depraz second

7/27/2019 Depraz Second

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World Futures, 65: 133140, 2009

Copyright c Taylor & Francis Group, LLC

ISSN 0260-4027 print / 1556-1844 online

DOI: 10.1080/02604020802595086

SECOND PERSONS: THE EXAMPLE

OF A PSYCHIATRIC EMERGENCY UNIT: E.R.I.C.

FREDERIC MAURIACH opital Charcot, Service durgence psychiatrique ERIC, Plaisir Cedex, France

NATALIE DEPRAZUniversit e de Rouen, Rouen, France

Universit e de la Sorbonne (Paris IV), Paris, France

The goal of this article is to put to the fore the importance and the relevance of

the second persons in the framework of the relational ethics where the person

has being related as a primacy over the individual as an isolated subject. While

using the psychiatric team of an emergency unit (E.R.I.C.) as a leading thread we

seek to show the anthropology of being related, which underlines the practical

ethics of such emergency team.

KEYWORDS: Intersubjectivity, phenomenology, resonance, second person.

We take as leading thread the psychiatric work of an emergency unit named

E.R.I.C. (Equipe Rapide dIntervention de Crise), which is located at the Charcot

Hospital (South Yvelines/78). We seek here to bring forth the relational anthro-

pology that underlies the practical ethics at work in the psychiatric emergency

intervention of such a unit. Our leading question will be the following: What is the

part played by the second persons within the framework of a relational ethics in

which the person as relational subject has a primacy over the individual as isolated

subject? The clinical focus of our investigation, the second persons, results in a

compulsory addition to the cognitive research that already puts to the fore the linkbetween the first-person and the third-person approaches.

Such an anthropology relies on a change of epistemology that is supported in

turn by the very method of phenomenology: the epoche. The latter amounts to

a radical modification of attitude: I suspend my spontaneous orientation toward

the object (the isolated individual), in order to pay attention to my own personal

way of orienting myself toward it. While so doing, I let emerge my way to relate

myself to such an individual, that is, its very quality of subject as person: whereas

the individual is characterized by an experience of separation, the person as such

is a related subject. But such an experience of being related does not involve


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134 FREDERIC MAURIAC AND NATALIE DEPRAZ

as such anything else as a horizontal structure of immanence. In order to pave

the way for the possibility of a vertical relation, we contend that a dynamic of

self-transcendence alone is able to reveal the person in her whole amplitude.

Hence the necessity, so as to prove the epistemological relevance of such aphenomenology of the (second) person(s), to detail as a starting point the method-

ology proper to the cognitive sciences, which puts to the fore the co-generative

link between the first-, second-, and third-person approaches and lets emerge the

key relational part played by the second-person approach. Thanks to such a taking

into account of the importance of the second-person approach it results in the

possibility to let arise the singularity of the relational ethics that is the specificity

of the post-psychiatric work of the emergency unit E.R.I.C.

In clinical practice as well as in psychiatric theory, the doctor is interested

in the subject who is considered as pathological and identified as such by her

or his pathology (schizophreny, melancholy, mania-depression delirium). At the

very best, the pathological subject is seen as a subject in its full meaning and the

clinician/psychiatrist involves her- or himself in the intersubjective relationship

with the patient: here is the path that is followed by the phenomenological or

existential psychiatry (Daseinsanalyse) from Binswanger onward till Tatossian

and Kimura. We rely on such an existential and intersubjective path (quite

opposed to the still commonly shared classical psychiatry, which remains largely

objectivist) in order to suggest the possibility of a psychiatric phenomenology

founded on a relational practice: in such a framework we have no longer to do

with an individual subject in relationship with another individual subject, but withan ethical dynamic of mutual attention and co-presence of the different persons

with one another.

We will proceed in two steps: (1) we will describe the epistemological frame-

work within which we situate our conception of the psychiatric practice as re-

lational ethics, namely the co-generative neurophenomenology, which puts to

the fore the irreducibility of the second person as an intersubjective validation

of objectivity; (2) we will show how the practical ethics at work in E.R.I.C.s

clinics is fruitfully grounded in such an epistemology but lets also arise its cru-

cial limitation: hence our shift from an immanent circularity toward an ethics ofself-transcendence.

