Let’s Stay in Touch by Brian Treanor

Brian Treanor is currently Professor of Philosophy Department and Charles S. Casassa SJ Chair in Social Values at Loyola Marymount University, in Los Angeles. He writes and teaches on a diverse range of issues including hermeneutics, environmental philosophy, ethics, and philosophy of religion. He was the editor, with Richard Kearney, of Carnal Hermeneutics (Fordham 2015), a collection that makes the case that hermeneutics goes “all the way down” to our senses and perceptions, that our carnal sensations are already interpretations. Additional projects include Melancholic Joy: On Life Worth Living (Bloomsbury 2021), Philosophy in the American West: A Geography of Thought (Routledge 2020), Being-in-Creation: Human Responsibility in an Endangered World (Fordham 2015), and Emplotting Virtue (SUNY 2014), among others.

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In in a series of recent blog postings on Hermeneutical Movements, David Utsler makes the case that the reaction to the COVID-19 pandemic highlights a number of issues relevant to hermeneutics. He is certainly right in doing so, particularly in light of the “material turn” that has gained traction in many philosophical sub-fields in recent years.

In the following, I want to engage David’s insightful posts, and to contribute in some small way to reflection on the COVID-19 pandemic and our response to it.

Carnal Hermeneutics and COVID-19

David points out that while the COVID-19 pandemic presents a challenge to our thinking in various ways, it focuses our attention on touch with particular clarity. As there is, currently, no effective vaccine or treatment for COVID-19, we are left with nothing to fall back on other than good, basic public health responses, including now-ubiquitous efforts at “social distancing.” This term and its many associations draw our attention, as David points out, to our shared social spaces and how we inhabit them. As the pandemic gained speed and governments struggled to respond, we were regularly reminded to maintain a two-meter distance between ourselves and others, and almost as regularly reminded that “social distancing” is a misnomer (though too late, I fear, as “social distancing” is now fixed in the shared lexicon of the generations who will remember this pandemic). The real point is to engage in “physical distancing” and, in particular, to become aware of touch. We were reminded not to touch others—dropping handshakes for “elbow bumps” and then, realizing even those were too “touchy,” adopting bows, nods or other inclinations of the head, and eventually waves from a strictly-maintained two-meter distance.

But the two-meter bubble of social distancing is only part of our new “sensitivity” to touching and being touched. Others can “touch” us by using door handles or light switches or shopping carts immediately before we do. We’ve become anxious about touch even at the level of proprioception, intensely aware of how often we touch our faces to scratch our nose or rub our eyes. Comically, though understandably, early during the US outbreak I watched official after official touch his or her face during interviews and press conferences, culminating with a health official in California licking her finger to turn the pages of her notes shortly after advising us not to touch our faces.

The rehabilitation of touch has been a particular concern for thinkers associated with “carnal hermeneutics.” In fact, Richard Kearney, who co-edited Carnal Hermeneutics with me, has just finished a book on this very topic: Touch (New York: Columbia University Press, 2021). As David notes, all sensate experience is an interpretation, something demonstrated with abundant clarity by thinkers as diverse as Aristotle, Merleau-Ponty, and Shusterman. Nevertheless, the history of hermeneutics—and, indeed, of philosophy—is one in which the body and the senses are downplayed or denigrated in favor of the mind/soul and reason/language. It is for this reason that I have been arguing for some time that we need to articulate a hermeneutics “beyond the metaphor of the text.”

Touch

What makes touch distinctive among the senses?

