Understanding the self of people with dementia : Psychological and philosophical considerations.

BACKGROUND: The ability to create and maintain an ongoing life narrative is a key characteristic of what makes us human; however, people with dementia lose this ability in the course of the disease. If the notion of having a self is intimately linked with being able to create and maintain a life narrative and if people with dementia tend to lose this ability, what kind of self do people with dementia still possess? OBJECTIVE AND METHODS: Recent theories developed in psychology and philosophy suggest that at least two notions of the self have to be distinguished: the experiencing self and the remembering self. This distinction is applied to people with dementia. RESULTS: While the remembering self is impaired in people with dementia, their experiencing self remains relatively intact. Critically, the experiencing self is a self with inner depth, mirroring the life history of the individual. Thus, the self of people with dementia is not unextended in time. Although people with dementia may have lost the ability to tell a story about their life, they are still able to express this story in their behavior. CONCLUSION: Understanding the structure of the self of people with dementia can help guide interactions as well as the designing of appropriate interventions and environments. Moreover, realizing the inner depth of the self of people with dementia may help acknowledge their dignity and personhood.

Embodiment and personal identity in dementia.

Theories of personal identity in the tradition of John Locke and Derek Parfit emphasize the importance of psychological continuity and the abilities to think, to remember and to make rational choices as a basic criterion for personhood. As a consequence, persons with severe dementia are threatened to lose the status of persons. Such concepts, however, are situated within a dualistic framework, in which the body is regarded as a mere vehicle of the person, or a carrier of the brain as the organ of mental faculties. Based on the phenomenology of embodiment, this paper elaborates a different approach to personal identity in dementia. In this perspective, selfhood is primarily constituted by pre-reflective self-awareness and the body memory of an individual, which consists in the embodiment and enactment of familiar habits, practices and preferences. After describing the different types of body memory, the paper develops a phenomenology of dementia as a loss of reflexivity and meta-perspective. This is contrasted with the preservation of individual forms of body memory even in the later stages of the illness. The ethical consequences of an embodied approach to dementia are outlined. A final look is given to narrativistic and constructionist concepts of the self in dementia.

The Interactive Phenomenal Field and the Life Space: A Sketch of an Ecological Concept of Psychotherapy.

Based on the phenomenology of the body and ecological psychology, this paper introduces a series of concepts that enable us to overcome the still prevailing idea of an inner psyche and a corresponding individualistic view of psychopathology. These concepts are the phenomenal field, lived space, intercorporeality, and body memory; they correspond to an embodied, enactive, and ecological view of the mind. On their basis, psychiatric illnesses may be conceived as relational disorders resulting in various restrictions and impairments of the patient's lived space. The main tasks of psychotherapy, then, are to use the interactive phenomenal field as a means of restructuring the patient's relational patterns and to support his or her capacity to engage in more beneficial interactions with others. In this way, phenomenology can valuably contribute to a deeper understanding of the intricate processes of the psychotherapeutic encounter.

Give Me Five? Examining the Psychophysiological Effects of High-Fives in Athletes.

High-fives are a phenomenon that is frequently observed in sports. However, investigations on effects of high-fives are missing. Therefore, the aim of the present study was to examine psychophysiological effects of high-fives. From an embodied cognition perspective, dynamic, upward movements compared to downward movements should activate positive concepts that are represented by psychological as well as physiological states. Thirty-four athletes performed high- and low-fives (dynamic movements) as opposed to high and low static postures (control conditions) in a double-blind, within-subject design. Psychological states (i.e., feeling motivated, feeling strong) and physiological changes (i.e., cortisol, testosterone) due to the manipulation were measured. Results showed the predicted significant interaction effect for cortisol changes, but not for the other psychological (i.e., feeling motivated, feeling strong) and physiological (testosterone) state measures. In detail, a decrease in cortisol was found after athletes performed high-fives compared to low-fives. The observed effect on cortisol should be considered with caution and needs to be replicated, however, might add information to the current discussion about the crucial relevance of movement for embodied cognition effects. Future research could investigate the effects of high-fives with a partner and add performance parameters to provide more information on the effects of high-fives on performance in sport.

[Dignity, freedom, embodiment : Ethical categories concerning the use of freedom-depriving measures in people with dementia in acute care settings]. / Würde, Freiheit, Leiblichkeit : Ethische Kategorien bei der Anwendung freiheitsentziehender Maßnahmen bei Menschen mit Demenz im Akutkrankenhaus.

