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An enactivist approach to treating depression: cultivating online intelligence through dance and music

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Abstract

This paper utilizes the enactivist notion of ‘sense-making’ to discuss the nature of depression and examine some implications for treatment. As I understand it, sensemaking is fully embodied, fundamentally affective, and thoroughly embedded in a social environment. I begin by presenting an enactivist conceptualization of affective intentionality and describing how this general mode of intentional directedness to the world is disrupted in cases of major depressive disorder. Next, I utilize this enactivist framework to unpack the notion of ‘temporal desituatedness,’ and maintain that the characteristic symptoms of depression result from a disruption to the future-directed structure of affective intentionality. This can be conceptualized as a loss of “online intelligence” and a shrinking of the field of affordances. Then, I argue that two of the standard modes of treatments for depression, medication and cognitive behavioral therapy, are not fully sufficient means of restoring online intelligence, and that these limitations stem partly from the approaches’ implicit commitment to a brain-bound, overly cognitivist view of the mind. I recommend expressive arts interventions such as dance-movement therapy and music therapy as important supplementary treatment methods that deserve further consideration. Insofar as they revitalize subjects’ bodies and emotions, cultivate an openness to the future, and promote self-insight and social synchrony, these treatment modes not only reflect key insights of enactivism, but also offer great potential for lasting healing.

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Notes

  1. Other versions of enactivism, not to be examined here, include ‘sensorimotor enactivism’ (O’Regan and Noë 2001; Noë 2004), ‘radical enactivism’ (Hutto 2011; Hutto and Myin 2012), and ‘computational enactivism,’ (Kirchoff, 2016; Kirchoff & Froese 2017; Ramstead et al. 2016).

  2. There are important questions here about how social and cultural values arise, given that these considerations seem to be undetermined by biological values associated with survival and adaptivity. For a discussion, see Froese and Di Paolo (2011).

  3. Here I attempt to characterize some general features that are common across many instances of major depressive disorder. However, it should be noted that even if “temporal desituatedness” is central to depression, this may manifest and be experienced somewhat differently in different cases.

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Acknowledgements

I presented earlier versions of this paper at the international conference on "Time and Intentionality" (organized by Maxime Doyon and Thiemo Breyer) held at the University of Montreal in September 2016, as well as the conference on "4E Cognition and the Landscapes of Mental Disorder" (organized by Joel Krueger) held at the University of Exeter in April 2018. Many thanks to the conference organizers and other attendees for their thought-provoking questions and helpful feedback.

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    Michelle Maiese

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Maiese, M. An enactivist approach to treating depression: cultivating online intelligence through dance and music. Phenom Cogn Sci 19, 523–547 (2020). https://doi.org/10.1007/s11097-018-9594-7

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