In recent years the enactive framework of cognition has begun to slowly filter through into the world of psychiatry. It goes like this: If, as radical enactivists propose, the mind is a dynamical system extended throughout the brain, body and environment, this must hold true of a disordered mind. Our neural machinery is just one necessary constituent involved in mental disorders but our body and environment are so tightly coupled that they too are necessary. The point here, is that our psychosocial environment doesn't just provide a context in the form of inputs to the brain, it is literally part of what enactivists conceptualise as the mind. This might seem strange or indeed outright ridiculous but bear with me.
Research into explaining the social cognitive deficits seen in autistic spectrum disorders is turning more and more to the embodied principles of enactivism. Classic theories of social cognition, such as theory theory and simulation theory, rely heavily on complex metarepresentational states or simulations in order to explain how we infer the beliefs and desires of others. Thus the primary deficit in social difficulties faced in ASD is an impairment in the ‘theory of mind domain’ residing somewhere in the brain.
Both these theories make the assumption that the minds of others are not directly accessible and therefore we need some “extra-perceptual cognitive operation” in order to make inferences. On an enactivist account however, we do have some access to minds through our direct interaction as humans.
Gallagher’s interaction theory emphasises the “perceived social affordances and engaged interactions taking place in our shared intersubjective world.” without relying on the need for abstract representations. He appeals, for example, to the role of primary and secondary intersubjectivity in newborns and babies, providing a non-representational account, whereby motor and sensory processes allow infants to engage socially through facial recognition, vocalization and mimicking. Such phenomena are shown to be impaired in autistic children.The advantage of this kind of approach is that it has the potential to generate equal explanatory power with the advantage of parsimony, i.e. without relying on complex algorithms governing social norms.
The importance of all this, is that if mental disorders, truly are embedded in the brain, body and environment, there will be consequences for how they are conceptualised, researched and treated by psychiatrists. Fuch, for example, proposes the need for circular models of mental illness. He explains “The final disorder is the product of a cascade of subjective, neuronal, social and environmental influences continuously interacting with each other. Within these circular interactions the brain acts as a mediating, translating and also amplifying “relay station”, but not as “the monolinear cause.” In other words, from an enactive perspective, mental disorders cannot be understood solely by focusing on impaired neuronal circuits - it’s just one piece of the system.
Fuchs, T. (2009). Embodied cognitive neuroscience and its consequences for psychiatry. Poiesis & Praxis, 6(3-4), 219-233.