemical marketing. Think about how tobacco, vaccines, or really any drug or environmental chemical is marketed to the public; how dissent is not only squashed but turned around against the dissenter in a manner that strengthens the manufacturers message of safety and/or efficacy. Closed political systems hold tight to the tobacco playbook.

The second example came from an article published in the journal Nature about environmental warming, and specifically how warming affects soil based carbon cycles. The gist of the modeling presented suggested that we have only 2 more degrees Celsius of warming before we switch to an essentially feedforward loop of environmental destruction. The authors used the term carbon feedback to describe the situation, and the math used to model the phenomena was quite linear, but the data they presented were suggestive of a feedforward type of reaction, one where each new input strengthened the progression towards catastrophe; the point at which it would become impossible or nearly impossible to reverse course and the point at which the ‘energy’ required to flip back to a feedback system, was insurmountable.

In my work with mitochondrial illness, I see patterns like this regularly. Ideologically, mitochondrial illnesses are so complex that they defy our current epistemic understanding of what illness looks like, and as a matter of course, those within the epistemic bubble that is modern medicine, decry their very existence. These illnesses are attributed to psychosomatic origins, filed in the ever expanding ‘all-in-the patient’s-head’ category. The reasoning is such that if an illness does not respond to an available medication, and often a laundry list of medications, it must not be real. The non-response becomes the proof, a proof that is constantly reinforced and magnified with each new failed treatment. Much like the closed political ideologies, no amount of evidence will convince the ‘inside-the-circle’ group of what veracity of the ‘outside-the-circle’ group sees or experiences. In no small part due to decades long information campaigns touting the benefits of this particular medical ideology, all evidence from the out-groups serves only to reinforce the beliefs of the in-group. It is a collapsing circle.

Climate change follows the same pattern. Its causative factors, the pervasive use of toxic chemicals that overwhelm the ‘environment’s’ ability to effectively manage these insults, follows the same pattern of collapse we see in human mitochondrial health. Both are prefaced on the notion that all we need are better chemicals. Indeed, the entirety western health, whether it is human or environmental, relies upon on the notion that not only are these chemicals rarely deleterious to health, but they are necessary for health. As with the political groups, those within the circle of the current medical paradigm never see the problems with chemical toxicities, except within the narrow confines of anaphylaxis. When chemical toxicities appear, a more open circle episteme would address it and correct accordingly. A closed circle, a settled science, sees only the need for another chemical. Damage is not indicative a failure or a cue to readjust but rather reinforces the belief that the answer resides in what we already know – more chemicals.

That is where we find ourselves now, in a closed circle, endlessly reinforcing our own beliefs about health, the environment, politics, and culture, coming perilously close to the collapse of each.

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This article was published originally on March 1, 2021.

A Matter of Episteme

by Chandler Marrs, PhD

Published on February 6, 2019

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Last week I wrote about a series of articles claiming that folks who question vaccine safety and efficacy have constructed an alternate, and by the authors’ accounts, incorrect episteme. The length of the article prohibited a full discussion of the concept of episteme and epistemic ‘truths’. I would like to dig into that a bit more here.

Episteme is a Greek philosophical term that refers to the rules by which knowledge is determined and accepted. It refers to a system of understanding that is, in many regards, codified culturally by the acceptance of others. Those who study epistemology are interested in understanding the conditions for, and structures of, knowledge as it applies to systems of thought like those employed in science, politics, or culture. In general, epistemology asks questions about how ‘truth’ is defined, who is allowed to speak about truth, and how these truths are disseminated. The how and the who of epistemic knowledge are important considerations when evaluating systems of thought as they are often deeply entangled in webs of influence that may or may not be clear to those operating within that system.

