The temporality of becoming: care as an activity to support the being and becoming of the other

ABSTRACT

This study addresses what it means to care for a person who has been catapulted into an unfamiliar new world and has lost a sense of being-in-the-world. I develop the relational ontological framework extending Heidegger’s ontological structure of care and Bakhtin’s dialogical interaction to focus on encountering the Other in asymmetrical power and knowledge distribution situations. Within this theoretical framework, a longitudinal micro-ethnographic analysis of audio/videotaped high-tech medical encounters shows how the therapeutic dimensions of care unfold engaging a practitioner in a complex process of building a temporal-existential-horizon with and for the Other. The temporal-existential-horizon emerges at the tension between the physician’s desire to create for the Other a cohesive sense of being and an existential narrative that must ultimately be developed by the Other. A relational ontological approach makes visible in the analysis of the moment-to-moment interactions “becoming” as a learning process. For the patient, this means to inhabit a new world in which things matter and one can orient toward Others and new ends. For the physician, “becoming” is not only a social positioning manifested in the world the professional inhabits but also toward oneself, taking a stand on one’s path of becoming this kind of practitioner.

Acknowledgments

I wish to thank the healthcare professionals and patients who participates in the project, Dr. Mario Deng for his participation, invaluable and constant support and help un navigating the complexity of the AdHF practices and for being a constant inspiration in caring for others. Chuck Goodwin, Candy Goodwin and the members of the Co-operation Action lab offered important insight and constructive comments that helped my work immensely. I thank the Editor Dr. Jennifer Vadeboncoeur and three anonymous Reviewers for their encouraging constructive as insightful comments. Their insight helped me reflect and work toward revising the earlier version of this manuscript. I thank my graduate student Nadine Tanio for her insightful feedback on a previous version of this paper and the volunteer students Liliana Madrigal and Deepa Sridhar for their invaluable collaborative work toward the transcription of the encounters.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. As Blattner (2005) discusses: “Dasein’s [a person’s] originary past is its attunements, the way things already matter to it. I am always already ‘thrown’ into the world and into my life, because I am always attuned to the way it matters to me. These attunements are the ‘drag’ that situates and concretizes the ‘thrust’ of my projection [into possibilities] ” (p. 315) of being this person.

2. As a reviewer of this manuscript pointed out, Figure 2 could be misinterpreted as a double structure creating an improper dualism (person-social world dualism); however, this is not my intent. The perspective of the person’s sense of being “oneself” is not a mentalistic or psychological concept; it is the phenomenological perspective, a person’s sense of being-in-the-world.

3. As Jefferson (1989) showed, most long silence interval durations cluster around the one second interval (0.9–1.2).

4. Similarly, Goodwin and Cekaite (2018); describe a dyadically organized transformation in parent-child interactions and point to the skillful affective tenor of a directive in response to a child expressing affective opposition resulting in collaborative engagement rather than a dispute.