ABSTRACT‘If I experience X, is it because of the illness, the medication, or is it ‘just me’?’ (Karp 2009) [Is it me or my Meds? Living with Antidepressants. Harvard University Press]. This issue is known as self-illness ambiguity (SIA) (Sadler 2007) ["The Psychiatric Significance of the Personal Self." Psychiatry: Interpersonal and Biological Processes 70 (2): 113–129]. In her paper Know Thyself: Bipolar Disorder and Self-concept, Carls-Diamante (2022) [“Know Thyself: Bipolar Disorder and Self-Concept.” Philosophical Explorations, 1–17] offers a taxonomy of different (...) ways in which Bipolar Disorder can be related to one’s self and self-concept. In contrast to the essentialist model of mental disorders she seems to adopt, I propose a different outlook on SIA, following an enactive approach to psychiatric disorders as disorders of sense-making. One’s way of making sense of the world and/or oneself can become stuck in a rigid pattern that is stronger than oneself and at odds with how one would want to be. I argue that it is helpful to distinguish between the experiential SIA of specific experiences (Am I over/underreacting?) and the long term concerns of existential SIA (How to live my life in accordance with what matters to me despite/while having certain vulnerabilities?). I conclude that knowing oneself is not an intra-individual matter, nor primarily a matter of reflection: it is rather a relational and material practice of trying to live your life in accordance with what matters to you. (shrink)

Predictive processing theorists have claimed PTSD and depression are maladaptive and epistemically distorting because they entail undesirably wide gaps between top-down models and bottom-up information inflows. Without denying this is sometimes so, the “maladaptive” label carries questionable normative assumptions. For instance, trauma survivors facing significant risk of subsequent attacks may overestimate threats to circumvent further trauma, “bringing forth” concretely safer personal spaces, to use enactive terminology, ensuring the desired gap between predicted worries and outcomes. The violation of predictive processing can (...) go in the opposite direction too, as when depression coincides with energy-depletion, and hence objectively strenuous situations in which things look farther away because they are (accurately anticipated to be) harder to reach. These examples partly encapsulate what predictive processing theorists call “active inference,” yet with differences. In the first case, actions fruitfully obviate predictions rather than fulfilling them. In the second, mental models do not dysregulate bodily processes, making coping harder. Instead, problems (e.g., personal obstacles, gastric illness) deplete energy, eliciting a depressive and adaptive slow-down. Some predictive proponents apply correspondence criteria when alleging mismatches between internal models and the world, while incongruously asserting that the brain did not evolve to see things veridically, but to execute actions. An alternative is to adopt pluralistic, pragmatic epistemologies suited to the complexity of mind. The upshot is that mental outlooks can depart from the norm without epistemically being distorted and that mismatches between anticipatory worries and outcomes, when they actually exist, can be a measure of adaptive and epistemic success. (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 contrast between third- and first-personal accounts of the experiences of autistic persons has much to teach us about epistemic injustice and epistemic agency. This paper argues that bringing about greater epistemic justice for autistic people requires developing a relational account of epistemic agency. We begin by systematically identifying the many types of epistemic injustice autistic people face, specifically with regard to general assumptions regarding autistic people’s sociability or lack thereof, and by locating the source of these epistemic injustices in (...) neuronormativity and neurotypical ignorance. We then argue that this systematic identification pushes us to construe epistemic agency as resulting from a fundamentally relational and dynamic process between an individual, others around them, and their social, cultural, or institutional environment, rather than as a fixed and inherent property of individuals. Finally, we show how our relational account of epistemic agency allows us to introduce the novel concepts of epistemic disablement and epistemic enablement. We argue that these two concepts allow us to more accurately track the mechanisms that undermine or facilitate epistemic agency, and thereby to better understand how epistemic injustice arises and to design more effective interventions to foster greater epistemic justice for autistic people. (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)

Affordances are action-possibilities, ways of relating to and acting on things in our world. They help us understand how these things mean what they do and how we have bodily access to our world more generally. But what happens when this access is ruptured or impeded? I consider this question in the context of psychopathology and reports that describe this experience. I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these (...) reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and consequences, of affective disorders and diminished spatial agency in self-world disturbances. It also highlights some under-explored ethical and political dimensions of these issues that need further attention. (shrink)

It has been argued that affordances are not meaningful and are thus not useful to be applied in contexts where specifically meaningfulness of experience is at stake (e.g. clinical contexts or discussions of autonomous agency). This paper aims to reconceptualize affordances such as to make them relevant and applicable in such contexts. It starts by investigating the ‘ambiguity’ of (possibilities for) action. In both philosophy of action and affordance research, this ambiguity is typically resolved by adhering to the agents intentions (...) and concerns. I discuss some recent accounts of affordances that highlight these concerns but argue that they tend to adopt an ‘atomistic’ approach where there is no acknowledgement of how these concerns are embedded in the agents wider concerns, values, projects and commitments. An holistic approach that does acknowledge this can be found in psychological research on agents having a sense of what they’re doing. I will discuss this research in the second part of the paper and argue that agents can analogously have a sense of what is afforded. This is deemed the entry point for understanding the meaningfulness of affordances. In the final part of the paper I apply this analysis to recent attempts which seek to make sense of authentic and autonomous agency in terms of affordances. (shrink)

Agency can be approached from the human case (anthropogenically) or coming from life in general, with organisms like bacteria in mind (biogenically). Each perspective is biased: the former approach tends to set the bar for agency very high, while the latter invites very liberal attributions of agency. Such a polarisation is epistemically flawed. As a rectification, this paper calls for a hermeneutical back-and-forth between opposite approaches to agency – reducing excessive restrictiveness or permissiveness and combining the unique explanatory strengths of (...) both approaches. Five common research tasks are used to illustrate the merits of such flexibility and the risks of rigidly clinging to any single approach. After questioning the dichotomy between the two approaches to agency, the findings are summed up. (shrink)