Extended Network Generalized Entanglement Theory: Therapeutic ..... experienced by cranio-sacral therapists and other manual therapists may also be.
1 Extended Network Generalized Entanglement Theory: Therapeutic Mechanisms, Empirical Predictions and Investigations
Michael E. Hyland, PhD Department of Psychology University of Plymouth UK
Key words: Complexity, entanglement, mechanism, complementary and alternative medicine, theory, Hox genes, healing, homeopathy, acupuncture, massage, Reiki
Running head: Entanglement Theory
2 Abstract
Extended network generalized entanglement theory (entanglement theory for short) combines two earlier theories based on complexity theory and quantum mechanics. The theory’s assumptions are: the body is a complex, self-organizing system (the extended network) that self-organizes so as to achieve genetically defined patterns (where patterns include morphological as well as life-style patterns). These patternspecifying genes require feedback that is provided by generalized quantum entanglement. Generalized entanglement has additionally evolved as a form of communication between people (and animals) and can be used in healing. Entanglement theory suggests that several processes are involved in complementary and alternative medicine (CAM). Direct subtle therapy creates network change either through lifestyle management, some manual therapies and psychologically mediated effects of therapy. Indirect subtle therapy is a process of entanglement with other people or physical entities (e.g., remedies, healing sites). Both types of subtle therapy create two kinds of information within the network – either that the network is more disregulated than it is, and the network then compensates for this error, or as a guide for network change leading to healing. Most CAM therapies involve a combination of indirect and direct therapies, making empirical evaluation complex. Empirical predictions from this theory are contrasted with those from two other possible mechanisms of healing: (a) psychological processes and (b) mechanisms involving electromagnetic influence between people (biofield/energy medicine). Topics for empirical study include a hyperfast communication system, the phenomenology of entanglement, predictors of outcome in naturally occurring clinical settings, and the importance of therapist and patient characteristics to outcome.
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Introduction Extended network theory and the theory of generalized quantum entanglement are two speculative but separate theories that have been applied in different ways to mechanisms underlying Complementary and Alternative Medicine (CAM) (Hyland, 2001a, Hyland & Lewith, 2002; Walach 2000, in press; Milgrom, 2002, 2003a, 2003b; Weingartner, 2003). Accounts of both theories have also been published without reference to CAM in medical (Hyland, 2001b), psychological (Hyland, 2001c, 2002) and physics (Atmanspacher, Römer, & Walach, 2002) journals. This paper (a) provides a brief description of the two theories, (b) shows that a combination of the two theories, Extended Network Generalized Entanglement Theory (Entanglement Theory for short) explains how pattern-specifying genes (e.g., Hox genes) act as supervisors in a self-organizing system, (c) uses Entanglement Theory to describe different processes underlying CAM therapies, and (d) provides empirical predictions that are contrasted with two other possible processes involved in CAM: psychological and electromagnetic (e.g., biofield explanations).
One of the central assumptions of this paper is that CAM therapies usually act through several different mechanisms. Consequently, particular therapies cannot be linked with particular mechanisms on a one to one basis. This paper therefore focuses initially on mechanism, and the link between mechanism and therapy is discussed later – I ask for tolerance from clinically minded colleagues. However, empirical evaluation of therapy is always made in the context of implicit or explicit mechanisms, and it can happen that negative findings are the consequence of tests that
4 are unfair to potential mechanisms of CAM (Hyland, in press a). Hence, an understanding of potential mechanisms is important.
Extended network theory Extended network theory (Hyland 2001a, 2001b, 2000c, 2002) falls within a more general movement of applying complexity theory to medicine (Goldberger, 1996; Wilson & Holt, 2001) and to CAM in particular (Bell, Baldwin & Schwartz, 2002). The underlying assumption of the theory is that the body has a superordinate system, the extended network, that sets the parameters (e.g., set point, gain etc – by analogy the thermostat settings and the output of the boiler of a central heating system) of the body’s control systems. The term ‘body’s control systems’ is interpreted in its broader sense to include control systems controlling internal physiological parameters (e.g., temperature, blood glucose, etc) as well as those controlling external parameters (e.g., access to food, rest, etc) through behavior. This superordinate system is assumed to be a network-based intelligent system that has the ability to co-ordinate conflicting requirements of a system that requires temporal specialization of function (network systems are particularly suited to this kind of task). So, for example the extended network co-ordinates temporal change in homeodynamic systems (many physiological systems are homeodynamic rather than homeostatic as the set point varies throughout the day), as well as providing a co-coordinated response to internal or external challenge.
Although traditional medical science assumes the body’s control systems are independent or at best haphazardly connected, it is evident that they are highly coordinated in function. For example, there are many simultaneous physiological
5 changes in the fight and flight response to external challenge, and these changes are controlled suggesting an alteration of reference criteria. Similarly, when the body experiences an internal challenge (e.g., infection or trauma), one of the many consequences is the production of cytokines which, in addition to effects on immune activity, creates the sensation of fatigue via hypothalamic and other receptors, leading to the organism resting. The functioning of internal and external environments is coordinated; indeed, it is difficult to conceive how the body could function without some overall coordinating system.
