The Soul of a Hidradenitis Suppurativa Patient: A Philosophical Exploration.

My name is Jaap, and I am a biomedical scientist that also used to live with severe Hidradenitis Suppurativa, the kind that takes over your life. Today, I am completely asymptomatic because I learned how to heal Hidradenitis Suppurativa from within. More importantly, I’ve had the privilege of helping many other individuals with HS get their lives back too.

Introduction: The Lived Experience as a Philosophical Problem

The Onset of Alienation

The onset of a chronic illness like hidradenitis suppurativa (HS) is not merely a medical event; it is a profound philosophical crisis. For the individual, it begins as a painful, unpredictable, and isolating mystery. The body, once a transparent and reliable vehicle for navigating the world, transforms into a source of “unending discomfort and frustration“. HS has severe impact on mental health and increases the chances to develop anxiety, depression and suicidal thoughts. The lived reality of HS is one of deep-seated nodules, abscesses, and draining tunnels that create a crushing impact on mental health and trap the sufferer in a seemingly endless cycle of medications and surgeries.

This experience aligns with phenomenological explorations of chronic pain, which describe it as a state of profound alienation. The body ceases to be an integrated part of the self and becomes an external object of constant, painful awareness. It is a hostile entity that must be monitored, managed, and endured. This creates what philosophers of pain describe as an unhomelike existence, where the sufferer feels alienated not only from their own body but from the world itself. This process forces upon the individual the ultimate mind-body problem, establishing a painful duality between the conscious self, the soul (the observer), and the ailing body(the observed). It is within this alienation of your core self (body and mind) that the most fundamental questions about the nature of reality, consciousness, and the self begin to surface.

Hidradenitis Suppurativa – a Crisis of Epistemology

The philosophical crisis of HS is compounded by an epistemological one (=a crisis of knowledge). The journey to a correct diagnosis is notoriously long, with an average delay of a “staggering 10 years”.  During this period, patients are frequently dismissed or misdiagnosed, their suffering invalidated by a system that fails to recognize their condition. This delay is not simply a failure of medical procedure but a failure rooted in a philosophical bias.

This epistemological void extends beyond the initial diagnosis. Even after a name is given to the suffering, patients often find that the knowledge offered by the medical establishment is itself incomplete and inadequate. Official guidelines and clinical advice tend to focus heavily on pharmaceutical and surgical interventions, while remaining “notably sparse” on the foundational role of diet and lifestyle in managing a disease deeply rooted in systemic inflammation. This creates a frustrating gap where patients are left to navigate the crucial aspects of their own healing journey alone, often receiving incomplete or even damaging information that sets them “on the wrong foot for years. The crisis of knowledge, therefore, is twofold: a struggle to have one’s personal experience validated as a diagnosis, and a subsequent struggle to access a complete and holistic body of knowledge that addresses the root causes of the illness, not just its downstream symptoms.

This diagnostic battle highlights a profound epistemological divide. On one side, the patient possesses a direct and REAL, observed and experienced knowledge of their suffering, a reality that is immediate and certain to them. On the other, the conventional medical paradigm operates from a third-person standpoint, prioritizing externally verifiable signs over subjective reports. Phenomenology (philosophical movement from 1900) illuminates this gap: pain is inherently invisible to others, and when it cannot be measured, it risks being dismissed. The patient’s struggle, therefore, becomes a fight to have their subjective truth validated as objective medical fact. This conflict exposes the limitations of a purely physicalist approach in medicine, which grants authority to external data while often failing to adequately account for the patient’s internal, lived experience which a true reality.

Section 1: The Mind-Body Connection: A New Frontier in Understanding HS

The struggle to understand a chronic illness like HS forces a confrontation with the nature of the mind-body relationship. Modern medicine operates on a clear model of the body as a biological system, but an emerging scientific field is revealing the profound and measurable ways our mental and emotional states influence the physical reality of disease.

The Conventional View: The Body as a Biological Machine

The conventional medical model is a clear application of Physicalism, the philosophical thesis that everything is physical, or that reality is fundamentally composed of matter and energy. Within this paradigm, consciousness and subjective experience are seen as emergent properties of complex physical systems, namely the brain.

