Paula Muhr

This paper examines how integrating clinical video recordings into the diagnostic encounter shapes a patient’s experience of functional seizures, a contested neurological condition historically known as hysterical attacks. Drawing on James Gibson’s theory of affordances and de Haan et al.’s account of how individuals perceive affordances based on their needs and concerns, the study analyzes a single in-depth interview with an 18-year-old patient recently diagnosed with functional seizures. It explores what viewing seizure videos with a doctor offers the patient—in clinical, epistemic, emotional, and experiential terms. The interview was subjected to a close reading, attending to how video-mediated communication of diagnosis intersects with the patient’s prior illness history, sociocultural context, and understanding of self. The analysis identified three positive (epistemic insight, diagnostic validation, trauma recollection) and three negative affordances (shame, vulnerability, resignation). These affordances emerged not only from what the videos showed but also from how they were viewed, framed, and interpreted during the diagnostic encounter. The study concludes that the videos’ affordances cannot be separated from an individual patient’s interpretive resources and biography. Clinical video viewing can generate meaningful diagnostic insights, but it also risks harm unless embedded within a carefully structured dialogical process that attends to the patient’s specificities.

This article examines how functional neurological disorder (FND), historically called hysteria, is currently enacted in biomedical treatment discourse. Drawing on Annemarie Mol's concept of enactment, it explores how different therapeutic approaches produce divergent versions of the disorder across symptom clusters. Through a close reading of eleven narrative reviews published between 2016 and 2025, I analyse how targeted therapies for functional motor symptoms and functional seizures are justified, how they relate to diagnostic logic, and how they are shaped by historical assumptions. While both symptom clusters are diagnosed through rule-in criteria based on physical signs—rather than psychological aetiology—their treatment diverges substantially. Functional motor symptoms are increasingly addressed through FND-specific physiotherapy, grounded in neuroimaging studies and aimed at retraining automatic movement. Functional seizures, by contrast, are treated through adapted psychological therapies, particularly CBT-based interventions targeting emotion, stress, and behaviour. This divergence, I argue, enacts a therapeutic split that implicitly reflects a historical mind-body dualism. The disorder is neurologically diagnosed in both cases, yet treated physically in only one. Rarely problematised in the literature, this discrepancy has consequences for patients and FND's coherence as a diagnosis. This finding highlights a structural inconsistency in current clinical reasoning and raises questions about how FND might be managed without perpetuating outdated assumptions about emotion and the nature of somatic symptoms.

Functional neurological disorder (FND), historically referred to as hysteria, is a contested illness characterised by heterogeneous and often co-occurring neurological symptoms, such as seizures, abnormal movements, and paralysis. Its diagnosis remains challenging due to the disorder’s complexity and lack of standardised procedures. Recent neuroimaging research has sought to link FND symptoms to brain dysfunction, with three pioneering studies using resting-state functional magnetic resonance imaging (fMRI) to train machine learning (ML) classifiers for diagnostic purposes. These studies have aimed to identify biomarkers for future clinical application, while also providing new insights into FND’s neuropathophysiology that have eluded traditional data analyses. Combining perspectives from science and technology studies and media studies, this paper critically examines how researchers navigate the technical constraints of resting-state fMRI when constructing the datasets to train ML classifiers for diagnosing FND. Through a close reading of the published studies, it analyses operations performed during patient selection, resting-state data acquisition, preprocessing, and connectivity modelling to translate FND’s clinical complexity into ML-ready datasets. Drawing on Annemarie Mol’s concept of ontological politics, it argues that these operations enact specific versions of FND as a condition diagnosable through individual patients’ brain connectivity patterns, while excluding multiple key aspects of the disorder as algorithmically illegible. Whereas the studies present ML classifiers as tools to support future clinical decision-making, they overlook the political implications of inadvertent diagnostic exclusions these systems enact. The paper concludes that the development of neuroimaging diagnostic ML classifiers for FND and related conditions demands critical scrutiny of the new diagnostic realities they enact and their implications for patients.

