Dignity in Context, and Out: Discussion of Lynne Jacobs’ “On Dignity, a Sense of Dignity, and Inspirational Shame”

ABSTRACT

Dr. Lynne Jacobs’ “On Dignity, a Sense of Dignity, and Inspirational Shame” is an interdisciplinary integration of a priori ethics and a phenomenology of dignity. She contends that the human person’s engagement with other people—writ large in the therapeutic encounter—is inherently ethically situated. Moreover, she avers an inherent content to this ethics, namely, mutual respect for distinctively human value—dignity—between and among people. Her ethics of dignity informs her psychoanalytic exploration of experiences of dignity, indignity, and her notion of inspirational shame, among others. I join in Jacobs’ advocacy for therapeutic facilitation of a person’s sense of inherent worth, as well as her opposition to relational contexts of devaluation and degradation. However, the primordiality Jacobs grants to her ethics of dignity often obscures the constitutively cultural, familial, and personal contextuality of, first, her—and in my view, any—ethical conviction; second, what she describes as the experience of being human; third, the alleged indignity of human vulnerability; and finally, the claim that shame is the natural reaction to one’s failure to live up to personal ideals. In the end, and subject to certain clinical concerns, Jacobs’ article integrates into psychoanalysis primordial ethical duties that she and others claim inhere in us as human beings.

Notes

1 I acknowledge Leonard Bearne for the collegiality and generous exchange of ideas he extended to me in connection with my reading of Dignity, and writing this discussion of it. His contributions were essential and invaluable to the content and completion of this article.

2 Jacobs draws explicitly upon her “own experience of traumatic degradation” (p. 386) in Dignity.

3 One consequence of losing sight of relational context is that psychoanalytic understanding becomes circumscribed—perhaps especially in its capacity to illuminate the context-specific personal meanings and functions that structure a given emotional experience or behavior. For example, it is true that in one person and relational context dignity may aptly refer to a healthy sense of inherent self-worth or entitlement to receive others’ respect—especially respect for that person’s human being and emotional life. However, in a different context I have heard it used to refer to a person’s trauma-rooted imperious demand to feel universally honored—to be seen by others as dignified—in order to protect against his/her painful conviction of inherent personal unworthiness. Two phenomena—one spelling healthy development, the other pathology—that may facially look similar and thus both be called dignity until one examines the distinct contexts in which they are felt or enacted.

A further consequence, and one carrying some irony, is that clinical understanding that fails to adequately account for context is apt to deal a blow to the patient’s sense of importance within the transference (perhaps what Jacobs’ later refers to as a sense of wholeness). To riff on Jacobs’ (2017) own turn of phrase, “if to be is to be related” (p. 387) then for an analyst’s understanding to decontextualize or derelationalize a patient’s experience is to deal a blow to the contextual integrity—dignity? —of the patient’s being and experience.

In the end, the thrust of my critical reaction to Jacobs’ claims derives from my relational conviction in respect of human emotional life—a conviction in which I know Jacobs shares. A corollary to this relational conviction is that claims—whether psychoanalytic, ethical, or otherwise without exception—that have the effect of denying or obscuring such relational contextuality are inherently suspect in the psychoanalytic clinical project, which I see as one of fundamentally relational understanding and influence.

4 A final introductory note: Given the substantive breadth of Dignity, I had to pick and choose what I would discuss. A major casualty of these choices was the array of poignant clinical vignettes through which Jacobs animates her contentions regarding dignity, indignity, inspirational shame, and related therapeutic attitudes.

5 One might read Jacobs’ conceptualization of dignity as a unified subjective phenomenon entailing four important dimensions of experience. First is self-experience, where dignity shows up in the sense of self-worth, agency, coherency, and individuality. The second is the experience of other, including the sense of other’s worth (other-esteem) and others as having distinct centers of initiative and experience. The third dimension entails one’s experience of organic relatedness or interconnection with other, in particular in action, such that the integrity of one’s values in action/behavior within such relatedness becomes relevant and important. And the fourth is a dimension of one’s experience of one’s world, particularly one’s being-with-other-in-our-world, kinship and belonging within our human world, or being human among fellow humans.

For Jacobs, dignity is hardly an experience reserved to the narcissistic realm, but rather involves a broader, affectively and behaviorally integrated phenomenology of self-other-world in concrete interaction.

