Cognitive science explains mind and brain in terms of computation, information-processing, and representationalism: the ability of a cognitive system to change internal microstructure so as to correspond with important features of the internal or external world. One could do worse than to sum up the cognitivist model of the mind as “computations over representations”, in [...]
Arthur Barsky on unexplained symptoms: clinical existential-physiological discrepancy
Arthur Barsky has a thought-provoking chapter entitled “The Validity of Bodily Symptoms in Medical Outpatients” in Arthur Stone’s important Science of Self Report (more available here):
“Although history-taking is the key to diagnosis in clinical medicine, and symptom relief is the goal of medical treatment, symptoms are often unreliable and invalid measures of the extent and [...]
Mental models of health professionals about patient symptom reports and “subjectivity”
Medicine has developed a pragmatic way to represent the verbal reports of patients within the context of diagnoses: for instance, patients report something about their experience; this is represented as a “symptom” on a “SOAP note” (Cutler, 1997): an acronym for subjective, objective, assessment, and plan. Health professionals duly record what a patient says about [...]
the legacy of Cartesian “objectivity” makes it hard to understand patient verbal reports
Psychiatrist Allan Beveridge (2002) hones in on a facet of the patient-physician relationship relevant to neurophenomenology: the over-adoption in medicine of the scientific attitude of objectivity towards phenomena. While entirely appropriate in the many research contexts, this may make understanding the personal body-knowledge of the patient more difficult (pg. 101):
“In the mental state examination, a [...]
symptom verbal reports and existential-physiological discrepancy
While the anatomical basis of how nerve projections enable perception of the body is rather well known, physicians confront situations where patient verbal reporting about symptoms does not match models based on neurophysiological mechanisms. For instance, the Merck Manual Medical Library (2009) states:
“Painful stimuli from thoracic organs can produce discomfort described as pressure, gas, burning, [...]
