Summary of the impact

New avenues for diagnosis and treatment in a variety of psychotherapeutic settings were influenced by Hutto and Gallagher's innovative approach to social cognition, improving the quality of life of individuals. Their research has contributed to the development of diagnostic tools for the early detection and treatment of schizophrenia and new methodological guidelines for the clinical evaluation of Autism Spectrum Disorders. They developed the Embodied and Narrative Practices framework for understanding social cognition in terms of non-representational embodied interactions, enhanced and supported by highly contextualised socio-cultural, narrative practices. Pivotally, this approach offers an alternative to individualist and intellectualist mainstream cognitivist — e.g. `theory of mind' — approaches, reconceiving the status and importance of these practices in our capacity to relate to and understand others.

Underpinning research

Hutto and Gallagher's research provides a unified alternative framework for understanding the full range of our everyday or `folk' psychological abilities (at both basic and sophisticated levels). It focuses on situated interactions and social practices rather than mechanisms in individual minds/brains. It defends the view that most of our everyday social engagements and modes of understanding have different bases and functions than supposed by the standard cognitivist framework. For example, the latter typically assumes that understanding other minds requires the manipulation of mental representations in theoretically based inferences and/or simulation.

Gallagher and Hutto developed their joint framework in publications, since 2003, building on each other's work. This culminated in a joint position paper describing their new framework in 2008 (see references in section 3 below), after Gallagher joined the Department of Philosophy at the University of Hertfordshire in 2007. Drawing on phenomenology, Gallagher developed a distinctive, embodied approach to social cognition and philosophy of mind. With Hutto he considered evidence from developmental psychology and neuroscience, arguing that embodied practices of social interaction (posture, movement, gesture, facial expression, vocal intonation, etc.) support our skills for detecting and dealing with the purposeful intentions of others. Rather than attributing mental states, individuals cope in such interactions by perceiving and responding to the expressive attitudes of others situated in particular pragmatic and social contexts. This embodied practice approach directly challenges the overly mentalistic explanations of these phenomena found in `theory of mind' accounts in philosophy, psychology and cognitive science.

Drawing on analytic philosophy, Hutto added to this framework, developing the `Narrative Practice Hypothesis', which holds that even our most sophisticated language-based ways of making sense of ourselves and others are grounded in socio-cultural practices. Hutto's hypothesis, defended by philosophical arguments informed by empirical findings, promoted the idea that our everyday ability to make sense of actions in terms of reasons is developed by and takes the form of engaging in a distinctive kind of narrative practice, involving stories about protagonists who act for reasons. With Gallagher, he argued that these high-level folk psychological capacities can be explained without the need to posit the existence of any kind of inherited `theory of mind' devices.

Gallagher and Hutto discussed how this core research might be applied in psychology in the main publications that articulate the Embodied and Narrative Practices framework.

References to the research

Hutto, D.D. 2004. `The limits of spectatorial folk psychology', Mind and Language 19(5), 548-73. doi: 10.1111/j.0268-1064.2004.00272.x
(Hutto builds on Gallagher's embodied practices proposal.)

*Gallagher, S. and Hutto, D. 2008. `Understanding others through primary interaction and narrative practice', in J. Zlatev, T. Racine, C. Sinha and E. Itkonen (eds), The Shared Mind: Perspectives on Intersubjectivity, 17-38. Amsterdam: John Benjamins. ISBN 978-9027239006
(Joint statement of the ENP framework.)

Evidence of Quality

The h-index of Gallagher's research is 37; Hutto's is 16. Publications with Google scholar citation counts cited more than 100 times indicated with [*]. The many positive reviews of Hutto, 2008 testify to ground-breaking importance of the underlying research, regarding it as a `promising basis [for the field] to reorient itself' — Science; as opening `up new lines of empirical research' — Notre Dame Philosophical Reviews; as transforming `the debate about human social cognition' — Philosophical Investigations.

Key Research Awards

2008 (7-13 July). Collegium/Summer School. Social Cognition and Social Narrative. European Science Foundation. €46,000. Co-Organisers: Gallagher and Hutto. (Participants included researchers/clinicians who facilitated the framework's impact.)

2007 (12-15 July). European Science Foundation. £16,653. Four-day conference, `Narrative Alternatives to Theories of Mind'. Co-organisers: Gallagher and Hutto. (Participants included researchers who facilitated the framework's impact.)

2005 (12 months). `Folk Psychological Narratives'. Arts and Humanities Research Board Research Leave Scheme. £14,000. PrincipaI Investigator: Hutto. (Support for primary research relating to the Narrative Practice Hypothesis.)

2004-5 (6 months). `Folk Psychological Narratives.' Mind Association Research Fellowship. £11,100. PI: Hutto. (Support for primary research relating to the Narrative Practice Hypothesis.)