6 Jacobs finds that dignity “encompasses more than we can say of it” (p. 380).

7 Its value in Federal constitutional law, for example, is made evident in the following essay excerpt from the Hanna Arendt Center (see: Hanna Arendt Center of Bard College blog-essay at hannaharendtcenter.org/?p=10974; italics added for emphasis): “Justice Kennedy’s majority opinion in United States v. Windsor did much more than declare unconstitutional section 3 of the Defense of Marriage Act. It did more than affirm the right of states to allow gay marriage; it went beyond insisting that the Federal Government must recognize those lawful unions. Kennedy’s opinion … argues forcefully that depriving gay people of the right to marry is an affront to their basic human dignity. In making this argument, Kennedy … takes one more step in the evolution of dignity as a meaningful legal ideal. … Justice Kennedy invokes the word “dignity” 11 times in his short majority opinion.”

8 Jacobs is a fellow member and faculty member at the Institute of Contemporary Psychoanalysis (ICP) in West Los Angeles, CA. Just a few examples of her long-standing contextual activism as an ICP faculty member include her 2015–2016 doctoral level course entitled, “Diversity and privilege,” her one-day seminar in the ICP San Diego Saturday Series entitled “Unpacking the meaning of Whiteness,” and her 2015 ICP Symposium presentation entitled “Complexity and the relational unconscious.” She has taught similar courses over the years and has participated actively in ICP’s efforts to raise awareness of diversity matters within its membership of psychotherapists.

9 And there can be no greater instance of such ethical work than the act of closing that perceptual gap, including closing it through acknowledgement of regions of the impossibility of its closure that thereby open possibilities for dialogue (see Jacobs’ clinical vignette of the participant at her workshop in Germany).

10 And perhaps good, bad, right, and wrong.

11 When I employ my psychoanalytic phenomenology to critically examine Jacobs’ claim that human behavior is a priori ethically situated, I play devil’s advocate and imagine a person for whom a sense of agency is so nonexistent that the idea of ethical engagement is nowhere to be found in his/her experiential world. If such an experiential world is possible, I find myself wondering whether one can validly claim, as she does in Dignity, that “all human behavior is inescapably ethically situated” (p. 383) and, if so, what the basis for such a claim’s validity might be? Is it, for example, found in a form of philosophical phenomenology, theological illumination, or other avenue of knowledge into the realm of the a priori? If so, is the human person’s a priori ethical situatedness true, in some sense of the term, even if impossible to experience or know for those traumatized within annihilating relational contexts?

12 For example, Jacobs writes variously: “All of these attitudes, directly or indirectly, are sensitive responses to the foundational issue of human dignity, or what it means to be human” (p. 383, italics added for emphasis), and “Thus, we ordinarily treat people with sensitivity to their dignity, which means we treat them with sensitivity to qualities that we think inhere in human life” (p. 384, italics added for emphasis).

13 When a person’s (or society’s) ideas and actions fail this duty to recognize and respect the value that inheres in the other—his/her dignity—then there is something essential to such other’s human being that is being violated. That is, in circumstances where this inherent human worth is under assault—whether out of an offender’s ignorance, negligence, or (probably fearful) intentionality—a form of dehumanization is in process because understandings, actions, or events that diminish this worth—by failing to see and respect it—deprive the other of something that “defines [him] as human” (p. 381).

14 Psychoanalysis (at least my version of it) is fundamentally distinct from disciplines concerned primarily with primordial universals—like philosophy and a priori ethics. Interdisciplinary work that integrates purported philosophical/ethical knowledge of universals into psychoanalytic knowledge of lived, particular, context-bound subjective experiences can be a thorny activity because, among other reasons, each discipline arises from its own distinctive context of concern, history and culture—including phenomenological focus, epistemological assumptions and method, as well as language—or what might be called a matrix of disciplinary character. As such, it is crucial to closely track and compare disciplines’ characters and consider their commensurability between and among one another. Such critical reflection on one’s methodological process seems to me requisite in achieving valid and psychoanalytically helpful interdisciplinary integrations.

15 Although the risk may be methodological in origin (and thereby relate to matters of validity, et cetera), it turns out to produce substantive trouble.

16 Such an outcome also deprives such a person from becoming a relational psychoanalytic true believer, in so far as seeing is believing.

