Monthly Archives: August 2019


Thinking about relationality, in many dimensions.  As a lesbian married to my partner, living in a rural area in the woods of northern New York State, there are times when loneliness is very intense.  Online work and activism, combined with periods of travel, connects me to community; my marriage and the home and land we live on connects me to a place in the world where I know I belong.  There’s no other home that is my home, no other woman I am bonded with as with my wife.  These are intimate things and new to me, or unexpected that it could be so powerful.

Nevertheless thinking about getting older (both of us now over 60), and participating in the Open Ended Working Group on Ageing, I started to think about the need for positive and strong relationships with more people beyond my partner in real life, as they say, as we both age.  Desire for community and search for community has always been with me, but I have been confronted with barriers at almost every turn, some of which I have written about in this blog.

At the International Academy for Law and Mental Health 2019 conference, I was most interested in certain philosophical papers and sessions.  A session on ‘The second-person perspective in medicine and bioethics’ especially drew me.  While I had some disagreements with each paper in that session, the power of a second-person perspective in how we understand any issue of law and policy is worth exploring.  That’s something I still need to look at – there’s both the issue of intersubjectivity as an ethical approach to relationships (e.g. in context of respect for legal capacity, and decision-making support) including collective relationships (e.g. policymaking processes subject to contesting structural oppression), and more deeply, as a value to be promoted for human community and our community with the non-human world.  (This is a strong thread in justice practices and ecological practices of indigenous communities that have inspired me, that I’ve written about also on this blog.)

Practicing in my own relationships I have come to understand a difference between background relationality and a more deliberate intersubjective relationality.  I have often talked about intersubjectivity in an abstract sense, perhaps in a more cognitive sense of negotiation.  But in reality intersubjectivity – an I-I relationship – is something deeper, it’s interpenetration and mutual reflection to infinity, seeing the other in oneself and oneself in the other.  It’s an encounter between two beings, giving myself to the other directly in her presence and as presence.  I see this as being related to the fourth chakra, the heart chakra.  When I intentionally lift a response into that place, intentionally act from that energy center, I relate differently.  I see the other’s wellbeing not only abstractly as connected to my own, but experientially and literally inseparable from my own.  This doesn’t mean having no boundaries, it means talking about needs and boundaries through the heart and as part of this space of interconnectedness.

Related on the collective level, on the plane going to the conference, I watched the movie ‘The Best of Enemies‘, about a process in the civil rights movement era for a community to decide about school integration, that brought together Black activist leaders and Klansmen with an unexpected result (spoiler) that the central Klan leader was changed and became friends with the leading activist in the Black community.  I am naturally and politically skeptical of such a thing, but it was based on a true story.  At some level in most of what we do, oppressed people have to risk ourselves in processes that involve those of the oppressor class, and when any of us seek to become allies to oppressed people (e.g. for me as a contingently white (Jewish) person to be anti-racist), we have to risk ourselves in facing truths that require us to reorient our loyalties and our view of the world.

I’m not sure how this is going to relate to my conceptual policy framework to address support and non-discrimination in crisis situations as a positive alternative to the violent practice of forced psychiatry.  The practices that will lead to the right kind of support will have this genuine approach and value of an I-I relationship.  Looking into and through one another to a truth that is found and not made.  The IPS concept of co-creation and also intentionality in relationships fits here.  It’s not a cognitive intentionality I think, but a deliberate shift of consciousness in relation to the encounter and the moment, that can be especially brought into play when any of us feels challenged in a relational context that is nonetheless important to honor and preserve.  But it seems to go further, and I’m not sure where it will lead.

I had the opportunity to talk with Sarah Knutson about the conceptual framework together with what I’m thinking about relationality.  Sarah has worked out a way of thinking about high-stakes situations and the stress response that is an alternative to the psychological and medicalized model of ‘mental illness’ and crisis in particular.  Through that conversation I could refine my understanding of crisis as being composed of an objective situation that I don’t know how to deal with, and a stress response that makes me feel a great deal of physical and emotional discomfort.  Support for decision-making as well as practical support for comfort, safety and well-being from the person’s perspective can address both of these components, e.g. the stress response can be addressed through bodywork, calming or meditative exercises or in the process of talking about things in a heart-focused way or in an intersubjective I-I way that relates to the other person’s pain with deliberate ethical empathy and accompaniment.

