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. (shrink)

Technology has been at the centre of existentialist (e.g. Heidegger) and sociological (e.g. Marcuse) critique for a long time. The latest versions of criticism rely on the results of “science and technology studies”: they argue that essentialist conceptualisations of technology should be replaced while aiming at “democratizing technology” (e.g. Feenberg). However, even these approaches are characterised by a shortcoming when it comes to providing a normative basis: as contemporary technology intermeshes with the elementary levels of existence (such as perception or (...) cognition), it remains in the blind spot of those users, who could “democratize” it through their critique. Accordingly, the formal normative bases (e.g. the one provided by Feenberg, who relies on Habermas’ democracy principle), need to be complemented with substantive claims. For this purpose, a phenomenological-existentialist framework is elaborated with the help of Merleau-Ponty and Levinas. It is argued that due to the ongoing expansion of social systems relying on various forms of technology (Luhmann), the “mediated flesh” becomes rigid. By losing the plasticity of the chiasm, subjects are exposed to existential crises unmanageable by mere technology (e.g. mental disorders). Such experience of technologically induced social suffering could serve as a normative basis for criticising the over-expansion of technology. (shrink)

In this paper, I explore how our experience of pain and suffering structure our experience over time. I argue that pain and suffering are not as easily dissociable, in living and in conceptual analysis, as philosophers have tended to think. Specifically, I do not think that there is only a contingent connection between physical pain and psychological suffering. Rather, physical pain is partially constitutive of existential suffering. My analysis is informed by contemporary thinking about pain and suffering as well as (...) Indian Buddhist philosophy. (shrink)

This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP theory proposes to explain pain (...) in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint. (shrink)

The article aims at reconstructing how pain is used in contemporary societies in the process of engraving power. Firstly, a social phenomenological analysis of pain is conducted: Husserl’s and Merleau-Ponty’s ideas are used for clarifying the experience of pain itself; Elaine Scarry’s analyses are overviewed in order to reconstruct how pain contributes to the establishing of power. Secondly, this complex approach is applied in early modern context: the parallel processes of the decline of a transcendental and the emergence of a (...) medical interpretation of pain is introduced, along with the marginalization of violence. Thirdly, the era characterized by the triumph of medical pain management is analysed: it is argued that the constitutive role of pain in establishing power does not cease to exist with the emergence of technologies of discursive governance ; it is an open question, what sort of power is engraved through pain understood in strictly medical frames. (shrink)

During the last few decades, many thinkers have advocated for the importance of the phenomenological approach in developing the understanding of the lived experience of illness. In their attempts, they have referred to ideas found in the history of phenomenology, most notably, in the works of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Jean-Paul Sartre. The aim of this paper is to sketch out an interpretation of illness based on a yet unexplored conceptual framework of the phenomenology of French thinker (...) Jean-Luc Marion. Focusing on concepts of the saturated phenomenon and flesh, the paper develops an interpretation of illness as the saturated phenomenon, which highlights a variety of dimensions of illness already elaborated within the phenomenology of medicine, such as the affective dimension of illness, the disruptive dimension of illness, the transformed perception of the self in illness, mineness of flesh in illness and the inexpressible and hermeneutical dimension of illness. In addition to that, the paper explores some of the consequences the proposed interpretation of illness offers regarding the nature of illness and health. It is argued that illness in its essence is very similar to the experience of other saturated phenomena, suggesting that the difference between them does not lie within the character of the affective givenness, but rather within the dynamic relationship between the affective givenness and its conceptualization. It is also shown that the experience of health is compatible with the experience of saturation and thus is not limited to the tacit and harmonious background state. (shrink)