In this chapter, I approach recent developments in neuroimaging research into somatic symptoms historically called hysteria and now labeled functional neurological disorder. From the perspective of science and technology studies, I examine how the intersection between trauma, gender, and brain-environment relations has been empirically negotiated in recent neuroimaging experiments that searched for female-specific neurophysiological underpinnings of such symptoms. Drawing on Bruno Latour’s notion of the relative existence of phenomena, I analyze how four pioneering studies used quantitative structural neuroimaging methods to explore associations between patients’ symptoms and previous traumatic experiences, thus looking for possible gender-specific differences in symptoms’ neurophysiological mechanisms. I argue that instead of merely reviving problematic historical views of hysteria as a biologically predetermined female disorder, the studies discussed here operate with a more nuanced and multifactorial concept of gender specificity. I also emphasize that the studies’ empirical findings on the existence of gender-specific neuropathology remain ambiguous and inconclusive.

This chapter examines how different kinds of images have been deployed in disparate medical contexts to render long-term fatigue—an elusive and quintessentially intangible pathological physical and mental condition—visually communicable and epistemically explorable in the mid-twentieth and early ­ twenty-first centuries. First, by focusing on two disparate case studies, we intend to perform in-depth analyses of select context-specific uses of images in mediating the production and dissemination of biomedical knowledge of fatigue in different historical contexts. Second, through such an unusual juxtaposition of two mutually independent case studies, each written by a separate author, we want to exemplify the heterogeneity of context-specific functions that diverse images have fulfilled in the medical discourse on fatigue. To achieve this twofold aim, we selected two case studies from different historical periods and medical contexts, characterized by different conceptual framings of fatigue and the use of different types of images, whose separate analyses necessitated employing two different methodological approaches.

In this chapter, I approach recent developments in neuroimaging research into somatic symptoms historically called hysteria and now labeled functional neurological disorder. From the perspective of science and technology studies, I examine how the intersection between trauma, gender, and brain-environment relations has been empirically negotiated in recent neuroimaging experiments that searched for female-specific neurophysiological underpinnings of such symptoms. Drawing on Bruno Latour’s notion of the relative existence of phenomena, I analyze how four pioneering studies used quantitative structural neuroimaging methods to explore associations between patients’ symptoms and previous traumatic experiences, thus looking for possible gender-specific differences in symptoms’ neurophysiological mechanisms. I argue that instead of merely reviving problematic historical views of hysteria as a biologically predetermined female disorder, the studies discussed here operate with a more nuanced and multifactorial concept of gender specificity. I also emphasize that the studies’ empirical findings on the existence of gender-specific neuropathology remain ambiguous and inconclusive.

Near-death experiences (NDEs), reported by individuals who nearly died but survived, are vivid conscious experiences occurring in near-death states, such as cardiac arrest, when the brain is expected to cease functioning. This paper examines recent developments in neuroimaging research aimed at characterising neural activity in the dying human brain to identify neural correlates of consciousness and NDEs. By combining historical epistemology and media studies, I situate this research within its historical context that I trace to the mid-20th-century technological changes in identifying NDEs and determining death. I then analyse several pioneering studies that utilised clinical EEG recordings from deceased patients to investigate if neural activity in the dying human brain indicates conscious processing. Drawing on Hans- Jörg Rheinberger, I argue that these studies have established a new experimental system capable of formulating new questions and generating novel empirical findings about its object of inquiry. Finally, using Ludwig Jäger’s concept of transcriptivity, I discuss why the complex patterns of synchronised brain activity in dying individuals identified by these studies elude clear interpretation and stabilisation as neural markers of disconnected consciousnesses and NDEs. Apart from tracing how this emerging neuroimaging research introduces epistemic shifts in the medical investigation of neural underpinnings of NDEs, this paper also contrib- utes to broader discussions in the philosophy of science about the processes of knowledge production within exploratory experimental research. It does so by drawing attention to how such processes are configured in an emerging experimental system that is not yet capable of articulating its object of inquiry and by discussing why such a system can, despite its limitations, be regarded as epistemically productive.

Much has been written, mostly in overly critical terms, about Jean-Martin Charcot’s use of images in his hysteria research. Besides the images of patients Charcot produced for his clinical research, one other image has preoccupied present-day scholars—André Brouillet’s painting Une leçon clinique à la Salpêtrière. Unveiled at the 1887 Salon in Paris, this life-sized painting depicts Charcot lecturing on hysteria to his male audience while presenting a swooning female patient. For many present-day critics, Brouillet’s painting symbolizes Charcot’s purported misuse of his female hysteria patients. Contrary to such interpretations, this article shows that Brouillet’s painting did not merely serve as an iconic visual representation of Charcot’s hysteria research but was also used by Charcot as an active epistemic tool in his research on hysterical amnesia. Through a close reading of Charcot’s only published lecture on hysterical amnesia, which he held on December 22, 1891, I analyze the process through which Charcot generated new medical insights into hysterical amnesia. I thereby trace the decisive role that Une leçon clinique played in this process.