17 In short, keeping our focus for now on the impact upon the therapist’s or candidate’s perception and understanding, such content-primordializations may prereflectively organize clinical perception with presumed, universally valid content, and thereby predetermine what is seen and how it is explained. Such theoretical organizations will, in turn, deemphasize close examination of the person’s (whether the patient’s or therapist’s own) unique phenomenology and the relational contexts within which it forms. Specifically, the emotional complexities of transference/countertransference systems (what I deem to be at the quintessential center of psychoanalytic inquiry and process) risk being seen and understood in terms of predetermining universals, rather than the nuances of the particular patient-analyst intersubjective system.

18 Again, Jacobs writes that a sense of dignity includes the following component experiential senses: sense of worth, sense of agency, sense of coherence (sense of one’s life having an intelligible narrative or story), sense of having a personal idiom or uniqueness (distinctness or individuality), sense of meaning or purpose, sense of having something of value to give, sense of wholeness, sense that our bodies and emotional lives will perform properly and possess an internal integrity and competency, sense of respect for others (other-esteem) and corresponding integrity in one’s behavioral treatment of such others, and a sense of being human among fellow humans.As such, Jacobs’ view of dignity draws on a complex developmental foundation. Even an immature, evolving sense of dignity would appear to entail development of an array of experiences, including self-other differentiation and recognition of the other as a center of his/her own feelingful initiative. Moreover, per Jacobs, dignity entails agency and, as elaborated previously, concrete action in the living of life, all of which presumes a high degree of consolidation in a person’s sense and way of being in the world.

19 The methodological critiques I have articulated in respect of Jacobs’ interdisciplinary process produce a less substantive complaint I have about Jacobs’ organization of Dignity. I found that because Jacobs weaved in and out of different language games in sometimes subtle ways, I was frequently left standing on the somewhat unstable ground of ideas whose interconnections occur across different orders of discourse and/or abstraction. This produced noteworthy experiences of oscillating understanding and then confusion in me as an interested reader (naturally, there are other explanations for this sort of experience in me that would be unfair to pin on Jacobs, including my ever-finite wit).

20 I acknowledge the limitations of my moral pluralism and join Gergen (2009) in believing it needs to go further in what he calls “second order morality” (p. 364). By virtue of this order of morality, such pluralism would entail a duty to sustain dialogue with those others who hold distinct conceptions of the good (i.e., alternative ethical/moral perspectives and cultures) so that inevitable conflict between and among us and them does not degenerate into significant forms of mutual destruction and even attempts at elimination.

21 I have not thought a lot about ethics in psychoanalysis, nor about my ethics in my psychoanalysis, prior to reading Dignity and writing this article. I offer this confession as first-hand evidence of the value of Jacobs’ ethical contextualism and activism. Whether or not one agrees with her views on ethics in psychoanalysis, I am embodied proof that her activism is thought-provoking and gets people, like me, to think about such issues, and perhaps act on them, if only in the form of articulating what they deem important.

22 From my (Maduro, 2015) perspective, nothing provides distinctiveness and uniqueness to a person more that his/her particular contextual situatedness.

23 With respect to development of the sense of wholeness and being human (as central components of the sense of dignity), Jacobs illuminates the importance of clinical attitudes that embody the therapist’s “openhearted intent to learn from the patient and from the[ir] emergent dialogue” (p. 383). Such welcoming attitudes as epistemological fallibilism (Orange, 2011), humility and openness to surprise (Brothers, 2008), anti-reductionism (Sucharov, 2009), and structure-bracketed openness to the person (Kunz, 2007) will characterize therapeutic systems that cultivate therapeutic investigation and understanding of a patient’s whole world-embedded personhood and thereby, per Jacobs, facilitate in him/her the sense of dignity.

Additionally, such therapeutic systems are well advised to involve clinical attitudes of humility and generosity (Orange, 2011), as well as perceptual focus on the person versus content (Kunz, 2007), so as to protect against dialogic collapse into reductive dichotomies, foundational truths, or other predetermined and thus constraining categories of relating and speaking. Instead, such clinical attitudes and focus will valorize flexible, usable meanings that are open to revision and that address the person as a whole as s/he becomes progressively understood, versus some distilled content s/he presents.

In a similar vein, Jacobs (2009) articulated a Buberian “I-Thou” (p. 383) attitude in which, through attunement to the patient’s distinctive affect, the analyst does not merely recognize but “confirms” the “wholeness of the patient” in all his or her unique and intelligible historicity (p. 383). Such confirmation “accords … a respect and dignity” to the patient as a “separate center of initiative” in all his or her personal particularity (p. 383). Parallel to Buber’s assertion that “sicknesses of the soul are sicknesses of relationship” (Buber and Friedman, 1969, p. 160), Jacobs’ Buberian attitude might hold that “health of the soul depends on healthy dialogue and confirmation in relationship with other.”

