Mimetic Self-Reflexivity and Intersubjectivity in Complementary and Alternative Medicine Practices: The Mirror Neuron System in Breast Cancer Survivorship.

Vinita Agarwal

doi:10.3389/fnint.2021.641219

Abstract

This study examines complementary and alternative medicine (CAM) providers’ practices in the treatment of their breast cancer survivor (BCS) clients and interprets these practices within the context of existing neuroscientific research on the mirror neuron system (MNS). Purposive and snowball sampling was conducted to recruit CAM providers (N = 15) treating BCSs from integrative medicine centers, educational institutions, private practices, and professional medical associations across the United States. In-depth semi-structured interviewing (N = 252 single-spaced pages) and inductive qualitative content analysis reveal CAM therapeutic practices emphasize a diachronic form of mimetic self-reflexivity and a serendipitous form of mimetic intersubjectivity in BCS pain management to allow the providers to tune-in to their clients’ internal states over time and experience themselves as an embodied subject in an imaginative, shared space. By employing imagination and an intentional vulnerability in their embodied simulation of the others’ internal states, CAM providers co-create experiences of pain while recognizing what about the other remains an unknown. Although MNs provide the mechanism for imitation and simulation underlying empathy through a neuronally wired grasp of the other’s intentionality, the study suggests that examining mimetic self-reflexivity and intersubjectivity in the therapeutic space may allow for a shared simulation of participants’ subjective experiences of pain and potentially inform research on self-recognition and self-other discrimination as an index of self-awareness which implicates the MNS in embodied social cognition in imaginative ways.

Highlights

Greater understanding of the prevalence, risk factors, and experience of chronic pain among breast cancer survivors (BCS) can help improve the quality of life for patients at a high risk of postsurgical pain
By opening themselves to a vulnerable form of sharing another’s suffering, the complementary and alternative medicine (CAM) provider seeks to create a therapeutic space that is aware of the relationality constituting both the provider’s and the clients’ inner experiences
The CAM provider drew upon selfreflexivity through language, relationality, the body, the other, and the self (Arbib, 2011) that simulated an embodied awareness

Summary

Introduction

Greater understanding of the prevalence, risk factors, and experience of chronic pain among breast cancer survivors (BCS) can help improve the quality of life for patients at a high risk of postsurgical pain. Because CAM providers employ their embodied presence in intentional, self-and otherdirected healing processes (Agarwal, 2018b; Sneed and Hammer, 2018), examining their practices for conceptualization of their BCS patients’ pain can enhance understandings of embodied approaches to empathy and pain management in the therapeutic relationship. As neuroscientific research on the MNS straddles the interface of bio-philosophical conceptualizations of simulation and embodiment (Gallese, 2006; Goldman, 2009), interpreting CAM provider practices in the context of MNS research can help explicate embodied phenomena such as proprioception, empathy, mentalizing, and action imitation in fields such as somatic-affective-motor studies, education, and post-structuralist critiques of human relations (e.g., di Pellegrino et al, 1992; Montero, 2006; Abraham et al, 2018; Pietrzak et al, 2018; Alcalá-López et al, 2019). The study examines CAM therapeutic relationship practices in BCS pain management and interprets these practices within the context of the MNS to offer conceptual insights into the CAM therapeutic relationship

Methods

Results

Conclusion