The extended network is assumed to be a superordinate organization of existing neurological and humoural networks, and is therefore extended throughout the body, using both neurological and humoural causal connections. The extended network is a parallel processing system and therefore has properties exhibited by other parallel processing network systems, including pattern recognition and adaptive selforganization. Using genetically conferred rules, the network self-organizes so as to create more effective self-regulation at the lower level control systems. For example, temperature regulation is a lower level control system, and the body self-organizes (i.e., grows or develops) to create mechanisms that create effective self-regulation of temperature. Other lower level control systems include immune activity, bowel motility, glucose levels etc. However, under specific circumstances, the rules that create self-organizational change lead to less effective self-regulation, and this less effective self-regulation creates the distal cause for chronic disregulatory diseases (Figure 1). For example, in the case of autoimmune diseases, the immune control system is disregulated as there is excessive immune activity. Similarly, in the case of irritable bowel disease, there is either too much or too little (or both) little bowel
6 motility. Thus, the lower level disregulation – i.e., the proximal cause of disease – is the consequence of error at the superordinate level of regulation – i.e., the distal cause of disease (Hyland, 2001b). Figure 1 about here please
Most conventional therapy or ‘robust therapy’ (e.g., pharmacological interventions, the physical aspects of manual therapy such as freeing a trapped nerve) works either by correcting the consequences of the disregulated control system or changing the control system directly, or by some other structural change. By contrast, subtle therapy (Hyland, 2001a) aims to create self-organizational change in the extended network, and thereby creates more effective self-regulation in the body’s control systems by getting to the ‘root of the problem’ – i.e., that which causes the control systems to become disregulated. Subtle therapy (see Figure 1) affects the distal rather than proximal cause of disease, and because it deals with that which causes the lower level control system to become disregulated, is particularly relevant to disease prevention.
It is proposed that CAM treatments deliver subtle therapy in two ways: push therapies and pull therapies. Push therapies provide the extended network with information that the network is in a more disregulated state than it actually is (Bellavite et al., 1997; Hyland & Lewith, 2002). When provided with this information, the network compensates by self-organizing in the direction of greater regulation, because one of the self-organizing rules, the compensation rule, makes the network compensate for disturbances to its expected pattern. Thus, the present hypothesis is that part of the therapeutic effect delivered by CAM is a compensatory reaction to information
7 provided into the extended network (Hyland & Lewith, 2002). Evidence in support of this mechanism is provided by the observation that many CAM treatments lead to an initial worsening of symptoms, and that one of the largest double-blind controlled trials of homeopathy to date showed an oscillation of symptoms and physiology (worsening, then improving, then worsening, then improving) (Lewith et al, 2002). Although the mechanism underlying homeopathy remains controversial, the less controversial effect of hormesis shows that small but physically present doses of toxins that create symptoms similar to the disease state can have a therapeutic effect, again consistent with the hypothesis that subtle therapy works by providing informational inputs to the extended network. Finally it should be noted that although the biological effects of CAM are consistent with extended network theory (Hyland & Lewith, 2002), this theory does not explain how CAM treatments actually provide that information into the extended network.
The second way that CAM therapy is believed to be effective is through pull therapies. The extended network has chaotic properties: people’s health state varies. However, this slightly chaotic system has local attractors (or local minima) that tend to stabilize the network round a particular trajectory. Consequently, the body can be prevented from self-organizing in a healthy direction because it is locked onto a local attractor that maintains the disease state. Pull therapies provide the network with a different attractor that guides the network away from the pathology maintaining attractor. Thus, pull therapies act as kind of network guide that shows the network the route it needs to take in order to achieve a more healthy, regulatory state.
8 One of the features of the way networks operate is that slow self-organizational change has certain advantages in terms of overall function (e.g., the avoidance of local minima). Assuming, therefore, that the extended network is a slow self-organizing system, it is expected that subtle therapies will be slow in their effect – and certainly much slower than could be achieved by robust therapy. Subtle therapies are ways in which the network is influenced so that it can re-establish its natural state of health. Subtle therapy is therefore merely the catalyst for a slow self-healing process. Generalized quantum entanglement theory Quantum entanglement is an accepted aspect of quantum mechanics. Generalized quantum entanglement is a far more speculative idea. Quantum entanglement is a counter-intuitive prediction from the mathematical formalization of quantum mechanics. The prediction is that quantum systems can, under specific circumstances, behave holistically so that observations made on part of the system have an effect throughout the system, and thereby break the contiguity principle of cause-effect relationships (Bell 1987). There are several types of demonstration of quantum entanglement, but they typically involve the demonstration that an observation made on one of a pair of particles (e.g., photons) that are entangled because they come from the same quantum state, affects the other particle instantly wherever it is in the universe. Such findings can be interpreted in terms of non-local causality, which has been defined as ‘the mysterious ability of Nature to enforce correlations between separated but entangled parts of a quantum system that are out of speed-of-light contact; to reach instantaneously across vast spatial distances or even across time itself, to ensure that parts of a quantum system are made to match’ (Cramer, 1997). More prosaically, Nielsen (2002) says “If something is entangled with other objects, a measurement of it simultaneously provides information about its partners.” Although
9 entanglement is often viewed as an all-or-nothing phenomenon, recent research (Nielsen, 2002) suggests that entanglement varies – there are maximally entangled pairs of objects as well as incompletely entangled pairs of objects which can combine to form entangled information (a Qbit), and entanglement can occur between several objects.