This worldview dictates the entire approach to treating HS. The disease is conceptualized as a mechanical and chemical malfunction of a biological machine. The process begins with a physical event: the occlusion of a hair follicle. This triggers a cascade of other physical processes: an overactive immune response, the proliferation of bacteria, and the release of inflammatory molecules called cytokines. Consequently, the treatments are physical interventions designed to correct the machine’s errors. Antibiotics are administered to eliminate bacteria, powerful biologic drugs are used to block specific cytokine pathways, and surgery is employed to physically excise damaged tissue. The patient’s mental and emotional suffering, the depression, anxiety, and shame, is categorized as a comorbidity, and is often not screened for.

The Inadequacy of Current Physicalist Interventions

A critical look reveals that these physicalist interventions (the drugs and surgery) are often not even correctly addressing the disease’s physical mechanism. The modern treatment plan is primarily focused on suppressing symptoms (inflammation, infection, and lesions) rather than targeting the root cause, which requires a holistic view of the human body and a deeper understanding of nutrition, stress, natural therapies and anti-inflammatory practices. Fields of scientific study not recognized nor actively adopted by modern medicine.

From a purely biological standpoint, the ultimate physical cause of HS is systemic inflammation and imbalance in the whole human body. Current treatments (antibiotics, localized surgery, biologics that block a single inflammation pathway) fail to consistently resolve this cellular-level defect that when addressed could fully halt the inflammatory cascade. They manage the visible manifestations (symptoms) but do not address the fundamental dysfunction.

The Emerging Science of the Mind-Body Connection: Psychoneuroimmunology

Besides the before mentioned use of nutrition, stress, natural therapies and anti-inflammatory practices to treat hidradenitis suppurativa naturally. An even more nuanced and integrated understanding of illness is emerging from the scientific field of Psychoneuroimmunology (PNI). PNI is the study of the intricate, bidirectional communication between our psychological processes (the psycho), the nervous system (neuro), and the immune system (“immunology”). This field provides a scientific framework for the mind-body connection, demonstrating how our thoughts, emotions, and stress levels can directly influence the inflammatory processes at the heart of diseases like hidradenitis suppurativa.

The mechanism for this connection is well-documented. When we experience psychological stress, our brain activates two major pathways: the Hypothalamic-Pituitary-Adrenal (HPA) axis and the sympathetic nervous system. This activation leads to the release of a surge of pro-inflammatory cytokines, the very same molecular messengers that drive HS.¹⁸ The skin is uniquely sensitive to these signals, possessing its own local HPA axis that allows it to respond directly to stressors. Chronic stress (which we often see in hidradenitis suppurativa patients) leads to a dysregulation of this system, which can trigger or worsen immune-mediated skin diseases like psoriasis and atopic dermatitis.

This doesn’t mean the mind causes the disease in a metaphysical sense, but rather that our psychological state is a powerful biological factor that can either fuel or calm the inflammatory fire.

The Vicious Cycle: When the Body’s State Shapes the Mind

This causal pathway is not a one-way street. The physical reality of HS creates a powerful feedback loop that reinforces the disease process. The chronic pain, unpredictable flares, and social stigma of HS are themselves significant sources of psychological stress. This stress, in turn, activates the PNI pathways that drive more inflammation, creating a vicious cycle: the disease causes stress, and the stress exacerbates the disease.

This is starkly illustrated in conditions like autoimmune encephalitis, where a physical immune attack on the brain can directly cause severe psychiatric symptoms, including psychosis and personality changes. In HS, the systemic inflammation contributes to brain fog, fatigue, and depression, which are central to the patient’s subjective reality and which further tax an already overloaded system. Breaking this cycle requires an approach that addresses both the physical inflammation and the psychological stress that fuels it.

