This paper presents the foundation upon which the contemporary knowledge of body integrity dysphoria (BID) is built. According to the World Health Organisation’s International Classification of Diseases, 11th edition (ICD-11), the main feature of BID is an intense and persistent desire to become physically disabled in a significant way. Three putative aetiologies that are considered to explain the insurgence of the condition are discussed: neurological, psychological and postmodern theories. The concept of bodily representation within the medical context is highlighted, with (...) the concept of dysphoria, which was brought to the fore with the introduction of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and the ICD-11. Contemporary issues of “justice” are addressed to identify ethically relevant distinctions between BID and sex reassignment surgery. It is argued that there is no ethically relevant difference between the BID actor’s desire for invasive surgical intervention and the wish of gender dysphoric individuals to undergo sex reassignment surgery procedures. Some BID actors self-mutilate, and this presents medical professionals with difficult choices regarding whether or not to intervene in order to satisfy the BID patient’s desire. Both abstention and intervention may lead to severe ethical complications for doctors and patients despite the positive outcomes in terms of quality of life for BID individuals who manage to undergo such procedures. (shrink)

John Protevi’s project aims to combine the embodied school of affective cognition with Deleuze’s poststructuralist philosophy. I examine the validity of Protevi’s claim that his reading of Deleuze manages to “sharpen, extend and / or radicalize some of their [4EA] explicit presuppositions, that Deleuze lets us go “above” and “below” the abstract subject of embodied cognitive psychology, “above” to politics, and “below” to biology. I argue that rather than radicalizing phenomenologically-informed 4EA, Protevi’s reductive reading of Deleuze falls short of both (...) Deleuze and phenomonogical-4EA in his understanding of what it means for living systems to be “radically relational”. Protevi’s treatment of living systems splits mind, body and world into externally and weakly interacting encapsulated redundancies: bodily affect modules are encapsulated off from the conscious subject which they motivate, outside of awareness, from below. Meanwhile, individual subjective intentionalities are encapsulated off from the group intentionality that enculturates them from above. We are not given a way to see affective and cognitive-intentional processes of persons as co-implicating each other as an inseparable mesh, nor the joint activities of discursive groups as an enriching furthering of self-constitution rather than as an invading impingement from ‘above’ the self. (shrink)

In this paper, we introduce an enactive account of loving as participatory sense-making inspired by the “I love to you” of the feminist philosopher Luce Irigaray. Emancipating from the fusionist concept of romantic love, which understands love as unity, we conceptualise loving as an existential engagement in a dialectic of encounter, in continuous processes of becoming-in-relation. In these processes, desire acquires a certain prominence as the need to know (the other, the relation, oneself) more. We build on Irigaray’s account of (...) love to present a phenomenology of loving interactions and then our enactive account. Finally, we draw some implications for ethics. These concern language, difference, vulnerability, desire, and self-transformation. (shrink)

In search of our highest capacities, cognitive scientists aim to explain things like mathematics, language, and planning. But are these really our most sophisticated forms of knowing? In this paper, I point to a different pinnacle of cognition. Our most sophisticated human knowing, I think, lies in how we engage with each other, in our relating. Cognitive science and philosophy of mind have largely ignored the ways of knowing at play here. At the same time, the emphasis on discrete, rational (...) knowing to the detriment of engaged, human knowing pervades societal practices and institutions, often with harmful effects on people and their relations. There are many reasons why we need a new, engaged—or even engaging—epistemology of human knowing. The enactive theory of participatory sense-making takes steps towards this, but it needs deepening. Kym Maclaren’s idea of letting be invites such a deepening. Characterizing knowing as a relationship of letting be provides a nuanced way to deal with the tensions between the knower’s being and the being of the known, as they meet in the process of knowing-and-being-known. This meeting of knower and known is not easy to understand. However, there is a mode of relating in which we know it well, and that is: in loving relationships. I propose to look at human knowing through the lens of loving. We then see that both knowing and loving are existential, dialectic ways in which concrete and particular beings engage with each other. (shrink)

Reports of patients with schizophrenia show a fragmented and anomalous subjective experience. This pathological subjective experience, we suggest, can be related to the fact that disembodiment inhibits the possibility of intersubjective experience, and more importantly of common sense. In this paper, we ask how to investigate the anomalous experience both from qualitative and quantitative viewpoints. To our knowledge, few studies have focused on a clinical combination of both first- phenomenological assessment and third-person biological methods, especially for Schizophrenia, or ASD therapeutics (...) and diagnosis. We will thus attempt to bring forward a second-person scientific design, accounting for both the first-person subjective experiential aspects, and respective third-person neurobiological correlates of embodied aesthetics in anomalous experience. From this proposal, we further explore the consequences to clinical and research practice. (shrink)

