Crisis of consciousness: Christof Koch on abortion, AI and the reality in your head

For the average person, any explanation about philosophers and physicists warring over the nature of consciousness — no matter how colorfully described — would probably sound like an embarrassingly low-stakes Ivory Tower slap fight. Fair enough. After all, we’re in the middle of a mental health epidemic, a national fight to save abortion rights, and an artificial intelligence boom putting people out of work. What’s the use of listening to esoteric academic chatter about quantum physics and human brains? 

Christoff Koch answers exactly that in his forthcoming work “Then I Am Myself the World: What Consciousness Is and How to Expand It.” The famed neuroscientist and author reaches through the abstract realm of academic debates on consciousness by climbing down a richly biographical thread, connecting the high-minded with hard-and-fast reality. Koch’s fresh, politics-facing approach to the question of what human consciousness really is takes the debate out of the classroom and into our lives.  

In an interview with Salon, Koch discussed why the renewed fervor for that debate matters, and how his appealingly intimate book not only untangles the mess but stakes out new ground about how we might expand into new frontiers of consciousness. 

This interview has been lightly edited for length and clarity.

In the history of these debates over the nature of consciousness, the element of the subjective is often either dismissed as a casualty of empiricism, or downplayed as though it’s not as valuable. Yet, at the same time, research in clinical psychology always relies on a test subject’s personal, subjective experience. Why was it important to bring your personal, biographical experience into this work?

Because it's all about experience. It's not about black holes, or biases or brains. You have to go where the data is. And the data in this case is precisely my experience of the world … These feelings, the voice inside my head, the movie inside my skull — how does that come about? The primary data is our own human minds. What happens in conscious experience of the world, and what happens to us under normal everyday consciousness on these extraordinary unconscious experiences?

That's a raw material that we need to explain. That's the challenge that has always been the challenge of the Mind-Body Problem.

From an interdisciplinary approach, there’s a frustrating persistence to this physics-and-philosophy standoff in the conversation about consciousness. Humanities disciplines record humans’ near-universal experiences of expanded consciousness. Is it possible that modern physicists are simply not equipped with the language to cross that interdisciplinary bridge, and discuss concepts about subjective experiences which are observable? 

What you just said makes many philosophers very queasy, because they feel you're opening the back door. A back door full of ghosts and goblins to enter … it took us you know, the last millennia to get rid of ghosts and goblins…which I think is totally nonsense. I mean, if you look at Integrated Information Theory, there's nothing there about spirits. There's nothing there about God. Ultimately, it's all for the power (of material causality). 

But the fact of the matter is, we have conscious experience. We have to explain it. If science fails to explain why I love, how does love die? How does the love for my dog or my child or mum or my spouse — how does it happen then? Science is just inadequate to deal with a central aspect of all of our lives. I think science can do it, but you have to go out of the narrowly-construed.

We are in our laboratories playing God with machine networks and not really having updated scientific language to describe the old ghouls and goblins. We’re also now faced with the same issues in describing the ghost in the machine. Is the intent of the book at all to confront that growing pressure for answers?

Yes, that's also why, as I describe in the book, now things like panpsychism or even good old idealism are coming to the forefront … These faint voices that used to be completely excluded from polite discussion in the 20th Century. No one in their right mind would discuss Dualism, panpsychism, idealism. Philosophy would say, “Well, that's ridiculous. We disproved that hundreds of years ago. Don't take us back.” So it's all materialism that's now sort of renamed physicalism. 

But these old and fainter voices, now come to the forefront because of the continuous challenge to explain inner experiences. And so now we have theories for the first time in our history — scientific theories, not just metaphysical theories, where we can test things well, and can predict certain things. And so that makes some people very nervous.

I hang out with a lot of quantum physicists, and they get excited about it because quantum physics, of course, also has this challenge to define what actually exists.

You talk in the book about the difference between consciousness in, say, a fully developed human brain and that of a fetus. And about your amicus brief to the Supreme Court, disputing certain fetal-consciousness theories. 

When we talk about human consciousness, what seems to be required is a cortex … And that needs to be connected to the thalamus, to the eyes, to the ears, to all the other sensors, as well as to the interior body. And that connection is probably made in the second stage or the second trimester, 20 to 24 weeks. 

That's not to say that a fetus might not be able to reflexively move in response to a painful stimulus … We know from doing experiments in animals that you can have responsiveness without there being meaning, just like when you sleep. Your partner tickles your foot — you might reflexively withdraw the foot without waking up and becoming conscious, right? So just because reflex is there, it means that the organism is alive but it doesn't mean that it's conscious.

We also have to be fair. Ultimately, it's very difficult to know in these liminal cases. When does consciousness first happen? That's a question that's rather difficult to address in a 100% conclusive way.

Let's say you have a massive car accident and have a massive traumatic brain injury. You come to the ER and three days later you're still unresponsive. You might moan or you might move your legs reflexively. But when I ask you “Please tell me, can you move your eyes? Can you move your fingers?” Then, if you can’t say anything, how do I know that you aren't conscious but unable to respond? And it turns out 20% of these patients are what's called “covertly conscious.” Yet, because they've been so grievously injured, they're unable to signal that. 

And again, those are sort of liminal cases where, you know, we can say the best evidence suggests that some of these are actually conscious. But right now we don't have precise enough tools to really be 100% sure of that. So I find that I have to be a little bit humble. 