Feature	The Conventional Medical Paradigm	HS Armor (AIA) Community Paradigm
Nature of Reality	Physicalism. Fundamentally physical matter and energy.	Analytical idealism. A complex, interconnected system where mind (soul) and body are in constant communication.
Nature of the Body	A complex biological machine.	An integrated system where psychological states directly influence physical health via the nervous, endocrine, and immune systems.
Nature of Disease (HS)	Chronic progressive. Meaning there for always and will only get worse. A mechanical/chemical malfunction; a system failure.	Chronic but preventable and mainly environmentally induced. An systemic inflammatory condition significantly influenced and exacerbated by psychological stress.
Locus of Causality	Upstream physical factors (genes, hormones, bacteria).	A bidirectional relationship between physical triggers and psychological factors (stress) that modulate the immune response.
Role of Consciousness	An emergent property of the brain; a secondary effect of the physical disease (e.g., psychological toll).	A key modulator of the disease process; stress, thoughts, and emotions are biological inputs that can alter immune function.
Primary Treatment Goal	Suppress inflammatory symptoms and manage physical manifestations through pharmaceutical and surgical interventions.	At the HS Armor community, we are fully committed on addressing the physical ROOT CAUSE of hidradenitis suppurativa, while also teaching about scientific natural therapies and practices to calm stress and the mind)
Patient’s Role	A passive recipient of treatment; the owner of the broken machine.	Free will. An active participant whose mental and emotional self-regulation is a crucial component of the healing process.

Section 2: The Observer and the Observed: Consciousness in the Face of Hidradenitis Suppurativa Suffering

Moving from the physical nature of the body to the metaphysical experiential reality of the patient, the focus shifts to how consciousness relates to its own suffering. The alienation inherent in chronic illness creates a distinct split between the self that experiences and the body that suffers.

The Alienated Self: When the Body is the ‘Observed’

The lived experience of HS forces the sufferer into the position of an alienated observer of their own body. The conscious self, the “I,” becomes detached from “the body,” which is now perceived as the source of pain, shame, and defilement, the observed object.

In the conventional medical world, you are an object to be observed. You are a body, a complex biological machine that can be measured, analyzed, and described with data. This is the “Observed” self. It’s the world of symbols and data: Your condition is defined by the diameter of a nodule, the presence of sinus tracts, or the level of C-reactive protein in your blood. It’s the realm of classical physics: Your body is treated as a predictable system of cause and effect. A specific cytokine (the cause) leads to inflammation (the effect). Therefore, a drug is designed to block that cytokine. This perspective is incredibly useful. It gives us powerful tools to manage the physical devastation of HS.

The “Observed” state tells us nothing about what it’s actually like to be you. It’s a description from the outside, a materialistic perspective that misses the most important part of the story, your real experiences an soul.

The Creative Observer: Insights from Federico Faggin

This painful duality can be re-examined through the lens of physicist and philosopher Federico Faggin’s theory of consciousness. This brings us to the second, and Faggin argues for a more fundamental, state of being: the Observer. You are a subject: This is your direct, first-person experience of existence. It is not an object to be measured; it is the one who is doing the experiencing. Knowledge is direct and felt: You know the pain of an HS flare not because a chart tells you so, but through the direct, undeniable, and private feeling and experience of that pain. This is the realm of your sensations, emotions, thoughts, and self-awareness, it is your consciousness your “soul“.

A neuroscientist can scan your brain while you feel frustrated about a flare-up. They can see the “Observed” correlates of that feeling, the blood flow, the electrical signals. But they can never, ever experience your frustration. That belongs to you, the Observer, alone. This is the reality of HS that gets lost in the clinic. The shame that makes you avoid social events. The anxiety of wondering when the next flare will hit. The exhaustion from chronic pain. This inner reality, your “Observer” state, is not a byproduct of your physical condition. According to this philosophy, it is the very center of your reality.

Faggin posits that consciousness is not a byproduct of the brain but is fundamental and primary to reality. In his view, the physical body is a vehicle or tool that consciousness uses to experience and know itself. Crucially, Faggin argues that the act of observation is not passive perception but an active act of creation. Drawing from interpretations of quantum mechanics, he suggests that consciousness “participates in shaping what is actualized” from a field of potentialities. Observation is not merely an act of measurement but an act of creation, where the meaning, attention, and intention of the observer play a causal role.