The article aims at elaborating a non-speculative concept of social pathology. In the first section, various conceptualizations (e.g. Habermas, Honneth) are critically revaluated. It is argued that (a) applying the originally medical concept of ‘pathology’ on social entities has untenable connotations (due to the lacking social equivalent of death); (b) grounding social pathology on the level of ‘social suffering’ is not in accordance with the actors’ horizon shaped by biomedical- and psy-discourses. To avoid these dead-ends, social pathologies are reinterpreted as (...) structural distortions causing diseases or mental disorders. To refine this initial definition, in the second section, Merleau-Ponty’s concept of chiasm is used as an ontological framework translating between medical and social diagnoses. The proposed concept of social pathology refers to those patterns of disrupted pre-intentional, intentional and mediated intertwining, which manifest as ill or psychopathological chiasm. In the third section, two case studies are elaborated: the intersubjective structures of depressed and asthmatic chiasm. Finally, the implications for critical theory and praxis are overviewed. (shrink)

The phenomenology of medicine is that part of the research field of the philosophy of medicine that asks about the subjective experience of illness. In contrast to the philosophy of medicine, the phenomenological approaches explicitly include medical and bioethical questions as part of their research interests. The paper provides an overview of the most important questions and topics of the phenomenology of medicine. Subsequently I will refer to the fundamental critique articulated by feminist positions in the field of phenomenology of (...) medicine. In addition to the socio-political contextualisation of the experience of illness, this also includes the necessary recourse to empirical research. (shrink)

Contemporary pain literature increasingly acknowledges the need of a multidimensional approach to pain, which accounts for its complex biological, psychological and social components. This is reflected in the recently revised definition of the International Association for the Study of Pain (IASP) and some contemporary philosophical positions. This paper addresses the need to offer a theoretical approach that integrates the biopsychosocial and qualitative multidimensionality of pain by developing the “social grounding view of pain”. My focus is on seeking a multidimensional philosophical (...) approach that accounts not only for its complex biological and psychological aspects but also and specifically does justice to its social dimension. I draw from some of the most recent multidimensional theoretical and methodological approaches that attempt to account for the social component of pain, including enactivism and interpretative phenomenological analysis (IPA), to propose the advancement of the social grounding view, which has a particular focus on socially shared linguistic concepts in relation to the meaning and modulation of pain. More specifically, the social grounding view is based on the argument that the meaning of the experience of pain is determined in part by socially shareable linguistic concepts habitually associated with pain. I test this view against empirical cases drawn from pain neuroscience education (PNE) and try to demonstrate how the modification of the linguistic concepts of pain could be used effectively to modulate its experience. (shrink)

In recent years, facial difference is increasingly on the public and academic agenda. This is evidenced by the growing public presence of individuals with an atypical face, and the simultaneous emergence of research investigating the issues associated with facial variance. The scholarship on facial difference approaches this topic either through a medical and rehabilitation perspective, or a psycho-social one. However, having a different face also encompasses an embodied dimension. In this paper, we explore this embodied dimension by interpreting the stories (...) of individuals with facial limb absence against the background of phenomenological theories of the body, illness and disability. Our findings suggest that the atypical face disrupts these individuals’ engagement with everyday projects when it gives rise to disruptive perceptions, sensations, and observations. The face then ceases to be the absent background to perception, and becomes foregrounded in awareness. The disruptions evoked by facial difference call for adjustments: as they come to terms with their altered face, the participants in our study gradually develop various new bodily habits that re-establish their face’s absence, or relate to its disruptive presence. It is through these emergent habits that facial difference comes to be embodied. By analyzing the everyday experiences of individuals with facial limb absence, this article provides a much-needed exploration of the embodied aspects of facial difference. It also exemplifies how a phenomenological account of illness and disability can do justice both to the impairments and appearance issues associated with atypical embodiment. (shrink)

