Abstract
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.
Highlights
Pains are among the most fundamental experiences that we undergo in everyday life
Before we can apply the enactive framework to the particular phenomenon of pain, we need a better understanding of the dimensions that determine the field of affordances
We conceptualize acute pain as an altering stance in the interactive relation between subject and world, while chronic pain can be conceptualized as a permeating stance of engagement with the environment
Summary
Pains are among the most fundamental experiences that we undergo in everyday life. Many of us know the unpleasant burning sensation when accidentally touching a hot plate or the agonizing ache of a fracture. Pain constitutes a fundamental part of our life and provides substantial biological benefit, due to its intimate link to action (Coninx, 2020b; Klein, 2015) This is especially true for acute pains that have a relatively short duration and are typically associated with concrete injuries (e.g. burn or fracture pain), illnesses (e.g. body aches related to a flu), or homeostatic imbalances (e.g. headaches related to dehydration). One of the central goals of pain research is to gain a better understanding of chronic pain and, building on this, the development of more effective therapeutic measures. We aim to develop an enactive approach to acute and chronic pain.
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