This perspective fundamentally reframes the role of the patient. The consciousness observing the pain is not merely a passive victim. The way it observes becomes an active force in its own reality. This provides a deep, metaphysical justification for the holistic healing strategies advocated for HS patients. Practices such as dietary changes, stress management, and finding support in a community are not just physical inputs; they are profound acts of consciousness. Following Faggin’s logic, these practices represent the “symbolic choice, attention, and meaning” through which consciousness creates its reality. Choosing an anti-inflammatory diet is a symbolic choice to nourish rather than harm. Practicing meditation is an act of directed attention away from pain and toward peace. Finding hope and solidarity in a community is an act of creating new meaning. Therefore, the holistic healing journey can be interpreted as a conscious practice of observing the self into a new state of being. The patient actively uses their consciousness to shape a different experiential reality, a healthier physical body.

Healing as Reintegration: Becoming Both Observer and Observed

The radical claim here is that modern medicine, for all its power, has focused almost exclusively on treating the “Observed” self. It tries to fix the biological machine. (But they do not understand the human body on deep level and can only treat symptoms not root causes). Moreover it often neglects the “Observer“, the conscious agent at the center of the experience. This leads to the disease not being diagnosed in time and a total lack of focus on a core part of this healing journey: actively managing the stress, anxiety, and emotional toll of the disease through robust, science-backed techniques, as the “Observer” is deeply affected by stress, which is a massive trigger for inflammation in the “Observed” body.

The journey also requires a shift from being a passive object of medical treatment to the active, conscious Observer of one’s own experience. It’s about meticulously identifying personal inflammatory triggers through diet and lifestyle, listening to the direct knowledge the body provides. A foundational, anti-inflammatory lifestyle isn’t just about giving the “Observed” body the right nutrients; it’s about creating a calm, resilient internal environment for the “Observer.” When this is done, one is not just managing symptoms, but fundamentally changing the conditions that allow the disease to exist.

The ultimate goal of this healing process is the dissolution of the painful duality between self and body. Faggin describes a personal transformative experience where he realized, “suddenly I was both the observer and the observed. This state of unity, of non-dual awareness, represents the endpoint of healing. It is the process of reclaiming the body from its status as an alien “other” and reintegrating it into the unified field of the self. The state of remission, where a patient becomes “completely asymptomatic,” is not just the absence of physical symptoms; it is the restoration of this unified state of being (the soul), where the body is once again a transparent, trusted, and integrated aspect of the whole person.

Section 3: The Path of Illness: Determined Fate or Chosen Future?

The philosophical frameworks of physicalism and analytical idealism have profound implications for patient agency and the perceived trajectory of an illness. They inform the narrative of the disease, casting it as either an unavoidable fate or a future open to change.

The Deterministic Narrative of Chronic Disease: A Script Written in Genes and Biology

The conventional medical understanding of HS aligns closely with a deterministic worldview.

“Determinism is the thesis that all events, including the course of a disease, are causally inevitable based on a set of prior conditions.”

The medical narrative often frames HS as a chronic, progressive disease, implying an unavoidable trajectory. Given the initial conditions, a person’s genetic predispositions, hormonal profile, and environmental exposures, the progression through worsening Hurley stages can feel like a fixed and unalterable script. Grim statistics, such as those suggesting that HS patients are dying 15 years younger, reinforce this sense of a predetermined, tragic outcome. This deterministic narrative can foster feelings of helplessness and fatalism, positioning the patient as a passive character in a biological story whose bleak ending has already been written. And sadly this even leads to self-destruction in many cases.

Indeterminism and the Agency of the Patient: Rewriting the Script

In stark contrast, a patient-empowered, holistic approach is a powerful assertion of indeterminism.

Indeterminism is the view that at least some events are not strictly determined by past causes, and that multiple futures are possible from the same starting point.”

The core message that the “progression isn’t inevitable” and that the disease is “fully controllable” is a direct challenge to the deterministic narrative of HS.

This shift in perspective is bridged by the concept of free will. The philosophical frameworks of Idealism and the Observer both grant consciousness a primary, causal role in shaping reality, a role that Faggin explicitly links to free will. The practical, actionable advice central to a holistic recovery, altering one’s diet, committing to stress management techniques, are all expressions of the patient’s conscious, free choices. These choices are not predetermined by biology; they are new causal inputs into the system. Therefore, the patient’s exercise of free will becomes the very mechanism by which the creative power of their consciousness can intervene in the physical world. It is the causal lever that allows one to shift from a seemingly determined biological trajectory to an undetermined, chosen one. In this light, patient empowerment is not merely a psychological boost; it is the exercise of a fundamental metaphysical capacity to alter the future and become totally asymptomatic while having hidradenitis suppurativa.

