Beyond clinical reduction : Levinas, the ethics of wonder and the practice of autoethnography in community mental health care

• Main Author: Racine, Catherine Ann
• Published: Durham University 2016
• Subjects: 362.2
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.695032

The central claim of this thesis is that wonder has the capacity to interrupt the institutional entrancement of the clinician to exert a gravitational pull on her awareness. This can “awaken” her from the normalized perspective of clinical praxis, and a clinical environment that defiles the vulnerable help seeker while contributing to the clinician’s moral disengagement or paralysis. In making this claim, our inquiry revisits many well-rehearsed ethical questions about the therapeutic relationship, the construct of mental illness and its care, the politics of power within the institution of community mental health care, and the supposed and real dangers of emotional intimacy in the clinical relationship. These questions also point uncomfortably—devastatingly—back to why and how the ethics of educated and dedicated clinicians can be diluted, for which the possible “cure” of wonder is being sought here. Wonder represents but one aspect of our ethical analysis in this interdisciplinary study. We turn in equal measure to an emerging strand of moral research, called autoethnography, and to the radical ethical vision of Emmanuel Levinas who informs our final understanding of wonder. In this inquiry, autoethnography takes the form of a short story in chapter 2 and as a series of personal epiphanic vignettes thereafter. Autoethnography affectively illuminates the theory being presented here and evokes the horrifying imperative of our ethical quest that calls for radical institutional change, albeit enigmatically. It is in Levinas’ ethical vision, however, that the clinician may discover the astonishing holiness and relationality at the heart of the clinical relationship and all this implies. This perfection, apprehended through the stunning approach of the vulnerable help seeker, extends an ethical invitation to the beleaguered clinician that she can hardly resist, but that she will almost inevitably fail to answer.