'Deep brain stimulation is no ON/OFF-switch': an ethnography of clinical expertise in psychiatric practice.

Despite technological innovations, clinical expertise remains the cornerstone of psychiatry. A clinical expert does not only have general textbook knowledge, but is sensitive to what is demanded for the individual patient in a particular situation. A method that can do justice to the subjective and situation-specific nature of clinical expertise is ethnography.

The affordances of art for making technologies.

With this inaugural lecture as Socrates Professor on the topic of Making Humane Technologies, I aim to show that artistic practices afford embedding technologies better in society. Analyzing artworks made at RAAAF, an art collective that makes visual art and experimental architecture, I will describe three aspects of making practices that may contribute to improving the embedding of technology in society: (1) the skill of working with layers of meaning; (2) the skill of creating material playgrounds that afford free exploration of the potential of new technologies and artistic experiments; and (3) the skill of openness to the possibility of having radically different socio-material practices. I will use images of several RAAAF projects to make these skills involved in making more tangible.

Metastable attunement and real-life skilled behavior.

In everyday situations, and particularly in some sport and working contexts, humans face an inherently unpredictable and uncertain environment. All sorts of unpredictable and unexpected things happen but typically people are able to skillfully adapt. In this paper, we address two key questions in cognitive science.

Skilled we-intentionality: Situating joint action in the living environment.

There is a difference between the activities of two or more individuals that are performed jointly such as playing music in a band or dancing as a couple, and performing these same activities alone. This difference is sometimes captured by appealing to shared or joint intentions that allow individuals to coordinate what they do over space and time. In what follows we will use the terminology of we-intentionality to refer to what individuals do when they engage in group ways of thinking, feeling and acting.

Situated anticipation.

In cognitive science, long-term anticipation, such as when planning to do something next year, is typically seen as a form of 'higher' cognition, requiring a different account than the more basic activities that can be understood in terms of responsiveness to 'affordances,' i.e. to possibilities for action.

Optimizing Deep Brain Stimulation Parameters in Obsessive-Compulsive Disorder.

Objectives: Deep brain stimulation (DBS) is an innovative and effective treatment for patients with therapy-refractory obsessive-compulsive disorder (OCD). DBS offers unique opportunities for personalized care, but no guidelines on how to choose effective and safe stimulation parameters in patients with OCD are available. Our group gained relevant practical knowledge on DBS optimization by treating more than 80 OCD patients since 2005, the world's largest cohort.

How mood tunes prediction: a neurophenomenological account of mood and its disturbance in major depression.

In this article, we propose a neurophenomenological account of what moods are, and how they work. We draw upon phenomenology to show how mood attunes a person to a space of significant possibilities. Mood structures a person's lived experience by fixing the kinds of significance the world can have for them in a given situation.

The Ecological-Enactive Model of Disability: Why Disability Does Not Entail Pathological Embodiment.

In the last 50 years, discussions of how to understand disability have been dominated by the medical and social models. Paradoxically, both models overlook the disabled person's experience of the lived body, thus reducing the body of the disabled person to a physiological body. In this article we introduce what we call the Ecological-Enactive (EE) model of disability.

Skill-based engagement with a rich landscape of affordances as an alternative to thinking through other minds.

Veissière and colleagues make a valiant attempt at reconciling an internalist account of implicit cultural learning with an externalist account that understands social behaviour in terms of its environment-involving dynamics. However, unfortunately the author's attempt to forge a middle way between internalism and externalism fails. We argue their failure stems from the overly individualistic understanding of the perception of cultural affordances they propose.

Embodying addiction: A predictive processing account.

In this paper we show how addiction can be thought of as the outcome of learning. We look to the increasingly influential predictive processing theory for an account of how learning can go wrong in addiction. Perhaps counter intuitively, it is a consequence of this predictive processing perspective on addiction that while the brain plays a deep and important role in leading a person into addiction, it cannot be the whole story.

General ecological information supports engagement with affordances for 'higher' cognition.

In this paper, we address the question of how an agent can guide its behavior with respect to aspects of the sociomaterial environment that are not sensorily present. A simple example is how an animal can relate to a food source while only sensing a pheromone, or how an agent can relate to beer, while only the refrigerator is directly sensorily present. Certain cases in which something is absent have been characterized by others as requiring 'higher' cognition.

Effective Deep Brain Stimulation for Obsessive-Compulsive Disorder Requires Clinical Expertise.

