Table Of ContentNourishing the Inner Life of
Clinicians and Humanitarians
Nourishing the Inner Life of Clinicians and Humanitarians: The Ethical
Turn in Psychoanalysis demonstrates the demanding, clinical, and humani-
tarian work that psychotherapists often undertake with fragile and devas-
tated people, those degraded by violence and discrimination. In spite of this,
Donna M. Orange argues that there is more to human nature than a relent-
lessly negative view. Drawing on psychoanalytic and philosophical resources,
as well as stories from history and literature, she explores ethical narratives
that ground hope in human goodness and shows how these voices, personal
to each analyst, can become sources of courage, warning, and support, of
prophetic challenge and humility, which can inform and guide their work.
Over the course of a lifetime, the sources change, with new ones emerging
into importance, others receding into the background.
Orange uses examples from ancient Rome (Marcus Aurelius), from
twentieth-century Europe (Primo Levi, Emmanuel Levinas, Dietrich
Bonhoeffer), from South Africa (Nelson Mandela), and from nineteenth-
century Russia (Fyodor Dostoevsky). She shows not only how their words
and examples, like those of our personal mentors, inspire and warn us, but
also how they show us the daily discipline of spiritual self-care. Though
these examples rely heavily on the discipline of spiritual reading, other
practitioners will find inspiration in music, visual arts, or elsewhere and
replenish the resources regularly.
Nourishing the Inner Life of Clinicians and Humanitarians will help
psychoanalysts to develop a language with which to converse about ethics
and the responsibility of the therapist/analyst. This exceptional contribution
is highly suitable for both practitioners and students of psychoanalysis and
psychotherapy.
Donna M. Orange teaches, consults, and offers study groups for psycho-
analysts and gestalt therapists. She seeks to integrate contemporary
psychoanalysis with radically relational ethics. Her recent books include
Thinking for Clinicians: Philosophical Resources for Contemporary Psycho-
analysis and the Humanistic Psychotherapies (2010) and The Suffering
Stranger: Hermeneutics for Everyday Clinical Practice (2011), both published
by Routledge.
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Nourishing the Inner Life of
Clinicians and Humanitarians
The Ethical Turn in Psychoanalysis
Donna M. Orange
First published 2016
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2016 Donna M. Orange
The right of Donna M. Orange to be identified as author of this work has
been asserted by her in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilized in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Orange, Donna M.
Nourishing the inner life of clinicians and humanitarians : the ethical
turn in psychoanalysis / Donna M. Orange.
pages cm
Includes bibliographical references and index.
1. Psychotherapists—Psychology. 2. Psychotherapist and patient.
3. Psychic trauma. 4. Intersubjectivity. 5. Humanitarianism—
Psychological aspects. I. Title.
RC451.4.P79O73 2016
616.89´14—dc23
2015020090
ISBN: 978-0-415-85610-2 (hbk)
ISBN: 978-0-415-85611-9 (pbk)
ISBN: 978-1-315-67681-4 (ebk)
Typeset in Sabon
by Keystroke, Station Road, Codsall, Wolverhampton
For Natalie Gannon, CND
And in memory of Frances Madden, SNJM
[O]ne must yield to the other the first place in everything, from the après
vous before an open door right up to the disposition—hardly possible but
holiness demands it—to die for the other.
(Emmanuel Levinas, Is It Righteous to Be?)
Contents
Preface ix
Acknowledgments xxi
1 Trauma and traumatism 1
2 Radical responsibility and clinical hospitality 20
3 Is ethics masochism? Infinite ethical responsibility
and finite human capacity 46
4 Philosophy as a way of life: Pierre Hadot 63
5 Witness to indignity: Primo Levi 79
6 Substitution: Nelson Mandela and Dietrich Bonhoeffer 99
7 Ethics as optics: Fyodor Dostoevsky 121
Written in collaboration with Maxim Livshetz
8 Clinical and humanitarian work as prophetic word 146
9 From contrite fallibilism to humility: clinical,
personal, and humanitarian 170
Index 193
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Preface
Non basta. It is not enough. I am not enough. My previous two books,
Thinking for Clinicians and The Suffering Stranger, made available
some resources from my chief intellectual traditions—philosophy and
psychoanalysis—for describing my psychotherapeutic sensibility. These
books attempted to show significant convergence between dialogic attitudes
and radical post-holocaust1 ethics with “ethical-turn” trends emerging in
recent psychoanalysis. But these books left the struggling clinician, including
their writer, in a painful gap between infinite responsibilities to the suffering
others and the worker’s all-too-finite human capacities.
Each book answered an appeal from psychotherapist colleagues. The first,
Thinking for Clinicians (Orange, 2010), responded to clinicians who asked
for help reading philosophy, using its concepts and questions to help
them read psychoanalytic literature. The Suffering Stranger (Orange, 2011)
answered those who for many years had requested a book on hermeneu-
tics, the study of interpretation and meaning, for those who work with the
devastated, with those whose suffering seems beyond meaning. Now I am
responding to two more requests.
Sometimes colleagues have asked me to produce something more
personal, even a memoir. A combination of personal reticence and ethical
sincerity—intended, at least—prevents me. My life is not about me, but for
the other. And yet, biography haunts us all: how much fate and how much
choice brings us where we find ourselves today? Born a Roman Catholic in
the Pacific Northwest, I took a radical turn in early midlife to New York,
studied at Yeshiva University, and have since lived and worked in a mostly
Jewish world. While embracing psychoanalytic culture, I also learned
German (allegedly to read philosophy and Freud) and married into a
German-American family. While I have studied the German Lutherans’
enthusiastic support for National Socialism—as the reader will see in
Chapter 6—I have avoided looking much into the Catholics’ complicity and
energetic participation, which were probably worse. Similarly, I have avoided
biography and memoir, hoping to tackle the works of “mourning and
moral psychology” (Lear, 2014), of internalization, integration and integrity,
