Sep 20, 2026 · @Lori Hogenkamp
Why I no longer state my purpose as a paradigm shift
The word I stopped using
For years I described what I was building (sometimes what we were building) as a paradigm shift, and others described it that way too. The phrase is everywhere. Sequencing the human genome was going to transform medicine. The microbiome was going to rewrite our understanding of disease. Epigenetics was hailed as Lamarck’s revenge, and the call for an extended evolutionary synthesis was cast as a rebuilding of evolutionary theory. Anthropology rarely announces a new fossil without a headline saying it rewrites the story of human origins. Closer to home, the neurodiversity paradigm and the anti-pathology movements have been described as overturning centuries of assumptions. Each produced real findings, and some changed practice. Few changed what their fields take for granted in the way the announcement promised.
I have stopped using the phrase, and not out of modesty. Whether this work changes a field’s governing assumptions remains to be established, and announcing a shift claims that outcome in advance. What I can do now is open questions, specify alternatives, and make their consequences testable. That is work, not a verdict, and “opening” is the word for work
Kuhn’s own account is more careful than the slogan made from it. A revolution replaces a paradigm in whole or in part; instruments and much of the vocabulary carry over, put to different uses; most of a community is eventually persuaded, though some never are. Nothing in that requires a losing side, and nothing in it forbids a scientist from proposing a transformation while it is under way. The proposal simply does not settle its significance. That is the difference between undertaking the work and claiming its eventual importance, and it is the only difference I need.
There is a second, smaller reason. The phrase has been worn smooth: every protocol with a landing page claims a paradigm shift, and a framework that wants to be tested rather than sold should not borrow the vocabulary of selling. I even titled a piece “Something Is Shifting,” and something is. What is shifting is the willingness to look.
What an opening asks
Stress science has established many mechanisms — endocrine, immune, autonomic, metabolic — and they are real, well measured, and in many cases treatable. Nor has the organism as a coordinating system ever been absent from science. Allostasis describes regulation through change, including anticipatory adjustment; allostatic load describes the cumulative physiological burden that can accompany repeated or prolonged demands; network physiology studies how interactions among organ systems change across physiological states. What remains uneven is the translation of that understanding into shared measurements, explanations, and clinical decisions. The level was recognized. It was not made consistently usable. My work takes up part of that unfinished task: specifying how regulatory organization, current state, and developmental history shape responses to particular demands, and how those responses are evaluated in terms of cost, protected function, and time horizon.
Existing findings and effective methods remain resources. The variables of population science found things that required empirical investigation, the social gradient in health among them, and they will go on finding them. What becomes open to revision is the assumption that these already provide a sufficient account of the person as a regulating system. Some assumptions may not survive that opening: that any difference between people can be represented as settings on a shared architecture; that a ranking of capacity travels unchanged across kinds of demand; that improvement in a measured outcome establishes improvement for the person. An opening preserves the achievements and changes what counts as an adequate explanation.
By an opening, I mean a widening of the set of admissible questions, explanatory units, and kinds of evidence. Architecture alongside parameters. An ecology of evidence rather than a single hierarchy — with the plain rule that different kinds of evidence answer different questions and each stays accountable to the inference it supports; breadth confers no equal weight. And a different first question: not how much stress a person carries, but what their system is doing, at what cost, relative to which demand. The variable and the framework are different contributions within one investigation, each named at its own level.
An opening needs a gate
There is a danger in the word, and I want to name it before someone else does. “Opening” can be heard as “anything goes,” and the multisystem space — nutrition, metabolism, environment, relationships, the whole territory this level covers — is exactly where claims are easiest to make and hardest to check. If I ask science to widen what it admits, I owe it a gate.
The gate is the part of the work I care most about. Capacity, I have argued, is not a scalar, but the failure of a one-number model rejects a one-number model and nothing more. The architectural hypothesis earns support only when it predicts responses to new challenges better than a strong, prespecified shared-architecture alternative, after accounting for model complexity and measurement uncertainty. If the shared-architecture alternative predicts equally well, that comparison provides no additional support for architectural heterogeneity, and I will say so. This is also where Lakatos’s question applies: whether a research programme generates novel predictions, and whether some of them receive empirical support. Explaining familiar findings is valuable, but it does not by itself establish progress. My programme has to earn its standing through a developing record of discriminating tests — not through one experiment, and not through the elegance of its account of what was already known.