In addition entanglement can occur in ways that are not time dependent, so
that non-locality occurs with respect not only to place but also to time.
Entanglement demonstrates an important philosophical feature of quantum mechanics – that the world we live in works in a way that we simply cannot visualize. The quantum universe is fundamentally different from our common sense ideas about cause and effect and the assumption that reality is independent of observation (Nadeau & Kafatos, 1999, chapter 2). Those common sense ideas arise because under most circumstances we can safely ignore the effects of light speed and quantum action. The possibility that we cannot ignore quantum effects in every-day life has profound implications.
In the recent formalization of weak quantum theory (Atmanspacher, Römer, & Walach, 2002), some of the requirements of quantum mechanics are relaxed, leading to the prediction of entanglement in contexts beyond the quantum level, that is, generalized quantum entanglement. There has been no empirical demonstration of generalized quantum entanglement, though entanglement has been observed in macroscopic (but still quite small) objects (Julsgaard, Kozhekin & Polzik, 2001), and the relevance to biological processes has been suggested for many years (Josephson & Pallikari-Viras, 1991; Ho, 1993)
10 However, the conditions under which generalized entanglement could arise are prescribed by the theory: they include the requirement that the descriptions of the whole and the elements of the whole are complementary. Such complementary descriptions have long been associated with mental and physiological descriptions (Kirsch & Hyland, 1988; Walach, & Römer 2000), but we might also expect that certain sorts of social unit also have properties where individuals are complementary parts of the whole.
The possibility of generalized quantum entanglement is relevant to a paradox noted by Walach. Walach (2000) points out that although meta-analysis of clinical trials suggests that homeopathy has an effect beyond that of placebo, a more critical reading of the literature suggests that the effect is, at best, very small. Although views are divided, most would agree that the research findings are inconsistent with clinical observations of the efficacy of homeopathy, and which are difficult to explain merely as placebo (e.g., animal studies). Walach suggests that homeopathy does not work in the way suggested by homeopaths (i.e., the memory of water hypothesis), nor does it work in the way suggested by those who dismiss homeopathy out of hand (i.e., a purely psychologically mediated process). Instead, he suggests that it works through a process of entanglement between the therapist and patient, which is set up by the ‘ritual’ of the homeopathic interview. Thus, formal double blind clinical trials fail to support homeopathy because the therapist is an important component of the therapeutic process. Although Walach applies entanglement in the context of homeopathy, his idea has wider application in the field of CAM. In principle, any CAM technique could work in part through entanglement.
11 Generalized quantum entanglement applies not only to the effect of one on another, but can also be applied to entanglement with physical entities (Milgrom, 2002, 2003a, 2003b; Walach, in press), and this possibility means that homeopathic remedies can also feature as part of an entangled system. Milgrom uses the term patientpractitioner-remedy entanglement, but the idea of entanglement with physical entities has wider application, including, for example, to phenomena such as buildings having ‘an atmosphere’, and where people are ultimately linked into the whole universe – that is, have non-local connections with the whole universe. Walach (in press) suggests that the combination of person-person and person-object entanglement can be particularly effective due to the synergy created from these two types of entanglement , and this suggests a whole range of possibilities, including therapists being more effective in one setting than another.
Entanglement Theory – derivation of the theory One of the assumptions of extended network theory is that the body has the capacity to self-organize. This assumption is well established through observation: selforganization is a key feature that distinguishes living organisms from complex nonliving systems. When damaged, living organisms are often able to repair themselves. Complex man-made systems such as jumbo jets do not do this; furthermore, big jumbo jets do not grow from little jumbo jets. Self-organization provides the beginning of a scientific rationale for defining life in terms of a complex system (Cilliers, 1998). However, it is also clear that this capacity for self-organization follows certain constraints (people end up with four fingers and a thumb on each hand), and so self-organization must be of a particular kind, that known in network
12 theory as ‘supervised learning’ (Ellis & Humphreys, 1999). The supervisor is, presumably, the genes. Thus, extended network theory proposes that the body is a self-organizing system where self-organization takes place on the basis of inputs to the network supervised by the genes. These supervising genes specify a pattern in the same way that an architectural blueprint specifies a pattern. Different builders may produce different buildings using the same blueprint depending on choice and availability of building materials – only the overall pattern remains the same. Thus, the supervising genes do not exactly specify the phenotype but only the general form, and there is considerable evidence to support this idea. The development of both the neurological and immune systems depends on stimulation, where external inputs (e.g., visual cues or immune challenge) have substantial and long lasting effects on adult structure and function (Blakemore & Cooper, 1970; Yazdanbakhas, Kremsner & van Ree, 2002). The impact of stimulation on structure (also, for example, muscle wasting in weightlessness) is consistent with a system that self-organizes in response to simulation and in accordance with genetically specified patterns.