The use of freedom-depriving measures (physical and medicinal restraints) in people with cognitive impairment or dementia in clinical care settings is of ongoing importance. At the same time, these coercive measures are not only heavily debated but also in most cases ethically questionable from the perspective of the ethics of human dignity. Usually, the ethical evaluation of freedom-depriving measures follows classical paradigms of medical ethics, such as the Principles of Biomedical Ethics by Beauchamp and Childress. To enrich the debate at this point, the ethical category of embodiment ("Leiblichkeit" ) is introduced and discussed after a short summary of the ethical problem at hand. The phenomenon of the living body that has received increasingly more attention in several sciences since the proclaimed "corporeal turn" enables new perspectives towards human dignity, freedom and deprivation of freedom: freedom-depriving measures do not take place in an invisible realm of ideas but are directly applied to the psychophysical unity that is the living body of a person. Thus, freedom-depriving measures are an intervention into the bodily autonomy of the human being and the personal freedom that is manifested in the living body. The concept of the living body ("Leib") that is applied here, signifies more than just a physical object and is especially apt to capture the (inter)subjective dimension that has to be taken into account here. Finally, it will have to be investigated whether the use of medicinal restraints represents an especially serious interference into the sphere of human embodiment. Once introduced into the debate on freedom-depriving measures in clinical care, the category of embodiment can warrant decisive new emphases.

Does Body Memory Exist? A Review of Models, Approaches and Recent Findings Useful for Neurorehabilitation.

Over the past twenty years, scientific research on body representations has grown significantly, with Body Memory (BM) emerging as a prominent area of interest in neurorehabilitation. Compared to other body representations, BM stands out as one of the most obscure due to the multifaceted nature of the concept of "memory" itself, which includes various aspects (such as implicit vs. explicit, conscious vs. unconscious). The concept of body memory originates from the field of phenomenology and has been developed by research groups studying embodied cognition. In this narrative review, we aim to present compelling evidence from recent studies that explore various definitions and explanatory models of BM. Additionally, we will provide a comprehensive overview of the empirical settings used to examine BM. The results can be categorized into two main areas: (i) how the body influences our memories, and (ii) how memories, in their broadest sense, could generate and/or influence metarepresentations-the ability to reflect on or make inferences about one's own cognitive representations or those of others. We present studies that emphasize the significance of BM in experimental settings involving patients with neurological and psychiatric disorders, ultimately analyzing these findings from an ontogenic perspective.

The neuroscience of body memory: Recent findings and conceptual advances.

The body is a very special object, as it corresponds to the physical component of the self and it is the medium through which we interact with the world. Our body awareness includes the mental representation of the body that happens to be our own, and traditionally has been defined in terms of body schema and body image. Starting from the distinction between these two types of representations, the present paper tries to reconcile the literature around body representations under the common framework of body memory. The body memory develops ontogenetically from birth and across all the life span and is directly linked to the development of the self. Therefore, our sense of self and identity is fundamentally based on multisensory knowledge accumulated in body memory, so that the sensations collected by our body, stored as implicit memory, can unfold in the future, under suitable circumstances. Indeed, these sets of bodily information had been proposed as possible key factors underpinning several mental health illnesses. Following this perspective, the Embodied Medicine approach put forward the use of advanced technologies to alter the dysfunctional body memory to enhance people's well-being. In the last sections, recent experimental pieces of evidence will be illustrated that targeted specifically bodily information for increasing health and wellbeing, by means of two strategies: interoceptive feedback and bodily illusions. See also Figure 1(Fig. 1).

Collective Trauma, Implicit Memories, the Body, and Active Imagination in Jungian Analysis1.

This presentation attempts to show the healing potential underlying the inclusion of the patient's body in the analytic process, while honouring and revisiting the understanding of the psyche-body connection described by Jung in his early work. In addition, the author offers reflections on the impact of collective trauma whose aftermath, among others, has been the disappearance of thousands of people, consequently breaking the family genealogy, leaving hundreds of children stripped of their roots and true identity. Referencing clinical material, the author describes how the process of translation and integration-from the sensory-perceptual to the conceptual-symbolic-can be halted on account of collective trauma occurring at an early stage in development. Moreover, it is shown how the potential of the archetype or image schema, linked to the somatic-affective early experiences encoded as implicit memories, can be recovered, when Embodied Active Imagination is included in the analytic work. The patient's bodily gestures and somatic experience may bridge the gap between the preverbal-implicit knowledge and the emergence of emotions and images that allow for the creation of a new symbolic narrative.