The same discipline applies to intervention. Whatever the modality — a drug, a diet, a change in sleep or light or social demand — the commitments are to specified benefits and harms, regulatory costs, durability, and the outcomes that matter to the person, with the framework’s capacity hypotheses tested alongside those outcomes rather than installed as their arbiter. Agnostic about modality; strict about evidence.
Who the opening is for
I have sometimes written this as a two-sided ask, one to the neurodiversity community and one to science. I belong to both of the communities that argument is staged between, and so do many of the people I hope to work with, so I have stopped writing it as a negotiation. Biological inquiry becomes more trustworthy when autistic people help shape its questions, interpretations, and purposes. Participation does not depend on accepting any particular biological explanation, and recognition does not wait for one. The community’s distrust was earned, and institutions carry the responsibility of demonstrating why renewed trust is warranted. What I can offer is an opening on those terms.
Why the word also describes my job
Over the past year, my emphasis has moved toward making the framework easier to test. My job, as I now understand it, is to specify the level precisely enough to be wrong; to distinguish its predictions from scalar and shared-architecture alternatives; to write explicit, revisable definitions so that mathematicians, clinicians, and autistic people can work on the same object with their own instruments; to say, each time, what the framework does not claim; and to make the definitions, predictions, and revisions available for others to test. Depositing the work makes its development traceable. Independent testing establishes where its claims hold, where they fail, and what they add. Those are different jobs, and I try to keep them distinct.
Galison called the places where scientific communities coordinate while keeping different interpretations trading zones, and they run on working languages nobody fully owns. That is closer to what I am building than any revolution. It does not promise that anyone’s practice stays unchanged. It promises that the work can begin before agreement.
An opening does not promise that every assumption will survive. It creates room to discover which ones should. My responsibility is to make the questions precise, the alternatives comparable, and the work available for correction. Whether that eventually amounts to a paradigm shift is something the work, and the people who test it, will determine.
The Evolutionary Stress Framework and Regulatory Bandwidth are conceptual lenses for research. Nothing here is medical advice.
Selected sources
Galison, P. (1997). Image and logic: A material culture of microphysics. University of Chicago Press.
Hogenkamp, L. (2026). From evidence hierarchies to evidence ecologies (CAS white paper v1.0). Zenodo. https://doi.org/10.5281/zenodo.21907022
Hogenkamp, L. (2026). Medicine kept the mechanisms of stress and lost the system [Preprint]. Zenodo. https://doi.org/10.5281/zenodo.22144364
Hogenkamp, L. (2026). Regulatory bandwidth: A theoretical integration of present multisystem stress-regulatory capacity. Psychoneuroendocrinology, 192, 107955. https://doi.org/10.1016/j.psyneuen.2026.107955
Hogenkamp, L. (2026). Regulatory capacity is not a scalar: Metrics, perturbations, and viability in network physiology. Frontiers in Network Physiology, 6, 1961712. https://doi.org/10.3389/fnetp.2026.1961712
Ivanov, P. Ch. (2021). The new field of Network Physiology: Building the human physiolome. Frontiers in Network Physiology, 1, 711778. https://doi.org/10.3389/fnetp.2021.711778
Kuhn, T. S. (1962). The structure of scientific revolutions. University of Chicago Press.
Lakatos, I. (1978). The methodology of scientific research programmes. Cambridge University Press.
McEwen, B. S., & Stellar, E. (1993). Stress and the individual: Mechanisms leading to disease. Archives of Internal Medicine, 153(18), 2093–2101. https://doi.org/10.1001/archinte.1993.00410180039004
Sterling, P. (2012). Allostasis: A model of predictive regulation. Physiology & Behavior, 106(1), 5–15. https://doi.org/10.1016/j.physbeh.2011.06.004
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