Background: Deep brain stimulation (DBS) is an innovative treatment for severe obsessive-compulsive disorder (OCD). Electrodes implanted in specific brain areas allow clinicians to directly modulate neural activity. DBS affects symptomatology in a completely different way than established forms of treatment for OCD, such as psychotherapy or medication.

Trusted strangers: social affordances for social cohesion.

How could the paradigm shift towards enactive embodied cognitive science have implications for society and politics? Translating insights form enactive embodied cognitive science into ways of dealing with real-life issues is an important challenge. This paper focuses of the urgent societal issue of social cohesion, which is crucial in our increasingly segregated and polarized Western societies. We use Rietveld's (2016) philosophical Skilled Intentionality Framework and work by the multidisciplinary studio RAAAF to extend Lambros Malafouris' Material Engagement Theory (2013) to the social domain.

Obsessive Compulsive Disorder: A Pathology of Self-Confidence?

A striking change OCD patients repeatedly describe following treatment with deep brain stimulation (DBS) of the ventral anterior limb of internal capsule (vALIC) is an immediate increase in self-confidence. We show how the DBS-induced changes in self-confidence reported by our patients can be understood neurocognitively in terms of active inference.

Reconceiving representation-hungry cognition: an ecological-enactive proposal.

Enactive approaches to cognitive science aim to explain human cognitive processes across the board without making any appeal to internal, content-carrying representational states. A challenge to such a research programme in cognitive science that immediately arises is how to explain cognition in so-called 'representation-hungry' domains. Examples of representation-hungry domains include imagination, memory, planning and language use in which the agent is engaged in thinking about something that may be absent, possible or abstract.

Free-energy minimization in joint agent-environment systems: A niche construction perspective.

The free-energy principle is an attempt to explain the structure of the agent and its brain, starting from the fact that an agent exists (Friston and Stephan, 2007; Friston et al., 2010). More specifically, it can be regarded as a systematic attempt to understand the 'fit' between an embodied agent and its niche, where the quantity of free-energy is a measure for the 'misfit' or disattunement (Bruineberg and Rietveld, 2014) between agent and environment.

Donor sclera versus bovine pericardium as patch graft material in glaucoma implant surgery and the impact of a drainage suture.

Purpose: To compare the use of human donor sclera with bovine pericardium as patch graft material for a glaucoma drainage device (GDD), with respect to the incidence of tube exposure, and to study the role of a drainage suture.

Methods: All GDD surgeries between 2010 and 2014 performed at the VU Medical Center were examined in this comparative, retrospective cohort study. A total of 244 cases were included; 163 in the human donor sclera cohort and 81 in the bovine pericardium cohort with a median follow-up of 31 and 36 months, respectively.

Developmental effects of environmental light on male nuptial coloration in Lake Victoria cichlid fish.

Background: Efficient communication requires that signals are well transmitted and perceived in a given environment. Natural selection therefore drives the evolution of different signals in different environments. In addition, environmental heterogeneity at small spatial or temporal scales may favour phenotypic plasticity in signaling traits, as plasticity may allow rapid adjustment of signal expression to optimize transmission.

The anticipating brain is not a scientist: the free-energy principle from an ecological-enactive perspective.

In this paper, we argue for a theoretical separation of the free-energy principle from Helmholtzian accounts of the predictive brain. The free-energy principle is a theoretical framework capturing the imperative for biological self-organization in information-theoretic terms. The free-energy principle has typically been connected with a Bayesian theory of predictive coding, and the latter is often taken to support a Helmholtzian theory of perception as unconscious inference.

Becoming more oneself? Changes in personality following DBS treatment for psychiatric disorders: Experiences of OCD patients and general considerations.

Does DBS change a patient's personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson's disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients suffering from psychiatric disorders.

Foregrounding Sociomaterial Practice in Our Understanding of Affordances: The Skilled Intentionality Framework.

Social coordination and affordance perception always take part in concrete situations in real life. Nonetheless, the different fields of ecological psychology studying these phenomena do not seem to make this situated nature an object of study. To integrate both fields and extend the reach of the ecological approach, we introduce the Skilled Intentionality Framework that situates both social coordination and affordance perception within the human form of life and its rich landscape of affordances.

Situating the Embodied Mind in a Landscape of Standing Affordances for Living Without Chairs: Materializing a Philosophical Worldview.

Sitting too much is unhealthy, but a widespread habit in many societies. Realizing behavioral change in this area is hard. Our societies promote being seated via the way its places are structured: they are filled with chairs for example.

Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder.

Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %.