Bio and psycho and social embraidedness

I think "embraidedness" is an actual word. I hope so. Whether it is or isn't, here goes:

The more one reads about the brain the harder it is to maintain any sort of concept that there is NOT almost complete interpenetration of everything. Just yesterday I saw this: Violent homes have the 'same effect on brains of children as combat does on soldiers'
Brain scans were done as children looked at pictures of faces.

"... children who had been exposed to violence at home showed increased brain activity in the anterior insula and amygdala in response to the angry faces."

Both these areas are involved in what Legrain et al. call the salience detection system for the body (as opposed to "pain" matrix.) (Great paper, by the way.)
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Over at Edge.org, Andrian Kreye contributed something interesting about "subjective environment":

"Explanations tend to be at their most elegant, when science distills the meanderings of philosophy into fact. I was looking for explanations for an observation, when I came across the theory of "Umwelt" versus "Umfeld" (vaguely environment versus surroundings) by the Estonian biologist and forefather of biosemiotics Jakob von Uexküll. According to his definition "Umwelt" is the subjective environment as perceived and impacted by an organism, while "Umfeld" is the objective environment which encompasses and impacts all organisms in it's realm."

Well, not quite, because the truly objective environment, according to Uexküll is, well, fairly un"know"able:

"These umwelten are distinctive from what Uexküll termed the "umgebung" which would be objective reality should such a reality exist."

But still: Oh. My. That's it. Right there. Trust German to have come up with the perfect word already. I wish I spoke German. It would save me an awful lot of time and energy probably. Oh well..

For a long time I've discussed (with many words and only vague notions and scarce concepts) this very thing: inner and outer environments. The brain has to reconcile them, it has to "embraid" them, in its internal regulation system. Its internal regulation system (according to Mayo Clinic Medical Neurosciences 5th Ed.) is full of opioid receptors, everywhere, and includes the insular cortex and anterior cingulate - part of the salience detection system.

My brain immediately clunked into a new place: I'm pretty sure this is in the ball park:

1. umwelt ("subjective environment as perceived and impacted by an organism"... aka first-person, aka "effective","efferent") 

2. umfeld ("objective environment which encompasses and impacts all organisms in it's realm"...aka, third-person, aka "affective", "afferent").

The brain has to figure out how to intersect itself, coming and going, inner and outer, like a mobius strip, AND still keep itself sorted. Big job. No wonder it is not monolithic.

I find these ideas of umwelt and umfeld to line up fairly well with the ideas of endothermic (warm-blooded) and exothermic. An exothermic creature, like a reptile, loses its heat to the environment. Its environment controls its activity. An endothermic creature, like a mammal, just makes more heat for itself, and goes about its business, doing whatever it wants. Stronger umwelt, completely organic, fights against the umfeld. Even trees push their leaves off when they find them to be a physiological detriment. Their umwelt is better off without them at a certain point. It's all about boundaries, and how to make, then maintain them. Bio or psycho or social.
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Also, I saw this posted on Facebook yesterday: Cure and Healing by a cancer surgeon, about two patients, both with throat cancer, who to him illustrated the difference:
Patient 1:

"Her surgery and radiation therapy were completely successful and her cancer was controlled.  Nevertheless, she was overwhelmed by depression. She continued to smoke and drink, refused to go out in public, quit her job, and rejected her friends.  She agonized over her appearance and speech. She refused to return for follow-up visits or counseling. I eventually lost track of her."   

Patient 2:

"I received a letter that she had prepared in her own hand prior to her death. “Please don’t feel that you failed me,” she wrote. That message of comfort and gratitude was emotionally wrenching, but nevertheless, welcome and still treasured."   

His conclusion:

"One person was cured but not healed. The other was healed but not cured. We aim for both Cure and Healing, but the difference, I believe, rests in the relationships."  

I agree, it's all in the relationship: but as a therapist, I don't do either. I'm an interactor, not an operator.
I think, rather, with therapeutic contact, both physical and verbal, and by staying well inside my own umwelt, trying hard to not become too much umfeld to the patient, I give his or her brain sufficient and necessary distraction so it can fix itself, sort out its own umwelt and umfeld more optimally. Furthermore, my umwelt does not need to invade anyone elses' umwelt to feel real or validated. It prefers to be left alone, and it assumes everyone elses' likely does too.
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I have considered my own umwelt quite a lot. It is hypervigilant, like the children mentioned earlier, having been through physical abuse as a young child, before it had any capacity to defend itself. It became obese. Now it is becoming non-obese. It has gained a lot of inner strength and resolve throughout  the entire 20-year process. For whatever reason, it had to expand itself out into the world, and it did it the only way it could - through gaining weight for a time - until it could "feel" itself as "big" as most of those populating its umfeld, and (somehow) gain the idea it was as competent, that it had sufficient agency. At least, that's my story and I'm sticking to it. Now it's ready to change, and it is changing, decluttering, de-hoarding, lightening itself. Pushing off its leaves.
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I saw this 4 and a half minute video earlier today, and know it's just the way I'd like to be in another 35 years: My friend Maia, about a 95- year-old ballerina living a beautiful life inside her umwelt. Ah. Nothing about that is the least bit umfeld to my umwelt. In fact I feel like I expand toward, or am drawn toward, her existence, or one similar.

