The weak and the orphaned are deprived of justice all the foundations of the earth are shaken. Ps. 82.3–5 Leininger (1988) maintains that caring is the essence of humanity and is essential for human growth and survival. She contends that care is one of the most powerful and elusive aspects of our health and identity and must be the central focus of nursing and the helping and healing professions.
Similarly, Roach (1987) claims that care is the basic constitutive phenomenon of human existence and thus ontological in that it constitutes man as man. She points out that all existentials used to describe Dasein’s self have their central locus in care. Roach states, “When we do not care, we lose our being and care is the way back to being. Care is primordial, the source of action and is not reducible to specific actions” (1987, p. 15). Although Roach (1984) claims that caring is the human mode of being, she wonders how convincing the view is that caring is the natural expression of what is authentically human when there is so much evidence of lack of caring, both within our personal experiences as well as in the society around us. Roach points out that we live in an age where violence is commonplace and where atrocities are committed against individuals and communities everywhere. To compound the effect of such violence on the broader social body, many incidents enter our living rooms through the press, radio, and television often as quickly as they occur. As a result, modes of being with another in our world involve both caring and uncaring dimensions. What, then, are the basic modes of being with another? By analyzing two of my own studies on clients’ (patients’ and students’) perceptions of caring and uncaring encounters (Halldorsdottir, 1989, 1990), as well as related literature, I have determined that there are five basic modes of being with another as follows: life-giving (biogenic), life-sustaining (bioactive), life-neutral (biopassive), life-restraining (biostatic), and life-destroying (biocidic) (see Figure 12.1 and Table 12.1). In this chapter, I describe the five basic modes of being with another through examples of caring and uncaring encounters in hospitals as experienced by former patients, my co-researchers in the former study (Halldorsdottir, 1989). The phenomenological perspective of qualitative research theory guided the methodological approach to the studies analyzed, involving the use of theoretical sampling, intensive unstructured interviews, and constant comparative analysis. TABLE 12.1 Five Basic Modes of Being With Another Life-destroying (biocidic) mode of being with another is a mode where one depersonalizes the other, destroys the joy of life, and increases the other’s vulnerability. It causes distress and despair and hurts and deforms the other. It is transference of negative energy or darkness. Life-restraining (biostatic) mode of being with another is a mode where one is insensitive or indifferent to the other and detached from the true center of the other. It causes discouragement and develops uneasiness in the other. It negatively affects existing life in the other. Life-neutral (biopassive) mode of being with another is a mode where one does not affect life in the other. Life-sustaining (bioactive) mode of being with another is a mode where one acknowledges the personhood of the other, supports, encourages, and reassures the other. It gives the other security and comfort. It positively affects life in the other. Life-giving (biogenic) mode of being with another is a mode where one affirms the personhood of the other by connecting with the true center of the other in a life-giving way. It relieves the vulnerability of the other and makes the other stronger and enhances growth, restores, reforms, and potentiates learning and healing. FIGURE 12.1 The caring/uncaring dimension or continuum. Nine former patients participated in the former study and data were collected through 18 in-depth, open-ended interviews. Nine former nursing students participated in the latter study and data were collected through 16 in-depth, open-ended interviews. In both studies, interviews were tape-recorded and transcribed verbatim for each participant. The excerpts used from the former study will be referred to as “modes of being with a patient,” and for the sake of clarity, the feminine will be utilized in reference to the nurse and the masculine in reference to the co-researcher/patient/client. In the text, however, “nurse” and “co-researcher/patient/client” can refer to both males and females. Evidence from literature, that has a bearing on this matter, will also be given. The life-destroying, or biocidic, mode is the most inhumane mode of being with another in the list as given and is represented by violence in all its forms. It means hurting, harming, or deforming the other. This destructive mode manifests in numerous ways as follows: making people dependent or fostering infantilism; being threatening; involving manipulation, coercion, hatred, aggression, and humiliation; involving various kinds of abuse; and often involving an evident lust for power, followed by dominance and depersonalization of the other. Hardheartedness or coldheartedness also may be present here. This mode of being with another most often changes the other to the worse, the harm done depending on the other’s strength to endure. It involves the transference of negative energy or darkness to the other. It is the frost the human flower has a hard time enduring without loosing its luster, petals, leaves, and life. In many
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