Pain and temporality: a merleau-pontyian approach.

Chronic pain is a common disorder with enormous sociomedical importance. A major part of primary and secondary costs of illness is caused by the various pain syndromes. Nociception - the sensory perception of a painful stimulus - is a complex process relying on an intricate system of anatomical, neurophysiological and biochemical networks. This applies even more so to pain - the state of experiencing a nociceptive event, of interpreting it in terms of meaning for the affected individual and of suffering a range of emotions it elicits. This intricacy renders it obvious, that the empirical medical sciences alone cannot explain all aspects of pain. Hence, it has also become a focus of phenomenological research. One aspect of these investigations is the interaction of pain and the perception of the lived body's spatiality. The focus of this article will build on these concepts to develop a construct of the alteration of temporality caused by chronic pain and the effects this spells out for the affected subject. To this end, I will primarily draw on Merleau-Ponty's ideas of the lived body as well as on theories of enactivism and embodiment. I will also point out parallels to neuroscientific data, thereby demonstrating the proximity of phenomenology and neuroscience. A possible partial solution to the pain dilemma may be derived from psychology: techniques relying on cognitive behavioural intervention, awareness training, and existential analysis may provide alleviation to patients suffering from chronic pain.

Philosophy of psychiatry: theoretical advances and clinical implications.

Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important - psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence-based and values-based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi-level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of "difference-makers", as well as a consideration of "lived experience" in both research and practice. Third, in considering a range of questions about the brain-mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain-mind as embodied, embedded and enactive offers a conceptual approach to the mind-body problem that facilitates the clinical integration of advances in both cognitive-affective neuroscience and phenomenological psychopathology.

Embodied cognition and the imaging of bio-pathologies: the question of experiential primacy in detecting diagnostic phenomena.

This article investigates the origins of the experiences involved in the diagnostics (detection and normative evaluation) of biological entities in image-based medical praxis. Our specific research aim presupposes a vast discussion regarding the origins of knowledge in general, but is narrowed down to the alternatives of anthropomorphism and biomorphism. Accordingly, in the subsequent chapters we will make an attempt to investigate and illustrate what holds the diagnostic experiential situation together-biological regularities, manifestation via movement, conscious synthesis, causal categories, or something else. We argue that as long as knowledge originates out of practices, a promising way forward is to oscillate between the prominent although controversial ideas of the history of philosophy and observations of concrete human practices, such as, in our chosen example, image-based medical diagnostics of biological pathologies. Although a number of thinkers are involved in the discussion, Aristotle and Husserl are most important here as the representatives of historical paradigms on the matter. The body in this research was not taken solely as the physical entity (Körper) but rather as a transcendental, constitutive structure where diagnostic and biological processes synchronize in teleological movement (Leib). However, philosophical speculations are illustrated by actual radiograms, the interpretation of which brings us back to the aforementioned question of primacy regarding cognition.

[Pain and its limits : A phenomenological consideration of chronic pain]. / Der Schmerz und seine Grenze : Eine phänomenologische Betrachtung chronischer Schmerzen.

Chronic pain poses a significant global socio-medical challenge causing significant costs. It is only since the mid-20th century that pain syndromes have been considered diseases in their own right. According to the definition of the International Association for the Study of Pain, pain is a complex, context-dependent-and hence modifiable-phenomenon. The philosophical view on pain is no less multi-facetted and allows for a wide range of viewpoints. This analysis aims at a characterisation of pain including a-mainly phenomenological and enactivist-philosophical perspective. The discourse will be guided by the concept of the limit(s) of the lived body: what is the relationship between pain and the perception of the lived body's boundaries? Does a reciprocal influence exist? And may the perception be modified in order to reduce the patient's suffering? These musings will also clarify that neurosciences and philosophy are not competing sciences, but rather inform each other.

The Human Affectome.

Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features). This teleologically-grounded framework offers a principled agenda and launchpad for both organizing existing perspectives and generating new ones. Ultimately, we hope the Human Affectome brings us a step closer to not only an integrated understanding of human affective phenomena, but an integrated field for affective research.

Predicting instabilities: an embodied perspective on unstable experiences with art and design.

