Neuralink: the allure of brain-computer interfaces

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“You better be careful telling him something’s impossible. It better be limited by a law of physics or you’re going to end up looking stupid.” – Max Hodak, Neuralink president

As the gap between humans and computers becomes smaller every day, the startup Neuralink, backed by figures including Elon Musk, Vanessa Tolosa, and other individuals, recently hosted a public conference in which they revealed their efforts create neural interfaces between brains and computers. The futuristic dream of a brain-computer interface for mutual exchange of information between humans and works of artificial intelligence may sound like something out of a science fiction dream, but the neural interface, a device to enable communication between the human nervous systems and computers, would include invasive brain implants and noninvasive sensors on the body.

During the livestream on July 16, 2019, Neuralink revealed their work to the public for the first time with the pressing goal of treating neurophysiological disorders and a long-term vision of merging humans with artificial intelligence. With $158 million in funding and nearly 100 employees, the team has made advances in flexible electrodes that bundle into threads smaller in width than human hair inserted into the human brain. As the computer chip processes brain signals, the first product “N1” is meant to help quadriplegic individuals using brain implants, a bluetooth device, and a phone app.

In their paper “An Integrated Brain-Machine Interface Platform with thousands of channels,” Musk and other team members noted that electrode impedances after coating were really low allowing for efficient information transmission. Each electrode uses pixels at 3 Hz bandwidth to measure spikes, a neuron’s responding to stimuli that are generally about 200 Hz but can reach up to 10 kHz at times. The dense web that the team creates would let them feed the entirety of a brain’s activity to a deep learning program for creating artificial intelligence at a great degree of accuracy, study the neuroscientific basis for phenomena, or even decode the basics of other features such as language. For the Human Connectome project, an initiative to create a complete map of the human brain, Neuralink’s scale would give more precision than the project has done before.

This precision could address the ethical issues raised when the cognitive response of a brain-computer interface doesn’t appropriately match what a patient communicates. Neuralink’s work should take into account the risks associated with such a fine level of precision. Most strikingly, brain-computer interfaces so intimate to who we are raise the ethical issues of whether neurologically compromised patients can make informed decisions about their own care. Philosopher Walter Glannon said in his paper “Ethical issues with brain-computer interfaces,” the capacity to make decisions is a spectrum of cognitive and emotional abilities without a specific threshold that would indicate how much constitutes the ability to make an informed decision. Just as philosophers and ethicists have studied the basis for ethical frameworks in the decision-making process among physicians, patients, and other roles in health care, the complex semantic processing of brain-computer interfaces may not constitute enough to show a patient has the cognitive and emotional capacity to make an informed and autonomous decision about life-sustaining treatment. It would need some a behavioral interaction between the patient and the health care professional so that the brain-computer interface’s response reflects only what it’s capable of communicating.

Tim Urban of “Wait But Why” described Neuralink as Musk’s effort to reach the “Wizard Era” – in which everyone could have an AI extension of themselves – “A world where AI could be of the people, by the people, for the people.” The promise of cyborg superpowers as humans step into the digital world calls back to science fiction stories such as 2001: A Space Odyssey and Jason and the Argonauts. From the electrode array that joins the limbic system and cortex of the human brain gives Nerualink the information for those regions of the brain. It creates a reality in which information and the metaphysical nature of what we are depend less on the physical structures of the brain itself, but, rather the information of the human body. Prior to artificial intelligence, the brain evolved to develop communication, language, emotions, and consciousness through the slow, steady, aimless walk of natural selection, and a collective intelligence that can contribute to machine learning algorithms like Keras and IBM Watson. The Neuralink interface would let us communicate effortlessly with anyone else in the collective intelligence. The AI extension of who are means that the machines that are built upon this information are part of us as much as they are machines. With machines connecting all humans, we achieve a collective intelligence that goes against how human and animal minds have evolved over the past hundred million years.

A machine learning approach to Traditional Chinese Medicine

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Modern science can uncover ancient wisdom. While it may seem regressive or pseudoscientific to study concepts from Traditional Chinese Medicine (TCM), they reveal deeper meanings about who we are as humans when subject to scrutiny by the scientific method. The herb formulas, plant-derived nature produces of TCM are still used in disease prevention and treatment despite the dominance of modern science. When medical researchers performed machine learning classification methods on 646 herbs are according to organ systems, known as Meridians, they found the 20 molecule features were most important for predicting these Meridian. It included structure-based fingerprints and properties of absorption, distribution, metabolism, and excretion. As the first time molecular properties of herb compounds have been associated with Meridians, this provides molecular evidence of Meridian systems. 

The Meridian system dictates how he life-energy qi flows through the body. Qi includes actuation of the body, warming, defense again excess, containment of body fluids, and transformation between qi and food, drink, and breath. Each Meridian corresponds to a yin yang quality, an extremity (hand or foot), one of the five elements (metal, fire, earth, wood, or water), an organ (such as heart or kidney), and a time of day. The yin yang qualities describe how complementary, opposite forces of the universe interact, such as Greater Yin or Lesser Yang. Given these roots in traditional, non-scientific thought, scholars have debated the scientific justification behind why and how TCM works. In their paper “Predicting Meridian in Chinese Traditional Medicine Using Machine Learning 2 Approaches,” the researchers assumed Meridian can be found through scientific methods to begin with. The five elements are qi are metaphysical, not modern physiological or medical phenomena. The researchers emphasized the need to examine the herb medicine actions as they relate to disease etiology to create a formal understanding of TCM.

Qi and yin yang as they relate to human health date back to texts of discussion and debates from the Warring States period (475–221 BC) of ancient China. Philosopher Zhaunghzi noted qi was the basis of the body’s physical being with the six qi (wind, cold, summer heat, fire, dryness, and damp) in harmony with one another as they affect the seasons. These theories would be used in medicine to describe relations and analogies between the body, the state, and the cosmos, or the universe.

A metamodernist narrative of genetic engineering


Screen Shot 2019-07-06 at 9.18.18 PMWith the ethical concerns raised by issues of gene editing of human embryos, academic ethics research has set the foundation for and discussed the bioethical threats mankind faces. Alongside artificial intelligence (AI) and similar issues such as data science privacy and the power of social media, the steps into baby manufacturing are illustrated through a mix of modernist and postmodernist ideologies and require a revised notion of a biological-digital autonomy that can account for the changing self. The CRISPR-Cas9 gene editing technology have already shocked and disgusted scholars in science and philosophy around the world. Questions of how much of who we are we should be able to change and what we should do with the rapid power of artificial intelligence on the horizon have taken center stage. With the newfound metamodernism appraoch to science, reality, and existence, we step into gene editing the same way we jump off the deep end of a lake and hold our breath until we rise to the surface.