Details of the impact

The Embodied and Narrative Practices Framework led to impacts in a range of situations.

A. Improved clinical practice in early detection and treatment of schizophrenia by motivating a revision in the Examination of Anomalous Self-Experience (EASE) diagnostic tool.

EASE is a questionnaire used in phenomenological interviews. In its original format, EASE focused on individual self-experience and hence underappreciated and underemphasised intersubjective aspects — such as difficulties in interpersonal rapport, communication, and emotional and cognitive reactions to others. Revisions were made in both content and method. Questions were added to focus on interpersonal dimensions, and both interviewees and interviewers were filmed, making it possible to analyse interactions between them.

Gallagher and Hutto's research had a direct influence on noticing and correcting these limitations. The relevant changes in practice were facilitated through work of the Marie Curie Disorders and Coherence of the Embodied Self (DISCOS) Training Network (2007-2011), a consortium of nine European centres of excellence in neuroscience, philosophy, psychology and psychiatry. Twelve psychiatrists and psychologists in this project trained with the revised EASE and interviewed over eighty patients, leading to the recognition of thirty hitherto undiagnosed cases of early schizophrenia. Eight of these patients went on to receive appropriate treatments in Heidelberg.

Professor Thomas Fuchs, Principal Investigator of DISCOS, acknowledged that thorough acquaintance with Gallagher and Hutto's framework became part of the `necessary theoretical background' for those involved in DISCOS. Three clinical sub-projects of DISCOS — one each in Heidelberg and Copenhagen on the embodied self in schizophrenia, and one in Munich on somatoform disorders — took particular advantage of it. A manual for the diagnostic tool, including an introduction to the Embodied and Narrative Practices Framework, is in press.

B. Influenced the use of alternative therapeutic approaches to schizophrenia by clinicians in the UK

Clinicians of the Coventry and Warwickshire Early Intervention Team used Gallagher and Hutto's insights into embodied, enactive and narrative social cognition as an important theoretical impetus in modifying their approach to early psychotic illness. The research helped them to develop narrative-based strategies that decreased the occurrence of schizophrenic episodes in some patients. It enabled them to better understand the importance of the role of the social environment in the early stages of psychosis. This led to modified strategies that successfully enabled these clinicians to meet both their Department of Health caseload targets (fifty-five clients per year) and the national target for the duration of untreated psychosis of three months. The Early Intervention team focused on subjects aged 14-35 presenting their first episode of psychotic illness, typically schizophrenia. The narrative-based strategies provided clinicians with an understanding of patients' `delusional realities' and fostered patients' notions of self-worth and autonomy. Dr Matthew Broome (NHS Team) became acquainted with the work of Gallagher and Hutto through their mutual involvement in the AHRC `Feelings and Emotions in Psychiatric Illness' Network (2009-10).

C. Shaped the formulation of new methodological guidelines for the clinical evaluation of Autism Spectrum Disorders (ASD) and monitoring of treatment

These guidelines, developed at the Bambino Gesú Ospedale Pediatrico, Rome (one of the largest children's hospitals in Europe), direct clinicians to focus on early social practices by analysing bodily movement and the development of gesture. Researchers and clinicians, using Gallagher and Hutto's innovative view of intersubjective understanding, began to focus on early signs of sensorimotor problems and problems with pointing and gesture in children with autism spectrum disorders, instead of relying on standard `theory of mind' measures. From 2010 this enabled the development of a taxonomy for evaluating different options for specific treatment strategies. This was done at the hospital's Child Neuropsychology Unit, where, on average, sixteen new ASD patients are evaluated per month and twenty-four ASD patients are treated per month. This impact was facilitated by the work of Dr Laura Sparaci (Bambino Gesú), who studied as a Fulbright Fellow with Gallagher and as a Visiting Researcher at the University of Hertfordshire with Hutto in 2007-8. She also participated in the ESF-funded conference in 2007 and the summer school in 2008. She explored the use of the new approach to social cognition in diagnosing ASD in a 2008 publication.

D. Influenced other treatments of ASD

Dr Belmonte, then in the Faculty of Human Development at Cornell University and a Senior Research Associate of the Autism Research Centre, Cambridge, used the Narrative Practice Hypothesis as a theoretical grounding for a research project that was top-ranked by the US National Science Foundation in 2008. This led to new therapies for children with severe autism to learn to convey information by training in the basic sequencing of actions. An initial clinical study in 2008, involving nine children in a therapeutic environment, yielded positive results — children who underwent the training increased the complexity of their communicative output; larger follow-ups are planned.

Sources to corroborate the impact

Institutional Corroboration

Four individuals currently or formerly connected with the organisations or units referred to in section 4 have agreed to corroborate the impacts described above. Their contact details are supplied separately.