When we look at systems of thought, there is always a dominant one that defines what truths are acceptable and who is allowed to speak them as well as countervailing, non-dominant epistemes, with equally defined roles and expectations, but different beginning points, and thus, different endpoints. In this case, the dominant episteme holds that vaccines are completely safe, always effective, and thus, necessary, even if by compulsion, to achieve public health. It is a zero-sum framework, an all or none conceptualization of medical or pharmaceutical capability that accepts no gray area whatsoever. The alternate episteme suggests that maybe these chemicals are neither as safe, nor as effective as proposed by their manufacturers and perhaps we ought not make vaccines mandatory. Which one is correct? Is vaccine safety and efficacy a settled science such that a zero-sum approach is reasonable? Or, as the advocates of the alternate episteme argue, are there safety, efficacy, and ethical issues that we are not considering in our application of what has become an almost completely compulsory program of vaccination?

The answer, it seems, depends upon what questions one deems reasonable to ask. That is, how one constructs the questions, informs what ‘truths’ one might find. If the science is settled, then safety and efficacy are foregone conclusions. This means that not only does one not need to ask about safety and efficacy, to do so implies a heresy of sorts, one that invites almost necessary ridicule. As a foregone conclusion, there is no need to investigate and all research to contrary is automatically false. The only questions that can be asked within this episteme then, become how best to compel higher rates of vaccination. There are no other valid questions. Since safety and efficacy questions cannot be asked, then again, and necessarily, those folks who ask them operate in an alternate, and by definition an incorrect and heretical episteme. It is a very circular line of reasoning to be sure, but in one fell swoop, the pro-vaccine framework of total safety successfully forecloses any admonitions to the contrary.

Of course, this aligns beautifully with the economic interests of the manufacturers, the political and economic interests of folks who benefit from happy manufacturers (lobby, advertising, medical societies, journals and schools, doctors, and everyone along the food chain). And if we are honest, it aligns perfectly with our innate desire to ward off illness, without effort and without thought. Just get a shot and all will be well. It also aligns with what I think may be the overriding episteme of the late 20^th and early 21^st century – that of man’s technological invisibility, his infallible rightness of reason. In the vaccine industry and somewhat less brazenly, though no less dominantly, across all of the chemical industries, pharmaceutical, food additives, environmental, industrial included, the prevailing episteme is marked by two mutually reinforcing themes: man’s technological (and intellectual) invincibility and a concept of toxicological safety I call ‘not quite fatal’. The first theme implies that no matter what problems arise, technology, in this case, synthetic chemistry, is the answer. While the second holds that so long as something does not kill us or kill us immediately, it is safe and if it is safe, it is beneficial. What follows from the ‘not quite fatal’ perspective, is that if the individual does succumb quickly to a chemical toxicant within a dose deemed safe, then the fault lies with the individual, not the chemical; never the chemical. As is the case with most things, particularly in Western countries, these two themes align perfectly with economic and political interests.

Returning to vaccines, if man is invincible via his technology and if safety is defined only as the absence of immediate death, then, of course, vaccines are always the answer to any question. They are always safe and when mortality or morbidity occurs, as they do so often, the blame can be placed on some inherent weakness of the individual. The entirety of the Western vaccine apparatus, from the initial premises mentioned above, through the legal, economic, and political institutions that have been developed around these notions and that absolve the chemical companies of responsibility, enforce these truths. Thus, in the vaccine debate, there can be no debate. It is a zero-sum, with us or against us proposition. Vaccine science, safety, and efficacy are settled and only those who are unquestioningly pro-vaccine are allowed to speak and disseminate knowledge (aided and enforced in no small part by the billions of dollars spent on marketing, trolling, ghostwriting, journal sponsorship, medical society sponsorship, institutional grants, CDC, FDA, grants and fees, sponsored research, opposition research, political bribes and the like).

According to the authors of previously critiqued ‘vaccine denialism’ papers and by this definition of episteme, because vaccine safety is unassailable, those who question vaccine safety must operate in or by a different episteme than those who do not question said safety. Ignoring for a moment the fact that vaccine safety is neither settled nor unassailable, and thus, the entire argument becomes moot, this construction of episteme fails to recognize the play of power in defining the boundaries of knowledge. For that, we have to look at the work of the late French philosopher, Michel Foucault. He argued that the rules of knowledge, the episteme, have to include the influence of power.

