PMC10133725_01
Ecosystemic Embedding of Depressive Symptoms. The figure illustrates some of the many links between symptoms, processes and experience that constitute the ecosocial system of the patient described in the vignette. The arrows represent causal influences mediated by diverse mechanisms. Closed loops can give rise to feedback amplification, resulting in vicious cycles of symptom exacerbation or, when regulatory mechanisms are sufficient, can lead to allostatic changes that contribute to resilience and recovery. For the links marked with asterisks, the mechanisms of influence depend on nonverbal and linguistic communication through embodied and enactive loops that give rise to intersubjectivity, positionality and ongoing negotiations of meaning as depicted in Figure 2. Based in part on.
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In the case of the patient in the vignette, the causal mechanisms of anxiety, demoralization and depression can (and likely do) start at many different points in the network depicted in Figure 1. Many of the links shown in Figure 1 are mediated by personal, social and cultural processes of meaning making.
Embodied and Enactive Processes of Meaning Making. The figure outlines the cyclical processes of embodiment and enactment that give rise to meaning and experience. Experience emerges through developmental processes and engagement with others in particular social-cultural contexts. There is two-way traffic between bodily processes and individual experience mediated by cognitive processes of metaphoric thinking, imagery and imagination. Similarly, there is traffic between experience and social discourse mediated by interpersonal communication and narrative practices. All of this occurs in a field of cultural affordances provided by local niches and larger social contexts (Adapted from Figure 20.1 in; originally published in Embodiment, Enaction, and Culture: Investigating the Constitution of the Shared World, edited by Christoph Durt, Thomas Fuchs, and Christian Tewes, reprinted courtesy of The MIT Press).
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These involve bodily and discursive practices as depicted in Figure 2.