Cette présentation vise à montrer le potentiel de guérison qu'il y a quand on inclut le corps du patient dans le processus analytique. En même temps la présentation fait honneur et revisite la compréhension du lien psyché-soma que Jung a décrite dans ses écrits précoces. De plus, l'auteur offre des réflexions sur l'impact de traumatismes collectifs dont les suites ont été - entre autres - la disparition de milliers de personnes, et en conséquence la cassure de la généalogie familiale, laissant des centaines d'enfants privés de leurs racines et de leur identité véritable. En faisant référence au matériel clinique l'auteur décrit comment le processus de traduction et d'intégration - du sensoriel-perceptuel au conceptuel-symbolique - peut être stoppé du fait d'un traumatisme collectif se produisant à un stade précoce du développement. D'autre part, il est montré comment le potentiel de l'archétype ou schéma-image, lié aux expériences précoces affectives et somatiques codées en tant que souvenirs implicites, peut être retrouvé quand on inclut l'Imagination Active Incarnée dans le travail analytique. Les mouvements du corps du patient et son expérience somatique peuvent agir comme une passerelle entre la connaissance implicite préverbale et l'émergence d'émotions et d'images qui permettent la création d'un récit symbolique nouveau.

Esta presentación propone mostrar el potencial curativo que subyace a la inclusión del cuerpo del paciente en el proceso analítico, al tiempo que honra y revisita la comprensión de la conexión psique-cuerpo descripta por Jung en sus primeros trabajos. Además, la autora ofrece reflexiones sobre el impacto del trauma colectivo cuyas secuelas, entre otras, han sido la desaparición de miles de personas, rompiendo en consecuencia la genealogía familiar y dejando a cientos de niños despojados de sus raíces y de su verdadera identidad. Tomando como referencia material clínico, la autora describe cómo el proceso de traducción e integración, de lo sensorio-perceptivo a lo conceptual-simbólico, puede detenerse debido a que el trauma colectivo se produce en una fase temprana del desarrollo. Se muestra, a su vez, cómo puede recuperarse el potencial del arquetipo o esquema-imagen, vinculado a las tempranas experiencias somato-afectivas codificadas como memorias implícitas, cuando se incluye la Imaginación Activa Corporizada en el trabajo analítico. Los gestos corporales y la experiencia somática del paciente pueden tender un puente entre el conocimiento preverbal-implícito y la emergencia de emociones e imágenes que permite la creación de una nueva narrativa simbólica.

Bodily Learning Through Creating Dance: Student Teachers' Experiences From Norwegian Physical Education Teacher Education.

Creating dance in physical education teacher education (PETE) is described as a way of expressing subjective experiences based on movements that the students have already mastered or as a way of composing dance with set movements from various dance forms that are further explored through concepts such as time, space, power and flow. This article shows how 13 Norwegian student teachers experienced the creation of dance as part of their PETE. It explores the following questions: how do student teachers in PETE experience dance creation as an embodied process of exploring, transforming and creating movements, and how were these experiences facilitated by bodily learning that was initiated by body memories? The results show that creating dance is a intersubjective, intercorporeal and interaffective phenomenon where the sense-making process happens as both an individual and a joint process. This ongoing individual and participatory sense-making can further be understood as a reciprocal dependency between culture and self, where the students' bodily learning process evolves on an existential level over time. Through this process, the students develop a sense of confidence and trust in each other, which creates a feeling of belonging. The educational potential of bodily learning through creating dance can be seen in relation to the affordances the students perceive and utilize within their learning culture in PETE.

The neuroscience of body memory: From the self through the space to the others.

Our experience of the body is not direct; rather, it is mediated by perceptual information, influenced by internal information, and recalibrated through stored implicit and explicit body representation (body memory). This paper presents an overview of the current investigations related to body memory by bringing together recent studies from neuropsychology, neuroscience, and evolutionary and cognitive psychology. To do so, in the paper, I explore the origin of representations of human body to elucidate their developmental process and, in particular, their relationship with more explicit concepts of self. First, it is suggested that our bodily experience is constructed from early development through the continuous integration of sensory and cultural data from six different representations of the body, i.e., the Sentient Body (Minimal Selfhood), the Spatial Body (Self Location), the Active Body (Agency), the Personal Body (Whole Body Ownership - Me); the Objectified Body (Objectified Self - Mine), and the Social Body (Body Satisfaction - Ideal Me). Then, it is suggested that these six representations can be combined in a coherent supramodal representation, i.e. the "body matrix", through a predictive, multisensory processing activated by central, top-down, attentional processes. From an evolutionary perspective, the main goal of the body matrix is to allow the self to protect and extend its boundaries at both the homeostatic and psychological levels. From one perspective, the self extends its boundaries (peripersonal space) through the enactment and recognition of motor schemas. From another perspective, the body matrix, by defining the boundaries of the body, also defines where the self is present, i.e., in the body that is processed by the body matrix as the most likely to be its one, and in the space surrounding it. In the paper I also introduce and discuss the concept of "embodied medicine": the use of advanced technology for altering the body matrix with the goal of improving our health and well-being.

