“The body does not keep the score”

Interesting example of theorising in paper by Kotler et al. (2026), “The body does not keep the score”. I haven’t read van der Kolk’s (2014) classic The Body Keeps the Score, which they critique, but I don’t think that critique is central to their claims. I also don’t think their analysis needs Friston’s “free energy principle”.

Key quotes:

“… trauma over-weights the precision of danger priors: the brain assigns excessive confidence to threat predictions, constraining inference based on the prior premise of enduring danger. The result is hypervigilance, flashbacks, and avoidance—symptoms of a system caught in self-confirming predictions.”

“Internal threat expectations dominate the search for—and attention to—sensory evidence of danger; unattenuated interoceptive signals (racing heart, tight chest, etc.) are interpreted as confirmation of danger rather than imprecise noise. The ‘score’ the body appears to keep is thus an artifact of circular inference: the brain predicts pain, senses arousal, and takes that arousal as proof that pain persists. The body participates in trauma, but as messenger, not archive.”

“If the old story held that ‘the body keeps the score,’ the emerging narrative elides somatic chauvinism. It’s subtler, and more hopeful. The body does not keep the score; the brain keeps predicting it. When prediction becomes too rigid, experience repeats itself, not because it is stored, but because it cannot yet be reinterpreted. Flow—and other states that expand metastability offer the nervous system a chance to update its model of the world, to reassign precision where it belongs, and to rediscover safety in uncertainty.”

Flow is often attributed to Mihály Csíkszentmihályi, and is the name for the feeling of absorption in an activity that people tend to experience when they perceive that

“the environment contains high enough opportunities for action (or challenges), which are matched with the person’s own capacities to act (or skills). When both challenges and skills are high, the person is not only enjoying the moment, but is also stretching his or her capabilities with the likelihood of learning new skills and increasing self-esteem and personal complexity.” (Csíkszentmihályi & LeFevre, 1989, p. 816)

An example of when people frequently experience this flow state is when driving. There’s a lot to unpack in the “metastability” aspect of the theory. They describe this in terms of neural states, being able to “fluidly switch among semi-stable network states” (Kotler et al., 2026, p. 1), but their examples seem to signal that they mean being flexible in responses to situations, e.g., not only perceiving potential threats.

References

Csíkszentmihályi, M., & LeFevre, J. (1989). Optimal experience in work and leisure. Journal of Personality and Social Psychology, 56, 815–822.

Kotler, S., Mannino, M., Fox, G., & Friston, K. (2026). The body does not keep the score: Trauma, predictive coding, and the restoration of metastability. Frontiers in Systems Neuroscience, 20, 1812957. https://doi.org/10.3389/fnsys.2026.1812957

van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking Press.

Reckless and treacherous theorists

“[…] the most reckless and treacherous of all theorists is he who professes to let facts and figures speak for themselves, who keeps in the background the part he has played, perhaps unconsciously, in selecting and grouping them […]”

– Alfred Marshall (1885, February 24). The present position of economics. Inaugural lecture, University of Cambridge. Reprinted in Hodgson, G. M. (2005). Journal of Institutional Economics, 1(1), 121–137.

Ordinary people making sense of their social experience

“Let’s pause for a moment and ask a very basic and very important question: what is theory? We start by answering in the negative: the production of theory is not necessarily a scholastic exercise; the site of production of theory is not necessarily the ivory towers of academia; the producers of theory are not necessarily academically trained personnel in possession of qualifications that bestow on them the status of ‘officially approved theorists’.

“Positively, we would argue that the building blocks of the production of theory are the efforts of ordinary people to make sense of their social experience; the sites of production of theory are, then, everywhere such activity may take place; the producers of theory are – potentially – everyone who engages in reflection on their experiences so as to develop new and improved practices to problematic aspects of that experience.”

