International Journal of Qualitative Methods
January 1, 2021
Peter Stilwell, K. Harman
43 citations
Phenomenology as a qualitative research method has become overly rigid and prescriptive, especially regarding the epoché and reduction. This process paper argues that the emerging paradigm of post-cognitivism and the aligned movement of enactivism—rooted in phenomenology and embodied cognition—offer a flexible alternative. Enactivism treats sense-making as a 5E process (Embodied, Embedded, Enacted, Emotive, and Extended) and can be integrated with existing methods like observation, interviews, and thematic analysis. The authors draw on their enactive study of pain-related meaning co-construction between clinicians and patients to illustrate how this approach moves beyond methodological individualism and captures the dynamic, context-sensitive nature of subjective experience. A sample interview guide, codebook, and rigor components are provided.
Medical humanities
October 19, 2020
Peter Stilwell, Christie Stilwell, Brenda Sabo et al.
23 citations
Pain is not just a brain event but emerges from interactions between a person's body, mind, and environment, according to enactive theory. This paper applies that framework to pain, critiquing dualist and reductionist approaches in medicine. The authors analyze pain-related metaphors used by clinicians in recorded appointments and interviews, classifying them and connecting them to enactive theory. Five paintings visually depict these metaphors, showing how clinical language can shape patients' pain and agency. The authors argue that clinicians often overlook how their metaphors become enacted through treatment, and suggest that intentionally shaping these metaphors could improve pain management.
The journal of pain
May 2, 2025
Peter Stilwell, Mael Gagnon-Mailhot, Anne Hudon et al.
8 citations
Pain-related suffering can occur through an immediate, disruptive impact on one's sense of self, even without self-reflection. Interviews with 12 adults across Canada living with various pain conditions revealed that during their worst pain episodes, the experience overwhelmed thoughts and self-reflective capacities, disrupting foundational aspects of self-experience such as agency, bodily ownership, and time. Participants described these experiences as incapacitating, dehumanizing, and dissociating. The accounts closely resemble first-hand reports of torture, supporting a new mode of pain-related suffering that does not require self-reflection. This expands traditional understandings, which have exclusively anchored suffering to self-reflective thought, to include two inter-related modes.