Predictive Processing (PP) provides a theoretical framework that describes perception as a process attempting to increase the predictability of stimulations by updating predictions or exploring new sensations. Moreover, perception and action are assumed to be closely linked within this process. While organisms seem to strive for predictability, we sometimes expose ourselves to objects and situations that challenge sense-making-such conditions often break perceptual habits or offer multiple possible meanings. This paper updates a previous qualification of these experiences of 'Semantic Instability' (SeIns) by following an embodied and situated understanding of perception and cognition. We suggest that art perception essentially differs from problem-solving as in engaging with art, we typically integrate contradictory elements dynamically and without the ultimate goal of resolving the contradictions-on the contrary, SeIns itself can generate aesthetic hedonics and interest. We discuss how current embodied accounts of PP might help understand what motivates such unstable yet insightful and pleasurable nonlinear sense-making processes. This article is part of the theme issue 'Art, aesthetics and predictive processing: theoretical and empirical perspectives'.

El estudio de la cognición: hacia una perspectiva corporizada / O estudo da cognição: em direção a uma perspectiva incorporada / The study of cognition: towards an embodied perspective / L'étude de la cognition: vers une perspective incarnée

Resumen El campo de la cognición ha tenido una larga historia en la que los modelos formales, el cuerpo y la interacción con el mundo físico y social han tenido significados y papeles variados. En los últimos años, las propuestas han intentado reintroducir el cuerpo y la variabilidad cognitiva resultante de la sensibilidad a contextos ricos e impredecibles. Este artículo presenta el enactivismo autopoiético, una de las versiones esenciales de las teorías encarnadas dentro de las ciencias cognitivas, señalando algunas limitaciones de las teorías clásicas de procesamiento de la información y sus nociones de representación. En este distanciamiento, las ciencias cognitivas han recuperado el cuerpo, la sensibilidad y flexibilidad de los procesos cognitivos, la naturaleza dinámica de la experiencia y el valor de los sistemas culturales que sustentan la actividad cognitiva.

Resumo O campo da cognição tem uma longa história na qual modelos formais, o corpo, e a interação com o mundo físico e social tiveram significados e papéis variados. Nos últimos anos, as propostas tentaram reintroduzir o corpo e a variabilidade cognitiva resultante da sensibilidade a contextos ricos e imprevisíveis. Este artigo apresenta o enativismo autopoiético, uma das versões essenciais das teorias corporizadas dentro das ciências cognitivas, apontando algumas limitações das teorias clássicas de processamento de informação e as suas noções de representação. Nesse distanciamento, as ciências cognitivas recuperaram o corpo, a sensibilidade e flexibilidade dos processos cognitivos, a natureza dinâmica da experiência e o valor dos sistemas culturais que sustentam a atividade cognitiva.

Abstract The field of cognition has had a long history where formal models, the body, and interaction with the physical and social world have had varied meanings and roles. In recent years, proposals have tried to reintroduce the body and the cognitive variability resulting from sensitivity to rich and unpredictable contexts. This article presents the autopoietic enactivism, one of the essential versions of embodied theories within the cognitive sciences, pointing out some limitations of classical information processing theories and their notions of representation. In this distancing, cognitive sciences have recovered the body, the sensitivity and flexibility of cognitive processes, the dynamic nature of experience, and the value of the cultural systems that support cognitive activity.

Résumé Le domaine de la cognition a connu une longue histoire dans laquelle les modèles formels, le corps et l'interaction avec le monde physique et social ont eu des significations et des rôles variés. Ces dernières années, des propositions ont tenté de réintroduire le corps et la variabilité cognitive résultant de la sensibilité à des contextes riches et imprévisibles. Cet article présente l'enactivisme autopoïétique, l'une des versions essentielles des théories incarnées au sein des sciences cognitives, en soulignant certaines limites des théories classiques du traitement de l'information et de leurs notions de représentation. Avec cet écartement, les sciences cognitives ont récupéré le corps, la sensibilité et la flexibilité des processus cognitifs, la nature dynamique de l'expérience et la valeur des systèmes culturels qui soutiennent l'activité cognitive.

The osteopath-parent-child triad in osteopathic care in the first 2 years of life: a qualitative study.