Many things to be sure; but, from the perspective of carnal hermeneutics, the distinction cannot be that touch is immediate while the other senses are mediated. All our experience, including sensuous experience, is mediated to one degree or another. Just as sight is not direct communion with that which is seen, or hearing direct communion with that which is heard, touch remains at a distance from that which is touched. Kearney reminds us that, in the De Anima, Aristotle tells us that touch does have a medium: flesh (sarx). “Flesh,” writes Aristotle, “is not the organ but the medium of touch.” There is a gap between touch and its objects, just as there is with the other senses; whence the need for and virtue of hermeneutics. Sensuous perception shares an “experiencing as” structure in common with other, more traditional forms of hermeneutics expressed in terms of the interpretation of texts. Touch does not provide a magical, direct access to the essence of things any more than does vision, or, for that matter, than the logos for which vision has traditionally been an analog. Of course, in another register, we could call into question the supposed remove of sight, smell, and the other senses from touch; sight takes place because photos strike the rods and cones on the retina, smell takes place because molecules come to rest on olfactory receptors, and so on (on this, see chapter 1 of Kearney’s forthcoming Touch).

Nevertheless, while touch may be mediated, we do have a feeling that it is, so to speak, “more direct.” Why is this so? Perhaps, because as Utsler points out, in touch we experience “resistance” in a distinctive way.

Touch is “reversible” in a way that other senses are not. We can see without being seen, hear without being heard; but we cannot touch without, at the same time, being touched. Precisely because touch is uniquely reversible in this way, when we touch, reality “pushes back” against us in a way that is different from the other senses, and certainly different from linguistic description or conceptual analysis. To touch something is to feel oneself being touched, to feel the resistance of that which is touched, to feel reality assert itself and push back against us. This resistance is emblematic of what Michel Serres calls “hard reality.” “Hard” reality goes by a variety of names in different thinkers: the given, nature, the wild. In general, hard reality is reality that resists us and makes demands on us, reality to which we must accommodate ourselves. “Soft” reality, in contrast, is reality as interpreted or experienced by us: culture, language, and so on. It is reality as bent to fit or accommodate us. Serres does not intend to set up a dualism of the hard and the soft, because there is, in the end, only one reality. Nevertheless, reality—a mixed bricolage of diverse phenomena—can and does present itself in harder or softer aspects, and we experience it in harder or softer ways. The point is to be able to travel between these different aspects of reality and translate responsibly.

Read in a phenomenological and hermeneutic register, one might take Serres to offer a kind of friendly amendment to the traditional phenomenological rallying call “to the things themselves,” which is this: “remember the hard.” That is to say, when we seek to return to the things themselves, which is to say the way that things are given to us in experience, remember the distinction between reality and our experience of it. Recognize, but do not overemphasize, the human role in the construction of the world. Remember the resistance of things to human experience, interrogation, analysis, and understanding. Remember the existence of things outside of and independent of human concern. Remember the wild heart of reality and the inhuman expanse of the cosmos and of deep time. Indeed, SARS-CoV-2 and COVID-19 are themselves manifestations of the hardness of reality: unforeseen, unwanted, and (at least so far) unsolvable disruptions to our all-too-human desires, goals, and plans. Until we find a vaccine, this is reality to which we must accommodate ourselves. A stark reminder that despite our wealth and power and technological might, our achievements are always at risk of being reduced to “two vast and trunkless legs of stone” among the vast, level cosmic sands.

One of the virtues of carnal hermeneutics is the way in which it gives us alternative metaphors with which to understand the core hermeneutic insight that we always experience, interpret, know, imagine, and understand from a particular perspective; and that while we our perspective can evolve or change, the root fact of having-a-perspective is something we can never escape. This is critical, because if hermeneutics tells us anything it is that every perspective reveals some things and conceals others. Thus, to view reality as a “book” to be “read” will reveal certain truths, and it has; it’s been one of the most fruitful epistemological metaphors of the 20th and early 21st century. But that same perspective will also conceal other truths, some of which will be more easily accessible if we consider reality not as a book to be read, but rather as something to be “held” or “embraced,” or a “banquet” to be “tasted,” or a “landscape” to be “traversed.” These alternative metaphors are not merely different modes of expression or variations in pedagogy, alternatives that are useful because some people are bookish and others are gourmets or saunterers. They are alternative ways of conceiving of and experiencing the world, alternatives that express the perspectival, partial, biased, revisable nature of our experience, perception, and understanding, alternatives that reveal and conceal different truths about the world and about ourselves.

