15. Enactive, Embodied Communication in Hermeneutic Healthcare - Part 3 (A model)

Dr Mandy Banton • February 6, 2022

In the last blog, I delved into the work of philosopher Susan Stuart, who became interested in the phenomenon of cranial osteopathic palpation, describing it as a form of “enkinaesthetic entanglement”. Now I wish to explore further how we can model a form of hermeneutic healthcare - one that may involve touch - in the light of both enactivist, embodied theories of consciousness and communication, as well as the hermeneutic model proposed by Frederik Svenaeus (see Blogs 8 and 9).

First and foremost, a hermeneutic experience of healthcare entails sense-making. The patient seeking healthcare is an understanding being, who wishes to know as meaningfully as possible what ails them. The account of the diagnosis might be of as much significance as the options for treatment, or the prognosis.


Secondly, a hermeneutic model of healthcare will see the patient and their practitioners as co-agents, participating in an intersubjective therapeutic alliance. 


Thirdly, within hermeneutic healthcare, there is an investment in skilful enactive communication: attending, being-alongside, participating, acknowledging, hearing, reflecting and sharing. This communication will, by virtue of its hermeneutic orientation, involve an intertwining and a fusion of horizons. 


Finally, the very fact that healthcare has a hermeneutic character, imbues it with the potential to instantiate symbolic change (a meta-semiotic sense of alleviation or relief) in the patient’s experience of their health. 


In my thesis, “Making Sense of Cranial Osteopathy: an Interpretative Phenomenological Analysis”, I describe cranial osteopathy as a hermeneutic form of healthcare. Having analysed data which led me to understand that bodily empathy - the mutual incorporation (in cranial osteopathic encounters), described by Fuchs and de Jaegher (2009) - involves a resonance in which the osteopath and the patient merge in their understanding, and what is meaningful is disclosed (ie. the clues to the diagnosis and to the re-orientation back to health).


In my next post...

I will return to the challenge presented to philosophers and practitioners of healthcare by non-dualism, and how we are used to thinking in dualistic and analytic, rather than holistic and gestalt, ways.

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18. Hermeneutic Healthcare: Osteopathic Reflections - Theory & Practice

By Dr Mandy Banton • April 25, 2022
In this post, I share a monologue I wrote while coming to understand the implications of using a hermeneutic model in osteopathic practice, particularly when using hands-on assessment and treatment approaches. I was thinking about the concept of hermeneutic realism and how it helps me understand what the phenomenological rallying cry, ‘back to the things themselves’ means - and applying this to the Mitsein I share with my patients.
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17. Hermeneutic Healthcare: Meaning / Materiality

By Dr Mandy Banton • March 7, 2022
Previously, I have discussed the concept of meaning in hermeneutic healthcare as an ontological partner to being – to have existence is to be engaged in sense-making (with meaning as the property that emerges from the interaction between a being and its environment). In this post, I am going to consider the structure of meaning as it pertains to health, particularly within a healthcare context, by discussing its ontology within two contrasting healthcare models (with an upfront caveat that these models are crude simplifications).
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16. Reflexive Non-Dualism in Research

By Dr Mandy Banton • February 21, 2022
The benefit of a non-dualistic ontological stance is that it liberates the phenomenologist from the constant challenge of having to agree that there is a distinction between internal things and external things, and in their manner of appearance to human consciousness.