B. Michael Ray

La dialéctica de Platón sobre la esencia y la apariencia no constituye una metafísica de dos mundos, el fenómeno y el noúmeno, sino más bien un dualismo formal entre la Idea (eidos) y el cuerpo (soma). Este dualismo formal proporciona la condición necesaria para el monismo materialista. Al romper la prohibición de Parménides de pensar en lo que no es, Platón suspende la igualdad entre pensar y ser, separando la sustancia de la Idea. Concomitante con la metafísica de la negación de Platón, hay una cierta negación de la metafísica entendida como una iteración tautológica de la equivalencia pensar = ser. Al reconocer que lo que no es, de alguna manera es, también estamos obligados a reconocer que lo que es, de alguna manera no es. Por otro lado, esas formas de materialismo metafísico que niegan el no-ser consagran involuntariamente la fusión idealista del pensamiento con el ser. Así, la exposición de Platón sobre el entrelazamiento del ser y el no-ser en el pensamiento acerca de lo que es, contiene una respuesta instructiva para aquellos sofistas contemporáneos que niegan la norma de la verdad para afirmar la inmanencia del ser.

Chronic pain is one of the most disabling medical conditions globally, yet, to date, we lack a satisfying theoretical framework for research and clinical practice. Over the prior decades, several frameworks have been presented with biopsychosocial models as the most promising. However, in translation to clinical practice, these models are often applied in an overly reductionist manner, leaving much to be desired. In particular, they often fail to characterize the complexities and dynamics of the lived experience of chronic pain. Recently, an enactive, affordance-based approach has been proposed, opening up new ways to view chronic pain. This model characterizes how the persistence of pain alters a person’s field of affordances: the unfolding set of action possibilities that a person perceives as available to them. The affordance-based model provides a promising perspective on chronic pain as it allows for a systematic investigation of the interactive relation between patients and their environment, including characteristic alterations in the experience of their bodies and the space they inhabit. To help bridge the gap from philosophy to clinical practice, we unpack in this paper the core concepts of an affordance-based approach to chronic pain and their clinical implications, highlighting aspects that have so far received insufficient attention. We do so with an analogy to playing video games, as we consider such comparative illustration a useful tool to convey the complex concepts in an affordance-based model and further explore central aspects of the lived experience of chronic pain.