Enactivism, a branch of embodied cognition theory, portrays cognition as a sense-making process distributed across brain, body, environment, and subjective experience. This theoretical paper introduces enactivism's background and main tenets and argues for its relevance to nursing, particularly mental health nursing. The authors contend that enactivism offers nursing an integrated framework for understanding human sense-making that includes physiological, psychological, and subjective perceptual factors, potentially enriching nursing knowledge.
Severe mental illness involves a radical alteration in the structure of being-in-the-world, not merely a set of symptoms. Through phenomenological interviews with 12 clinically stabilized adults, the illness emerges as a disentanglement of body, consciousness, and world. This manifests as a violent rupture of the intentional arc: the body loses its transparency, the world its familiarity, leading to withdrawal, corporeal doubt, blackouts of consciousness, and fractured intercorporeality. The findings call for a humanistic nursing that transcends symptom management, embracing an ethics of welcoming that validates lived experience and promotes new possibilities of being-in-the-world.
Under capitalist healthcare, nursing labor is subordinated to efficiency and profit, risking nurses' reduction to functional instruments and eroding the ethical essence of care. Nurses experience objectification by others, of themselves, and toward others, leading to moral fatigue and loss of subjectivity. This paper critically examines capitalism's impact on nursing and reconceptualizes self-care as moral agency and self-transcendence. Drawing on Marxian labor theory, Maslow's extended hierarchy, Orem's self-care deficit theory, and Watson's caring science, self-care is conceptualized as a process whereby nurses reclaim autonomy, restore relational integrity, and ultimately achieve moral agency and transcendence. Self-care transforms from an individual coping mechanism into a collective ethical practice challenging capitalism's dehumanizing logic and rehumanizing nursing.