Background: Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life. Aim: Since the literature considers that interactions with the environment, which enact the patients' experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent-child dyad during osteopathic care on children aged 0 to 2 years old. Methods: Semi-structured interviews were conducted with a purposive sample of nine osteopaths with experience in the field of pediatrics. Interviews were transcribed verbatim, and constructivist grounded theory was used to conceptualize, collect and analyze data. Codes and categories were actively constructed through an interpretive/constructionist paradigm. Results: The core category was the idea of the pediatric osteopath as a support for the family, not only for the child. Four additional categories were identified: (1) Preparing a safe environment for both children and parents, (2) Communication, (3) Attachment and synchrony, and (4) Synchronization. Conclusion: Through participatory sense-making, osteopaths manage contextual factors to establish an effective therapeutic alliance through the osteopath-parent-child triad to facilitate the construction of the child's internal generative model to promote healthy development. The therapeutic encounter is considered an encounter between embodied subjects, occurring within a field of affordances (ecological niche) that allows the interlocutors to actively participate in creating new meanings through interpersonal synchronization. Participatory sense-making and the establishment of a therapeutic alliance through the osteopath-parent-child triad are crucial to promote healthy development in the child.

Informational Resilience in the Human Cognitive Ecology.

Resilience is a basic trait of cognitive systems and fundamentally connected to their autopoietic organization. It plays a vital role in maintaining the identity of cognitive systems in the face of external threats and perturbances. However, when examining resilience in the context of autopoiesis, an overlooked issue arises: the autopoietic theory formulated by Maturana and Varela (1980) renders traditional Shannon information obsolete, highlighting that information should not be ascribed a role in cognitive systems in a general sense. This paper examines the current situation and suggests a possible way forward by exploring an affordance-based view on information, derived from radical cognitive science, which is exempted from Maturana and Varela's critique. Specifically, it argues that the impact of social influence on affordance use is crucial when considering how resilience can manifest in informational relations pertaining to the human cognitive ecology.

Ethical enactivism for smart and inclusive STEAM learning design.

Current global challenges of the 21st century promote STEAM (science, technology, engineering, arts and mathematics) education and digitalization as a means for humans to be the central actors in the construction of a sustainable society that favors a sense of worth and global wellbeing. In this scenario, new educational technology tools and immersive learning affordances (possibilities), offer unprecedented potential for the design of smart and dynamic learning systems and contexts that can enhance learning processes across varied audiences and educational settings. However, current STEAM education practice lacks attention to equipping all citizens with the necessary skills to use digital technologies in an ethical, critical and creative way. This gap calls for attention in design processes, principles and practices that are attentive to ethical considerations and values-based approaches. On the other hand, in its formulation STEAM as an educational approach is framed in four fundamental pillars: creativity, inclusion, citizenship and emerging technologies, which also put attention on the inclusion of disadvantaged and underrepresented social groups during STEAM education design. Following an apparent need to explore ethical and inclusive design in STEAM education, and inspired in the 4E cognition framework, ethical enactivism and embodied and ecosomaesthetics experience design, here we propose a theoretical framework grounded on systems thinking for the design of smart and dynamic STEAM learning systems and settings. The framework is aimed at STEAM educational psychologists, educational technologists, learning designers and educational practitioners who wish to address the global challenges of 21st century education by means of creative, innovative and inclusive education design.

Enactive artificial intelligence: subverting gender norms in human-robot interaction.

Introduction: This paper presents Enactive Artificial Intelligence (eAI) as a gender-inclusive approach to AI, emphasizing the need to address social marginalization resulting from unrepresentative AI design. Methods: The study employs a multidisciplinary framework to explore the intersectionality of gender and technoscience, focusing on the subversion of gender norms within Robot-Human Interaction in AI. Results: The results reveal the development of four ethical vectors, namely explainability, fairness, transparency, and auditability, as essential components for adopting an inclusive stance and promoting gender-inclusive AI. Discussion: By considering these vectors, we can ensure that AI aligns with societal values, promotes equity and justice, and facilitates the creation of a more just and equitable society.

Body social models of disability: Examining enactive and ecological approaches.

Autistic philosopher and neurodiversity proponent Robert Chapman (2021) argues that disability may be best understood by utilizing an ecological functional model where the focus is on the intersection and overlaps between relational contributions to collectives and group functioning with individual functionality. This presents an alternative to both social-relational models of disability advocated by other neurodiversity proponents and the orthodox medical model of disability. While enactivists such as Michelle Maiese and Juan Toro, Julian Kiverstein and Erik Rietveld have also offered relational models of disability that challenge the orthodox medical model, I argue that unlike the ecological functional model, these enactivist models remain problematically committed to an individualist methodology. Drawing on what Miriam Kyselo has labeled the body social problem, I show that the enactivist models not only face theoretical issues, but also practical issues in terms of their recommended intervention strategies for disability. I argue that for these reasons, if enactivists want a relational model of disability, then they should adopt both a neurodiversity paradigm approach and Chapman's ecological functional model.