The oft-repeated truism “science is moving so fast that ethics just can’t keep up” couldn’t be farther from the truth. Ignoring the baseless assumption that science and ethics were racing against one another, the scientistic idea that philosophers and ethicists in similar fields have not addressed the power and potential of science would be to disregard the decades of ethics research on genetic engineering. The claim also seems to treat science as an uncontrollable force that must be braced against because we can’t do anything to stop it. It’s false that mankind has complete control over nature, but the notion inaccurately portrays mankind as weak and vulnerable to the world when we can take a metamodernist approach that rests somewhere in between. Researchers in ethics have been paying close attention. They’ve been studying everything closely.

Screen Shot 2019-07-06 at 9.18.12 PMSociety and individuals have been shifting from postmodernism into metamodernism. We create the self as something between a postmodernist and modernist notion of reality through gene editing. As opposed to postmodernist traditions that nothing is real and modernist ones that reality is there beyond media, language, and symbols, right now we’re sure reality is somewhere in the middle in our notions of metamodernism. We are both a modernist believer in the power of science and technology and a postmodernist skeptical of the reality we find. Genetic engineers have begun using pluirpotent stem cells, ones that have the same properties of embryonic stem cells but come from manipulating ordinary adult cells rather than destroying embryos, that are more effective in providing dozens or hundreds of offspring for individual parent cells. As more stem cell research goes into how male sex cells can result from female cells and vice versa, this could even allow single parents or same-sex couples to produce biological children. Researchers have even predicted scenarios in which children result from the DNA of more than two biological parents, known as “multiplex parenting.”

Recent success in both cloning and CRISPR technologies have let scientists understand better the embryology and developmental physiology of human embryos as a result of the pluripotent stem cell advancements and in vitro fertilization (IVF). We must warn of the issues that may arise as stem cell reproduction methods gear towards manufacturing embryos for desirable traits. Couples who choose to keep their unwanted embryos frozen or donate them to further research or to other couples need to be aware of how those embryos are being used to assess their role of responsibility in stem cell research.

This stem cell method comes with the advantage as the daughter cells result similar to the adult ones, and researchers have posed solutions for the issues of eugenic control that would result. We can critique these ideas for their shortcomings in characterizing the eugenics movement. These movements do not thoroughly emphasize the social forces governing how individuals would be manufactured. To address the issues raised by gene editing, we need a deeper, more multidimensional view of the moral problems raised by eugenic control that accounts for the changing self and reality in a metamodernist world. We can engage in these subjects through personal narratives and humanized ideas of who we are that embrace ethics and threats of existentialism.

Researchers have, however, brought up solutions that derive from dangerous principles of eugenics and extreme notions of individual autonomy. In the transition to metamodernism, they prevent mankind from pushing back against looming threat of a full-fledged surveillance state, and, instead disregard the idea that a particular line of research can be inherently morally wrong. These transhumanist thinkers such as philosopher Nick Bostrom (who has also warned about the threat of Superintelligence) who proposes a solution to use stem cell sex cells for performing eugenic selection for intelligence, partially as a method for combating superintelligent AI. If humans can replicate natural selection on a group of embryos over the course of several generations, they can produce the most intelligent humans possible. This eugenics approach isn’t uncommon, either. Ethics professor Nicholas Agar wants prospective parents to choose how they can improve their children in a “liberal eugenics” fashion. This sort of scientific perfection fails to capture how these humans would supposedly relate to the rest of society given that they’ve attacked the fundamental ideals of community and sharedness that humans share. Bostrom does suggest there may be religious or moral grounds to prohibit this method of creating genetically enhanced children, but claims having children at a disadvantage to those around them would cause everyone to eventually pick up the technique. This reasoning rests on a dangerous egalitarian notion of human success and morality driven by competition in a way that forces those who disagree to accept the technique. It doesn’t rest upon morally reasoned principles or the virtues of humanism and research. Much the same way individuals would rapidly evolve under Bostrom’s scheme, the entirety of society should follow suit regardless of choice.

Bostrom’s idea also doesn’t recognize the reality of how natural selection and evolution work. Much like natural selection, this method wouldn’t automatically and instantly choose the most optimal DNA. Instead, it would choose a heritable trait without regard to DNA the same way nature influences which traits are optimal for survival and reproduction. Bostrom’s method relies on knowing which parts of the DNA are responsible for the trait which can be edited directly without the need for cycling through generations. Besides, the genetic basis for these traits have been shown to be limited as the traits themselves are a complicated amalgamation of environmental interactions, genetic pathways, what epigenetic factors activate throughout an individuals’ lifetime, how nature would “select” for certain traits, and the resulting phenotypes. It wouldn’t dictate how a superintelligent human may emerge. The typical issues of the artificial selection process being prone to error and having an inherent natural selection to it raise concerns as well. All of this lies on the inhumane assumption that we may find human perfection through genes regardless of how an objectified individual may control their own fate and what right they have to do so. Indeed, the vacuous claim that “science is moving so fast that ethics just can’t keep up” only measures unethical, unjustified notions of how fast science is moving to begin with.

The ethics of some reproductive technologies become blurrier in light of the newly complex understanding of heredity’s cross-currents. A maternal surrogate, for example, will likely exchange stem cells with the fetus she carries, opening the door to claims that baby and surrogate are related. If the surrogate later carries her own baby, or that of a different woman, are the children related? Parenthood becomes even stranger with so-called mitochondrial-replacement therapy. If a woman with a mitochondrial disorder wants a biological child, it is now possible to inject the nucleus of one of her eggs into a healthy woman’s egg (after removing its nucleus), and then perform in vitro fertilization. The result is a “three-parent baby,” the first of which was born in 2016. Zimmer doesn’t presume to make ethical judgments about procedures such as this, but warns that “informed consent” in such cases can be unexpectedly difficult to determine.