THE PRACTICAL NEUROPHENOMENOLOGY

OF THE SECOND PERSON

A disciplined method of gathering first-person data is necessary in order to study

consciousness in a scientific way (Varela and Shear 1999). Beyond any isomor-

phism, which merely correlates experiential subjective accounts and their neu-

ral counterparts, Francisco Varelas neurophenomenological research program

(Varela 1996, 1997) puts to the fore the contention according to which both anal-yses (neuro-dynamic and phenomenological) are generated through each other:


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SECOND PERSONS 135

While relying on such a first co-generative step, we wish to show that the third-

person protocols are not neutral, that is, independent from the intersubjective

situation of each subject in its own individuated spacetime (Bitbol 2002). Tak-

ing into account reports is required: not only first-person but also second-personreports. We therefore suggest to take seriously the multifarious types of commit-

ments of the second-person activities all along the whole process of experiential

validation. For example, in the framework of a scientific experiment that uses

the neurophenomenological method, the different subjects who are experimenting

and are descriptively accounting for their experience are co-researchers from the

start: they actively contribute to the production and to the description of the ex-

periment and of the experience, the former being then precisely correlated to the

neuronal third-person account; another kind of involvement of the second-person

approach is at work in the activity of the research supervisor, who takes part (as

a coach) in the ongoing research of the student; the authors of the referential

texts for the research finally, by interacting with the experiment, play the part

of first-hand reflecting actors for the researcher, namely of so many (each time

different) second persons.

A first step was already walked in this direction (Depraz, Varela, and Vermersch

2003): we contended the plastic continuity of the three approaches (first, second,

and third person) rather than their polar opposition, thus paving the way for a

gradual dynamic of intersubjective validations. Here the second person is not a

formal instance, but a relational dynamic of different figures in mutual interaction.

We thus question the methodological framework of the so-called hard problem asit was first stated (Nagel 1974; Levine 1983; Chalmers 1995). Starting from the

irreducible distinction between a third-person (experimental and quantified) and

a first-person (experiential and qualitative) methodology and then trying to fill in

the gap leads actually nowhere.

If the second person is less another pole than a continuous and plastic texture

of exchanges, it is problematic to carry on calling such a relational dynamic a

second person, as if (1) we had to do thereby with a separated and isolated

entity (a particular individual), and (2) such a distinct entity was secondary with

regard to another one (which would have the primacy): we therefore chose tospeak of second persons in the plural. As a result, we are also led to question in

turn the polar component of the so-called first and third persons. While putting

to the fore a renewed understanding of the second-person methodology, which

does not lie in the formal primacy given to a You as opposed to an I and

to a He/She, we bring forth a plurality of methods as intersubjective practices.

In that respect, the Husserlian empathy is a key concept of such a methodology.

More than a mere central condition of possibility of the science of consciousness

(Thompson 2001), empathy corresponds to an actual practice that articulates from

within the scientific research. In the same way as the Husserlian concept of

Einf uhlung requires to be adapted to the practical experimental framework, thelatter also is enlightened by the phenomenological intersubjective method (Depraz


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attitudes related to such a care for the other. Be it M. Buber and his understanding

of the You, E. Stein, who stresses the person as a unity of body, soul, and spirit,

E. Levinas with his unconditional openness to the Other, or again G. Marcels

approach of the person as mystery, all these approaches insist on the primacyof the other understood as an individual singularity. The question is then: Is

the very relationship with such an other put to the fore, or merely the other as

a singular individual put to the fore? How can we understand the empathetic

relationship while starting only from the singularity of the other person? As a

matter of fact, such personal ethics remain individualist insofar as no relationship

is thematized as such but only the relationship between one individual person and

one otherindividual person: never do you experience the relational linkage if you

are primarily interested in the individual persons themselves, be they understood

as subject (ipseidentity) or as object (idemidentity), according to P. Ricurs

distinction in Soi-meme comme un autre.