Ensuring wholeness: Using Code Biology to overcome the autonomy-heteronomy divide.

This paper presents an alternative to Autopoietic Enactivism in the form of a Code Biology-informed account on human sense-making. It demonstrates the possibility of avoiding a dualism between, on the one hand, the autonomy of individual sense-makers and, on the other, the heteronomy of social facts. This is possible because code biological principles are pertinent to different levels of biological and non-biological organization and cut across the organismic self-non-self border. Analytically, one can maintain the overall integrity of an agent as a separable unit of (inter)action while also avoiding an autonomy-heteronomy divide. We therefore emphasise the constitutive role of codified relations that, while irreducible to operational closure, connect the sense-making agent's social interactions to those of other agents. The move grants a central, constitutive role to external norms (or, heteronomy) as altering the internal, embodied integrity of an autonomous agent. Drawing on the case of prosthetics use in amputees, we show that successful integration of a prothesis cannot be reduced to the substitution of a missing limb. Rather, it demands experienced bodily wholeness on the part of the agent which can only be achieved by attuning and adapting to use of a prosthesis while also internalizing social norms and values. It is concluded that many aspects of the living actualize codified relations which incorporate both heteronomous and autonomous traits.

The biopsychosocial model is lost in translation: from misrepresentation to an enactive modernization.

INTRODUCTION: There are increasing recommendations to use the biopsychosocial model (BPSM) as a guide for musculoskeletal research and practice. However, there is a wide range of interpretations and applications of the model, many of which deviate from George Engel's original BPSM. These deviations have led to confusion and suboptimal patient care. OBJECTIVES: 1) To review Engel's original work; 2) outline prominent BPSM interpretations and misapplications in research and practice; and 3) present an "enactive" modernization of the BPSM. METHODS: Critical narrative review in the context of musculoskeletal pain. RESULTS: The BPSM has been biomedicalized, fragmented, and used in reductionist ways. Two useful versions of the BPSM have been running mostly in parallel, rarely converging. The first version is a "humanistic" interpretation based on person- and relationship-centredness. The second version is a "causation" interpretation focused on multifactorial contributors to illness and health. Recently, authors have argued that a modern enactive approach to the BPSM can accommodate both interpretations. CONCLUSION: The BPSM is often conceptualized in narrow ways and only partially implemented in clinical care. We outline how an "enactive-BPS approach" to musculoskeletal care aligns with Engel's vision yet addresses theoretical limitations and may mitigate misapplications.

How to Undo (and Redo) Words with Facts: A Semio-enactivist Approach to Law, Space and Experience.

In this essay both the facts/values and facticity/normativity divides are considered from the perspective of global semiotics and with specific regard to the relationships between legal meaning and spatial scope of law's experience. Through an examination of the inner and genetic projective significance of categorization, I will analyze the semantic dynamics of the descriptive parts comprising legal sentences in order to show the intermingling of factual and axiological/teleological categorizations in the unfolding of legal experience. Subsequently, I will emphasize the translational and enactive cognitive disposition underlying the construction of the second premise of the so-called judiciary syllogism and thereby the untenability of the idea that 'law makes its facts.' Hence, I will try to bring to the fore the cultural pre-assumptions encapsulated in the positivistic and therefore also formalistic or analytical approaches to legal experience and the loss of their inner consistency when legal experience confronts the phases and major changes of global semiotics. Finally, I will strive to relativize the opposition between the positivist and non-positivistic theories of law in view of an understanding of legal experience focused not only, or at least not primarily, on what 'law is' but also on 'how' it unwinds through, and in spite of, environmental and semantic transformations.

A Nonlinear Dynamic Approach of the Notion of Interaction.

Although it is not so obvious reading many of the interactionist works, interactionist theories can be tightly linked with a nonlinear dynamic approach of the psychological and social processes. The mathematical theory of dynamic systems (DST) could offer a more systematic conceptual and methodological outlook over the notion of interaction. From a DST perspective, interaction may be conceived as an interdependent continuous evolution in time of two or more dynamic variables, which are paradoxically simultaneously separated (as independent sources of variation), and undistinguishable, being united in a new, emergent, source of variation. This conception differs from the popular conception of the interaction as a succession of action and reaction. The key notion that, from a dynamic systems perspective, is linked with interaction is that of coupling, which is rarely used in the interactionist works. Future studies should specify the link between the dynamic approach of interaction and action theories.