The more honored individuals in bioethics such as Stanford law professor Henry Greely have voiced similar arguments. Greely has argued insurance companies and government agencies can help fund the effective DNA sequencing methods in fighting genetic disease. In his book The End of Sex and the Future of Human Reproduction, he predicts how we may perceive and judge the potential of stem cell technologies. He notes he wouldn’t ban embryos created from a single parent, but would still require pre-implamentation genetic diagnosis to select for optimal offspring. But, above all, Greely emphasizes that these should be closely scrutinized by a standing commission that can recognize what principles all people would believe in. What sort of principles all individuals would agree upon, such as the four common principles of medical ethics: autonomy, beneficence, non-maleficence, and justice, are up for debate. The principles of parenthood should be upheld even for extreme scenarios of the future that may select for the most desirable traits such that biological parenthood becomes meaningless. We must protect every notion of humanity that comes from our current methods of reproduction, both biologically and artificially, to address these issues.

With the growing threat of AI, namely that computers may become more and more Screen Shot 2019-07-06 at 9.19.35 PMhuman-like, our autonomy should reflect how the self has been changing through these innovations. The self can be changed artificially much the same way robots and computers are programmed, but they’re not completely fragmented that humans share nothing with one another. These stem cell methods can give humanity a more unified individualistic self that, when appropriately regulated, allow for even modified individuals to exercise appropriate rights and responsibilities. Greely’s ideas still disgust by suggesting market-driven factors to influence human reproductive choices. The principles that doctors and scientists must stand upon are far too likely to become cold, calculated treatments for dehumanized problems. Professor of public health Annelien L. Bredenoord and professor of bioethics Insoo Hyun argued in “Ethics of stem cell‐derived gametes made in a dish: fertility for everyone?” multiplex parenting will shake the very notions of responsibility and autonomy and moreso than other reproductive techniques. They will disgust individuals, citing ideas of the reaction by professor of philosophy Martha Nussbaum’s book Hiding from Humanity: Disgust, Shame, and the Law. Phyisican Leon Kass noted there is wisdom in this repugnance in his paper “The Wisdom of Repugnance: Why We Should Ban the Cloning of Humans.” No amount of sociological or psychological research into the well-being of multiplex children can prevent this natural sense of disgust that we feel at this idea – and with good reason. We must hold onto this disgust and other aesthetic, physiological responses and assess them to the extent which they provide us with moral clarity. From there, a metamodernistic view of gene editing can take place. Writer Carl Zimmer noted in She Has Her Mother’s Laugh that he doesn’t make ethical judgments about multiplex parenting, but “informed consent” in such cases can difficult to determine.

Reading, learning, and writing about these issues is the first step. For anyone to learn more about science and technology in this age would help spread humanism to fight ignorance. These issues need to enter the sphere of public debate and discussion in contrast to how they’re currently only governed by scientists, ethicists, and philosophers. We need laws in place to prevent these catastrophic consequences long before they occur. In our metamodernist society, we need not reject science and technology entirely. We may remain skeptical of the notions of progress and reality, but only to a point where we can begin a new direction for scientific research. Given the existential crises of genetic engineering and artificial intelligence, we may imagine a moral society through personal development and psychological growth in wrestling with and understanding these struggles. We need a humanized notion of reproduction to address psychological needs of individuals in a society that has the power of gene editing. We can create a grand narrative that mankind has an overarching worldview to connect all humans to one another, but hold it lightly enough to recognize the limits of what we know and should do. We can understand that we may create an idea of “reality” and methods of understanding the world around us that respect scientific research while still questioning the authority of problematic research techniques. By creating a “reality,” we can embrace the truths that we can create a moral society that determines who we are despite the changing self brought upon by genetic engineering and the digital age. We can determine what is honest, authentic, and true without being cynical, showing contempt for the beliefs and sensibilities of others, and turning to eugenics approaches for solutions. Metamodernism, as it begins to infect all areas of life, means our scientific research should seek elegant, morally refined methods that we embrace for knowledge.

Only then will we come closer to our selves in a metamodernist future. The intellectual thought to counter the doomsday dystopia scenarios of the future can involve selecting for desirable traits in offspring through trustworthy, verified methods that acknowledge the rights and responsibilities of the individual. We must remain skeptical of harmful progress, but remain open to gene editing technologies insofar as they may help mankind without raising ethical concerns.

A humanistic paradigm for mental illness

Da Vinci’s “The Skull”

Mental illnesses are much more than biological, physiological phenomena. Any attempt to reduce them down to the same features as other illnesses such as fever or cancer is inherently flawed. Genome-wide association studies (GWAS, pronounced “gee wahs”), attempts to scan individuals for thousands of genes to determine which variations lead to traits we can observe, have shown little substance for the past few decades. GWAS supporters argue that, if we find these genetic variations (single nucleotide polymorphisms (SNPs, pronounced “snips”) more frequently among those with a certain genetic trait (or a phenotype, an observable characteristic), the SNPs must be related to them somehow. GWAS studies themselves have already shown little correlation and similarity between one another, and, instead, many GWAS studies under the same conditions have returned significantly different results. Contemporary scholars such as Robert Plomin, in his book Blueprint: How DNA Makes Us Who We Are, have argued GWAS is a form of a “polygenic score” which can predict disorders. But these methods of de-humanizing mental illness and psychiatry into strict, science-exclusive disciplines have not shown the results they have claimed they will produce. Psychiatry as a field needs to return to its roots through philosophy and humanized notions of disease. Through thought-provoking questions and discussions on the nature of mental illness as it relates to the unconscious, debates between Freudians and Jungians on how to understand experience, and the resistance to pharmaceutical-lead pressures from industry to turn mental health into a for-profit system, we need a new humanized paradigm for psychiatry.

Psychiatry has dealt severe blows to Aristotle’s notion of man as inherently rational and, instead, embraced the idea that much of who we are is determined by genetics and other biological factors. The simplistic, reductionist view of mental illness as purely a genetic disorder has left psychiatry in the doldrums of intellectual activity and only furthered the stigma of mental illness itself. Regardless of these negative consequences, however, the differences between the science of the mind and that of the body are enough to present issues with this view in principle. The mind and body have different languages, different concepts (with differing levels of abstraction and complexity), and different sets of tools and techniques we use to study them. Psychological and physiological study of a patient in a state of anxiety might result in two separate and distinct sets of descriptive data, measurements, and formulations. There is no way to unify the two by translation into a common language or conceptual framework. We rely on analogy and comparison using abstract concepts of “disease,” instead. From a computational perspective, our psychophysiological and psychosomatic data consist in essence of covariance data, demonstrating coincidence of events occurring in the two realms within specified time intervals at a frequency beyond chance.