Altered Processing and Integration of Multisensory Bodily Representations and Signals in Eating Disorders: A Possible Path Toward the Understanding of Their Underlying Causes.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) eating problems are the clinical core of eating disorders (EDs). However, the importance of shape and weight overvaluation symptoms in these disorders underlines the critical role of the experience of the body in the etiology of EDs. This article suggests that the transdiagnostic centrality of these symptoms in individuals with EDs may reflect a deficit in the processing and integration of multisensory bodily representations and signals. Multisensory body integration is a critical cognitive and perceptual process, allowing the individual to protect and extend her/his boundaries at both the homeostatic and psychological levels. To achieve this goal the brain integrates sensory data arriving from real-time multiple sensory modalities and internal bodily information with predictions made using the stored information about the body from conceptual, perceptual, and episodic memory. In this view the emotional, visual, tactile, proprioceptive and interoceptive deficits reported by many authors in individuals with EDs may reflect a broader impairment in multisensory body integration that affects the individual's abilities: (a) to identify the relevant interoceptive signals that predict potential pleasant (or aversive) consequences; and (b) to modify/correct the autobiographical allocentric (observer view) memories of body related events (self-objectified memories). Based on this view, the article also proposes a strategy, based on new technologies (i.e., virtual reality and brain/body stimulation), for using crossmodal associations to reactivate and correct the multisensory body integration processes.

How Do Soccer Players Adjust Their Activity in Team Coordination? An Enactive Phenomenological Analysis.

This study examined how individual team members adjust their activity to the needs for collective behavior. To do so, we used an enactive phenomenological approach and explored how soccer players' lived experiences were linked to the active regulation of team coordination during eight offensive transition situations. These situations were defined by the shift from defensive to offensive play following a change in ball possession. We collected phenomenological data, which were processed in four steps. First, we reconstructed the diachronic and synchronic dynamics of the players' lived experiences across these situations in order to identify the units of their activity. Second, we connected each player's units of activity side-by-side in chronological order in order to identify the collective units. Each connection was viewed as a collective regulation mode corresponding to which and how individual units were linked at a given moment. Third, we clustered each collective unit using the related objectives within three modes of regulation-local (L), global (G), and mixed (M). Fourth, we compared the occurrences of these modes in relation to the observable key moments in the situations in order to identify typical patterns. The results indicated four patterns of collective regulation modes. Two distinct patterns were identified without ball possession: reorganize the play formation (G and M) and adapt to the actions of putting pressure on the ball carrier (M). Once the ball was recovered, two additional patterns emerged: be available to get the ball out of the recovery zone (L) and shoot for the goal (L and M). These results suggest that team coordination is a fluctuating phenomenon that can be described through the more or less predictable chaining between these patterns. They also highlight that team coordination is supported by several modes of regulation, including our proposal of a new mode of interpersonal regulation. We conclude that future research should investigate the effect of training on the enaction of this mode in competition.

O estatuto de corpo na obra de Freud pós-1920 / The Status of the Body in the Works of Freud After 1920

RESUMO Na perspectiva psicanalítica, a concepção de corpo e organismo se distinguem, sobretudo pelo fato deo segundo ser pulsional. O presente artigo se propõe investigar o estatuto de corpo que emerge após 1920, no qual se situa esta radicalidade. A discussão está articulada ao postulado da pulsão de morte, momento em que a dimensão econômica ganha relevo na teoria freudiana. São privilegiadas na investigação as problemáticas do excesso pulsional e da representação psíquica. Aponta-se que o corpo pode apresentar manifestações que não se restringem à esfera representacional, como, por exemplo, o fenômeno da memória corporal. Destaca-se, ainda, a função da dor na constituição de corpo e a importância fundamental da alteridade no processo de subjetivação.

Abstract From the psychoanalytic perspective, the concept of body differs from the concept of organism. The first differs from the second mainly because of drive. This study aimed to investigate the status of the body that emerged after 1920, in which this radicality is present. The discussion was framed in relation to the death drive principle, at which point the economic dimension becomes relevant in Freudian theory. The research highlighted the problems of drive excess and psychic representation. We pointed out that the body can manifest that which is not restricted to the representational sphere, such as, for example, the phenomenon of body memory. We also discussed the function of pain in body constitution and the importance of alterity in the subjectivation process.