The first I heard of umwelt was in this thread on somasimple.
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PS: I can't resist - I just saw this gorgeous-looking meaty paper on Facebook all about dopamine, open access, and must link it here: Dopamine, Affordance and Active Inference: 

ABSTRACT: The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal) cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions) about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order) in which cues are presented. These simulations provide a (Bayes-optimal) model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors) to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level. 

Hu/manual therapy: "Intention"? "Intent"?"Intending"?

Life is a highway, I want to ride it all night long.   

"There's no load I can't hold
The road's so rough this I know
I'll be there when the light comes in
Just tell 'em we're survivors"-Tom Cochrane

The discussion rages on the Facebook page, on several different threads simultaneously.

One discussion that is from oh so earlier in the week and is nearly buried, is one around Todd Hargrove's blogpost, More Deepities: Does Intention have Power?

People involved in manual therapy will have noticed that quite a few streams of it are almost religious in their fervor. The term "deepity" came my way from a lecture by Daniel Dennett, called the Evolution of Confusion, a great watch at about an hour long. Out of that lecture came "deepity"(see clip about 3 minutes long, an extract). Todd explains that a "deepity" is a "somewhat ambiguous statement that precariously balances between two possible meanings. One potential meaning is true but trivially obvious, while the other would be earth shatteringly profound if true, but is in fact false."

Manual therapy is full of these deepity things. Which is kind of Todd's point in writing his blog posts - he's trying to deconstruct belief-based nonsense (I think) to see if there is anything meaningful (actually solid enough to believe) in manual therapy conceptualization. Todd's posts on deepities: 

1. Is the “Mind Body Connection” New Agey or Scientific?

2. More Deepities: What is “Energy Work”?

3.  More Deepities: Does Intention have Power?

After I linked his latest blogpost to the Facebook page some puzzlement arose: What was truth? People with materialistic viewpoints think they know and that people who don't (have materialistic viewpoints) are wrong and stupid. It's all philosophical/debatable. The poster did not want to discuss her implication that not buying into ideas of "chi" etc was an ethnocentrist attitude and withdrew her post before it could be challenged. A quantum entangler arrived and discussed actions at a distance, which didn't really move the conversation along much.. Finally the idea emerged that "intention" might mean applying mental faculties to manual movement of hands in treatment. It prompted me to write this: "

"The discussion is not about the verb "to intend" - rather the discussion is about the noun, or construal, named "intention" - which as a noun (i.e., reification) can refer to whatever mental construal happens to be drifting through somebody's head. The argument is "some construals are more science-based (i.e., more objective, more reality-based, biologically-congruent) than others." The project is to slowly wean one's own mind off mental junk food onto ideas that are healthier. The goal is to save manual therapy from sloppy thinking and therefore, oblivion."

On another thread, in a post which I can no longer seem to find (dang you Facebook..) I posted a link to Manual therapy models: Operator or Interactor.  It was noticed by a poster that the definition I proposed for interactor models of manual therapy included the word "intended". And it does:

Interactor model: A physical therapy handling model which consists of therapist and patient, minus or with deliberately minimized objectification or reification; both parties choose to directly deal with patient pain and nervous system function, in a process intended to be therapeutic.

I pointed out that the word "intended" appears in my definitions of operator models as well:

Operator model

A physical therapy handling model which consists of therapist and patient, plus some pareidolic, reified objectification chosen by the therapist and implicitly agreed to by the patient, intended to be therapeutic.

A physical therapy handling model which consists of therapist and student, plus some pareidolic, reified objectification chosen by the teacher and implicitly adopted by the student, intended to be therapeutic.

There is no escape from intending or intention. There is only a choice about what set of ideas one moves or "intends" from. Moving strictly from a fixed set of ideas while in contact with another human being within a manual therapy context will not allow interaction. Interacting with another human being within a manual therapy context, and having the interaction become the focus, leads to a much different kind of "intending", more interesting process, and hopefully a greater sense of having attained and retained locus of control by the patient. The definition I propose for manual therapy itself, models aside, is:

                 Proposed definition for Manual Therapy:

A legally contracted, paid interaction, consisting of physical and verbal therapeutic contact, between a person trained and licensed to perform physical treatment to assist movement and/or relieve pain and a patient seeking such paid service.

Something like this might remove us from the messy sphere of arguing over what kind of model is better than anyone else's favorite model and how one model is better than another because it's more spiritual and less materialistic, more quantum entanglementle and less materialistic, more energy and less physical, more ethereal and less biological.

I'll probably spend a bit more time delineating the argument (some construals are more science-based [i.e., more objective, more reality-based, biologically-congruent] than others), the project (slowly wean minds off mental junk food onto ideas that are healthier [or at least more neuroscience-based]), and the goal (save manual therapy from sloppy thinking and therefore, oblivion), in future posts. It's good to have all three, clearly in one's mind, no? That, and only that, is my tripartite "intention" in most anything I write, pretty much. And it applies to me as much as anyone else.