Many complex disorders defy simplistic categorization within a purely biomedical model, reducing health concerns solely to physiopathologies in the brain or body. This holds true for many psychiatric disorders as well as chronic illnesses like chronic fatigue, Long Covid, and fibromyalgia. My presentation will specifically delve into chronic pain as a central case study.
When addressing complex disorders in general and chronic pain in particular, what alternatives do we have to the biomedical model? Examining the recent history of pain science reveals a promising shift from a purely biomedical approach to a biopsychosocial model. Unfortunately, this model, despite its potential, is frequently applied in a biomedical, fragmented, and linear manner, partly due to its limited theoretical foundation. To successfully implement the biopsychosocial model in both research and clinical practice, we must confront the ontological challenge of integration. That is, it is imperative to explicitly define the ontological relationship between the biological, psychological, and social factors contributing to the generation and maintenance of chronic pain.
Several frameworks have been proposed to address the challenge of integration, such as enactivism, which explicitly defines the relationships between biological, psychological, and social factors. For instance, by rejecting naïve reductionism and atomism and by incorporating dynamic feedback loops, these approaches aim to inherently account for the complexity and variability of chronic pain. 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 to identifying indicative differences between groups of pain patients and conceptualizing the effectiveness of specific therapeutic measures. My primary focus will centre on examining the ‘sticky’ patterns of pain dynamics.
Sabrina Coninx is an Assistant Professor in Philosophy at the Vrije Universiteit Amsterdam. Before that, she worked at Ruhr University Bochum as a postdoctoral researcher and scientific coordinator of the Research Training Group ‘Situated Cognition’. Her work is located at the intersection of philosophy of mind and philosophy of science, taking into account insights from neuroscience, psychology, medicine, and healthcare. Her research focuses on phenomena related to human suffering and pain in their biological, psychological, and social context.