Hox genes are a type of gene known to specify morphological patterns, and are therefore the kind of pattern-specifying gene that could act in this supervisory role (they occur in all animals with the possible exception of sponges). Mutations in Hox genes create morphological changes. For example, a mutation of a Hox gene in the fruit fly leads to an additional pair of wings; mutations in other animals include atavisms – i.e., a phylogeneticaly earlier form of structure is expressed (Papini, 2002). In sum, there is a known genetic mechanism which would allow some genes to act as supervisors in a self-organizing system.
13 There is, however, one problem. For genes to act as supervisors in a complex system, they must be able to detect and so respond to patterns that are at the macro-level – for example at the level of cell clusters. To illustrate this problem let us consider the idea of blueprint in more detail. The common statement that genes provide the blueprint for the body obscures the fact that blueprints can act in two entirely different ways. First, they can act as element specifiers – which is the type of blueprint provided by the manufacturers with a Lego or Meccano toy model. Second, they can act as pattern specifiers – which is the type of blueprint used in architectural drawings. A builder is able to build using an architectural drawing only by using a measuring rule that acts as a feedback system. A builder builds a wall until the pattern (e.g., height and length) specified in the architectural plan is achieved; then the builder stops building. Pattern specifying blueprints are possible only if there is a feedback device. The use of a pattern specifying blueprint in architectural drawings reflects the fact that they are a far more efficient way of specifying information compared with element specification (it is unnecessary to specify every brick); they are less sensitive to environmental variation (the builder can use the same blueprint with different materials); and they are less sensitive to environmental disturbance (if someone knocks a couple of bricks away, the builder will know to put them back). Element specifying blueprints are easier to use (there is no need for a measuring rule) but are highly sensitive to the correct availability of parts, and to damage. If you are missing a crucial Lego block or Meccano part, the model cannot be built. Given the advantage of pattern specifying genes, the existence of Hox genes may not come as a surprise. Equally, it is hardly surprising that animals other than humans use pattern specification to modify their environment – birds build nests according to patterns and so are able to repair the nest if it is damaged during the building process.
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However, in order for genes to act as pattern specifiers, there must be some way that the gene can ‘find out’ when a macro-structure pattern has been achieved. For example, in the case of a mutation causing an extra pair of wings in the fruit fly, there must be some way that the genes in the growing wings ‘know’ that the additional wing is not only there but has also reached the right size. That is, there must be some mechanism of feedback (the equivalent to the builder’s rule or the bird knowing that its nest ‘looks right’) between macro-level patterns and the genes. These macro-level patterns are not only morphological structures, but may also be temporal patterns or causal sequences and may be highly complex. For example, the concept of selfactualization suggests that people individualize in unique ways, and if so there may be some genetic representation of ‘the person you are supposed to be’. The concept of self-actualization implies that pattern-specifying genes must be able to detect very complex lifestyle patterns.
Although there are known gene feedback mechanisms at the level of the cell, there is no obvious biochemical way that feedback could be provided between macro-level patterns of cellular clusters and other non-morphological patterns. Nor is there any way that any of the four physical forces (the strong force, the weak force, the electromagnetic force and the gravitational force) could provide this information. Nevertheless, pattern specifying genes, such as Hox genes, seem to be able to function: it is here that the formalization of weak quantum theory provides a possible solution.
15 If we suppose that the description of macro-level patterns and the descriptions of genes are complementary descriptions, then this satisfies the condition for possible generalized quantum entanglement between those patterns and genes. Specifically, gene expression could be regulated by entanglement with patterns at a macro-level, where particles in the macro-level pattern are entangled with particles in the gene – either through some pattern of fractals (i.e., patterns that are similar at the macro-level and gene) or some other way that communicates positional or temporal information of the macro pattern to the gene. When a pattern specifying gene detects a mismatch between the pattern that is programmed into the gene (the ‘desired pattern) and the pattern exhibited by the organism (the ‘observed pattern’), then the gene initiates selforganizational change within the system until the ‘desired’ and ‘observed’ pattern are the same. The self-organizational change may be directed, or it may be random, but the eventual result is that the extended network evolves into the system that is specified by the gene. However, because environmental inputs are crucial to the way the network evolves, there is, in the case of pattern specifying genes, no one-to-one correspondence between the genotype and the evolved system or phenotype. The building depends on available material just as does the bird’s nest.
