Placebo From an Enactive Perspective.
Placebo From an Enactive Perspective.
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DOI：
10.3389/fpsyg.2021.660118
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发表时间：
2021
影响因子：
3.8
通讯作者：
Di Paolo EA
中科院分区：
文献类型：
--
作者：
Arandia IR;Di Paolo EA
由于其复杂性和可变性，安慰剂效应仍然存在争议。我们认为这也是由于一系列有问题的假设（二元论，还原论，个人主义，被动性）。我们批判性地评估目前的解释和经验证据，并提出了一个替代的理论框架，在体现认知科学的最新发展的基础上，对生命和心灵的生成方法。我们回顾了核心的制定概念，如自主权，代理，意义。根据这些想法，我们提出了一个从二元区别（例如，有意识与无意识）到更可行的反思和反思前活动类别。我们引入了个体化的本体论，遵循吉尔伯特西蒙顿的工作，这使我们能够看到安慰剂干预不是起源的因果链，而是调节器和触发器之间的紧张局势正在进行的体现和人际关系的过程。我们描述了这些相互关联的过程，涉及通过三个相互交织的维度的体现循环效果：有机，感觉运动，和主体间性。最后，我们认为有必要从参与性意义创造的角度来研究治疗性互动，超越对个体社会特征的识别（例如，同理心、信任），这些因素会导致安慰剂效应。我们讨论的共振和生成的建议，流行的解释，如期望和条件反射，和其他方法的基础上的意义反应和现象学/生态学的想法之间的差异。
Due to their complexity and variability, placebo effects remain controversial. We suggest this is also due to a set of problematic assumptions (dualism, reductionism, individualism, passivity). We critically assess current explanations and empirical evidence and propose an alternative theoretical framework—the enactive approach to life and mind—based on recent developments in embodied cognitive science. We review core enactive concepts such as autonomy, agency, and sense-making. Following these ideas, we propose a move from binary distinctions (e.g., conscious vs. non-conscious) to the more workable categories of reflective and pre-reflective activity. We introduce an ontology of individuation, following the work of Gilbert Simondon, that allow us to see placebo interventions not as originating causal chains, but as modulators and triggers in the regulation of tensions between ongoing embodied and interpersonal processes. We describe these interrelated processes involving looping effects through three intertwined dimensions of embodiment: organic, sensorimotor, and intersubjective. Finally, we defend the need to investigate therapeutic interactions in terms of participatory sense-making, going beyond the identification of individual social traits (e.g., empathy, trust) that contribute to placebo effects. We discuss resonances and differences between the enactive proposal, popular explanations such as expectations and conditioning, and other approaches based on meaning responses and phenomenological/ecological ideas.
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影响因子：
3.7
作者：
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