Substance addiction has been historically conceived and widely researched as a brain disease. There have been ample criticisms of brain-centred approaches to addiction, and this paper aims to align with one such criticism by applying insights from phenomenology of psychiatry. More precisely, this work will apply Merleau-Ponty’s insightful distinction between the biological and lived body. In this light, the disease model emerges as an incomplete account of substance addiction because it captures only its biological aspects. When considering addiction as a (...) brain disorder, it will be shown that research fails to account for the contextual, functional, and emotional aspects inherent to subjective health. It is concluded that, while the disease model is fundamental to our understanding of what happens in the brain, its brain-centred approach is cure-oriented. Instead, we suggest a care-orientated approach, which understands and treats the psychological feel as bodily experience situated in an environment, allowing for a more encompassing therapeutic perspective. (shrink)

Enactive approaches to psychiatry have recently argued for an understanding of psychiatric conditions based within relational interactions between individuals and their environments. A central motivation for these enactive approaches is the goal of social integration: the integration of a naturalistic approach to psychiatric conditions with their broader sociocultural dimensions. One possible issue, however, is whether appeals to the autonomy and authenticity of relationally constituted enactive individuals can provide a means of adjudicating between harmful and beneficial social constraints upon individual behaviour. (...) This paper seeks to provide enactive approaches to psychiatry with a possible means of evaluating normative influences of social contexts beyond direct interactions with relationally constituted individuals. Some of the most significant influences of the sociocultural dimension of psychiatric conditions consist not in direct interaction with individuals, but in setting the terms for interactions and interactants alike. Insofar as some social influences precede and predefine dyadic relations between individuals and their social context, these cannot be accounted for as features of interactions, but must be assessed as independent structures of the sociocultural dimension. I will provide one potential means for enactive models to assess social norms using Canguilhem’s distinction between health and pathology. I will argue that Canguilhem’s conceptualization of health in terms of adaptive normative structure provides a potential tool for social integration which strongly complements enactive approaches to psychiatry. (shrink)

Autism spectrum disorder is usually understood through deficits in social interaction and communication, repetitive patterns of behavior, and hyper- or hyporeactivity to sensory input. Affordance-based Skilled Intentionality that combines ecological-enactive views of cognition with Free Energy and Predictive Processing was proposed as the framework from which to view autism integrally. Skilled Intentionality distinguishes between a landscape of affordances and a field of affordances. Under the integrative Skilled Intentionality Framework, it can be shown that autistic differences in the field of affordances (...) stem from aberrant precision estimation. Autistics over-rely on the precision afforded by the environment—a stable econiche they build. According to this approach, autism is understood as characterized by an atypical field of affordances. I will build on the ecological-enactive account of autism to suggest that one way to shape the neurotypical landscape of affordances in accordance with autistic needs is through the use of Ambient Smart Environments (ASEs). Taking the cue from autistic lived experience, ASEs could help minimize environmental uncertainty and afford affective scaffolding by supporting dynamic and flexible niche construction in accordance with individual autistic styles. (shrink)

The aim of the paper is to deepen into a theoretical account on the role of behavioral settings and relational affordative space and how this perspective can be used to reconceptualize various human cognitive developmental trajectories and conditions. In the course of this theoretical work, we want to contribute in rethinking developmental trajectories based on the role of behavioral settings and relational affordances from an embodied perspective. Behavioral settings emerge from joint actions in conjunction with the affordances available. These affordances (...) will have multiple levels and kinds of meanings for the organism which is why we need to distinguish between the general affordances for a form of life and the particular affordances for particular agents that are generated through sensorimotor interactions. We propose to apply this theoretical frame in different developmental conditions, taking as a leading example the Autistic Spectrum, extending it to other lived experiences of other groups marginalized by “normative behavioral settings” – and the ensuing ethical concerns. (shrink)