In contrast, if the relational experience is defined as a circular dynamic where

the persons are mutually coupled without any primacy given to the one or to the

other, circularity appears as a relational mutuality, where experiences are given

as symmetric or reciprocal, and does justice to multifarious experiential contexts.

In that respect, the person as a singular instance is put to the back and the inter-

sections between persons to the fore, insofar as they become the very places of

experimentation of the relational dynamic (Wittezaele 2003, 31101). The irre-

ducibility of the person then disappears and the very linkage of the relationship

emerges (Elkam 1989). Again, it is necessary to keep the personal componentbecause it is the only way not to shift into the horizontal and anonymous imma-

nence of an ethics of nature; the latter, however, needs to unfold its multifarious

facets in order to avoid the other way round a tendency to abstraction linked to the

absolutization of the Other as a unique and irreducible singularity.

A PRACTICAL RELATIONAL ETHICS: E.R.I.C.S POST-PSYCHIATRIC

ANTHROPOLOGY

The thrust of neurophenomenology lies in its taking into account the validity ofthe second person. It makes it possible, then, to appreciate its inner limits, namely

its difficulty to integrate the ethical relational component and, more specifically,

intersubjectivity understood as a pluripersonal experience. Why? Because the

only genuine experience is the in-between between a non-relational thought of the

singularity of the person (the You seen as an Absolute) and a relational immanent

thought that erases and tendentially forgets the irreducibility of the person.

Now, the psychiatric field and, in particular, the specific practice at work in the

home-emergency unit E.R.I.C. stresses the primacy of the relationships between

the different persons: such a stress renews the epistemology of the second person,

which nevertheless grounds it (Robin et al. 1998). The relational anthropologythat is brought to light with its specific ethical orientation underlines the operative


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SECOND PERSONS 137

The psychiatric emergency unit E.R.I.C. (EquipeRapide Intervention deCrise;

Depraz 2005; Boszromenyi-Nagy 1987; Michard 1991) was founded in 1994 by S.

Kannas (2000) in order to tackle the problem of the chronicity of the hospitalization

of the patients. As a matter of fact, the goal of this 24-hour working unit was totry each time to avoid hospitalizing the patients (actually, for the time being half

of them are not), the alternative being to help them stay at home. How? The

doctor and the nurse are committed to intervene together to the patients house

according to the relational method of coupling a doctor and a nurse for each care.

Now, the crisis situation creates a context where the family as well as the family

physician are helpless. Given such a shared feeling of helplessness both the doctor

and the nurse work together in order to provide the family, the educators, and the

psychologists who already take care of the family with renewed functional skills (as

parents, as wife and husband, as professionals) within the critical situation itself.

Rather than increasing the feeling of powerlessness of relatives and despising

a patient who is already in a precarious situation, the caring team restores the

feeling of self-confidence of relatives and of the patient. While furnishing them

with a one-month-follow-up after the first care, the doctor and the nurse endeavor

to confirm the lived inner competence of the close relatives of the patient, that

is, help them becoming confident about their own ability to truly relate to each

other and above all to the so-called patient. Now, what is striking in this kind

of practice is not only the professional deontology, which thwarts the frequent

objectivization of the ill person and leads to the taking into account of the person

itself, but also its seeing paradoxal therapeutic efficiency. The leading motto is:How not to be efficient in order to help the relatives and the patient to be

efficient?

The crisis situation is an outstanding time that leads the family to the outburst

of its usual markers: contrary to what claims the family, namely a homeostatic

return to the previous family system, we decide to use such a time in order to

let emerge the multifarious relational problems by naming them, in order to

make reemerge the organic functionality of the family, whereas the latter had

been destroyed by the dysfunctional dimensions that brought about the critical

state: E.R.I.C.s practice lies in intensifying the outburst of the links, namely, indeveloping the going out of the frame. Of course, such an intensifying process

does not aim at being destructive. On the contrary: it creates a letting-go of some

inner resistances, which will help each person name more genuinely what is

responsible for her or his suffering. Consequently, the aftermath of the crisis does

not necessarily amount to returning to the previous precritical situation. On the

contrary: the immediate feeling of our own sufferings andthe ability to name them

with certain persons produces a radical transformative effect.

