Seeing Oneself Seize: A Case Study on the Affordances of a Video-Based Diagnostic Encounter for a Patient with...

This paper examines how integrating clinical video recordings into the diagnostic encounter shapes a patient's experience of functional seizures, a contested neurological condition historically known as hysterical attacks. Drawing on James Gibson's theory of affordances and de Haan et al.'s account of how individuals perceive affordances based on their needs and concerns, the study analyzes a single in-depth interview with an 18-year-old patient recently diagnosed with functional seizures. It explores what viewing seizure videos with a doctor offers the patient-in clinical, epistemic, emotional, and experiential terms. The interview was subjected to a close reading, attending to how video-mediated communication of diagnosis intersects with the patient's prior illness history, sociocultural context, and understanding of self. The analysis identified three positive (epistemic insight, diagnostic validation, trauma recollection) and three negative affordances (shame, vulnerability, resignation). These affordances emerged not only from what the videos showed but also from how they were viewed, framed, and interpreted during the diagnostic encounter. The study concludes that the videos' affordances cannot be separated from an individual patient's interpretive resources and biography. Clinical video viewing can generate meaningful diagnostic insights, but it also risks harm unless embedded within a carefully structured dialogical process that attends to the patient's specificities.