pp 1–18 | Cite as

More than our Body: Minimal and Enactive Selfhood in Global Paralysis

  • Miriam KyseloEmail author
Original Paper


This paper looks to phenomenology and enactive cognition in order to shed light on the self and sense of self of patients with locked-in syndrome. It critically discusses the concept of the minimal self, both in its phenomenological and ontological dimension. Ontologically speaking, the self is considered to be equal to a person’s sensorimotor embodiment. This bodily self also grounds the minimal sense of self as being a distinct experiential subject. The view from the minimal bodily self presupposes that sociality comes after the self, or that in other words, the essence of self remains independent of our social interactions and relations. In this paper, I rely on the idea of enactive autonomy and Heidegger’s and Merleau-Ponty’s views of human existence as primordially social, to argue for the contrary. The self is fundamentally relational and this is also reflected at the level of the subjective experience of being a self. I indicate how a strong relational view of selfhood can serve as a preliminary heuristic to make sense of the situation of the patient with LIS and conclude with some practical implications concerning patient autonomy, our ethical responsibility toward the patient, and the possibilities for improving the life of patients with LIS.


Minimal self Embodied self Enactive self Enactive autonomy Relational autonomy Social self Locked-in syndrome Personal identity Patient autonomy Distinction and participation 



  1. 1.
    Bruno, M.-A., Pellas, F., & Laureys, S. 2008. Quality of life in locked-in syndrome survivors. In Yearbook of Intensive Care and Emergency Medicine (p. S. 881–890).Google Scholar
  2. 2.
    Buhrmann, Thomas, and Ezequiel Di Paolo. 2017. The sense of agency–a phenomenological consequence of enacting sensorimotor schemes. Phenomenology and the Cognitive Sciences 16 (2): 207–236.CrossRefGoogle Scholar
  3. 3.
    De Haan, S. 2010. Comment: the minimal self is a social self. In The Embodied Self, ed. T. Fuchs, H.C. Sattel, and P. Henningsen, 12–17. Stuttgart: Schattauer.Google Scholar
  4. 4.
    Di Paolo, Ezequiel, Thomas Buhrmann, and Xabier Barandiaran 2017. Sensorimotor life: An enactive proposal. Oxford University Press.Google Scholar
  5. 5.
    Dreyfus, H. L. 2013. The myth of the pervasiveness of the mental. In J. K. (Ed. . Schear (Ed.), Mind, reason, and being-in-the-world: The McDowell-Dreyfus debate (pp. 15–40). London UK: Routledge.Google Scholar
  6. 6.
    Entwistle, V.A., S.M. Carter, A. Cribb, and K. McCaffery. 2010. Supporting patient autonomy: The importance of clinician-patient relationships. Journal of General Internal Medicine 25 (7): 741–745. Scholar
  7. 7.
    Fenton, A., and S. Alpert. 2008. Extending our view on using BCIs for locked-in syndrome. Neuroethics 1 (2): 119–132.CrossRefGoogle Scholar
  8. 8.
    Froese, T., and T. Fuchs. 2012. The extended body: A case study in the neurophenomenology of social interaction. Phenomenology and the Cognitive Sciences 11 (2): 205–235.CrossRefGoogle Scholar
  9. 9.
    Gallagher, S. 2000. Philosophical conceptions of the self: Implications for cognitive science. Trends in Cognitive Sciences 4 (1): 14–21. Scholar
  10. 10.
    Gallagher, S. 2005. How the body shapes the mind. Clarendon Press.Google Scholar
  11. 11.
    Gallagher, S. 2018. Deep brain stimulation, self and relational autonomy. Neuroethics 1–13.
  12. 12.
    Gallagher, S., & Zahavi, D. 2005. Phenomenological approaches to self-consciousness. Retrieved from Accessed 2 Oct 2018.
  13. 13.
    Grassian, S. 1983. Psychopathological effects of solitary confinement. The American Journal of Psychiatry 140: 1450–1454.CrossRefGoogle Scholar
  14. 14.
