I have tried here to present concepts that, for me, are essential in order to think about the meeting (clinical in particular). To do this, I have conducted a self-interview based on the reflections made on the book “Ethics” (Method 6) by sociologist and philosopher Edgar Morin.
The interviewer’s voice was modified in frequency to distinguish him from “Stevens” in the interview. I tried to have an understandable prosody as much as possible.
You can download the podcast at the following address: https://mega.nz/file/JnZiTBgI#GqsGc8yzf7J2-5eQMMNQTmPP475BDry4cZm-E0x74-4
I am sending you, below, the full transcript of the podcast, in order to follow it more easily.
Wishing you a nice listening (20 min.)
Transcription
Introduction :
Words allow the very expression of singularity, encouraging the expression of the Self and the therapeutic relationship. The latter soothe, but can also lock them up, when they are no longer listened to and recognized. Put forward by psychoanalysis, the importance of words, having for a long time favoured the clinical encounter, has, it seems, become secondarised, following the emergence of knowledge and objectification therapies. Knowledge has given us an unsuspected field of possibilities. At the same time, it seems to lead us to the dislocation of knowledge, through the different specializations of the professions.
Knowledge seems to have turned away from its duty, encouraging scientificity in favour of subjectivity and its wanderings. Those previous element being expressed through words. Knowledge refers to a set of processes linked to curiosity, and to the transcendence of our human condition. Sometimes preceding the feeling of efficiency, it comes gradually over time, from our experiences, and tends to an application that confronts the constraints of reality. It is, in fact, not supposed to be a finality, nor a fatality, since it is continuously inscribed in a dynamic field. It is a transition that must continually confront an ethic of responsibility, and more globally a collective ethic, at the risk of giving birth, with impunity and vulgarly, to bullshit.
Thus, shouldn’t knowledge be thought differently and be confronted with a double ethic at the risk of being fooled by scientific certainties? On a social and individual level. How can objectification and subjectivity be made to coincide? Edgar Morin has already asked these questions: “Is there not now an antagonism between the ethics of knowledge, which enjoins us to know in order to know without worrying about the consequences, and the ethics of human protection, which demands control over the uses of science? »
Isn’t there an antinomy here? In an attempt to answer these questions, we have with us today Stevens, a student in clinical psychology at the University of Nantes, who will present some concepts from the book “Ethics” by Edgar Morin. In order to allow us, perhaps, to think more about the clinic and its issues. Stevens, Good morning.
Hello.
As we have emphasized, knowledge seems to have, today more than ever, to be confronted with a real ethic of accompaniment. But what does ethics mean for you?
Very often, ethics and morality are confused; so much these two notions are linked. One calls for the universalism of rules applicable to all professionals and population as a whole (morality), while the other calls for a continuous personal work of oneself towards the other (ethics). For all that, morality is nothing but subjective, when knowledge pretends to be an objective truth. Ethics, and the view it involves, is to recognize, as Edgar Morin said, “the vital character of egocentrism as well as the fundamental potentiality of the development of altruism“. In fact, its demand is lived subjectively, and no rules can come to confront it. Ethics has no other foundation than itself; it is a requirement, a sense of duty. It is an emergence of value, of an internal position, of a framework that one sets oneself, for the other. Ethics “depends on the social and historical conditions” that form it but it is in the individual that this decision is situated. It is up to the individual “to choose his values and his ends“, values that refer to a continuous inner demand lived unconditionally.
It seems to me that this is a major problem, no? Ethics is therefore part of a form of individualism, which nevertheless depends on a deontology, a morality, inscribed in the social field. Stevens, how can we ensure that both can feed themselves?
Edgar Morin has demonstrated very well that “the progress of individual moral consciousness and that of ethical universalism are linked“. So, to be in contact with a patient, in clinic, is therefore thinking about the two sides of the same coin. Ethical values are intrinsic to the subjects and take the place of foundations that can enclose and partition an encounter. These values are supposed to be an “intrinsic transcendental reference” to the clinician, in order to make ethics self-sufficient, without superior external justifications (morality). In fact, ethics aims to be groundless, in order to favour, at best, the real encounter. That which can allow, sometimes, the reworking of an existential suffering.
But, Stevens, can’t this ethic without foundations give way to a form of omnipotence on the part of the clinician? Can’t drifts happen?
Yes, of course they can. And that is the danger of an ethics without content. It is for this reason that ethics must be intertwined with morality, at the risk of giving way to an “overdevelopment of the egocentric principle to the detriment of the altruistic principle” (Morin), and therefore of its aberrations. And the same is true for the overdevelopment of knowledge, of scientificity. The latter is inevitably confronted with the limited predictability it wishes to know. This reassuring predictability, however, is confronted with the inter-retroactions of the encounter. You know, even with the best knowledge, and the best intentions in the world, what is transmitted will always be subject to the patient’s interpretation, and sometimes, unfortunately, to distortions. As a clinician, we are therefore always, I said always, concerned by uncertainty, and we must integrate it into our practice, at the risk of overlooking the unconsciousness or neglect of perverse side effects of an action, which we, as caregivers, consider beneficial. I think, there is therefore, as Edgar Morin notes, “uncertainty in the relationship between the end and the means” that we use.
And how can this uncertainty be integrated into practice?