Seen in this light, both during the pandemic and in whatever post-pandemic world we craft, we should be concerned not only with “the stories that we tell,” but also with places we inhabit and the ways in which we are oriented within them, the activity (or inactivity) of our bodies and the ways in which they interact with the world, the things we touch (and are touched by) and those we keep at arm’s length.

Getting in Touch with a Post-Pandemic World

When the pandemic really got under way, people—at least those who could do so—went online. The effects of the digital divide during the pandemic will be well worth analyzing at some point. But what interests me here is the attempt to “keep living” by “moving online.” Virtual classrooms. Virtual barstools. Virtual relationships (professional, amicable, and romantic). Virtual church. Virtual weddings and, sadly, funerals. Virtual bedside comfort for the dying, and virtual life for the living.

What, asks Utsler, will be the effects of physical distancing on the social relationships that normally sustain us through face-to-face, body-to-body interactions? How will being confined to a singular place—and, thus, being displaced from the larger placescapes that also sustain us—disrupt and alter our being-in-the-world?

Wallace Stegner tells us that we cannot know ourselves without knowing our place, that is, without knowing the place in which each of us is a self. When we change places, our self begins to change as well. Generally, this takes place slowly, like evolution; but sometimes a radical disruption in place—a sudden, forced migration, or a sudden, forced confinement—can cause an abrupt disruption in one’s sense of self as well. Certainly, much of this is a necessary sacrifice; but it’s all happened so quickly that we are just coming to grips with what we’ve sacrificed. The sacrifices of front-line medical workers and first responders—a number of whom volunteered to work in COVID-19 wards and all of whom work in high-risk calling during this pandemic—are obvious and must be acknowledged. But there are other sacrifices that, while they are not selflessly or altruistically motivated, are no less deprivations. The students whose education has been put on hold. The parent whose projects are disrupted by caring for children in quarantine. The economic anxiety of the restaurant owner or worker whose livelihood has been destroyed. All the people—billions of them—under some version of a lockdown and cut off from their neighbors, colleagues, friends, and, perhaps less intuitively to some readers, from the concrete, physical places that shape and inform their identities.

What, then, is going to happen when the pandemic passes, as it eventually will in one way or another? What will it be like to get “back in touch” with the world?

Of course, I don’t want to overstate the case. As I write this, we are sliding into the seventh week of the stay-at-home order here in California; and it’s not as if we’ve been locked in solitary confinement. Nevertheless, in some form, this pandemic could last years, and various degrees of social distancing may be the order of the day for much of that time. If we spend a year or two under the shadow of this virus, that will constitute a non-negligible portion of many people’s lives. This will be especially disruptive for those near the beginning or the end of adult life. If, a bit arbitrarily, we mark the (beginning of the) emergence of a person’s adult self at around twelve or thirteen years old, an eighteen-year-old will have spent a third of her life in some under form of social, physical, and geographic distancing. Retirees who saved their entire life with the goal of pursuing some particular plan will have had those plans disrupted during precisely the years they hoped to execute them, and perhaps lost forever due to retirement savings devastated by a wrecked economy. People who are ill and who were hoping to spend their last days with friends and family, or revisiting old haunts, may well spend their last days in quarantine, video-chatting.

For those who are not at either end of their adult years, will they have adjusted, at least to some degree, to a new, virtual life? Will classes stay online? (Surely the bureaucrats will want this, but might some professors embrace it too?) Will we keep ordering food from Instacart rather than going to the market? Will virtual community replace community? Before you become too skeptical, consider our existing habits of touching. It’s a fair bet—as Leïla Slamani noted—that the thing most people touch most often is their smartphone. Or consider the degree to which both romance and sex—traditionally pretty immediate, first-person kind of experiences—have flourished online. As with everything else, efficiency and ease of access will make online life more attractive. When you can have an algorithm choose your mate, why go to the trouble of socializing? When you can have food delivered to your door, why go to the trouble of shopping and cooking? When you can teach philosophy online without having to live in an ugly city and endure a congested commute to campus, why not do so?