…truth isn’t outside power, or lacking in power: contrary to a myth whose history and functions would repay further study, truth isn’t the reward of free spirits, the child of protracted solitude, nor the privilege of those who have succeeded in liberating themselves. Truth is a thing of this world: it is produced only by virtue of multiple forms of constraint. And it induces regular effects of power. Each society has its regime of truth, its “general politics” of truth: that is, the types of discourse which it accepts and makes function as true; the mechanisms and instances which enable one to distinguish true and false statements, the means by which each is sanctioned; the techniques and procedures accorded value in the acquisition of truth; the status of those who are charged with saying what counts as true.

Epistemic knowledge from Foucault’s perspective is the very expression of power. The recognition of truth, and by association falsehood, conveys that power. The dynamic tension between the two is both necessary, but also, violent. We see that violence in vaccine debates, and indeed, in all debates where questions regarding the safety and efficacy of pharmaceutical, environmental, and industrial chemicals threaten to overturn the dominant epistemic embrace of man’s technological invincibility. This is a carefully constructed reality that bolsters economic interests by sowing the seeds of doubt but only of the science that points to risks. Of the science regarding the safety and efficacy of a product, there can never be doubt, mainly because it is paid for by the industry itself. It is a brilliant, if not maniacal method for achieving dominance, perfected in large part by the tobacco industry.

Faced with mounting scientific evidence and general agreement amongst credible researchers, those whose interests were threatened needed a strategy to win that didn’t rely on scientific evidence. The tobacco industry led the way by hiring “a public relations firm to challenge the scientific evidence that smoking could kill you,” (p. 15) and to ensure that “scientific doubts must remain.” (p. 16) ‘Doubt is our product,’ ran the infamous memo written by one tobacco industry executive in 1969, ‘since it is the best means of competing with the ‘body of fact’ that exists in the minds of the general public.’ (p. 34)

With the tobacco industry, however, it was a small group of individuals who beat the ‘body of facts’ down by simply contesting otherwise. Here now, we have a fully and financially entrenched marketing apparatus whose purpose is to sell products liability-free. To that end, they have been successful, perhaps more successful than any other industry ever, for they have defined and managed the modern medical episteme for decades.

…one has to reckon with its strokes of genius, and among these is precisely the fact of its managing to construct machines of power allowing circuits of profit, which in turn re-enforced and modified the power apparatuses in a mobile and circular manner.

The question becomes, what shall we do about it?

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More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

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The Disease – Medication Model of Modern Medicine

by Chandler Marrs, PhD

Published on November 21, 2017

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As we begin analyzing the data from our studies and I search for ways to quantify the value of our data, I am repeatedly struck by how the business of modern medicine, especially modern pharmaceutically based medicine, has been conceived of, constructed, and is evaluated on a false and outdated premise of separateness. The notion that a disease is a completely discrete entity, that the disease process is linear and that one medication or set of medications impacts only the specified disease, predominates. This is just not so. Life is complicated, disease is even more complicated, and with the exception of perhaps the outright physical trauma of a limb or the need for immediate decision-making in acute or emergent care, nothing is as simple as the one drug, one organ system perspective from which we measure modern healthcare.

As an example, data from our studies are showing complex clusters of adverse reactions that are multi-system and often evade existing diagnostic categories. The symptoms themselves appear to cluster in ways that are unique and will inevitably lead to a deeper understanding of medication reactions, and hopefully, illness itself. For now, however, they appear to defy the logic of current diagnostic categories. The symptoms never quite fit neatly into a single diagnostic box that defines the disease course or guides a treatment plan.

Instead, the symptoms fall into multiple and sometimes contradicting disease categories, and rather than drill down to an appropriate diagnosis, the individuals in our studies have been assigned a long laundry list of apparently, co-occurring diseases; none, accurately characterizing the scope of their illness. When one disease does not capture the full breadth of symptoms, the trend is to add another. If that doesn’t work and when the interaction between the medications creates more unexplainable symptoms, add yet another diagnosis or three or five. Soon the patient has many active diagnoses, with multiple medications to go with. One has to wonder, how so many individuals can have so many diseases at once. Since, I suspect the laws of probability, and indeed, human physiology are contrary to the current multi-disease trend, it leads me to believe that the western model of defining and treating illness, as anatomically and genetically discrete entities, has reached the limits of utility. A paradigm shift may be in order.

