Understanding patterns of dynamic interaction between biological, psychological, and social factors in the maintenance of chronic pain from the framework of enactivism will be crucial to identifying differences between groups of pain patients and conceptualizing the effectiveness of specific therapeutic measures, concluded Sabrina Coninx in her lecture titled “The Dynamic Patterns of Chronic Pain.”
In the lecture held on November 27th in the Grand Hall of the Institute of Social Sciences (via Zoom and in front of a live audience), an Assistant Professor in Philosophy at the Vrije Universiteit Amsterdam, dr Coninx, argued that many intricate disorders resist oversimplified classification within a purely biomedical framework, which oversimplifies health concerns by attributing them solely to physiological issues in the brain or body. This applies not only to various psychiatric disorders but also to chronic conditions such as chronic fatigue, Long Covid, and fibromyalgia. She specifically explored chronic pain as a central case study in her presentation.
When addressing complex disorders in chronic pain in particular, what alternatives do we have to the biomedical model? A closer look at the recent history of pain science reveals a promising shift from a purely biomedical approach to a biopsychosocial model. Unfortunately, despite its potential, this model is often applied in a biomedical, fragmented, and linear manner, partially due to its limited theoretical foundation. To successfully implement the biopsychosocial model in both research and clinical practice, we must tackle the ontological challenge of integration (problem of integration in psychiatry, posed by de Haan). In other words, it is crucial to explicitly define the ontological relationship between the biological, psychological, and social factors contributing to chronic pain’s generation and persistence.
Dr Coninx argues that to solve this problem; we must turn to the framework of enactivism, which explicitly defines the relationships between biological, psychological, and social factors, although she is not satisfied with the proposed solution from de Haan. By rejecting naïve reductionism and atomism and incorporating dynamic feedback loops, these approaches aim to account for the complexity and variability of chronic pain inherently. However, many approaches tend to overlook the characteristic patterns of dynamic interaction between biological, psychological, and social factors in the maintenance of chronic pain. Understanding these patterns is crucial for identifying distinctive differences among groups of pain patients and conceptualizing the effectiveness of specific therapeutic measures. She focused on examining the ‘sticky’ patterns of pain dynamics.
Sabrina Coninx’s lecture is the thirteenth in the series of seminars on “Philosophy and Psychiatry” organized by the Center for Philosophy at the Institute of Social Sciences. The seminar aims to allow young colleagues and doctoral students to present and enhance their work through the discussions following each lecture.