The dynamic of resonances is therefore used in each crisis intervention: the

doctor and the nurse are involved in the different talks with and within the different

members of the family because they listen through the talks of the latter to theway they relate to their own lived experiences (their personal history, their inner


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of fact, their own suffering is directly emerging through the way they talk to the

family, that is, handle the whole situation. Such an affective immersion is a full-

fledged method that enables them to ask the right questions, because they know

from inside what they talk about because they went through it already. Far frompresenting themselves as neutral external observers, they use their own affective

life as a methodical indicator of their therapeutic action toward the family.

As a result, it appears that the dynamic of questioning is common to the

affect-laden resonances and to the phenomenological method of epoche; the latter,

however, illuminates the former by embedding the local gesture of epoche into the

whole set of practical resonant moves. Correlatively the resonance is enlightened

by the epoche insofar as the latter stresses the specific quality of its suspending

time. Because of the resonant setting, the family is immersed into the dynamic

and begins to resonate with the other systems; because of the time-suspension

of epoche, the family is invited to get a broader view of the situation. Observing

distance (epoche) and affective adherence (resonance) might appear at first sight

contradictory. As a matter of fact, they are fully complementary. There is even a

kind of conjunctive functioning of resonance and suspension: first for the family

who is able to suspend its prejudices of powerlessness and to recreate its own rela-

tional ability; second in turn for the emergency team who suspends its competence

by resonating with the family and thus helps provide each member of the family

with its functional competence of father, mother, and child. The interplay of such

relational couplings reveals the ethical component of the whole functioning: the

cross-process of suspending and resonating enables each one to be re-establishedin ones own skill whereas each might have been discredited had the social or care

hierarchies been put to the fore (Depraz and Mauriac 2005).

By joining suspension and resonance it is thus possible to avoid the risk of the

horizontal immanence of relational circularity and to open up the possibility of

understanding the person as being fully conscious of the relational component.

So we have neither to do with a joint dialectical circularity where the three

persons are homogeneously situated on the same level (in contextual systemic

therapies, for example), nor with an exclusive primacy given to the second person

(in psychoanalytic care, for example). Here each person acts at one and the sametime unanimously with the others but differently for each (Kovalesky 1982, 163

187). In that respect, the relational cell is not the smallest common denominator:

it would suppress irreducible aspects, for what is common is what is shared

while being only partially included in each perspective (Kovalesky 1982, 29).

In short, in contrast with the phenomenological transcendence, which amounts

to an intentional dynamic of relatedness with an object, the movement of self-

transcending corresponds to the emergence of a subjective inner dimension that

is in a sense trespassing each individual subject and nonetheless fully involved in

each one. Each person thus arises in her or his own dynamic while relating both to

the others andto her or his personal vitality. It is truly what Maxim the Confessorearly called the tropos of the person: her or his quality, style, manner, changing


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SECOND PERSONS 139

relational dynamic without being fully absorbed in it, all the same. 1 It resonates

with such a dynamic while nourishing it from inside and and while finding in it a

suspension that allows it to remain oneself through it.

Such a process is frequently at work in the practice of many professionalsdealing with a relational therapeutic work. The unit E.R.I.C. chose (because of its

organization, its dynamic, and the history of its constitution) to make use of such

an energy in order to be able to deal with the context of crisis and emergency: in

this regard the term second persons is meant to describe a lived experience that

is the common ground of such a practice but is usually never taken into account

for it is not easily describable.

NOTE

1. Yannaras (1986) where the energy is seen as a common ground situated beyond the still one-sided

distinction between the Husserlian intentionality and the Heideggerian extasis.

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