Or, alternatively, will the forced immersion in “virtual” reality leave us craving the real thing? Will people reject sitting at home watching a screen (“reality TV”) in favor of the world (reality itself)? Will they embrace—metaphorically or literally—their neighbors rather than hiding in their single-family homes? Will they take up the risk of life rather than living in a risk-free, virtually-mediated simulacrum?

Already, I’m reading many accounts of people—from the ordinary to the famous—who insist that they’ve had an epiphany, that they are not going to go back to the old way of doing things: working overtime to buy things they do not need, struggling to pay the rent in a city where inflation and the cost of living outpaces wage growth, coming home exhausted to sit on a couch for hours watching a fantasy play out in the soft blue glow of an HD screen. Perhaps that will be true for some of them. But I remember reading the same kinds of sincere resolutions from people who lived through 9/11. I’ll never go back to commodities trading. Life is about more than work. I want to follow my dream. No doubt some people followed through; but a year after the twin towers fell, where were most of those people? Back in the rat race. In the same city, in the same types of jobs, pursuing the same sorts of goals that they were pursing on September 10, 2001. Contrary to our fantasies, in most cases enlightenment is not a sudden epiphany which is won once-and-for all. It’s a daily achievement.

The mind or the body? Logos or tact? The soft or the hard? It’s not as if it is an either/or choice; but the history of Western philosophy is marked by a decided, and problematically narrow, preference for the former. If philosophy can get back in touch with touch, perhaps it can place its fingers on the scale of the second alternative and balance things out.

Carnal Hermeneutics in a World of Social Distancing, Pt 2: Bodies in Place

Pt 2: Bodies in Place: Confinement and Displacement

David Utsler, PhD, is currently part-time faculty in philosophy for Texas Woman’s University and North Central Texas College. He is co-editor of Interpreting Nature: The Emerging Field of Environmental Hermeneutics (Fordham 2014) along with Forrest Clingerman, Brian Treanor and Martin Drenthen. He is also co-author with Cynthia R. Nielsen of “Fricker, Gadamer, and Honneth: Testimonial Injustice, Prejudice, and Social Esteem” in Recognition Theory and Epistemic Justice, eds. Paul Giladi and Nicola McMillan, forthcoming 2021 from Routledge.

I .  Getting a sense of sense

In the first installment, I noted that carnal hermeneutics refers to the body as interpretation. While “touching” primarily on touch, I highlighted that Kearney and Treanor insist on an “equiprimordial redistribution of the senses” as a necessary aspect of carnal hermeneutics in order to understand how we, through the body, interact with other bodies and make sense of the world. Interpretation of our world begins and is carried through within our senses.

So if we make sense of the world through the senses, Richard Kearney asks how we make sense of sense (Kearney. 2015, 15). He explains three senses of sense that, I take, are all weaved together in the interpretation of the world through our embodiment. The first is the five senses themselves. The second refers to meaning as in “getting a sense” of what someone is communicating. The third is expressed in the etymology of the word “sense” as direction or orientation. This last refers to how we “place” ourselves in the world. Our embodied place, our position, is an orientation to the world through which we make sense and understand meaning in the world.

There is no doubt that a world of social distancing has “re-placed” our bodies. The way that we orient ourselves to those around us has changed. The way we work has changed as many who went to the office now work from home, while others have been “dis-placed” as working non-essential jobs now have no job. Social distancing, for the most part, has “dis-placed” us from one another except to those in our immediate household. On a positive note, as I take walks in my neighborhood I am witnessing far more people that what is typical out and about themselves. A change of place often means a change of pace: what we do with our bodies (how we live) is in direct relation to where our bodies are placed.