    Grassian, S. (2006). Psychiatric effects of solitary confinement. Wash. UJL & Pol’y. 22:325.Google Scholar
  15. 15.
    Guenther, L. 2013. Solitary confinement: Social death and its afterlives. Minneapolis: Minnesota University Press.CrossRefGoogle Scholar
  16. 16.
    Gurwitsch, A. 1966. Studies in phenomenology and psychology. Evanston, Ill.: Northwestern University Press.Google Scholar
  17. 17.
    Haney, C. 2003. Mental health issues in long-term solitary and “supermax” confinement. Crime & Delinquency 49: 124–156. Scholar
  18. 18.
    Hanna, R., and E. Thompson. 2007. The mind-body-body problem. Theoria et Historia Scientiarum 7 (1): 23–42.CrossRefGoogle Scholar
  19. 19.
    Heersmink, R. 2011. Embodied tools, cognitive tools and brain-computer interfaces. Neuroethics: 1–13.Google Scholar
  20. 20.
    Heidegger, M. 1927/2001. Sein und Zeit. Tübingen: Niemeyer.Google Scholar
  21. 21.
    Heidegger, M. 1982. The Basic Problems of Phenomenology (translated by A. Hofstadter). Bloomington: Indiana University Press.Google Scholar
  22. 22.
    Henry, A., & Thompson, E. 2011. Witnessing from here: Self-awareness from a bodily versus embodied perspective. in Gallagher, S. (Ed.). The Oxford handbook of the self. Oxford University Press.Google Scholar
  23. 23.
    Husserl, E. 1950/1992. Ideen zu einer reinen Phaenomenologie und phaenomenologischen Philosophie 1: Allgemeine Einfuehrung in die reine Phaenomenologie. Text nach Husserliana III/1 und V. In E. (Ed. . Ströker (Ed.), Gesammelte Schriften/ Edmund Husserl (Vol. 5). Hamburg: Meiner.Google Scholar
  24. 24.
    Jonas, H. 1966/2001. The phenomenon of life: Toward a philosophical biology. Chicago: University of Chicago Press.Google Scholar
  25. 25.
    Krueger, J., & Legrand, D. 2009. The open body. In Antonella Carassa, Francesca Morganti & Guiseppa Riva (eds.), Enacting Intersubjectivity: Paving the Way for a Dialogue Between Cognitive Science, Social Cognition, and Neuroscience. Universita Della Svizzera Italiana. pp. 109–128.Google Scholar
  26. 26.
    Kyselo, M. 2014. The body social: An enactive approach to the self. Frontiers in Psychology 5.
  27. 27.
    Kyselo, M. 2016. The minimal self needs a social update. Philosophical Psychology 29 (7): 1057–1065. Scholar
  28. 28.
    Kyselo, M., and E. Di Paolo. 2015. Locked-in syndrome: A challenge for embodied cognitive science. Phenomenology and the Cognitive Sciences 14 (3): 517–542. Scholar
  29. 29.
    Laureys, S., F. Pellas, P. Van Eeckhout, S. Ghorbel, C. Schnakers, F. Perrin, et al. 2005. The locked-in syndrome: What is it like to be conscious but paralyzed and voiceless? Progress in Brain Research 150: 495–611.CrossRefGoogle Scholar
  30. 30.
    Legrand, D., and P. Ruby. 2009. What is self-specific? Theoretical investigation and critical review of neuroimaging results. Psychological Review 116 (1): 252–282.CrossRefGoogle Scholar
  31. 31.
    León-Carrión, J., P. van Eeckhout, and M. Del Rosario Domínguez-Morales. 2002. The locked-in syndrome: A syndrome looking for a therapy. Brain Injury 16: 555–569.CrossRefGoogle Scholar
  32. 32.
    Levy, N. 2012. Autonomy, responsibility and the oscillation of preference. In Addiction Neuroethics, 139–151. Elsevier.Google Scholar
  33. 33.
    Lucci, G., and M. Pazzaglia. 2015. Towards multiple interactions of inner and outer sensations in corporeal awareness. Frontiers in Human Neuroscience 9.
  34. 34.
    Mackenzie, C., & Stoljar, N. (Eds.). 2000. Relational autonomy: Feminist perspectives on autonomy, agency, and the social self. Relational autonomy: Feminist perspectives on autonomy, agency, and the social self. Oxford University Press.Google Scholar
  35. 35.
    Maiese, M. 2015. Embodied selves and divided minds. 1st ed. New York: Oxford University Press.CrossRefGoogle Scholar
  36. 36.