When the first empirical images of a black hole’s shadow were released in April 2019, they transformed this defining black hole feature from a theoretical into an explorable physical entity. But although derived from empirical measurements, the production of these images relied on the deployment of the algorithmic pipelines designed specifically for this purpose to enable the selection of optimal imaging parameters. How could the researchers involved trust their imaging pipelines to deliver faithful reconstructions of unknown images from the noisy, fragmentary measurements? This article analyses the media-specific operations through which the researchers generated sufficient evidence of the trustworthiness of their algorithmic outputs by constructing and deploying a specifically tailored ground truth dataset that comprised simulated model images and simulated measurement data. The article also argues that the epistemic trust established through such operational procedures is relational and contingent on the adequacy of the media-specific operations that generated it.

Vast archives of fragmentary structural brain scans that are routinely acquired in medical clinics for diagnostic purposes have so far been considered to be unusable for neuroscientific research. Yet, recent studies have proposed that by deploying machine learning algorithms to fill in the missing anatomy, clinical scans could, in future, be used by researchers to gain new insights into various brain disorders. This chapter focuses on a study published in2019, whose authors developed a novel unsupervised machine learning algorithm for synthesising missing anatomy in extremely sparse clinical MRI scans of thousands of stroke patients. By approaching the study from a media-theoretical perspective, I analyse how its authors dis-cursively negotiated the anatomical and operative plausibility of the unobserved anatomy that their black-boxed algorithm reconstructed from the existing sparse data. My analysis fore-grounds the processual, relational, context-dependent, and essentially unstable character of the thus established plausibility of the algorithmically synthesised neuroanatomy.

After the Event Horizon Telescope Collaboration released in April 2019 the first empirical images of a black hole, an astrophysical object previously thought “unseeable,” much of the public discourse has approached these images as straightforward visual depictions of a black hole. This article challenges this view by showing that the first images of a black hole went beyond merely making an invisible cosmic object visible and that the images published in April 2019 were just the first in a series of black hole images the researchers continue producing. Drawing primarily on Sybille Krämer’s concept of the cartographic impulse, the article demonstrates that the Event Horizon Telescope images are, first and foremost, epistemic tools. These epistemic tools enable researchers to actively explore various physical aspects and dynamic properties of a black hole’s immediate environment and test theoretical predictions about it, thus making this elusive environment empirically knowable. To demonstrate this, the article analyses the mapping operations that combined automated algorithmic procedures with expert human judgment and through which these images were produced, read, and interpreted. It also examines how the different Event Horizon Telescope images relate to one another, which particular epistemic functions they fulfil in the research context, under which conditions, and with which limitations, thus tracing how these images facilitate the production of new scientific knowledge about black holes.

Hysteria, a mysterious disease known since antiquity, is said to have ceased to exist. Challenging this commonly held view, this is the first cross-disciplinary study to examine the current functional neuroimaging research into hysteria and compare it to the nineteenth-century image-based research into the same disorder. Paula Muhr's central argument is that, both in the nineteenth-century and the current neurobiological research on hysteria, images have enabled researchers to generate new medical insights. Through detailed case studies, Muhr traces how different images, from photography to functional brain scans, have reshaped the historically situated medical understanding of this disorder that defies the mind-body dualism.

Contrary to the widely held belief in the humanities that hysteria no longer exists, this article shows that the advent of new brain imaging technologies has reignited scientific research into this age-old disorder, once again linking it to hypnosis. Even though humanities scholarship to date has paid no attention to it, image-based research of hysteria via hypnosis has been hailed in specialist circles for holding the potential to finally unravel the mystery of this elusive disorder. Following a succinct overview of how hypnosis was used in the nineteenth century hysteria research, the article details how the relationship between hysteria and hypnosis is currently renegotiated in the context of brain imaging studies. It shows that the current research has so far failed to deliver on its promise of uncovering the link between hysteria and hypnosis. It further argues that despite huge technological advances in imaging technologies, contemporary researchers grapple with conceptual problems comparable to those that plagued their nineteenth century predecessors.