It’s hard to talk about this without using the ‘heart’ reference, and I would not have found that at all meaningful or useful without the direct subjective experience.  I don’t know how it can be communicated in policy discussions or human rights language.  Maybe it can only be pointed at, and communicated directly in experiential contexts.  Interested to explore further, and welcome feedback to know if this makes sense to you or not, and why (or why not).

Edited postscript: Another aspect of this has been reading about African conceptions of the person, in writings by African and non-African philosophers and ethnographers, who  address the existence of a social as well as (and distinct from) personal self (see chapters in parts 1 and 2 of African Philosophy as Cultural Inquiry).  The social self sounds similar to what one of the authors at the IALMH session talked about, in relation to our being constituted by our relations.  That was meant, as I understood it, in both a wide social-cultural sense relating to the transmission of worldview that determines who we think/feel we are and also in a more direct interpersonal and present-tense sense that I was surprised the author was prepared to take for granted.  I recall a conversation I had with a much younger fellow student in law school (as I was in my early 40s) who said he saw himself as an isolated bubble trying to form relationships with others; I saw myself as a node in a web of interconnections but his view seemed to me more common.  I would now describe that view of myself as amounting to background relationality.  There is more to how I see myself now, but that background relationality is still important.  For me it’s essential to become conscious of those relations and become more deliberate in affirming them, sometimes loosening or strengthening them; it is possible to sever them and one needs the option of distance but in some constitutive way they remain part of me through my past even if I have no need or desire to interact with the person again.  And I can see the value of what’s sometimes called forgiveness as a way to make peace with severed connections.

Also, I’m interested in the relationship between the first-person and second-person perspectives.  One of the papers at the IALMH conference rehabilitated the third person as a technique of observation and talking about an external reality; in the example given, a doctor begins with a second-person interaction expressing concern and listening for the patient’s concerns and troubles and needs, what brought him there.  She is also trained to be aware of the appearance of the body and signs of potential illness, and notices that the whites of his eye are yellowed; this leads her to eventually shift the conversation to a third-person perspective in which doctor and patient jointly look at his body from an externalized standpoint.

Two things – his perspective on his body is still different than the doctor’s; she only observes (and does it through her body), while he both observes and experiences.  And when he is engaging with the doctor he is likely to be primarily focused on his subjective experience, rather than on the interaction itself.  There was no mention of a first-person perspective; I suspect because the doctor’s standpoint was the one ultimately being taken as central.  In another paper, the author invoked second-person perspective as a foundation for supported decision-making, somewhat in contrast to a first-person perspective viewed as isolated and decontextualized.  I continue to think that is problematic because it blurs the actual distinctions between one person and another, the existence of two subjectivities however much they may interpenetrate, they are ontologically and physically distinct.   First-person perspective, one’s own direct experience including but not limited to self-awareness of experience and the faculty of directing one’s consciousness and becoming able to shift it, is crucial to the kind of intersubjective second-person perspective that ensures an ethical relation rather than one that ignores boundaries or that denies the presence of self to other, with the effect of dominance and/or subordination.

And (the second thing related to the doctor-patient scenario described) – instrumentalizing another person as an object is not the same as observation, which can be directed towards oneself or another in search of a dispassionate grounding for knowledge.  Witnessing one’s thoughts and feelings is a common strategy for meditation, as is also observation of breath or minute observation of something in the natural world.   Instrumentalizing another person is related to a third-person perspective (subject-object)  as well as an unethical dominance relation within a second-person perspective.  As feminist theorists have pointed out, e.g. Carole Pateman and Gerda Lerner, dominance relations of patriarchy require women’s participation as subordinated subjects.

Where is conflict situated in all this?  Bitter, painful conflicts can’t always be solved by heart-connection, or can they?  Can we value ourselves enough to say no, ‘learn to leave the table when love’s no longer being served‘?  Are we trapped by situations where there’s still just a little love left, begging us to hold on or hold out, to keep it going so long as we can?  Maybe the heart-connection helps us to let go.