According to this hypothesis, generalized quantum entanglement is a physical mechanism that is exploited by living organisms to transfer information between macro-level structures and micro-level structures, so as to exploit the more efficient use of genes as pattern specifiers. The transfer of information from macro to micro level is crucial to the functioning of the extended network, as it is part of the mechanism used in self-organizational change. A mathematical formalization of how decentralized agents can contribute through entanglement to self-organizational
16 change has been proposed recently (Zak, 2002), but not in the context of entanglement with Hox genes.
Generalized quantum-entanglement applies in principle to any relationship where there is complementarity of description. Just as a person is a cooperative population of cells, so groups in society are cooperative populations of people. It is therefore theoretically possible that people can become entangled if together they form a whole. If genes evolve to exploit the laws of physics, and if they exploit it in the form of Hox gene entanglement, then it is possible that entanglement has also evolved as a simple form of communication between organisms and, in the case of humans, a form that predates the evolution of speech. Entanglement between people is likely to involve simple or fundamental types of information transfer, such as the sensation of danger or other emotions. Language is often a more efficient form of communication and certainly better for communicating complex cognitive ideas, and so entanglement for communication is unlikely to have evolved much and may even have atrophied after the evolution of language.
One fundamental assumption of modern physics is that all particles in the Universe originate from a singularity, and therefore all particles are in some sense entangled (Nadeau & Kafatos, 1999, p. 185). This assumption leads to the idea that everything in the Universe is connected in some kind of web of information, and therefore entanglement can occur also between people and physical objects – such as remedies, crystals, particular rooms or sites which are felt to be healing, etc. (Milgrom, 2002, 2003; Walach, in press). Of course, the possibility that the whole Universe is entangled leads to the question, why does entanglement not occur more often? An
17 answer to this question may arise from analogy with the nature of light. Light, depending on the type of observation, ‘collapses’ into either a wave or particle. In a similar way, entanglement may be simultaneously present and not present and it is the act of observation that creates the entanglement. That is, there may be a particular type of ‘observational stance’ that increases the likelihood of entanglement.
Entanglement Theory – Mechanisms of Healing Earlier in this paper, I suggested that there were two mechanisms by which therapy could alter the extended network: push therapies and pull therapies. For each of these therapies to work, there must be some way of altering the activation rules of the extended network – i.e., the rules governing causal connections between the nodes of the network. Entanglement theory suggests that this alteration can be achieved in two ways, one way involving processes consistent with classical physics, direct subtle therapy and the other involving entanglement between people, indirect subtle therapy.
Changing the network using classical physics: direct subtle therapy The network self-organizes through a combination of supervisory genes and inputs to the network, in the same way that a builder uses an architectural drawing and available building materials. Changes to the inputs to the network will therefore be one way in which the network can be induced to self-organize. Inputs to the network are affected by lifestyle, and lifestyle modifications include exercise, diet, and psychological factors. Many CAM therapies involve advice about exercise and diet (including nutritional supplements) and all involve psychological factors associated with the placebo response defined in its broadest sense (i.e., expectancy, conditioning, empowerment, social support) (Hyland, in press b). There is considerable evidence
18 showing that these psychological mechanisms have both short term and long term health benefits, and the health benefits of exercise and diet are also well established. Thus, CAM therapies would be expected to be effective for lifestyle and psychological reasons, and this type of therapy is likely to be a pull therapy.
There is a second possible mechanism by which the network can be influenced directly. Hox genes, which in vertebrates comprise four distinct Hox gene clusters (HOX A, B, C, D) provide patterning information that governs structure and function in the body. These genes can specify information across several locations in the body, and one way of thinking of this information is as a kind of meridian running through the body. For example, the differentiation of gonads, fingers and toes is influenced by HOXA and HOXD genes, and it has been suggested that finger and toe ratios correlate with sexual morphology and function as well as diseases that have a sex linked basis (e.g., breast cancer) (Manning, Callow & Bundred, 2003).
As Hox genes specify patterns across the body, then if the macro-pattern provides entangled information to the gene, stimulation of one part of the pattern should influence the whole pattern. Thus acupuncture may work because needles stimulate points associated with a Hox gene pattern, and which then has an effect on the whole pattern associated with that Hox gene, including the regulation of processes leading to specific diseases. Similarly, manual therapies may work by manipulating parts of a pattern that then influences the whole of that pattern associated with a Hox gene or other pattern specifying gene. The meridians running through the body suggested by traditional medicine may be genetic meridians based on pattern specifying genes, such as Hox genes. These meridians will not appear as physical structures in the body, but
19 they are represented by the different maps that make up the body’s blueprint. The type of direct influence into the network may create either pull or push therapies, depending on the way the body’s patterns are stimulated. Changing the network using generalized entanglement: indirect subtle therapy If one person can become entangled with another person or with a physical object (e.g., a remedy, crystal, healing site etc), then the entanglement can provide information directly into the network. Both push and pull therapies are possible through this type of influence. For example, the similarium principle of homeopathy would be consistent with a push based, indirect subtle therapy where the homeopathic remedy or homeopath provides a signal to the patient’s network that it is more disregulated than it really is – either in terms of symptoms (symptom-based prescribing) or in terms of some overall feature of the system (constitutional-based prescribing). Push based therapies are expected where the therapist focuses on the patient’s problems. By contrast, pull therapies are expected where the therapist focuses on the healed state of the patient – that is where the patients want to go in terms of health. Therapies based on healing (healing touch, Reiki, qi gong etc) often involves the therapist focusing on the healed state of the patient. However, it seems plausible that any therapy can have push or pull effect or mixture of the two, depending on the particular form of entanglement.