In recent years, the societal and personal impacts of pain, and the fact that we still lack an effective method of treatment, has motivated researchers from diverse disciplines to try to think in new ways about pain and its management. In this paper, we aim to develop an enactive approach to pain and the transition to chronicity. Two aspects are central to this project. First, the paper conceptualizes differences between acute and chronic pain, as well as the dynamic process of (...) pain chronification, in terms of changes in the field of affordances. This is, in terms of the possibilities for action perceived by subjects in pain. As such, we aim to do justice to the lived experience of patients as well as the dynamic role of behavioral learning, neural reorganization, and socio-cultural practices in the generation and maintenance of pain. Second, we aim to show in which manners such an enactive approach may contribute to a comprehensive understanding of pain that avoids conceptual and methodological issues of reductionist and fragmented approaches. It proves particularly beneficial as a heuristic in pain therapy addressing the heterogenous yet dynamically intertwined aspects that may contribute to pain and its chronification. (shrink)

The lived body has structures of ability built up over time through habit. Serious illness, injury, and incapacity can disrupt these capacities, and thereby, one’s relationship to the body, and to time itself. This paper focuses attention on a series of healing strategies individuals then employ on the “chessboard” of possibilities intrinsic to lived embodiment. This can include restoring past abilities (pointing to the future to recreate the past); and/or transforming one’s bodily structure or use-patterns, or the external environment, to (...) compensate. With many conditions, including progressive aging, no full rehabilitation is possible. Nevertheless, one can also seek consolation, richness, or hope by remembering the past; anticipating the future; or presencing, that is, living fully in the now. Insofar as past, present, and future are interwoven in one’s life experience, many also meet adversity by a life-story revision, constructing a new narrative to render events meaningful. Some also access a sense of transpersonal timelessness, whether through anticipation of an afterlife, or a sense of the eternal present. There is a literature on the adaptive coping mechanism used by the chronically ill, but with its diverse patient populations, methodologies, and categories, it has proved difficult to systematize. This article suggests that the structures of lived embodiment, as explored by phenomenology, provide a way to understand the modes of wholeness individuals access over time, and in relation to time—what is here termed chronic healing. (shrink)

Encounters with illness, impairment, and aging can disrupt one’s experiential relationship with self, body, others, and world. “Healing” takes place when the individual is able to re-integrate his or her world, even if the condition is not medically curable. Drawing on work in the phenomenology of the body, this article examines a series of eight “healing strategies” individuals employ, each representing a different way of orienting toward the painful or impaired body. One may lean into freeing oneself from the body, (...) through strategies of “refusing,” “ignoring,” “objectifying,” or “transcending” its problems. Conversely, one may choose to embrace the body, through strategies such as “accepting,” “listening,” “befriending,” or “witnessing.” It can be beneficial to have a good number of such coping strategies at one’s disposal, enhancing flexible response to chronic challenges. They also are often used in synergistic or complementary combinations. (shrink)

El objetivo central de este artículo es exponer las herramientas que la fenomenología husserliana aporta a la definición, descripción y análisis del mal moral. Parto de la distinción Ricoeuriana entre mal moral y mal sufrimiento, con la intención de justificar la introducción del instrumental husserliano en ambas esferas. Me interesa analizar esta distinción en un marco de interpretación fenomenológico que nos permita explicar el mal sufrimiento como dolor y el mal moral como violencia y envilecimiento. En un primer momento expongo (...) las limitaciones del análisis hermenéutico en relación con la descripción del dolor como pura pasividad; en un se-gundo momento analizo los desarrollos contemporáneos de la fenomenología del dolor a través de los conceptos centrales de la teoría husserliana de la constitución, concretamente, de la teoría de la corporalidad que aparece en este contexto; en un tercer momento trato de definir el mal moral como violencia, y la violencia como acción articulada a través de un conjunto de técnicas de envilecimiento o deshumanización, caracterizadas por la intención de un otro hostil, de dañar o alienar la identidad del yo mediante la manipulación de los sentimientos sensibles de la víctima, a través de la creación de escenarios y condiciones materiales consideradas infrahumanas.The main goal of this paper is to expose the tools offered by Husserlian phenomenology for the definition, description, and analysis of moral evil. My starting point is the Ricoeurian distinction between moral evil and suffering evil, in order to justify the insertion of the Husserlian analysis in both spheres. My purpose to highlight this distinction within a Husserlian interpretation frame so we can understand the suffering evil as pain, and the moral evil as violence and degradation. First, I expose the limitations of hermeneutical analysis in the assumption of pain as pure passivity. Second, I analyze the contemporary developements of the phenomenology of pain through the central concepts of the Husserlian theory of the constitution, specifically, the theory of corporeality. Third, I try to define moral evil–the same contemplated within the Ricoeurian distinction–as violence, and violence as an articulated action through an array of degradation techniques, or dehumanization, characterized by the hostile intention of the other to damage or alienate the identity of the ego by manipulating the sensible feelings of the victim, through the creation of scenarios and material conditions considered as infrahuman. (shrink)