Arguing mental illnesses are just like body illnesses causes us to view those suffering from mental health issues as fundamentally flawed or different from other people. It leaves those suffering in fatalistic, defeatist views and, in many cases, even a cynical, disillusioned state of mind. In the most extreme case, they may even lead to eugenics-based arguments that throw ethics under the bus for the pursuit of scientific perfection. The body-based view of mental illness has let psychiatrists, researchers, and other industry professionals ignore much of what makes mental illnesses what they are. Depression becomes simply a lack of serotonin that Prozac will alleviate, and other illnesses only need patients to take medicine without much else. It’s easy to see how these disease models can be abused for industry-related motives to maximize profit under the veil of minimizing human suffering.

Instead, we need to view mental illness through dynamic, human-based issues everyone faces about who we are as human beings. We can, then, treat individuals from existential points of view in their methods of valuing life and finding a purpose in the world. Those entering psychiatry with backgrounds in mathematics, economics, and biology need to understand the etiology of disease, metaphysics of psychology, logic of diagnosis, and causal assumptions underlying epidemiology. They need the patience and reflective abilities to discover what the human mind undergoes when suffering from mental health issues far beyond what sort of gene may be responsible for depression or schizophrenia. Even the causal models GWAS purportedly infers need to be scrutinized for their epistemic limits before being put into practice. Since their inception, GWAS studies have put forward hundreds of genes responsible for different phenotypes, and, despite the wide availability of data and the large of amount of data to begin with, these GWAS studies haven’t had much more success than the genetics studies before them. Instead, scientists argue that, because they haven’t found correlations, the causes must be more complicated and composed of more and more genetic phenomena. They’ve yet to uncover specific mechanisms or causal relationships for disease, and rely on reductionist approaches that genes that are significantly expressed must cause the phenotypes themselves. Neuroscientist Kevin Mitchell summed it up: “Simply put, nothing really definitive comes out. In fact, the strongest result from these studies is a general one, and it is ‘negative’: there are no convergent patterns of gene expression in adult brain that characterise these various psychiatric conditions.” in his blog post “If genomics is the answer, what’s the question? A commentary on PsychENCODE.”

Psychiatry needs a deeper understanding of the etiology of disease. As Freud wrote in Mourning and Melancholia, psychopathology has two etiological components: constitutional (including genetic) predispositions and early experiential factors. He used this multifaceted dynamic view of psychiatric illness to demonstrate the role environmental factors and traumatic events play in the causation of posttraumatic stress disorder (PTSD), especially ones early on in life. Much the same way Johann Sebastian Bach was Bach not because he simply had the appropriate genes, but through his study of music at such a young age, the brain forms through these combinations of genetics and experience. Studies such as those by psychiatrists Charles Nemeroff and Paul Plotsky have verified depressed patients release more corticotropin-releasing factors (CRFs) in their central nervous system in mammals. Memories themselves form and evolve through the prefrontal cortex as it integrates sensory information and links this information to planned movement. Research in neuroscience has revealed the prefrontal cortex is part of a short-term holding function for information, including information stored in declarative memory. Neuroscientists Joaquin Fuster and Patricia Goldman suggested the prefrontal cortex represents some aspects of working memory in recalling from preconscious to conscious. It plays essential roles in speaking, driving, weighing ethical decisions, or performing mathematical calculations. This suggests it may be involved in coordinating functions that psychoanalysis experts claim function between ego and superego. This holds promising results for the benefits of psychoanalytic therapy. The extent to which psychoanalysis may bring about changes in habits, attitudes, and conscious and unconscious behavior through differences in gene expression that produce neurophysiological changes relies on this connection between biology and psychoanalysis. Brain imaging techniques may, then, improve these techniques for neurotic illnesses through psychotherapy. Neuroscientist Eric Kandel has further argued the need for a dialogue between biology and psychoanalysis towards these goals.

Such a dialogue should address how biology and psychoanalysis have drifted apart from one another over the 20th century. Both fields have faced a mix of strides and setbacks over this time period. Advances in bacteriology would lead biologists to believe toxins in the intestine, mouth, and sinuses harm brain functions. While it may have seemed controversial at the time, recent microbial work has suggested possible that bacterial imbalance alters the body’s metabolism of dopamine and other molecules that may contribute to depression. Similarly, the theory bacteria causes peptic ulcers proposed in 1983 was met with widespread contempt, but, as experimental evidence has since shown it true, antibiotics are now regularly used to ulcers. Meanwhile, the twisted practice of the transorbital lobotomy spread across the United States in the 1940s. It was only until the 1970s it was banned in most countries, after psychiatrists raised concerns of its safety, ethics, and effectiveness. Psychiatry itself faced challenges to its legitimacy given its stance of homosexuality as a mental illness until the 1970s as well as the reformation of mental hospitals from what scientists compared to concentration camps. Psychiatrist Aaron Beck proposed the effectiveness of cognitive behavioral techniques in treating psychiatric disorders with a 1977 study showing cognitive-behavioral therapy (CBT) outperforming one of the leading antidepressants of the time. Researchers would further show the neurophysiological basis for CBT, suggesting the more we discover about the brain the easier it will be to disregard the apparent divide between mind and body. CBT has faced criticism, though, with its supposed effectiveness and its own theory that don’t appropriately account for agency, free will, and rationality. These chaotic, turbulent histories of both fields make a dialogue between them difficult, but possible and necessary to address the issues they face.

Psychoanalysts themselves have raised arguments for and against a reductionist biology of mind. Psychiatrist and author Marshall Edelson wrote in Hypothesis and Evidence in Psychoanalysis, “Efforts to tie psychoanalytic theory to a neurobiological foundation, or to mix hypotheses about mind and hypotheses about brain in one theory, should be resisted as expressions of logical confusion. Efforts to tie psychoanalytic theory to a neurobiological foundation, or to mix hypotheses about mind and hypotheses about brain in one theory, should be resisted as expressions of logical confusion.” Others believe there’s fertile room for cultivating psychoanalysis in the context of the science of the mind. French biologist François Jacob wrote in 1998, “The century that is ending has been preoccupied with nucleic acids and proteins. The next one will concentrate on memory and desire. Will it be able to answer the questions they pose?” in Of Flies, Mice, and Men. Kandel also believes future research on the mind will focus on memory and desire through a combination of biology and psychoanalysis with greater scientific understandings of the unconscious. Kandel has argued that research in biology will make strides in the genetic basis for the unconscious mental processes and their roles in psychopathology in solidarity with psychoanalysis.