Cox, L. and Nilsen, A. G. (2005). Why do activists need theory? Euromovements Newsletter

Ioannidis and Psillos (2018) on mechanisms

“Mechanisms are causal pathways described in theoretical language that have certain functions; these descriptions can be enriched by offering more detailed or fine‐grained descriptions; the same mechanism can then be described at various levels using different theoretical vocabularies (e.g., cytological vs biochemical descriptions in the case of apoptosis); lastly, the descriptions of biomedically important mechanisms are often such that they contain specific causal information that can be used to make interventions for therapeutic purposes.” (Ioannidis & Psillos, 2018, pp. 1180–1)

Ioannidis, S., & Psillos, S. (2018). Mechanisms in practice: A methodological approach. Journal of Evaluation in Clinical Practice, 24(5), 1177–1183.

Data alone can’t determine causal structure

Suppose we find that the probability of a successful programme outcome (out) depends on treatment (treat) and mediator (med) as per the Bayes network depicted in part 1 of the figure below. Suppose also that there are no other unmeasured variables. This model defines \(P(\mathit{out} | \mathit{treat}, \mathit{med})\), \(P(\mathit{med} | \mathit{treat})\), and \(P(\mathit{treat})\). The arrows denote these probabilistic relationships.

Interpreting the arrows as causal relations, then all six models above are consistent with the conditional probabilities. Model 2 says that treatment and outcome are associated with each other because the mediator is a common cause. Model 3 says that the outcome causes treatment assignment. Model 4 says that the treatment causes mediator and outcome; however, outcome causes mediator. And so on. These six models are all members of the same Markov equivalence class (see Verma & Pearl, 1990).

We need something beyond the data and statistical assocations to distinguish between them: theory. Some of the theory might be trivial, e.g., that the outcome followed treatment and can’t have caused the treatment because we have ruled out time travel.

References

Verma, T., & Pearl, J. (1990). Equivalence and synthesis of causal models. Proceedings of the Sixth Annual Conference on Uncertainty in Artificial Intelligence, 255–270.

Visualising programme theories

Lovely collection of examples of the folllowing ways of visualising a programme theory:

  1. Logic model
  2. Logical framework
  3. Theory of change
  4. Context-mechanism-outcome configuration
  5. Causal loop diagram
  6. Stock and flow diagram
  7. Concept map
  8. Network map
  9. Path model
  10. Nested/Hybrid model

Also includes links to tools for reasoning about the representations (where they have some genre of formal semantics).

Examples

References

Lemire, S., Porowski, A., & Mumma, K. (2023). How We Model Matters: Visualizing Program Theories. Abt Associates.

A cynical view of SEMs

It is all too common for a box and arrow diagram to be cobbled together in an afternoon and christened a “theory of change”. One formalised version of such a diagram is a structural equation model (SEM), the arrows of which are annotated with coefficients estimated using data. Here is John Fox (2002) on SEM and informal boxology:

“A cynical view of SEMs is that their popularity in the social sciences reflects the legitimacy that the models appear to lend to causal interpretation of observational data, when in fact such interpretation is no less problematic than for other kinds of regression models applied to observational data. A more charitable interpretation is that SEMs are close to the kind of informal thinking about causal relationships that is common in social-science theorizing, and that, therefore, these models facilitate translating such theories into data analysis.”

References

Fox, J. (2002). Structural Equation Models: Appendix to An R and S-PLUS Companion to Applied Regression. Last corrected 2006.

Overrated: The predictive power of attachment (2016)

“The fact is that there’s no strong evidence for parent–child attachment in infancy predicting anything much about children’s later development. Indeed, Booth-LaForce and Roisman’s definitive 2014 study showed that early attachment doesn’t even predict attachment later in development, let alone all of these other things.”

Nice, concise, critical analysis of attachment claims, by Elizabeth Meins (2016).

Conventional versus non-conventional facets of reality

One of the slipperiest concepts in social theorising is that of social construction. Another potentially more productive way to look at social reality is in terms of what properties of the world are conventional rather than non-conventional. A great example comes from the physics of time. I’ll briefly introduce this and then sketch out parallels with theorising sex/gender.

