Beyond Clinical Dehumanisation Toward the Other in Community Mental Health Care offers a rare and intimate portrayal of the moral process of a mental health clinician that interrogates the intractable problem of systemic dehumanisation in community mental health care and looks to the notion of "wonder" and the visionary relational ethics of Emmanuel Levinas for a possible cure.
An interdisciplinary study with transdisciplinary aspirations, this book contributes an original and compelling voice to the emerging therapeutic conversation attempting to re-imagine and transcend the objectifying constraints of the dominant discourse and the reductive world view that drives it. Chapters bring into dialogue the fields of community mental health care, psychology, psychology and the Other, the philosophy of wonder, Levinasian ethics, clinical ethics, the moral research of autoethnography and the medical humanities, to consider the defilement of the vulnerable help seeker, the moral injury of the clinician and look for answers beyond.
This book is an ethical primer for mental health professionals, researchers, educators, advocates and service users working to re-imagine and heal a broken system by challenging the underpinnings of entrenched dehumanisation and standing with those they "serve".
Table of Contents
Chapter 1. James’ Story
Chapter 2. Three Opponents of Wonder
Chapter 3. From Behind the Mask: Writing Autoethnography
Chapter 4. Wonder: A Turn Towards the Divine
Chapter 5. Levinas and the Wholly/Holy Other
Chapter 6. Clinical Application and Beyond: The Function of the Holy
Chapter 7. The Politics of Need and Desire
Catherine A. Racine, is an independent Canadian scholar, feminist, ethicist and writer. She completed her PhD at Durham University in England in 2017.
The value in Beyond Clinical Dehumanisation lies in its daring call to community mental health care providers and researchers to confront the dehumanisation of the "vulnerable help seeker" (the patient, the client), and their own moral injury. The book offers a multidisciplinary and fascinating analysis of the issues Catherine Racine raises through moving personal testimony about her work as a clinician, and through an examination of "wonder" informed by the philosophy of Emmanuel Levinas. Racine illuminates the de-moralising, de-humanising subtext of the institution and points to the ethical clinical relationship that "ought to be". This thoughtful, well-argued and compelling book offers no simple answers. It is an intervention, a call to action, and an example of how the work of change can be approached. This is a worthy ethical primer and an inspiration for anyone working for structural and cultural reform inside or outside the walls of community mental health care.
Harold G. Koenig, MD, Professor of Psychiatry & Behavioral Sciences, Associate Professor of Medicine, Director, Center for Spirituality, Theology and Health, Duke University Medical Center, Durham, North Carolina
At a time when healthcare professionals are increasingly stressed and healthcare systems under-resourced, what might result if the clinical encounter were to become a moment of wonder? Catherine Racine's beautifully observed, searchingly honest examination of community mental health care explores the nature of wonder by means of Levinas's ethical vision. It is both elegant testimony to autoethnography's disruptive potential in unmasking institutional power, and eloquent advocacy for a reimagining of the relationship between the medical professional and vulnerable help seeker in ways that could be profoundly humanizing for each.
Robert Song, Professor of Theological Ethics, Department of Theology and Religion, Durham University, United Kingdom
Catherine Racine’s book is an important and timely literary contribution. Her engagement with wonder, autoethnography, and Emmanuel Levinas adds a unique voice to the philosophy and the theology of wonder and manifests as a rich resource for mental health professionals, researchers, activists, students and service users worldwide challenging the problem of clinical dehumanisation.
Jan B. W. Pedersen, author of Balanced Wonder: Experiential Sources of Imagination, Virtue and Human Flourishing
'The benefits of fostering wonder in mental health care are examined here, to awaken practitioners from entrancement by the system and help them transcend the "institutional reduction" of the mentally ill. Through a series of case studies, independent scholar Racine asks community mental health clinicians and researchers to see how the clinical mental health system/structure may dehumanize clients, calling on such professionals to examine their ethics and protect vulnerable clients. Using autoethnography as a method, Racine reveals how clients are subordinated and the system is flawed and broken, instead encouraging resistance through reverence for and even awe of clients. She argues that practitioners, understanding social forces, have a moral obligation to try to "break" theory/jargon and structures that subjugate clients. An examination of professional boundaries is needed to clarify the systemic injustice they perpetuate. Obstacles to humanizing clients may include practitioners' own fear of boundary violation. "Hard sciences" dictates can blind the practitioner who lacks the skill of empathic reflection. But reflection can transform both therapist and client. While Racine asks practitioners to recognize that wonder is a gift of meaning that should not be eclipsed by an increase in knowledge, she also cautions against boundary violation, which may exploit clients through abusive exercise of the practitioner's self-interest and gratification.'
S. M. Valente, University of California, Los Angeles, USA; CHOICE review