Psychiatry needs philosophy. Researchers in the field need to draw from Plato, Freud, Jung, Adler, and many other thinkers who have put forward ideas on what it means to be human given the constrains of the human mind. When Freud laid the foundations of psychoanalysis, one may have argued that his ideas paralleled Plato’s. He adopted Plato’s theory of dreams and similar ideas of the tripartite human soul. Freud’s idea of unconscious also bears similarity to Aquinas’ who believed human acts come through reason, yet still have unconscious desires and habits. Freud contrasted Jung on the meaning of sex as the former believed it was the cause of all human desire and the latter had his doubts about that idea. Freud contested Adler’s ideas of the social realm of equal importance to the individual and that role of sole interest individuals have in advancing social welfare. Though these theories have met a combination of arguments for and against them in many different contexts over the past century, their relevance remains. Kandel has argued that we should not get stuck on Freud to idolize or denigrate him. While many of Freud’s ideas have been rejected as pseudoscientific or sexist, many elements of psychoanalysis remain in psychiatry and psychology. Psychiatric literature and psychoanalysis themselves need Nietzsche, Proust, Schopenhauer, Kant, and Descartes to put them in an appropriate context.

These issues of psychiatry have formed the foundation for many of society’s issues. We’ve created an individualistic view that our psychological shortcomings are solely due to biological deficiencies as though we were computers that simply haven’t been programmed the right way. The same way culture fashions us to understand aesthetics, value, ethics, and other humanistic qualities, our struggles with mental illness are better explained in the way our bodies understand the world. In this sense, our mental health is the way we search for meaning and satisfaction in the world. As such we need a humanized notion of mental illness.

Neuroethics: the delicate balance of neuroscience and morality

Pew pew pew

How can we create frameworks of practical moral reasoning in the absence of free will? Can neuroscience research shed light on how we make moral judgements? What are the general implications of neuroscience research itself? How can we differentiate between the study of the mind or the brain to begin with? In the current development of neuroscience research, scenarios have changed. Researchers are beginning to uncover a new knowledge about personal identity, emotions, awareness, and free will. All of these are key pieces in the understanding of the puzzle of the mind human. These issues that seemed to be alien to science are now exposed in the scenario of Neuroethics, the ethical issues brought upon by neuroscience as well as the neuroscience of ethics itself. As presented by Kathinka Evers, principal investigator of the Center for Research in Ethics and Bioethics from the University of Uppsala, we can investigate a slew of questions that born in this interface between the sciences of the human spirit and the natural sciences in her book “Neuroetica.” It should be remembered, in the face of this reconciliation between science and ethics, that there have been challenges and struggles to write on neuroethics. Understanding “the analysis of the concepts involved in practical moral reasoning “(p 21), and the first, according to Robert Hooke, as “knowledge of natural things, and of all useful arts, manufactures, and mechanical practices, artifacts and experimental inventions “(p.22), it’s easy to come to incorrect conclusions on these ethical issues.

Fortunately, through history not all modern thinkers have seen science in this way. As Evers points out, in accordance with philosopher Francis Bacon’s views of science, the study well-organized and detailed in nature, science should be much more than the mere school search for knowledge. The sciences have to fulfill a fundamental function, namely: to allow human beings to improve their life on earth (p.21); objective that would be difficult to achieve if it were insisted on keep excluded the philosophical, political, moral and metaphysical that are born in their same this particular case, within the neurosciences.

Now, although the ethical problems initially raised in neuroscience referred to the practice and use of brain imaging technologies, neuropharmacology or the interests of research and sponsors of this, currently neuroscientific research itself is also concentrated in the construction of “adequate theoretical foundations that are required to be able to deal appropriately with the problems of application “(p.28). This establishes a distinction clear between an applied neuroethics and a theoretical neuroethics, concerned about the capacity that could have the science of nature to improve our understanding of moral thinking. We can determine whether the former is really important for the latter by considering both concerns as part of a greater question, that is, if human consciousness can to be addressed or not in biological terms.

It should be mentioned that any attempt to expose the complete set of ideas that go through neuroethics and the development of these would be foolish. We can still refer to a small, but representative, set that begins with the idea of unifying different levels and types of knowledge, taking both the techniques and the methodologies of each discipline, in order to build bridges. Fragile as they may be, they would allow the flow of the knowledge of the neurosciences to other sciences and disciplines, integrating in turn, this knowledge in the conception that have human beings of himself. It resonates through the world and morality in a shared theoretical framework (p.30 and p.57). The materialism position may respond, aptly illustrated and proposed in chemistry by French philosopher Gaston Bachelard in 1953 and extended by neuroscientist Jean-Pierre Changueux, to the neuroscience of the present. It may be that far from any naive reductionism and dualism (ontological), we can assume the brain as “a plastic, projective organ and narrative, which results from a sociocultural, biological symbiosis that appeared in the course of evolution … ” (p 69), judging emotion as the characteristic mark of consciousness from an evolutionary perspective.

Following, you can expose an idea pretty striking, a neurophilosophical model of the free agency that tries to answer how even though Free will is or can be: “1) a construction of the brain, 2) causally determined, or 3) initiated unconsciously “(p.80), it is not something” illusory .” As Evers argues, first, the fact that free will be a construction of the brain not necessarily means that it is an illusion, and that perhaps if it is an illusion it will be for other reasons (p.86); second, “causality is a prerequisite for the free agency “(p.88), otherwise the behavior would be totally random, in addition, causal determinism does not imply an invariable and necessary relationship between cause and effect, to the extent that this relationship can be variable and contingent; third, although the processes non-conscious appear to be far from control aware, the relationship and influence between both are “To a certain extent mutual, and not unilateral” (p.104). Of course, to understand the development and integration of each argument to think of free will as “The ability to acquire a causal power, combined with the ability to influence the use of said power ” (p.107), you need to read chapter II of the book, where Evers makes use of different authors (Changueux, Le Doux, Libet, Freeman, Churchland, Pinker, Blakemore, Pylyshyn, among others) to recreate the scenario in which situates all this discussion and each one of his ideas.

Finally, we note the normative relevance of the neurosciences according to the understanding of the neural bases of development of thinking and moral behavior. We can mention four innate tendencies closely related that appeared in the evolution: 1) self-interest, 2) the desire to control and security, 3) the dissociation of what can be considered unpleasant or threatening, 4) selective sympathy. Regarding the latter, the author risks saying that the human being is a xenophobe with natural empathy insofar as it is “empathic by virtue of [your] understanding of a relatively large set of creatures; but […] nice so much more narrow and selective towards the restricted group [in which born or has chosen to join] “(page 132). Although understanding (empathy) can be extended to broad groups (i.e. foreigners), the affective bond that unites human beings is restricted to their group more close. There’s an indifference to the foreigner or the which is considered different.