    Markus, H.R., and S. Kitayama. 2010. Cultures and selves: A cycle of mutual constitution. Perspectives on Psychological Science 5 (4): 420–430. Scholar
  37. 37.
    Maturana, H.R., and F.J. Varela. 1980. Autopoiesis and Cognition: The Realization of the Living (Boston Studies in the Philosophy of Science). Boston studies in the philosophy of science 42. Dordrecht: D. Reidel.CrossRefGoogle Scholar
  38. 38.
    Merleau-Ponty, M. (1964). The primacy of perception: And other essays on phenomenological psychology, the philosophy of art, history, and politics. Northwestern University Press.Google Scholar
  39. 39.
    Meurleau-Ponty, M. 1962/2002. The phenomenology of perception. London and New York: Routledge.Google Scholar
  40. 40.
    Murakami, Y. 2018. Phenomenological analysis of a Japanese professional caregiver specialized in patients with amyotrophic lateral sclerosis. Neuroethics.
  41. 41.
    Nizzi, M. C., Demertzi, A., Gosseries, O., Bruno, M. A., Jouen, F., & Laureys, S. 2011. From armchair to wheelchair: How patients with a locked-in syndrome integrate bodily changes in experienced identity. Consciousness and Cognition.
  42. 42.
    Nizzi, M.-C., V. Blandin, and A. Demertzi. 2018. Attitudes towards personhood in the locked-in syndrome: From third- to first- person perspective and to interpersonal significance. Neuroethics.
  43. 43.
    Ruhnke, G.W., S.R. Wilson, T. Akamatsu, T. Kinoue, Y. Takashima, M.K. Goldstein, et al. 2000. Ethical decision making and patient autonomy: A comparison of physicians and patients in Japan and the United States. CHEST 118 (4): 1172–1182. Scholar
  44. 44.
    Sass, L.A., and J. Parnas. 2003. Schizophrenia, consciousness, and the self. Schizophrenia Bulletin 29 (3): 427–444.CrossRefGoogle Scholar
  45. 45.
    Schütz, Alfred. 1971 "Das problem der transzendentalen Intersubjektivität bei Husserl." Gesammelte Aufsätze III. Springer, Dordrecht. 86–118.Google Scholar
  46. 46.
    Thompson, E. 2001. Empathy and consciousness. Journal of Consciousness Studies 8 (5–6): 1–32.Google Scholar
  47. 47.
    Thompson, E. 2005. Sensorimotor subjectivity and the enactive approach to experience. Phenomenology and the Cognitive Sciences 4 (4): 407–427.CrossRefGoogle Scholar
  48. 48.
    Thompson, E. 2007. Mind in life: Biology, phenomenology, and the sciences of mind. Harvard University Press.Google Scholar
  49. 49.
    Thompson, E., and F.J. Varela, 2001. Radical embodiment: neural dynamics and consciousness. Trends in Cognitive Sciences 5(10):418–425.Google Scholar
  50. 50.
    Varela, F.J., Thompson, E., and Rosch, E. 1991/2017. The embodied mind: Cognitive science and human experience. MIT press.Google Scholar
  51. 51.
    Vidal, F. 2018. Phenomenology of the locked-in syndrome: An overview and some suggestions. Neuroethics.
  52. 52.
    Walter, S. 2010. Locked-in syndrome, BCI, and a confusion about embodied, embedded, extended, and enacted cognition. Neuroethics 3 (1): 61–72.CrossRefGoogle Scholar
  53. 53.
    Zahavi, D. 2010. The experiential self. Objections and clarifications. In Mark Siderits, Evan Thompson & Dan Zahavi (eds.), Self, No Self?: Perspectives From Analytical, Phenomenological, and Indian Traditions. Oxford University Press.Google Scholar
  54. 54.
    Zahavi, D. 2014. Self and other: Exploring subjectivity, empathy, and shame. First ed. Oxford: Oxford University Press.Google Scholar
  55. 55.
    Zahavi, D. 2016. Openness versus interdependence: A reply to Kyselo. Philosophical Psychology 29 (7): 1066–1067.CrossRefGoogle Scholar
  56. 56.
    Zaner, R.M. 2003. Sisyphus without knees: Exploring self-other relationships through illness and disability. Literature and Medicine 22 (2): 188–207.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Institute of PhilosophyTechnical University BerlinBerlinGermany

Personalised recommendations