II .   The confinement of social distancing

In his contribution to Carnal Hermeneutics (“Skin Deep: Bodies Edging into Place”), Edward S. Casey writes: “Some places are hard to bear—to bear bodily” (Casey. 2015, 159). Casey writes of the specific example of solitary confinement and the devastating effects such can have on a human being. Now, while I would not think to equate being confined in the comfort of our own homes with prisoners in solitary confinement. But there are some comparisons alongside the differences, the differences being different to an extreme order and degree.

Consider the language that has entered our discourse. Shelter-in-place. In other words, stay where you are and do not come out. Whereas a prisoner is placed is solitary as a punishment, we are asked to “place” ourselves at home for our own safety and the safety of others. Yet, what many experience is still a kind of confinement. As Casey says of the prisoner, he has nowhere to go (Casey, 160). While the prisoner is limited by walls, many feel limited by the walls created by COVID-19. Our ordinary lifeworld has been re-oriented such that we have limitations on where we can go. Places we went at will at now no longer available to us. To varying degrees from mere frustration to fear of losing property (losing place), how we dwell has been destabilized and we are forced to re-orient ourselves in place by externalities outside of our control. To cite Casey in this context, “one’s coherent, customary world” (Casey, 159) has been, for an unknown length of time, upended. It no longer coheres the same and our customary way of being in the world is, for now, gone. In both “social distancing” and “shelter-in-place,” how we orient ourselves toward others and in place is altered requiring that we “make sense” of the world in new ways. This can have devastating effects on the human psyche and devastating effects socially. Yet, we can be hopeful for more positive outcomes.

III.  Displacement within place

I speak of “displacement” in two senses. People can be physically displaced by war, natural disaster, or other means where they are forced to leave one place and go to another. There is another form of displacement, what I call “displaced in place” where a familiar place has been altered to the extent that our orientation to that physical space is forever destroyed. For example, in the context of environmental justice, there are seemingly a limitless amount of cases that one could cite where due to the environmental effects of the actions of others, entire ways of life of a people have been lost.

Casey writes of implacement and displacement in his book Getting Place Into Place. He writes: “The power of a place such as a mere room possesses determines not only where I am in the limited sense of cartographic location but how I am together with others (i.e., how I commingle and communicate with them) and even who we shall become together” (Casey. 2009, 23). In this single profound sentence, Casey has shown that a place is not merely a physical space but, to put it in the terms of carnal hermeneutics, is an embodied interpretation determined by our orientation to the place itself and to others with whom it is shared, effecting our very identities, both individual and communal. Certainly, social distancing and shelter-in-place orders have determined how we “commingle and communicate” with others and, I would add, the places wherein we have a sense of self. The loss of place (displacement) can occur even within the same material space. As hermeneutics in both Gadamer and Ricoeur have repeatedly communicated, interpretation always implies an interpretation of self. Identity is always bound up with understanding.

The current “landscape” in which we now dwell has been altered by COVID-19. How we are within the places where we are and who we are with one another has, even if only temporarily, changed. The question now becomes, “how shall we respond?” The discordance and disruption created by COVID-19 also creates the imperative that we must reorient ourselves bodily (refigure) the world to which we had become accustomed (prefigured and configured). In the final installment, I will reflect on this imperative in light of the narrative hermeneutics of Paul Ricoeur, particularly on his explication of threefold mimesis.

References

Kearney, R. (2015) “The Wager of Carnal Hermeneutics.” In Richard Kearney & Brian Treanor, eds. Carnal Hermeneutics, pp. 15 – 56. New York: Fordham University Press.

Casey, Edward S. (2015) “Skin Deep: Edging into Place.” In Richard Kearney & Brian Treanor, eds. Carnal Hermeneutics, pp. 159 – 172. New York: Fordham University Press.

Casey, Edward. S. (1993, 2009) Getting Back into Place: Toward a Renewed Understanding of the Place-World. 2nd Edition. Bloomington: Indiana University Press.