Keeping in mind these innate preferences, there’s no doubt about the difficult situation of current moral discussions. It becomes a priority then, to establish a diagnosis in neurobiological terms to be able intervene human behavior, recognizing that the structure of the brain determines to some degree the social behavior, moral dispositions and the type of society that is created, although the latter has an influence on brain development (p.149). At the same time, we can pose the question about the scientific responsibility of neuroscience at the socio-political level in terms of its adequacy (formulation of real problems), conceptual clarity, and application of methods and techniques without forgetting the origins and interests. Making it clear what a finding or fact (if it is) of neuroscience is not can give off categorical imperatives. A duty can be universal because of knowing that you have an innate preference does not follow that it is okay or that it must conceive this fact as good or bad.

In short, “Neuroethics” is an excellent introduction for both the unnoticed reader and for professionals from different areas of health (Psychology, Psychiatry, Neuropsychology, Medicine) and other professionals such as philosophers, lawyers and politicians, concerned about the participation of neurosciences in the understanding of the mind, the behavior, socio-cultural organizations, mental health, education, but first of all in the perception of human existence and its future. It may be “A Critique of the Neuroscientific reason,” a clear demarcation of the limits of this knowledge and its uses in society, a judgment by the other disciplines, to the extent that knowledge about the brain seems to give to neuroscientists certain power to expand their ideas beyond the laboratory, expanding their horizons and its explanatory power in domains already mentioned. It’s sometimes quite assertive when plotting new research paths, other times. But other times it’s about attacking different fields of knowledge by not knowing the limits of its frame of reference and in the impossibility to purge the investigations carried out of their own cognitive biases. That would respond more to the interests of certain ideologies than to the objective to improve human life on earth.

A modern-day paradigm for computational approaches to psychiatric illness


My research in computational neuropsychiatric genomics on the zebrafish has lead me to investigate what sort of methods and inquiries I could put forward using statistics and algebra. Though zebrafish are an inherently helpful model organism for psychiatric disease I want to extend the nature of zebrafish research such that we can achieve the full potential of psychiatric disorders no matter what species we are studying. The results of artificial intelligence in particular hold promising techniques that extend into biology and neuroscience. As scientists peek into the architectures and algorithms like hierarchical filtering and supervised learning, they can create more detailed and elaborate explanations of biological phenomena. OpenSource platforms in particular need to establish a framework or fundamental principles by which scientists can draw conclusions on the nature of psychiatric disease itself through accounting for the limits of experimental observation. In this post, we’ll discover some of the latest findings in computational neuroscience as they relate to the questions we’d like to answer.

As the field of neuroscience reaps the benefits brought upon by big data and advances in next generation sequencing, scholars have raised issues and questions brought upon by the questions and challenges they wish to address. Modeling data itself is a very important step for scientists to understand the nature of disease and neuroscientific phenomena. To benefit a field like psychiatry, researchers must find models formulated through prose that rely on several available empirical findings. But psychiatry and neuroscience can borrow principles and techniques from physics and mathematics, particularly those ideals which seek precise and explicit methods of creating predictions. The precision used in characterizing gravitational waves and in discovering the existence of the Higgs Boson are exceptional examples which show promising results for extending these processes into neruoscience. Still, the available models in computational neuroscience and neuropsychiatric genomics remain difficult to falsify and more descriptive than predictive. We see a coming together of disciplines, but not exactly the promising results that we had anticipated. For this reason, scientists must develop precise models drawing from modern neuroimaging techniques and mathematics.

On the bright side, neuroimaging has shown how complex, interconnected brain changes characterize psychiatric illnesses. This has informed researchers to select treatment targets of new therapies and form predictions on genetic risks for patients (Mayberg, et al. 2005). Many models remain lacking the appropriate mathematics to justify their use, however. Further statistical tests such as cross-validation would be necessary to justify generalizing a linear model from a set of training and test data. Computational researchers have put forward efforts, though, as shown in the issue of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. The issue showcases techniques from mathematics, physics, and engineering used in creating more rigorous models of psychiatric disorders. The articles in the issue share the premise that brain connectivity is the cause of psychiatric disorders, and, from this, scientists are able to borrow from graph theory, network theory, geometry, and even topology in describing networks and their functions. The tools are certainly available to researchers, but putting them into context and using them the appropriate way remain to some degree elusive. Network science (such as the work of Morgan et al., 2018) in recent months has shown effective results in studying autism, ADHD, and psychosis. The methods of borrowing techniques from one discipline to another require constant validation with the empirical evidence surrounding psychiatric illness to prove their validity.

Other advancements (such as that of Scholtens et al., 2018) search for unifying principles that can be used to explain any (or at least, many) data. These approaches account for the differences among varying sets of data such that the equations and algorithms that use network theory can be easily generalizable to any issue. Scientists should focus on these fundamentally-driven, elegant solutions to uncover the multiscale complexity of brain function. This method of drawing simplicity from complexity and moving between different levels of function and organization are what would allow neuroscience and neurobiology to actualize the full potential of their disciplines much the same way mathematics and physicists function as well.

Moving from descriptive to predictive models, as well, is a bottleneck for many models, and some researchers (like Janssen et al., 2018) have laid the foundation for using machine learning techniques to perform these predictions. The complexity and sheer amount of neuroimaging data can be simplified (in accordance with appropriate computational and physical limitations) and used for prediction illness outcome. They authors do warn, though, that overestimation of prediction performance is possible as test data may be overfit to training data. These machine learning methods still need to account for the multidimensional nature of large data sets and create realistic measurements of performance effectiveness.

Researchers need to engage in further work in determining the soundness and benefits of these models, especially from basic science principles to the clinical setting, to yield the true potential of computational neuroscience. For the complexity of psychiatry and biology to meet the same certainty and precision of mathematics and physics requires constant evaluation of scientific techniques. While the work done in recent years is a good start, there’s much, much more to be discovered.