Conclusion: From Alienated Object to Sovereign Author

The journey through hidradenitis suppurativa begins as a profound philosophical rupture, a crisis of being and knowing that splits the self from the body and subject the patient’s lived reality against a medical system that often fails to see it. This initial alienation, born from pain and diagnostic invalidation, FORCES the sufferer into the role of a helpless observer of their own disintegrating “Observed” self, a biological machine seemingly locked into a deterministic path of decline. Yet, where this physicalist modern medicine view is materialistically incorrect and misses the mark in the area it is supposed to excel. Namely, a wealth of SCIENTIFIC DATA and REAL real-word experiences support the idea that there is natural road (diet, lifestyle, therapies) that leads from severe hidradenitis suppurativa to a totally asymptomatic state. This is my personal journey and the people I’m connected with and guided personally to achieve full remission too.

The limitations of a purely physicalist approach, which treats the body as an object and its owner’s consciousness as a secondary comorbidity, compel a deeper inquiry. The science of Psychoneuroimmunology (PNI) provides the crucial bridge, revealing the undeniable, measurable pathways through which our mind, our “Observer” self, directly influences the inflammatory fire in our “Observed” body. This is not metaphysics; it is biology. This understanding transforms the patient’s role from a passive recipient of treatment to an active participant in their own wellness. The consciousness that was once alienated from the body is revealed to be the most powerful tool for its healing.

Ultimately, the philosophical exploration of HS culminates in a radical act of empowerment. By embracing the role of the Creative Observer, the patient leverages their free will to make conscious choices, through diet, stress management, and community, and more, that altogether rewrite their biological script. This is the ultimate rejection of a determined fate. The healing journey is no longer about just managing symptoms in a broken machine; it is about the reintegration of the observer and the observed (soul and body), by empowering yourself and actively exploring your personal healing journey and learning to listen to your body and find a balance trough adjusted lifestyle and your own free will interventions. your to long lasting remission. The soul of the patient, far from being a casualty of chronic disease, becomes the sovereign author of its own story, transforming a written fate of suffering into a world of endless opportunity for growth.

Important Medical Disclaimer

1. Not Medical Advice: All content and information on this website is for informational and educational purposes only. It does not constitute medical advice and is not a substitute for professional diagnosis, treatment, or consultation with a qualified healthcare provider.

2. My Role and Qualifications: I am a biomedical scientist and PhD candidate and share information from that perspective, combined with my personal experience as a patient with Hidradenitis Suppurativa. However, I am not a medical doctor, physician, or registered healthcare professional. Do not consider our relationship a doctor-patient relationship.

3. Consult Your Doctor: Always seek the advice of your medical doctor or another qualified health professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If you suspect you are experiencing a medical emergency, or a severe infection, do not rely on this website or the HS Armor community, please call your local emergency services or go to the nearest emergency room immediately.

4. A Critical Warning on Medication: Pharmaceutical drugs are a crucial tool in managing Hidradenitis Suppurativa for many people. Under absolutely no circumstances should you ever alter, reduce, or stop taking your prescribed medication without the explicit direction of the doctor who prescribed it. Doing so can be dangerous. Always consult with your doctor before doing anything related to your treatment plan.

5. No Liability: Your use of this website and reliance on any information provided is solely at your own risk.

6. Individual Results May Vary: Every patient’s biological baseline, genetics, and adherence to the protocol is different. Therefore, I cannot guarantee specific results, cures, or timelines for your Hidradenitis Suppurativa.

7. Scientific and Expressive Freedom: The articles published on this blog are distinct from formal peer-reviewed academic literature. They serve as an independent platform for my personal viewpoints, scientific hypotheses, and philosophical reflections as an independent scientist and HS patient. While grounded in biomedical research, I exercise a degree of expressive freedom to translate rigid academic data into insights from a patient perspective. These writings are my personal meditations on the science of HS and should be read as my individual perspective, not as universally accepted clinical consensus or formal peer-reviewed literature.