You actually just described, literally, exactly what happened to my brother. Car crash, injury, unresponsive — all of it. I mean, there’s no way you could have known, of course. But these instances where abortion and end-of-life decisions depend on what counts as consciousness — as much as they may be liminal cases averse to core questions — they’re certainly flashpoints for people.

You mentioned earlier that some people think, “Well, all this philosophy and physics is sort of very ethereal and abstract.” But in cases like your brother’s that's a very concrete question. Is consciousness present? Yes or no? And, as you indicated, it's literally a life and death question.

Across the book’s biographical threads, you also go on to invite the reader to join you in this seemingly scary thing — expanding one’s consciousness, perhaps even through the use of psychedelics. In our current mental health epidemic, many people are looking for answers. And even reality is somewhat up for debate, according to science. Can you offer any thoughts on what makes the current cultural moment right for consciousness exploration? 

Losing yourself a little bit is good, for those of us who are highly anxious, realizing that our conscious experience is constructed by us. This goes back to Immanuel Kant and other philosophers. We don't see the things themselves — we see constructions. You can go back all the way to Plato in the shadows in the back of the caves. We construct a reality and so everything we perceive is a construction based on inputs. But I also learned over my lifetime, as well as what my predecessors learned ... is this construction of reality is subject to my own beliefs and I can affect it for better or worse.

But it's also great news because … it means what I believe, good or bad, about the world and about my role in it can profoundly influence the way I perceive the world. And influence whether I'm anxious or whether I'm content, whether I emphasize the miracle of existence — the fact that there's anything, let alone this beautiful world that's out there — rather than focusing on a particular anxiety.

Embrace the world. That's what expands it: consciousness. And those people tend to be, on average, more content and happier than ever being fearfully enclosed, always worrying about the next thing. And this is what the wisdom literature — of all cultures and times — teaches us. It’s what you focus on and what you're conscious of, and how you approach it. You are the actor in this drama — the only drama that we ever get to experience. You are the director of it, to a certain extent. 

You can't help it if you're born in Ukraine at the time when Russia invaded, right? So there's a lot of happenstance. And it's not a question: if you're at the wrong place at the wrong time, bad things can happen. But then how you respond to these events is partially your choice. How you choose to confront whatever pain and karma you have, and whether you accept and say, “Yes, this happened to me. It's bad, but I'll work through it and life will go on.”

It’s been astonishing to read some of the recent studies about psychedelics enabling access to peak consciousness, and how those states seem to offer a sort of healing malleability in a brain affected by trauma. Where do you see us going as far as the precipice that we're on right now with research into psychedelics and mental health? 

It’s a very complex question. So, I do experiments on scheduled substances like psilocybin, [the active drug in “magic” mushrooms.] And they have seemingly miraculous effects. But so far, with the exception of ketamine, there's not a single well-controlled study where people are totally blind to the intervention. It's very difficult to blind-test [subjects], and to take a trip such that you will not know.

I can blind you to whether you get a COVID vaccine or not, but I can't blind you to “did you get a magic mushroom or not?” The one study that was really well done out of Stanford was for ketamine. These were all depressed patients. [The study] showed that people who were under anesthesia in surgery — and it didn't matter whether or not you got the ketamine — as long as these people knew they were part of a ketamine study, that there was a 50% chance of getting ketamine during anesthesia when they were unconscious, it helped them. So that tells us at least in this case, in this one study, that the patency effect is incredibly powerful. 

That should really caution us to the extent to which any of these, including MDMA, should be approved. In MDMA-assisted psychotherapy, say for PTSD, to what extent is that the MDMA chemical and to what extent is it the belief that people given this drug will improve? 

Right now, everyone's excited, but there could also be serious blowback. And mind you, these practices are very powerful, right? And if you're a 19-year-old kid vulnerable to schizophrenia, it may well trigger you to go into your first big schizophrenia episode in your life, triggered by mushrooms. I had some of the most meaningful experiences in my life — but they're also very powerful, very much so for the wrong people and particularly for young people. We have to use them with a great deal of trepidation. 

Among the most important voices left out of the conversation about the commercialized psychedelic movement are Indigenous peoples’ — and there’s a question about what impact we risk in separating traditional medicine from its traditional environment and administration. A cup of Ayahuasca could be brewed perfectly and shipped directly to my door, but taking it at home with no shaman to guide me could be catastrophic. I'm wondering what your thoughts are on separating indigenous medicines from their indigenous administration?

I totally agree. On the other hand, if we want these substances to be available in the United States of America, or in Germany or in Japan, we have to work within the existing legal framework, the FDA [Food and Drug Administration.] And the FDA will not approve a ceremony involving shamans and chanting and all of that. They will approve a known chemical substance that can be synthesized — but that's just the way our system works. And yes, I totally agree with you, but you're not gonna get the formula unless you're part of an Ayahuasca church.

The candles and the fire and all of that — it's going to be that much more powerful of an effect on you in combination with the molecule. So I think it's always a combination. And it may differ from person to person. Is it more the molecule or more the belief or is it both? In people who've gotten a placebo, some have had full-blown, mystical experiences. It worked just as effectively when they got a sugar pill — but they believed it was magic mushrooms. It's rare. It's not that common, but if you really believe it's a magic mushroom, you can get a full blown mystical experience.

An earlier version of this article originally appeared in Salon's Lab Notes, a weekly newsletter from our Science & Health team.