There appears to be no single technique for transmitting entangled information into a patient’s extended network. It may be that talking to a patient and finding out about the patient will, when coupled with therapeutic intent, be sufficient to achieve entanglement in which case any CAM therapy could achieve entanglement. Equally, entanglement with physical objects may be possible so that a homeopathic remedy has
20 an effect either through over-the-counter use without a homeopath or as prescribed by a homeopath. Walach (in press) suggests that the combination of homeopath and remedy potentiates the process of entanglement, and the same may occur of other therapies where there is some physical element (e.g., crystals, healing sites). However, entanglement may not require verbal communication. Reports from massage therapists suggest a sense of connection consistent with entanglement is sometimes achieved through the act of massage, and similarly, the connection experienced by cranio-sacral therapists and other manual therapists may also be mediated through touch. Healers will report sensations without actually touching the patient but which may involve other ways in which entanglement is achieved, for example through sensing of biomagnetic fields. Finally, prayer may achieve entanglement at a distance without the person being prayed for being aware of it. The hypothesis that communication is fed into the patient’s extended network through entanglement leaves open the question of exactly how that entanglement is achieved, and this an area for further development. However, we need to consider the possibility of multiple mechanisms as well the ‘observational stance’ being important to outcome. From mechanism to empirical predictions in CAM: some basic problems and three theoretical stances The possibility that a particular CAM therapy involves more than one mechanism creates fundamental, but not insurmountable problems for evaluating therapies. Let me illustrate the problem with massage therapy. Massage therapy could have a therapeutic effect because of (a) the robust therapy (Figure 2) that results from parts of the body being manipulated, (b) direct subtle therapy which is created by the psychological effects of massage on the person (e.g., feeling safe), as well as possible
21 direct subtle therapy from the act of manipulation on patterns associated with Hox genes and (c) indirect subtle therapy resulting from entanglement between therapist and patient. It is not possible to independently manipulate these mechanisms in an experiment without destroying the characteristics of massage therapy, and so it becomes difficult though not impossible to establish why massage therapy is effective. This logical impossibility of achieving experimental control means that simple randomized controlled trials are not the best way of providing empirical information about many CAM therapies (Hyland, in press a). Figures 2 and 3 about here please
Entanglement Theory suggests that several processes occur in CAM (Figure 3). To evaluate the theory, the predictions of a theory need to be considered in relation to other alternatives, not in a vacuum. It seems that there are three possible theoretical stances. First, that CAM therapies work only because of psychological or lifestyle changes brought about in the therapeutic process. These changes will include direct subtle therapy and therefore have long-term healing effects. Second, CAM therapies work, in addition to psychological mechanisms, through some form of energy transfer, probably weak electromagnetic energy transfer, between therapist and patient (Popp 2002; Smith 1994), that is, using one of the physical forces, the electromagnetic force and its associated particle the photon. This particular view, which can involve the idea of ‘entrainment’ of vibrational patterns between therapist and patient has been particularly influential in CAM and is sometimes labeled energy medicine (Oschman, 2000) or the biofield hypothesis (Rubik 2002). There is empirical support for the idea that electromagnetic radiation has a regulatory effect on organisms (Popp, 2002), and that, for example, the act of healing involves changes in photon production
22 in nearby living objects (Van Wijk & Van Wijk, 2003) or in terms of magnetic changes from healers’ hands (Seto et al, 1992). Of course, some energy medicine practitioners would not perceive themselves as providers of electromagnetic radiation, but that explanation is currently influential. Certainly, electromagnetic radiation could act as subtle therapy, although the theoretical link with complexity theory is not currently well developed. The third theoretical stance is that healing is achieved through a process of entanglement – i.e., Entanglement Theory. In this third case, observations involving electromagnetic radiation reflect three possibilities: either that electromagnetic signaling is a mechanism for achieving entanglement or that electromagnetic phenomena associated with healing are epiphenomena – that is, they are the consequence not the cause of entanglement , or that electromagnetism is a another communication system within the body that acts in parallel with entanglement. In the final section of this paper I consider various empirical predictions of Entanglement Theory, contrasting these predictions with those likely from a psychological perspective and those from the perspective of electromagnetic signaling but where entanglement is excluded.