This article explores the relation among illness, home, and belonging. Through a feminist phenomenological framework, I describe the disorientations of being diagnosed with borderline personality disorder and living with mental illness. This research anticipates the consequences of illness and serious disorientations for a conception of belonging as seamless body–world compatibility. Instead, this article examines how the stability of bodily dwellings in experiences of disorientation can suggest ways of being in the world that are more attentive to interdependency, unpredictability, and change (...) in human experience. I argue that these types of dwellings function as a more capacious and apposite metaphor to account for variations in belonging. This discussion outlines the ethical importance of building worlds that make room for different ways of being at home in and through our interactions with others. Although my discussion does not supply norms for ethical action, I contend that a feminist phenomenology of illness generates saliences and illuminates sensibilities that can transform our ways of being with others. (shrink)

Not all theists who are members of the Abrahamic faiths will sign up to a particular metaphysics of evil: some may be sceptical theists, and others may be uninterested in metaphysical questions altogether. In this paper, I argue that theists in the Abrahamic faiths who are interested in metaphysics and who are not sceptical theists should endorse a privative account of evil. This is because a privative view of evil is the only metaphysic of evil that is compatible with the (...) theism of the Abrahamic faiths. In order to persuade you of this, I will explain the religious importance of the privative view, and show how the three alternatives to the privative view that might initially appear compatible with theism are not, after all, compatible with the particular theism of the Abrahamic faiths. Privative views are often objected to on the basis that pain is an evil that does not seem like a privation. I will put forward one (non-exclusive) defence of the privative view of evil in response to this objection, drawing on the work of Herbert McCabe. (shrink)

In this article I investigate the ways in which phenomenology could guide our views on the rights and/or wrongs of abortion. To my knowledge very few phenomenologists have directed their attention toward this issue, although quite a few have strived to better understand and articulate the strongly related themes of pregnancy and birth, most often in the context of feminist philosophy. After introducing the ethical and political contemporary debate concerning abortion, I introduce phenomenology in the context of medicine and the (...) way phenomenologists have understood the human body to be lived and experienced by its owner. I then turn to the issue of pregnancy and discuss how the embryo or foetus could appear for us, particularly from the perspective of the pregnant woman, and what such showing up may mean from an ethical perspective. The way medical technology has changed the experience of pregnancy—for the pregnant woman as well as for the father and/or other close ones—is discussed, particularly the implementation of early obstetric ultra-sound screening and blood tests for Down’s syndrome and other medical defects. I conclude the article by suggesting that phenomenology can help us to negotiate an upper time limit for legal abortion and, also, provide ways to determine what embryo–foetus defects to look for and in which cases these should be looked upon as good reasons for performing an abortion. (shrink)

Objectification is a real problem in medicine that can lead to bad medical practice or, in the worst case, dehumanization of the patient. Nevertheless, objectification also plays a major and necessary role in medicine: the patient’s body should be viewed as a biological organism in order to find diseases and be able to cure them. Listening to the patient’s illness story should not be replaced, but, indeed, developed by the physical examination of his body searching for the causes of his (...) complaints. Whereas phenomenologists have so far mainly been identifying the back sides of objectification in medicine, in this paper the aim is to analyze differences between detrimental objectifications and objectifications that do not deprive the patient of his subjectivity but, rather, at least in some cases, may lead the patient to feel more at home with his body. (shrink)