Paradigms, especially in medicine and science, are often guided by forces that determine the limits of what can be known, or more cynically, what are considered acceptable pursuits of knowledge and science versus the flights of fancy of fringe scientists. In this case, I would argue that the forces controlling what can be known are those who profit directly from the current diagnostic system – the pharmaceutical industry. The deeply entrenched conflicts of interest between these corporations, policy makers, regulators, politicians, academic institutions, academic journals, medical societies, patient organizations, media organizations – the very ‘thought leaders’ that determine what is valid and what is not – lends credence to these suspicions.

And by every measure, what is currently valid, are the simplistic and discrete categories, with easily identifiable lists of medications for each, where additional diagnoses equal more medication possibilities or in economic terms more product sales opportunities. Whether the symptoms within these disease categories overlap with each other or even represent a true disease process seems to have little bearing on whether a medication can be fit to match a certain set of symptoms and linked to a diagnostic billing code. The diagnostic billing code becomes at once the arbiter of defined diseases and of what can be known about a particular disease. If there is no billing code, read no product or medication opportunity, the disease doesn’t exist, but if there are multiple, overlapping disease categories, no matter how poorly defined or distant from what the patient may actually be experiencing, there is product opportunity, and therefore the disease, or more likely, the diseases he or she is experiencing, exist. And, if the criteria for defining a particular disease can be relaxed to include more patients and to maximize prescribing opportunities, well then, that is even better.

Consider the most recent recommendation by the American Heart Association and the American College of Cardiology to reduce the risk level for heart attacks necessitating a need for increased prescriptions of statin drugs. The change in guidelines will mean more Americans will be diagnosed with heart disease necessitating prescriptions for the cholesterol lowering drugs, a boon to the drug industry. In a few years, epidemiologists and those who study healthcare trends will report a predictable increase in the number of Americans with heart disease, more money will be poured into preventing heart disease with more medications prescribed and so on. It’s a fantastic business model, control the definition of disease to control the market for products. Will more Americans have heart disease? Not likely, but changing the diagnostic criteria, changing the billing code, to open product markets will give illusion of increasing illness and this benefits the manufacturers of these products.

Unfortunately or fortunately, depending upon which side one is on, lowering the threshold for prescribing opportunities does more than simply increase the number of patients to be given a particular diagnosis, it opens up additional product markets or diagnostic opportunities when the side effects of the primary drug kick in and necessitate treatment. In women, for example, statins increase the risk of Type 2 diabetes. By lowering the criteria for diagnosing heart disease and prescribing statins to more patients, not only will we see an increase in the rates of heart disease in a few years, but because the research tabulating disease rates rely on the diagnostic billing codes, we will also see a corresponding increase in the rate of Type 2 diabetes, most likely created by the increased use of statins. Similarly, because the medication used to treat Type 2 diabetes elicits a corresponding reduction in vitamin B12 levels, which present as a heterogeneous set of neurocognitive symptoms, in a few years, we’ll also see an increased rate of mental health conditions indicated by the growing rates of psychotropic medication prescriptions. And so on.

To be both the arbiter of what is known and can be known, to control the definition of disease and the guidelines for prescribing, is a brilliant business model, but one that does nothing to improve human health, further medical discovery or scientific understanding. Indeed, the survival of this model relies entirely on maintaining the facade of anatomical separateness in disease processes and on not recognizing the totality of medication effects across an entire physiological system. This model relies on remaining ignorant of the inter-connectedness of disease processes and by association the possibility of broad based ‘complicated’ medication reactions.

If diseases remain separate entities and medications work only on specified disease targets, then disease categories remain entirely under the purview of those who stand to benefit from prescribing opportunities. Data that link the onset of a disease to the use of a medication or redefine the scope of a disease process and medication target beyond a specified anatomical region can be easily dismissed. And that is where I find myself, having collected data that questions the accuracy of the current model of anatomically discrete, one medication-one target model of disease. Our data question a paradigm. What does one do with that?

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This article was published originally on November 18, 2013.