Broadly speaking, these three theoretical stances can be viewed as incremental assumptions – all assume that psychological processes occur, the electromagnetic hypothesis that electromagnetic processes occur, and the entanglement hypothesis that entanglement occurs with or without electromagnetic processes. Thus, electromagnetic effects are consistent with Entanglement Theory (genes evolve to exploit any physical laws – including, perhaps, the use of signaling within the body by photons), but there is a specific prediction that healing is achieved through entanglement.
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There is an important philosophical difference between entanglement and electromagnetic theories of healing. The latter theories preserve the classical view of correspondence between physical theory and physical reality (Nadeau & Kafatos, 1999, chapter 2). That is, one can visualize what is happening in electromagnetic healing (e.g., electromagnetic waves are emanating from the hands of a healer) and this visualization is the physical reality of what happens in healing. Generalized entanglement is a quantum-related concept and therefore denies the classical view: There is a lack of correspondence between physical theory and reality. Not only is it difficult to visualize entanglement but these visualizations are not what is actually happening. We cannot visualize quantum events but only understand them indirectly through complementary descriptions. Interestingly, the quantum denial of the Aristotelian logic that an object cannot both exist and not exist is consistent with traditional Chinese philosophy which itself forms the basis for Traditional Chinese Medicine (Maciocia, 1989). In sum, the predictions of Entanglement Theory need to be considered in relation to the three theoretical stances listed above.
Empirical predictions and investigations The remaining sections provides some empirical predictions of the theory as well as investigations that could throw more light on the underlying processes. The hyperfast communication prediction Quantum entanglement is an instantaneous phenomenon, and generalized quantum entanglement should also be instantaneous. If we focus on generalized quantum entanglement within a single body, this leads to the prediction that there is a hyper-
24 fast or instantaneous communication system within the body whereby macro-level patterns communicate with pattern specifying genes, such as Hox genes. Entanglement Theory makes quite precise predictions about this communication system, because the systems are assumed to be linked to specific genes. If acupuncture meridians reflect, for example, individual Hox genes or gene clusters, then stimulation of one point of the meridian should lead to an instantaneous response at all other parts of the meridian. That is, the whole of the pattern specified by the Hox gene – or meridian – should ‘know’ if any part of that pattern is stimulated. There are methodological problems in setting up this test but there are some preliminary results indicating the existence of a hyperfast communication system with the predicted specificity of response to acupuncture meridians.
Research by Joie Jones (Jones, 2003; Jones et al., 2002) indicates that ultrasound stimulation of an acupoint in the foot leads to a specific response in the brain several orders of magnitude faster than predicted and observed from nerve conduction. Moreover, this hyperfast response is observed at other points on the meridian between foot and brain, but only on those sites specific to an acupuncture meridian.
Psychological theories make no predictions about a hyperfast communication system, but the prediction of various fast (i.e., speed of light but necessarily instantaneous) responses is predicted from electromagnetic theories of healing. Electromagnetic signals are, in terms of current measurement within the body, hyperfast, and the proposal that the body is a crystaline structure (Oschman, 2000), would also suggest hyperfast communication. However, Entanglement Theory makes a different kind of
25 prediction. In electromagnetic theory, information is encoded in a vibrational signal that is then transmitted throughout the body, and the relevant part of the body acts as a receiver for that information. Thus, there is no prediction of specificity of response as is the case with Network Entanglement Theory. The prediction and hence test of the latter is that there are several independent hyperfast communication systems within the body, and stimulation of one pattern only affects points on that one pattern. The prediction and test of specificity is the key distinction between these two different mechanisms.
The non-local prediction and the non-specific healing prediction Quantum entanglement is a non-local effect and so distance should not be a factor in healing once entanglement has been achieved. Thus, Entanglement Theory predicts distant healing, but only after entanglement has occurred.
The psychological
theories suggest that distance is irrelevant as long as patients have the correct psychological state, and electromagnetic theories suggest that that local connection is needed. Distant healing is therefore predicted by Entanglement theory but not by electromagnetic theory.
From an empirical perspective, there are two main forms of distant healing. First, there is healing or prayer where the recipient has had prior contact with the therapist and knows that he or she is being healed at distance or prayed for, and in this case the effect could be mediated either through the indirect subtle therapy of entanglement or the direct subtle therapy mediated by psychological factors, or both. Second, there is healing or prayer where the recipient does not know that therapeutic intervention takes place, and the therapist and recipients are strangers to each other. In this latter
26 case there is no possibility of a psychologically mediated effect, but at the same time it is possible that the likelihood of entanglement is reduced. If entanglement is achieved by an ‘observational stance’ then the observational stance of the therapist may create entanglement even under the minimal situation of distant healing between strangers, but one would expect entanglement to become more likely if contextual factors increase the connection between people. Thus, positive findings of distant healing of strangers would be a defining test of extended network, but, according to the theory, the effect may be weak (Astin, Harkness & Ernst, 2000; Jonas & Crawford, 2003).