Janssen, R.J., Mourão-Miranda, J., and Schnack, H.G. Making individual prognoses in psychiatry using neuroimaging and machine learning. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018; 3: 798–808

Mayberg, H.S., Lozano, A.M., Voon, V., McNeely, H.E., Seminowicz, D., Hamani, C. et al. Deep brain stimulation for treatment-resistant depression. Neuron. 2005; 45: 651–660

Morgan, S.E., White, S.R., Bullmore, E.T., and Vértes, P.E. A network neuroscience approach to typical and atypical brain development. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018; 3: 754–766

Scholtens, L.H. and van den Heuvel, M.P. Multimodal connectomics in psychiatry: Bridging scales from micro to macro. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018; 3: 767–776

Physician Rita Charon on how stories matter to medicine

Tasks like discerning difference between modern and postmodern illness would prove difficult for anyone without appropriate training in the arts and humanities. What is and what isn’t a fact has never been obvious or uncontroversial. There was no golden age of truth. Given the present day notions of post-truth in an era of decreasing trust towards authorities, physicians and other professionals in the field of health care find themselves faced with understanding humanity’s struggles in several different points of view. As I sat in the crowded audience of the Warner Theatre in downtown Washington D.C., I was lost in thought. Staring at the paintings that physician and literary scholar Rita Charon discussed, I reflected upon their aesthetic and moral value as they related to medicine. According to Charon, the field of narrative ethics seeks to address these issues. 

David Morris, a contributor to Rita Charon’s book Stories Matter, the modern perspective is “biomedical”: we are our genes, our organs, our laboratory measurements. The postmodern perspective is “biocultural”: we are made of stories. These stories have dimensions that are cultural, familial, emotional, interpersonal, psychological, and biological. 

Two weeks ago I had the amazing opportunity to attend Charon’s 2018 Jefferson Lecture in the Humanities “To See the Suffering: The Humanities Have What Medicine Needs.” As Charon projected Whistler’s painting “Sea And Rain 1865” before my eyes, she commented how the painting demonstrates, “the human scale of physicality, the cosmic scale of the oceans and relativity, and the existential dilemma of meaning are together in the universe and in each individual human body.” By the end of the lecture I found myself wanting to sit down and stare at paintings, read books, and spend the rest of my life in this intellectual bliss to cultivate my undergraduate passions I once had.

“Sea And Rain 1865” – James Abbott McNeill Whistler

As physicians treat patients, uncover the nature disease, and set educated standards in the field of health care, they create stories. These stories, when physicians create them, become the way of “reading” as Charon describes. Physicians and medical ethicists come together and, through the notion of constructionism that we are narratively constructed, we create meaning from the world and form a deeper understanding of medicine. A diagnosis becomes less about treating a patient like they’re a biological or physiological problem and more of a human. This gives rise to the ethical dilemmas, epistemic purposes, and other issues grounded in speculation a physician would encounter. Charon herself studies this issues from the point of view of both a physician and literary scholar. Shedding light on this humanistic discourse of medicine, these narratives constructed by narrative ethicists are a modified version of postmodernism. In this sense, narratives don’t constitute persons themselves, but they are the most effective way of accessing persons. Those who learn from fiction, literature, poetry, philosophy, and the arts gain a nuanced, heavy understanding of medicine they can use in any physician’s context. Doctors who embrace these techniques get the truest, most humanistic vision into what makes a patient a patient. They can attack fundamental ideas of disease and health such that those concepts carry appropriate meaning in a 21st century world of post-truths.

The self is within the narrative. One cannot look for one without finding the other. Searching for meaning as a physician would be like creating a pattern of a fabric interwoven that only becomes clear when one takes a step back and looks at the entire picture, or declaring a line as beautiful from points of data on a graph. Charon herself notes that “the self cannot be created — or even found — independent of narrative activities.” Still, other scholars might argue that a true self is to be found if one looks close enough or reflects for long enough. Regardless, physicians should understand how similar they themselves are to patients to practice with both their own objective professionalism alongside the personal, intimate stories of a patient. With characters that have their own backgrounds, morals, beliefs, and even blood type, physicians can make the most informed decisions to adequately provide for patients.

In the packed Warner Theatre of downtown Washington, D.C.,  I sat on the edge of my seat. I grasped my chin as I fell deep in thought and immersed every moment of time and inch of space into Charon’s speech. Inside of me a feeling erupted. I began to see elegant patterns between both science and the art. With this robust interconnected knowledge of both sciences and the humanities, I felt as though I could transcend both disciplines, and I sat in awe at how Charon used craftiness and wisdom to weave medicine and humanities in such a way that she could engage anyone with the pure intentions of learning and making the world a better place.

Physicians have a duty to recognize the principles that govern their profession, most notably beneficence, non-maleficence, justice, and autonomy. The role these concepts play in medical ethics and bioethics issues and the exact relationship among those principles serve the basis for decisions physicians make. But the narratives and principles physicians use are often at odds with one another. Marginalized groups of people have their own voice in narrative ethics which blurs the lines between human differences while “principlist” ethics lays down ethical rules by the fundamental principles themselves. Physicians and scholars can view the world through the absolutes of principlism or the gray area of narrative ethics. Taking the narrative to the extreme, in not just the lives of physicians but placing the narrative at the heart of all knowledge, provides a fundamental in the way scientific research is performed, as well. As medical ethicists take note of how these senses of constructionism and pirnciplist ethics govern medicine, they extended these narrative techniques to the sciences as well. The narrative of the sciences takes this human form to research. As more and more physicians and medical students realize the power and value of the humanities in their work, the more humanized, mature, and ethical approaches physicians can make in whatever task they may have to do.

Debra Malina of the New England Journal of Medicine, writes “Many of the contributors to Rita Charon’s Stories Matter are major players in this narrative movement. Here, they practice what they preach, building their essays on stories of patients who want to conceal their medical conditions from their families, 60-year-old women who want to use assisted reproductive technology, parents of infants born with neurologic injuries who want to let them die — stories on whose proper endings reasonable people might disagree. The authors do agree on certain concepts — the emphasis on particulars, multiple perspectives, context, and emotional as well as rational understanding. Many stress the obligation incurred by hearing a story of suffering.”

It’s difficult to establish clear rules and guidelines for physicians developing narratives. If anything, the way to form narratives that encompass the humanistic side of medicine is more about physicians and medical students developing senses of right and wrong, aesthetics, purpose, intention, and motive in whatever they do. What procedure a physician chooses to take, especially in the details of a story such as character development and plot, may not be set in stone, but the implications and premises upon which those conclusions are reached hold a great amount of value for the meaning of that story. Techniques from literature that become essential for physicians become the actions of physicians themselves such as the way doctors obtain consent from patients or debate among themselves on ethics committees. The variation could be seen as something that makes the process all the more humane, and embracing the uncertainty provides physicians the way to understand the human condition all the more. Physicians, however, need to account for this sort of ambiguity in the work that they do.