The duration of a second is conventional. One definition is that a second is

‘the duration of 9192631770 periods of radiation produced by transition of an electron between two hyperfine levels of a Caesium-133 atom.’

It is conventional in the sense that it could have been otherwise and in fact the definition of a second is changing. As Bradley Dowden explains:

‘conventions are up to us to freely adopt and are not objective features of the external world that we are forced to accept if we seek the truth.’

A non-conventional feature of time is the transitivity of events in the same frame of reference. That means if an event

A precedes B, and
B precedes C, then
A precedes C.

Let’s give this distinction a go for sex/gender. Phenotypic sex category at birth has a clear definition in terms of genitals which, for most people, coincides with sex chromosomes. The category is highly reliable and is predictive of much, including sexual reproductive roles – but only for cisgendered and heterosexual people, and even then it is imperfect (due to menopause, for instance). Sex category loses its predictive power for LGBTQ+ people.

The male/female dichotomy could have been otherwise. For instance it is a fact that many adults have a gender identity that differs from the phenotypic sex category they were assigned at birth and some people are nonbinary, i.e., neither a man nor a woman. In terms of social roles, there is much greater variation than two categories (see, e.g., twinks and bears). A binary category tethered to sexual reproductive role is not the only way to carve nature at its joints.

However, there are non-conventional facts about reproductive biology that determine, for instance, whether someone is able to become pregnant. Katrina Karkazis argues that sex/gender category should be detached from the specifics of what bodily organs we have:

‘It is long overdue that we understand sex not as an essential property of individuals but as a set of biological traits and social factors that become important only in specific contexts, such as medicine, and even then complexity persists. If we are concerned with certain cancers, for example, knowing whether someone has a prostate or ovaries is what’s important, not their “sex” per se. If reproduction is the interest, what matters is whether one produces sperm or eggs, whether one has a uterus, a vaginal opening, and so on.’

Sex versus gender

The distinction between sex and gender seems straightforward. Sex refers to biology, e.g., chromosomes and genitalia. Gender refers to psychosocial processes, e.g., roles and expression. However, they are more complex than this neat division. Like happiness and pain, gender is partly ontologically subjective. Gender identity is ‘deeply felt’ and ‘not necessarily visible to others’ (American Psychological Association, 2015, p. 862).

Sex has social facets. The classic sociological work Doing Gender by West and Zimmerman (1987, p. 127) illustrates how a sex category is assigned at birth:

Sex is a determination made through the application of socially agreed upon biological criteria for classifying persons as females or males. […] Placement in a sex category is achieved through application of the sex criteria, but in everyday life, categorization is established and sustained by the socially required identificatory displays that proclaim one’s membership in one or the other category. In this sense, one’s sex category presumes one’s sex and stands as proxy for it in many situations […].

This assigned sex category affects children’s social life in a variety of arbitrary ways, e.g., how they are dressed and expectations about behaviour, and feeds into the development of gender. For the majority of social contexts where sex category is applied, chromosomes and genitals are concealed and irrelevant.

Gender has biological facets: minds do gender identity and are embodied in the brain and nervous system, so even the phenomenology of gender identity has a biological correlate somewhere (Serano, 2013, pp. 138–168). There is emerging evidence that gender identity is a complex trait that is part-heritable and polygenic. A recent systematic review suggests that its heritability is likely in the range 30−60% (Polderman et al., 2018).

The interwoven biopsychosocial nature of sex and gender has led some scientists to use the combined concept sex/gender (e.g., Rippon et al., 2014). This does not mean that the multiplicity of facets blend into an amorphous blob. It does mean that it is important to clarify what particular facets are intended when discussing measurement and theory: chromosomes, genitalia, gender identity, socialisation, etc. The view of sex as only biological and gender as only psychosocial is too simplistic to progress theorising.

Excerpt from Fugard, A. (2020). Should trans people be postmodernist in the streets but positivist in the spreadsheets? A reply to Sullivan. International Journal of Social Research Methodology, 23, 525–531. [Preprint here]