Recent enactive accounts of cognition have begun to disentangle social and normative aspects of the human mind. In this paper, we will contribute to this debate by developing an enactive account of moral development, i.e. the learning of ethical norms, and critical engagement with these norms through social affordances, participatory sense-making, and moral concern. The difficulty in articulating such an account is in reconciling the affective embodied aspects of moral experiences with the more orthodox aspects of ethics like critical reflection. (...) In order to respond to this difficulty, we bring Ricoeur’s hermeneutics into dialogue with enactivism. Complementing the enactive tradition, we frame critical ethical learning as embodied interaction with diverse ethical dimensions allowing us to incorporate moral values in the form of critical narratives and the social imaginary. We agree with enactivist theories that participation and democratic dialogue are essential parts of critical reflection on ethical norms. Yet, we also contend that this kind of critical reflection benefits from hermeneutical interpretation, challenging larger participatory networks, such as social institutions, which nourish inequality and maintain unethical values. (shrink)

Several enactive-phenomenological perspectives have pointed to affectivity as a central aspect of mental disorders. Indeed, from an enactive perspective, sense-making is an inherently affective process. A question remains on the role of different forms of affective experiences (i.e., existential feelings, atmospheres, moods, and emotions) in sense-making and, consequently, in mental disorders. This work elaborates on the enactive perspective on mental disorders by attending to the primordial role of affectivity in the self-individuation process. Inspired by Husserl’s genetic methodology and Simondonian philosophy (...) of individuation, sense-making is described as the process of progressive concretization and structuration of the self-world structures that support the intentionality of conscious experiences. Accordingly, affectivity is described as the force that anticipates a partial self-world coherence in sense-making. Structurally different types of affective experiences are integrated into the genetic picture and, on this basis, a reinterpretation and classification of certain mental disorders, such as schizophrenia, depression, and the anxiety spectrum, is provided. In this way, this work contributes to a phenomenologically informed enactive account of mental disorders as disorders of affectivity. (shrink)

Participatory sense-making is already an established concept within enactivism. It is used to define the participatory nature of cognitive relations, designating that humans and other organisms make sense of their surrounding environments not just on their own. They build cooperative networks, working together, to create ways of making sense of the world. However, so far little attention has been paid to how enactive concepts, such as participatory sense-making, may apply to the field of bioethics, understood here as health care ethics. (...) In this paper, I examine health care practices cases of participatory sense-making. The paper aims to show that relations between patients and health care providers (HCPs) can be understood as participatory sense-making relations. To make my case, I discuss the so-called phenomenological interview, as proposed technique in health care. I argue that this interview technique has essential features that can be viewed also as features of participatory sense-making. More specifically, the phenomenological interview is an open-minded, a critical, and pro-active dialogue between patient and health care provider that is meant for the patient to raise self-awareness of their body and medical condition, as well as of the social conditions that may affect that experience and condition. I will argue that phenomenological interviews are exemplary cases of patient-health care provider relations in which both parties actively work together to make sense of what the patient is going through and to find adequate medical responses to that experience. I will conclude by proposing normative guidance based on my analysis of health care practice as participatory sense-making. I argue that viewing patient-HCP relations as participatory sense-making may be helpful for both patients and health care providers in that it shows that health care practice is not just a technical exercise or routine task, but essentially relational and patient-oriented. (shrink)

A key phrase in working with horses, “bringing up life” is taken in its literal sense of moving expressively and energetically in order to animate the movements of the horses. The phrase also points to both what the radical phenomenologist Michel Henry referred to as the auto-affectivity of life and the vital powers of an essential hetero-affectivity. “Bringing up life” is the kinetic, kinaesthetic, affective expression of this fundamental impression that life is shared with other animate beings and that it (...) is all the more powerfully felt for being so. Working with horses – in spite of all the human conceits that groundwork, liberty training, and the riding disciplines hold – can thus reveal what it means to “bring up life” as more than a topic of very practical interest and specific phenomenological description. Through the impressional investigation of this expression we may well begin to feel our way toward more life-affirming, life-enhancing interactions with others of our own and many other animal kinds. (shrink)

Underlying the recent focus on embodied and interactive aspects of social understanding are several intuitions about what roles the body, interaction processes, and interpersonal experience play. In this paper, we introduce a systematic, hands-on method for investigating the experience of interacting and its role in intersubjectivity. Special about this method is that it starts from the idea that researchers of social understanding are themselves one of the best tools for their own investigations. The method provides ways for researchers to calibrate (...) and to trust themselves as sophisticated instruments to help generate novel insights into human interactive experience. We present the basics of the method, and two empirical studies. The first is a video-study on autism, which shows greater refinement in the way people with autism embody their social interactions than previously thought. The second is a study of thinking in live interactions, which provides insight into the common feeling that too much thinking can hamper interaction, and into how this kind of interactional awkwardness might be unblocked. (shrink)