The crises people face today, brought upon by postmodernism and post-truth dialogue, mean it’s difficult for Charon and the other contributors to Stories Matter to give single, perfect answers to the specific issues physicians face, and, instead, provide a framework to manage the relationships among physicians and patients. However detached disillusioned one may be with these limitations, addressing them in a sense based in reality gives the reader some solace and connection to the thoughts of the contributors. Some of the contributors argue that going over different perspectives that seem to contradict one another is sufficient, while others maintain physicians should return to a narrative-based approach on the principles of medical ethics. The perspectives, research, anecdotes, and reasoning by the contributors can provide physicians with a place to start when understanding their profession on a more humane level. 

Charon’s writing and lecture gave me a greater appreciation for the work of physicians given my background in both the sciences and the humanities. It made me all the more excited to tackle the intellectual issues of the 21st century.

How to become who you are, according to Nietzsche

In Hiking with Nietzsche: On Becoming Who You Are, American professor of philosophy John Kaag shows how important and salient philosophy’s role in everyday life is. By hiking through mountains and experiencing what the Swiss Alps have to offer, Kaag illustrates a view of Nietzsche’s life that provides an intimate understanding of the challenges for which the German philosopher sought answers. Comparing himself to Zarathustra and Dionysus, Nietzsche actualizes his true potential in a way that other philosophers struggle with. He’s overcomes the limits and disadvantages of discourse and rumination and, instead, writes about the urgency of addressing issues of his time – many of which persist in the present day.

“As it turns out, to ‘become who you are’ is not about finding a ‘who’ you have always been looking for. It is not about separating ‘you’ off from everything else. And it is not about existing as you truly ‘are’ for all time. The self does not lie passively in wait for us to discover it.” I was incredibly satisfied by the immense level of reflection and thought put forward in analyzing and taking apart these arguments. It was a way of treating our thoughts and ideas as truthfully and justifiably as possible while still leaving room for the reader to maintain their own view of the issues Nietzsche brought up. It takes a tremendous amount of courage to address these issues, and, without the persistent and relentless work of both Nietzsche and Kaag, I’d struggle to even put these issues in words. I found the experience of reading the book absolutely insightful and eye-opening not only in the way Kaag depicted Nietzsche and the struggles he faced, but the way I related to them within myself. As I studied science and philosophy at Indiana University-Bloomington during my undergraduate years, I faced a tremendous amount of psychological and existential struggles. Things would get so worse with my mental health, social situations, academic performance, and even the thoughts I had about myself that, throughout senior year, I was just trying to leave my university as quickly and shamelessly as possible. I lost sight of the purpose in everything. My courses became tremendously more difficult, and I couldn’t ever figure out what to do. This book provides me with the ideals and arguments by which I can address those issues with far greater precision and clarity. I look forward to reading more Nietzsche in this thought-provoking and self-healing way such that I can continue to address these issues wherever I find them.

Even the pain and suffering that the individual experiences in society have home in Nietzsche’s work. By this, I mean that the way we react and deal with conflicts that cause us to suffer are taken with serious inquiry such that the individual can discover the true causes of what they are and the best ways to address them. As I read the book, I couldn’t help but compare the work and methods of the philosophers to how therapists approach individuals suffering from existential crises. A patient seeking help from an educated, wise therapist will often find him/herself at a loss of words and dumbfounded in terms of how to address his/her issues. It leaves the soul to suffer at the hands of a world that is wrathful, intimidating, and merciless. In concrete terms, this may include mental health issues such as depression or anxiety but also severe physical ailments such as cancer. Medicine and doctors should adhere to these truths and wrestle with them in their work in ways to treat patients and make the world a safer, healthier place by all means of measurement. Amazing work by physicians such as Richard Gunderman, Rita Charon, and Atul Gawande all hold the potential for making these changes happen. The way we internalize our suffering as part of a greater understanding of suffering that society has given us can let us internalize the reality of how and why we are meant to suffer. What might seem pessimistic and gloomy in our methods to understand the world turns out more encouraging and resilient to face whatever issues we experience in life.

Among the several lessons that Kaag and Nietzsche share discourse over include Nietzsche’s argument that self-discovery requires and undoing of the self-knowledge you assume you already have. This means that becoming yourself is a constant cycle between finding the self and also losing all sight of it. We can only truly become who we are as we overturn the fundamental truths and ideals that we believe make us who we are. This means there should be a level of trust and security as we perform these actions and do these things in life to become who we are. Nietzsche also elaborates that modern life distracts and deadens us in ways that prevent us from becoming who we are. The pleasures and fleeting desires of this world are nothing to compared to the near-unsurmountable challenge that is becoming who you are.

Kaag provides a clear example of these statements: “I remember too vividly an argument with my ex-wife that terminated with three words that I screamed before slamming our front door: ‘Let. Me. Be!’ I now know what I actually meant: ‘Get out of my way.’ Let me find my immutable essence. Unfortunately, there is no such thing as an immutable essence, at least not in my world. And so I left, but I never found what I was looking for, not even with (my new family) Carol and Becca. I found something else.” Carol is Kaag’s wife and Becca is his daughter.

Kaag can mention life story lessons as he ventures with his wife and daughter, and he draws upon his own personal experience in describing what Nietzsche himself sought to describe. The decadence, or decay, of the society around him, as Nietzsche noted, provides a careful, yet effective way of internalizing and dealing with the existential woes of today. As any philosopher dabbing in existentialism might come to realize, these concrete, realistic situations of philosophical truths come together in a neatly woven story. And the power which Nietzsche provided for his arguments has allowed them to resonate for decades.

As Nietzsche himself, said “It is an excellent thing to express a thing consecutively in two ways, and thus provide it with a right and a left foot. Truth can stand indeed on one leg, but with two she will walk and complete her journey.” (The Wanderer and His Shadow, 1880

Near the end of the book, Kaag explains how “‘Become what you are’ has been described as ‘the most haunting of Nietzsche’s haunting aphorisms.’” Indeed, it’s troubling to hear how who we are is something which we have to become, but that the thesis what we need to be is ourselves is all the more encouraging and reassuring for the reader.