Notes on Carnal Hermeneutics and Mental Health Nursing by Graham McCaffrey

Graham McCaffrey, PhD is an Associate Professor of Nursing at the University of Calgary. He has a book, Nursing and Humanities forthcoming from Routledge, that explores the relationship between nursing and the arts and humanities, including philosophical hermeneutics.

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I

This Fall, I taught an undergraduate class in addictions and mental health nursing, covering topics that included the neurobiology of addictions, early childhood development, and attachment theory. Whatever the topic, there is always the task of connecting theory to nursing care, of how to bring knowledge into practice with patients. It is a basic hermeneutic question for nursing: who is this facing me as a patient, and what do they ask of me? Mental health nursing has always been an interpretive practice in certain ways, but new developments in related scientific fields call us to develop more layered understandings of our practice. Carnal hermeneutics, as set out by Richard Kearney, offers a creative language to do so.

II

Mental health nursing has a hybrid history, reflected in changing trends in its naming. Previously, it was more commonly called psychiatric nursing, implicitly under the ideological and practical direction of a medical specialty. Thus it has followed trends in psychiatry over the decades, from a psychodynamic orientation (emphasis on inner life, language, interpretation of symbols and actions), to behaviourism (emphasis on outward actions as objective signifiers of mental disorder), to brain chemistry (emphasis on inner physical life, mind and body reduced to epiphenomena). Shifts in nomenclature may both reveal and conceal actual shifts in ideological commitment. The more recent preference for “mental health nursing” weakens the association with psychiatry and yet the profession itself continues to carry traces of all the trends listed above. Mental health nursing in addition carries the historical legacy of the asylum orderly role of containment and control (mental health nursing to this day tends to have a higher proportion of men than other nursing fields), and of professional nursing with its legacies of caring beliefs. Our latest iteration is “addictions and mental health nursing” – an unwieldy title that now reflects the actuality of overlap between addictions and mental health disorders, both at the level of causation and presentation.

III

With its hybrid ancestry, mental health nursing cannot escape being an interpretive practice, even where one or other tradition predominates. The nurse-interpreter, prejudiced in Gadamer’s sense, is always already being interpreted by a blend of professional traditions, cultural conditions (micro and macro), and personal dispositions. Even at its least interested in the patient’s inner world or past life, mental health nursing relies upon reading of actions and gestures, and on working through language, in relationships between people in space and time, all of which entail interpretation.

IV

Having spent some years working in a therapeutic community, using a model of psychosocial nursing closely based on psychodynamic principles, I have my own bias within my discipline towards the therapeutic possibilities of speech, dialogue, speaking and listening. However, there is a dialectical movement between control of behaviour and understanding of inner life that is enacted differently by individual nurses and according to the local dictates of clinical settings. It is possible to idealize the speaking/listening agent at the expense of the significance of bodies in space, in relation to furniture, doors, windows and other bodies.

 

V

There is a dialectic between inner life (both biological and mental) and outer behaviour (including expressed language). As I have sketched out above, mental health nursing has always moved inside this dialectical structure, but its terms have never been static and recently have moved in significant ways. In the 30 years I have worked in mental health, I have seen a shift away from psychotherapeutic modalities such as groups, towards reliance on psychotropic medications and the assumption that mental illness is all a matter of brain chemistry. Now there is a further, and more hopeful shift again, embracing neurological science but going beyond the oversimplification of brain chemistry.

VI

Addictions and mental health latterly have been tentatively welcomed into the fold of proper medicine, now that we can think about them in terms of neural pathways and brain chemistry. “We are our brains” is a popular mantra when examining the role of brain development in patterns of behaviour. It’s a Cartesian halfway house, “I think with my brain, therefore I am” though the body, apparently, remains an appendage, now a kind of puppet controlled by the all-important brain. While it may be true that nothing in human life happens without the involvement of the brain, to assert absolute self-identification is a kind of nihilism. The brain, pre-eminent in some ways, is at the same time the organ we are least aware of. Mental health nursing continues to be a matter of persons meeting persons in certain places within parameters of social value, relating for defined purposes through language and action. Knowledge of the brain changes nothing in this basic locus of action, but it does add interpretive layers, that carnal hermeneutics can work into an enriched account of mental health nursing as an interpretive practice.