In these ways, among others, therapeutic attitudes that facilitate the sense of dignity convey the analyst’s treatment of the patient not as an object of reductive understanding and treatment, but as a genuine “partner in the process” who is competent to “make meaningful choices about the direction of the work” (p. 383) and thus worthy of respect. Jacobs calls these ethical attitudes.

24 Or, in the alternative, as Jacobs poignantly advises, when, by virtue of degrading trauma, the patient’s experience of the analyst’s close understanding has been rendered impossible, they may join in “mourning the gap” that isolates their respective experiential worlds (see p. 386).

25 Wearing my philosophical hat, I join Jacobs in seeing the individual person as best understood through a rigorously contextual explanatory lens. Such an explanatory lens is consistent with western philosophical contextualism, like that of existential philosophy (see e.g., Heidegger, 1927), and, of course, the developmental and other empirical findings of Gestalt psychology and psychoanalysis (see, e.g., Jacobs, 1989, 1992) and psychoanalytic contextualism (see e.g., Atwood and Stolorow, 1984, 2014; Mitchell, 1988). That is, because human being/subjectivity is viewed from these perspectives as inherently embedded in its world, including its relationships with others, then it makes sense that the sense of being human might entail the experience of a multidimensional contextuality, i.e., the sense of wholeness.

26 Might Cartesian thinkers (see Stolorow and Atwood, 1992; Slavin, 2002) have felt that being human was more deeply disclosed in a sense of individuality grounded in radical distinctness and separation from the world? If so, from such a Cartesian vantage point, the vulnerabilities of embeddedness (see Orange, 2009; Maduro, 2015) would be seen and felt as undignified or subversive to a sense of being human. As I contend below, such a seemingly Cartesian point of view seems to prevail in other areas of Jacobs’ phenomenology of the sense of being human and dignity.

27 My maternally rooted nuclear family organizing principle consisted in an emotional equation between existential, physical, and emotional vulnerability, on one hand, and mortifying personal defectiveness, on the other. For an autobiographical account of the genesis and impact of this organizing principle see my memoir (Maduro, 2008b).

28 In a similar vein, although I concur that analytic attitudes of welcome, openness, presence, willingness to be affected, respect, and understanding for a traumatically degraded patient’s intrinsic value as human will, in most contexts, produce therapeutically developmental experiences, I contend that, in certain perhaps peculiar treatment situations, the same attitudes and empathic understanding may be experienced as invasive, humiliating or terrifying. It depends, I contend, on often nuanced features of context.

29 Ironically, I successfully liberated my sense of personal limitation from the grip of shame through therapeutic work with Jacobs herself!

30 Like a pretty ornament reflects positively upon the bejeweled tree from which it hangs.

31 I offer my critique as a clinical psychoanalyst, and not as a philosophical phenomenologist. There is a long-standing debate among those fascinated by the phenomenology of shame regarding whether, among other disputes, it is rooted in innate emotional structures or arises only from lived relational contexts, whether it serves valuable developmental and social functions, or is singularly damaging on individuals who feel it (see, e.g., literature review at Zahavi, 2014).

32 As noted, Dignity itself, and the challenge of discussing it for this issue of Psychoanalytic Inquiry, has moved me to consider more seriously my own psychoanalytic ethics. Additionally, it has drawn out in me a greater ethical activism (e.g., standing up for, and articulating, what is important to me). As such, although I have my critical reactions to aspects of Jacobs’ Dignity, the evidence is overwhelming that it has achieved what I can only imagine to be one of its central goals, namely, to draw readers into active consideration of their ethical convictions and, ideally, to move them into greater activism in respect of those convictions, whatever their content may be.

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Peter N. Maduro

Peter N. Maduro, J.D., Psy.D., is a clinical and forensic psychologist, and psychoanalyst, with a private psychotherapy practice in Santa Monica and South Pasadena, California. He is a Supervising and Training Analyst, and on the teaching faculty, at the Institute of Contemporary Psychoanalysis in West Los Angeles, California. Additionally, Dr. Maduro is a member of the International Association of Psychoanalytic Self Psychology, the International Association of Relational Psychoanalysis and Psychotherapy, and the Division of Psychoanalysis (Division 39) of the American Psychological Association.