Another similarity between direct (e.g., psychological) and indirect (entanglement) subtle therapies is found in the prediction that healing results not only in an alleviation of symptoms but also in other measures of well-being, including mood and selfactualization. Any healing process that creates self-organizational change should lead to a person becoming more consistent with ‘the person you are supposed to be’ as expressed in genetic patterns, and therefore will have a general rather than a specific effect, a prediction which contrasts with that of robust therapy. In the case of robust therapy indirect effects may occur as a consequence of symptom relief but not as part of the same therapeutic process. This implication is that the outcome measures used in studies evaluating the effects of subtle therapy, whether direct or indirect, should include general measures of well-being, such as, for example, sense of coherence and other measures of psychological well-being (e.g., Antonovsky, 1993; Dupuy, 1984).
27 Time duration predictions Self-organizational change is predicted to be slow – and so subtle therapy may have slow effects. A rapid improvement in symptoms of a patient (i.e., within 24 hours) may not necessarily be due to be due to self-organizational change. Psychological factors can operate in one of two ways (Note: there are several psychological mechanisms associated with the placebo effect, Hyland in press b). First, psychological state is a reflection of the state of the network. For example, the expectancy of pain relief is associated with endorphin production and rapid symptom relief, but such expectancy does not necessarily create long term healing. Second, other psychological states (e.g., the feeling of being loved or in control) appear to create self-organizational change leading to long term healing. Thus, psychological factors can either act as robust therapy creating rapid but unsustained change or subtle therapy creating slower but longer lasting change. The difference between these two effects is not well researched. A general conclusion is that research on subtle therapy should be long term – at least 6 months – as it may take that length of time to achieve therapeutic benefit. This methodological requirement contrasts with clinical trials in conventional medicine that are normally of no more than 2 months duration, by which time robust effects should be well expressed. Although some effects of subtle therapy may be equally rapid, the possibility of longer effects cannot be ignored.
Predictions of aggravations Aggravation refers to the emergence of specific symptoms after treatment – in contrast to general tiredness which may simply indicate that the system is selforganizing. Aggravations are an unpredictable feature of most CAM therapies. There are two topics for empirical investigation. First, why do aggravations occur on
28 some occasions and not others? Second what is the temporal pattern of an aggravation (i.e., when it occurs and for how long) should it occur?
First consider why aggravations occur. Push therapies predict a worsening of symptoms before recovery. Pull therapies predict a gradual improvement without an initial aggravation. Thus, a simple answer is that aggravations reflect the existence of a push therapy. However, this answer is not satisfactory as it leaves open why, on some occasions a therapy is push therapy and sometimes it is not. There are two (not mutually exclusive) possibilities. The first is that the tendency to have a push therapy is something which is determined by the nature of the therapist. That is, some therapists are more inclined to entangle with a patients in way that focuses on the health problem, whereas others focus more on the state of health desired by the patient. If this hypothesis were true, then there should be stable individual differences in the tendency to create aggravations between therapists. The second possibility is that whether a push or pull therapy occurs depends on the current state of the patient, and that for healing to occur, some patients need the destabilization created by a push therapy to move away from the pathological local attractor of their extended network. If that were the case, then the tendency to have an aggravation should be determined by patient characteristics.
These two hypotheses could be investigated. If each patient from a group of patients was treated in sequence by each of a group of therapists (e.g., healers), then it would be possible to test whether aggravations are associated with the therapists, or whether, for example, they occur at the initial stage of treatment or reflect some other aspect of patients.
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The second topic of investigation is the temporal pattern of an aggravation. An aggravation can be likened to a pendulum that is pushed away from the mid-position and, when released, travels past its original position. In fact one expects this process to create an oscillation because the over-response will also tend to be attracted back to the local attractor – just like a pendulum swings both ways once it is disturbed. Note that aggravations are a specific prediction of push therapies but not pull therapies.
Although CAM therapists recognize the existence of an aggravation, the prediction of a ‘double dip’ such that there is a second (or third) aggravation at a phase point defined by the first aggravation is a specific prediction from this theory. A second aggravation has been observed in one study (Lewith et al, 2002) where patients were given a homeopathic remedy by a non-homeopath GP. What is interesting about this study is that there was no evidence that verum improved health status – the aggravations were negative in relation to the placebo response. It may be that push therapies need to be combined with a pull therapy to stabilize the network in its new healthy position. Otherwise the system just oscillates. This study, where there appears to be entanglement involving the remedy but no entanglement involving a therapist, illustrates the difficulty of trying to achieve experimental control without destroying the therapeutic process. Over-the-counter (OTC) use of homeopathic remedies provides an instance where there is no entanglement with a therapist, and so this type of therapy provides a useful model for research. The difference between OTC and prescribed homeopathy allows one to compare the effect of a remedy with or without the psychological and entanglement effects created by a therapist. If remedies are self-selected on the basis of symptomatology, then Entanglement Theory