VII

Richard Kearney argues in Carnal Hermeneutics that Ricoeur extended Husserl’s phenomenology of the flesh into a carnal hermeneutics that recognizes the other as a body like oneself and as another that requires inferential reading or “a special grammar of carnal hermeneutics across distance, gaps and differences” (p. 54). Ricoeur, he notes, likened this interpretive relation to the reading of symptoms. Reading of symptoms through the body can become a reductive habit among mental health nurses. One piece of professional shorthand is to dismiss a patient’s actions as “behaviour” which on the face of it is meaningless, since to be alive is to exhibit behaviour of one kind or another. Condensed within the word, however, is a framework of judgement, that a specific behaviour is considered as manipulative, attention- seeking [1] and by implication under the person’s conscious control. “Behaviour” in this localized sense is never applied to oneself (possibly to a colleague, and if so to call their actions into question) and has a collusive function since to understand the intent of the term is already to participate in assumptions about where the border lies between the sick and the well, the sane and the mad.

VIII

Addiction is associated with chemical pathways in the brain, linking to desire, reward, the need for comfort, and connected to memories and meanings mapped on to the world. Desire is for something, comfort derived from something…chemical pathways lead out from the brain, through the flesh, into the world where desire, reward, and comfort take on meanings, actual and enculturated. Kearney says, “Every carnal act and organ inscribes its own imaginaire…Nature is already culture as soon as we sense it as this or that…Sensation is expression and expression is sensation. Flesh is word and word flesh” (p. 45-6).

IX

The rush for overly simple genetic explanations of personality traits and likelihood of developing mental health disorders has given way to the more cautious, complex and less certain science of epigenetics, the endlessly variable interchange between genetic loading and how genes become expressed in interaction with environmental stimuli. Hence the significance attributed by neurodevelopmental scientists to what they term “serve and return” interactions between infant and parent or principle carer. Very early on, the infant learns what to expect from the world, and how her or his expressions, facial, vocal, or gestural are likely to be received.

X

Prejudices are bred in the bone, or at least held in neural pathways that are shaped through interaction with the environment and fed by genetic availability. Freud has received a largely unacknowledged, if partial vindication in a new interest in “trauma-informed care.” Although the apparatus of Freud’s schema of the unconscious is gone, the basic insight that early experiences inform later patterns of emotional response and behaviors has been re-instantiated through empirical investigation of correlations between childhood trauma and later life health outcomes, and of the biological effects of trauma in the brain. A large longitudinal study known as the Adverse Childhood Experience study has found strong correlations between the numbers of “adverse experiences” a person had growing up (for example abuse, neglect, or a parent with addictions) and health outcomes later in life; not only mental health problems such as depression or anxiety, or addictions, but also physical conditions like heart disease (Center for Disease Control, 2019).

XI

Merleau-Ponty’s term chiasm describes a two-way crossing between self and world. Fleshly signification as well as language passes back and forth and behind the signification, in the flesh itself lie layers of dispositional matter, in nerve pathways, brain tissue, cellular functioning, bodily affordances. Addictions and mental health nursing is not random, it has threads it must follow through a mesh of meaning, carnal and enculturated, in constant interaction with the world. The charged flesh encounters the other, not in a vacuum, but in an environment that is itself charged with histories, laws, ethical codes, and local customs.

References

Center for Disease Control. (2019). Adverse childhood experiences (ACEs). Atlanta, GA: Author. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html

Kearney, R. (2015). The wager of carnal hermeneutics. (In R. Kearney and B. Treanor, eds., Carnal Hermeneutics) pp. 15-56. New York, NY: Fordham University Press.

[1] Another example of hermeneutic paucity – how many kinds of behaviour are about seeking attention in some way, and yet it is pronounced as an end to curiosity about a patient’s feelings, motives, desires – not as a start.