The Body Keeps the Score criticism
Let’s talk about one of the most massive, consequential screw-ups in the history of psychology.
And how we are watching a version of it all over again right now under the guise of cutting-edge trauma research.
You might have seen the new opinion piece in Frontiers in Systems Neuroscience by Steven Kotler and others, co-authored by none other than Karl Friston, arguing that “the body does not keep the score”. On the surface, that seems awesome. I mean, the title is “The Body Does Not Keep the Score” for goodness’ sake. You’d think I’d love it.
In it, Kotler uses predictive processing to explain that trauma is a loss of “metastability” (the brain’s ability to fluidly adapt and switch between states). And he correctly points out that “flow states” heal this rigidity by inducing “transient hypofrontality,” which successfully shuts down the brain’s ruminative, self-referential networks and restores flexible coordination. Again, awesome.
But if you look closely, you’ll see that Kotler has hijacked the vocabulary of a holistic framework to slip in the Trojan-horse of an outdated worldview.
The Trap of Surreptitious Substitution
Kotler accurately describes flow as a state that quiets the ruminative mind to achieve fluid flexibility. But then, he stubbornly insists on labeling this highly fluid, non-evaluative state as a return to “higher cognitive control” and “flexible top-down guidance” over “subcortical threat circuits”.
By doing this, he is committing a scientific error known as “surreptitious substitution,” i.e., taking the highly complex, dynamic reality of the nervous system and replacing it with an outdated simplification, and leaving unwitting readers to think that the simplification is the actual biological reality.
The 100-Year Mistake
Over a century ago, the philosopher John Dewey generated a botched integration with his “James-Lange theory” of emotion, a Frankenstein creation that sent psychology down a dead-end path for a hundred years.
Kotler is repeating this same sort of error, even if he doesn’t mean to. Using phrases suggestive of the outdated, mechanistic logic of “cognitive control” over animalistic arousal he is suffocating the readers’ understanding of both the holistic framework of predictive processing and the actual mechanism of why flow works.
What “Flow” Actually Is: The Sensory Edge
Kotler’s terminology leads the reader to believe “flow” works to resolve PTSD because “higher cognitive control” is reestablished. But the real mechanism has nothing to do with traditional “cognitive control”.
To truly heal, we don’t need more cognitive control; we need to suspend it. Which his explanation illustrates, but in such an obscure manner that it makes it nearly impossible for a reader unfamiliar with predictive processing to comprehend.
On the other hand, using neuroscience researcher Norm Farb’s language from his book, Better in Every Sense, one can understand that “flow states” are healing because they force you out of your “conceptual mind” and demand your complete absorption in the sensory present.
Being in this so-called sensory present drives your attention to the “sensory edge” of your experience, in what Farb calls “perceptual inference.” This state actively reduces activity in the midline prefrontal cortex (the network that gets the most metabolic juice during rumination and self-evaluation) and leads to the restored flexibility that Kotler refers to in the paper.
Blessedly, nothing in Farb’s language suggests that you are establishing top-down cognitive control. Instead, it suggests that you are starving the rumination loop that feeds physical arousal by flooding the brain with new, unelaborated sensory input.
Why the Body Doesn’t Keep the Score (Spoken plainly)
When you fail to engage with your senses through this “perceptual inference”—or “flow,” as Kotler calls it—you maintain the exact mechanism that perfectly explains why PTSD symptoms persist. And it proves exactly why the body does not keep the score.
Trauma is not a physical memory permanently frozen in your muscle tissue. But it also isn’t a “breakdown of top-down regulation” or a loss of “higher cognitive control,” as Kotler claims. Ironically, relying on top-down cognitive evaluation is exactly what traps traumatized brains in a loop.
Here is the real mechanism: Your nervous system operates a bit like a seesaw, constantly balancing “sensing” (taking in raw, present-moment information) and “thinking” (evaluating, predicting, and problem-solving).
When we experience severe stress or trauma, the physical and emotional error signals generated by the body become too powerful and aversive to simply accept. To protect itself, the brain effectively shutting down its sensory pathways.
Because you have blocked out raw, present-moment sensory information, your brain loses its balance. It becomes overwhelmingly fixated on problem-solving, top-down evaluation, and rumination (a process called “active inference“). You get stuck entirely on the “thinking” side of the seesaw.
When you shut down the senses, your brain gets trapped playing the exact same internal loops of threat. It constantly predicts danger, feels the resulting physiological arousal, and uses that arousal as “proof” that the threat is real. Because it refuses to let anything new in, your brain can never update its deeply entrenched expectations of danger.
Healing happens when you stop, drop your attention on stories, and deliberately take in new sensory information to balance the seesaw.
No shade, Steven. If someone already knows how to read the dense science of predictive processing, it’s obvious you’ve mapped out the right cure. But clinicians already avoid learning predictive processing because they suspect it’s just a fancy new way to say the same old thing.
By committing surreptitious substitution (wrapping a modern, holistic framework in the century-old vocabulary of “cognitive control”) that is exactly what you are doing.
You confirm their bias. You give them a free pass to avoid learning anything new, which masks the true cure and leads the field right back into making the exact same hundred-year old mistake.
People deserve better.
Want to know more? Check out Norm Farb’s book, Better in Every Sense; How the New Science of Sensation Can Help You Reclaim Your Life.
Leah Benson, LMHC is a licensed psychotherapist in private practice in Tampa, FL
