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Person-centred health care and pain
Published in Stephen Buetow, Rethinking Pain in Person-Centred Health Care, 2020
As a cluster of theories, enactivism accounts for how an experience such as pain is not simply in the body and created by the brain. Pain experience is an emergent state of being of whole persons who couple with, and cannot be separated from, their lived environment. Scaffolding this experience, this environment functions as part of the extended mind, a mind distributed across the brain-body-environment. Figure 4.3 empathetically expresses this relational state of being one with the world that, like a Doric column, scaffolds life, yet too often renders persons and pain invisible. In this dialectical space the stick in hand lends stabilizing support for sense-making that carries forth meaning from pain as a way of being. It actively brings the person into the world in which they are temporally and spatially situated and which they create and creates them.54 These conditions set the ground for persons as continually self-creating systems to enact pain to engage possibilities for growth.55
Philosophy and “placebo” analgesia
Published in Jennifer Corns, The Routledge Handbook of Philosophy of Pain, 2017
Giulio Ongaro draws on enactivism to broaden and deepen the concept of meaning as the working axis of the “placebo effect.” He writes: “Placebo effect,” then, is simply a pharmacocentric misnomer. In enactivist terms, we can better think of it as a response to a milieu that holds meaning for the individual, remembering that anything is meaningful to the extent that it relates to the organism’s norm at the particular condition the individual finds himself in. To be more precise, we can say that the placebo effect is a meaning response with a positive valence, while the nocebo effect is a meaning response with a negative valence.(Ongaro 2013: 13)
In support of physical literacy throughout life
Published in Margaret Whitehead, Physical Literacy across the World, 2019
With reference to monism, it was suggested by Whitehead (2010) that the low esteem in which physical activity is generally held is the result of deeply entrenched beliefs in dualism. On this view of the bipartite nature of human being, the body was always cast as inferior to the mind. While many still accept dualism without question, the academic study of the human condition has moved beyond this debate, with much work now being concerned with the way that monism operates. It seems generally agreed that there is no schism in respect of the human condition, and debate now includes a consideration of the role of human embodiment in life (see explanatory glossary). The notion of monism is, however, complicated by the fact that human embodiment has two forms of presentation, one being the body as an object or instrument, sometimes known as the living body, and the other being the embodiment as lived at a preconceptual level, referred to as the lived body. Monism accepts these two forms of presentation but is principally concerned with the lived body (see explanatory glossary). With reference to the lived body as a significant feature of human nature, new concepts are being developed such as embodied cognition and enactivism. Embodied cognition refers to the essential role that embodiment plays in shaping the mind (Claxton et al., 2010), while Valera et al. (1993) explain that the use of the term enactivism emphasises: the growing conviction that cognition is not the representation of a pre-given world by a pre-given mind but is rather the enactment of a world and a mind on the basis of a history of the variety of actions that a being in the world performs.(p. 9)
Bio-psycho-social interaction: an enactive perspective
Published in International Review of Psychiatry, 2021
A recent paradigm, enactivism, offers a novel outlook on the relation between body, mind and world.2 Developed initially for cognitive science, enactivism stresses that cognition can only be understood by taking the whole embodied organism and its environment into account (Varela et al., 1991). It draws on a wide range of sources, notably biology’s developmental systems theory, phenomenology, and dynamical systems theory. There are several strands and applications of enactive ideas (Di Paolo & Thompson, 2014), but most relevant for the integration problem is enactivism’s so called ‘life-mind-continuity thesis’ (Thompson, 2007; Di Paolo, 2009; Froese & Di Paolo, 2009). It states that mind, or sense-making, is central to living. Living beings are special compared to non-living matter in that they are self-organizing unities: they maintain themselves through a constant exchange with their environment. In order to stay alive, organisms need to take up nutrients and dispose of their waste. Organisms are thus dependent on continuous interactions with their environments. This means that they need to be able to distinguish what is relevant for their survival in their environment: what is food and what is not, what is dangerous and what is safe. Without such an ability to make some basic sense of their environments, living would not be possible. It is in this way that life and mind are continuous: living requires sense-making.