Until recently, I was unaware of how such really smart people (philosophers, neuroscientists, physicists, all the king’s horses…) were in a state far worse than losing their minds.  Apparently, they had never found their minds! (or anyone else’s for that matter).  They can’t even agree on what constitutes one’s mind.

How could something be so ill-defined and even controversial?  Moreover, can any of these ‘out-there’ ideas be relevant, if not beneficial for us in the real* world?

* subject to similar misunderstanding, scrutiny, and controversy.

Let’s dive dip our pinky toes in…

Clark & Chalmers (1998) proposed that cognition, and, therefore, the mind extend beyond the brain.  Weird!?  The agent, they argue, actively couples with an external entity, creating a cognitive system (active externalism).  These two reputable philosophers provide examples of two individuals, Inga and Otto, to make their point.  Inga and Otto both want to go to the same museum.  Inga has a keen memory, so she recalls the address while en route.  Otto has memory challenges, so writes the address down in a notebook he carries with him everywhere as a memory aid.  Both arrive at the museum successfully-Inga retrieving the address from her memory she presumably encoded in her brain, while Otto retrieved the address he encoded in the notebook.  They argue these distinctions between Inga’s brain and Otto’s notebook are arbitrary.  Using a statistical formalism that I admittedly don’t fully understand, Kirchoff and Kiverstein (2021), define Otto’s famous notebook as a vital component of how he fulfills his self-evidencing beliefs, and therefore maintains his identity as Otto, who as an agent, believes he is “the kind of person who goes to museums.”  This is essentially the active inference process – Otto is using the notebook essentially to minimizing prediction errors (not being able to find the museum). Kirchoff and Kiverstein (2021), go on to formulate a distinction between anything external being included in Otto’s mind (e.g., Otto’s encyclopedias) in that they don’t inform him on how to thrive as Otto, per se.    

I’m currently processing this potentially threatening story, literally as I type.  Does that mean my laptop is part of my mind?  Not sure, but it definitely has a role in my sense-making process, as does the language I am using to represent these ideas.

Before I literally lose my mind (and likely any formal argument about where and what it is), I’m going to at least accept that cognitive processes seem to extend beyond the brain, and even the body which it inhabits. 

Time to self-evidence.  As a physical therapist, does Extended Cognition inform my practice (preferably for the better)?  Or was this just an entertaining distraction (or worse, a weird dream that my laptop is having)?

First, the Otto story really puts me in further awe of what I see my colleagues in the Speech Language Pathology space doing.  Simple strategies, like memory binders, can literally work towards making someone whole in terms of restoring their ‘mind.’ (Gulp)

It also makes me think more about what other kinds of strategies will result in greater therapeutic efficacy, now that I have a broader and more fluid working definition of cognition.  As providers of care, we all esteem the ‘therapeutic alliance’ as a building block of the process.  I think the idea of extended cognition deepens the meaning and value of the alliances we build.  Indeed, cognition is also socially extended, meaning that in our interactions with others we literally engage in a meeting of the minds.  That is, during cooperative communication, our codependent action-perception cycles serve to collectively form a ‘shared narrative’ (Vasil, Babcock, Constant, Friston, & Ramstead, 2020).  This shared narrative functions as a belief update, minimizing uncertainty (prediction errors), increasing understanding, and reducing physical and psychological distress (McParlin, Cerritelli, Friston, & Esteves, 2022).  Essentially, the therapeutic conversation has the potential to change a mind.  A temporary active coupling with the (sacred) cognitive space of another person can lead to new beliefs and potentially a restored agency. 

This is both promising and frightening! 

Given all this, it seems crucial to get it right. 

What kinds of narratives and beliefs do we want to share with our patients?

I don’t have all the answers.  I want to extend my mind to this community.

Leave a comment below and / or post in our Slack community.

 All the best,

Marc

References

Clark, A., & Chalmers, D. (1998). The extended mind. analysis, 58(1), 7-19.

Kirchhoff, M. D., & Kiverstein, J. (2021). How to determine the boundaries of the mind: A Markov blanket proposal. Synthese, 198(5), 4791-4810.

Vasil, J., Badcock, P. B., Constant, A., Friston, K., & Ramstead, M. J. (2020). A world unto itself: human communication as active inference. Frontiers in psychology, 11, 417.    

McParlin, Z., Cerritelli, F., Friston, K. J., & Esteves, J. E. (2022). Therapeutic alliance as active inference: the role of therapeutic touch and synchrony. Frontiers in psychology, 13, 783694.