You are asking, here, a question that even the greatest philosophers have failed to convey, even though they have written and thought about it. I would say that it is a personal inscription, which is tied up thanks to the way we look at ourselves. A phrase by Jiddu Krishnamurti, an Indian philosopher, may perhaps be a guide for some of you : “To know oneself, one must observe oneself in interaction with others“. Personal ethics, as you will have understood, is therefore a long-term process, but it is never free of morality. However, love and fraternity, supreme expression of morality according to Morin, are easy to deceive, as we have seen together. Thus, it seems necessary to get rid, collectively and individually, of the simplification and the ethical and moral rigidity that ignores real understanding and listening. Knowledge must then serve a human reflection, at the risk of leading, without even conceiving it, to the disqualification of the discourse of others.
The Other’s discourse is essential, for you, Stevens?
Inevitably. It serves democracy; it expresses the limit, the framework. It also serves subjective logic, which is very well described by Lacan or Freud in their works. However, it can also serve reduction and Nietzschean morality. To shut oneself up in one’s knowledge, no matter what the field of practice, is to shut others up in what they are not necessarily. This can lead to violence of interpretation in diagnoses and psychological restitution, a concept that Aulagnier developed and conceptualized very well. There is therefore an ethic of knowledge and an individual knowledge of ethics, which must make the link and be the binding element of the encounter. It is therefore to think our practice to make the most accurate decisions possible, with all the complexities that this entails.
Earlier we were talking about the hyper-specialization of areas of expertise. Can you tell us about it?
I think, science today has a prominent place in French universities. All students, all minds are formed by knowledge, which puts the complexity and ambivalence associated with it in the background. We very often ask students to spit out knowledge, as if the field encounter with patients were associated with the same modalities. This is insane! This inevitably leads to a blindness associated with objective knowledge. This objectivism has repudiated self-awareness, its sensations, its interrogations, in the field of the modern clinic. From science has unfortunately dislocated human subjectivity, which gives way to the poetry of the encounter, sometimes, and the objectivity of knowledge, which has minimized the responsibility of the conscious subject one is led to meet. Morin demonstrates that “the classical scientific vision (determinism and reductionism) eliminates consciousness, the subject freedom“. However, the notion of responsibility and of the conscious subject cannot be scientific notions. Hyperspecialization has generated a disciplinary blindness, giving rise to a whole host of conflicts and contradictions where all our energies are lost. Neuropsychologists can easily castigate the analytical clinic, and vice versa. Analytical clinicians can point the finger at cognitive-behavioural therapies by denouncing a reductionism of subjectivity and encounter, and CBT clinicians can point the finger at the errors to which the interpretations associated with the counter-transference so dear to psychoanalysis can lead. In this sense, this disciplinary closure cannot link together knowledge that is nonetheless mutually enriching, which can lead to a form of irresponsibility for what is not known or accepted. And here again, the ethics of responsibility is expressed, inseparably linked to an ethics for others, which must be collective. There are ethical compromises that apply to all these fields of clinical practice, which must be considered and integrated, at the risk of continuing to generate insipid and boring parochial conflicts. We must, it seems to me, always keep in mind the primacy of the subject, of the patient, not our own egoisms. Conflicts are at the heart of our humanity, but they too can, in the professional field, generate regression that do not favor creativity at the heart of any relationship.
Relationship is therefore the watchword. If I understand correctly, to conclude, there is therefore a constant self-ethics that must be applied to a collective ethic. How can self-ethics be applied? What does it refer to?
For that, I will quote once again Edgar Morin who defines it as “the dynamics of the ‘passion of being oneself’ which meets the ‘responsibility of oneself’, and at the same time the weakening of the superego“. It allows the loss of the absolute certainty, the decrease of the moralizing judgment, while taking into account the contradictions and the ethical uncertainties. Finally, this concept refers to the fact that we can become aware that science, economics, politics and art do not have intrinsically moral ends. They are only to be considered as a reality that one tries to understand through knowledge and words, which can be sometimes technical and specific. This personal ethics thus enables individual autonomy to empower one’s own personal ethics. It refers, as Morin points out, to the fact that “the decision and reflection proper to self-ethics are only possible if the individual feels within himself the moral requirement that (…) involves a faith in himself, without any external or recognized superior foundation“. It is nourished by active sources such as sociology, culture, anthropology or psycho-affective forces. It contains no truth, much less a path to be integrated and acquired. It is a true psychic culture cultivating self-examination, benevolent self-criticism, where complexity works against morality and reductionism. It accepts incomprehension, castration, and the consequences it bears. It accepts our incompleteness in order to tend towards more humanity, in order to elucidate a minimum of ourselves, to try to touch the subjectivity of the patient we are led to meet. This way of “thinking well” through self-observation is a way, it seems to me, of creating a new self-awareness, in order to minimize the impact of our own selfishness, our shortcomings, our fears, our weaknesses, so that it is at the service of a human and non-judgmental practice. It is in this way that it does not spare us anguish, but teaches us to live with it, and to “arouse its antidotes which are love and live it with love” in the humanistic sense of the term. For a clinical practice without a bond tirelessly excludes understanding and a sense of freedom.
It is therefore a whole path that you are offering to us… A whole life force that is being acquired, that is being built slowly and without a will to perform. Perhaps it allows us to forgive abominable acts in order to get out of the cleavage that is so easy to establish. Because, as we have seen, morality and immorality can be closer than we think. Stevens, thank you.
Thank you for the invitation, and for giving me this space to express myself.
Thank you for following us. We will meet again next week in the company of Albert Moreno, who will come to talk to us about the link between clinical psychology and cinema. Goodbye.
Words I have learned:
Intertwined : Entrelacé, imbriqué, interconnecté
Parochial conflicts : Conflits de clochers, guerre de chapelle
Oneself: Soi-même
Groundless: Sans fondement
Confused: Confondues
Bibliography
Morin, E. (2004). La Méthode numéro 6 : Éthique. Ed. : Seuil, Paris.