chapter  9
7 Pages

Two impossibilities

Burnout and the depersonalisation of care-giving
ByOwen Dempsey

Freud described the inter-personal care-giving relation as a fully sensual but aim inhibited relationship. The carer’s Ideal-Ego inhibits her from caring too much, that is, from caring at the expense of the other. Anticipatory care on the other hand is population-based and so is non-personal, and so risks caring with interventions regardless of the harms they may cause.

Jacques Lacan’s Graph of Desire is used as a theoretical resource to show how a care-provider’s subjectivity is formed through the imagined sense of wholeness as the Ego-Ideal which reflects back to the individual as her Ideal-Ego: as her ‘necessary’ social and caring role. This chapter addresses two deadlocks for caring with love for the other, inter-personally.

First, Lacan’s concept of the impossibility of ‘doing the good’ by actually knowing the real needs of the other is described. Psychoanalytic theory is used to show how attempting to care with love risks psychic conflict and emotional stress and may lead to burnout. This can lead to depersonalisation, and a withdrawal from caring.

Second, this chapter shows that depersonalisation of the care-provider is also caused by the neoliberal pragmatist basis for anticipatory care which makes unconditional demands through imposed guidelines for ‘best’ practice.

Thus anticipatory care diverts the care-provider from caring with love through depersonalisation and, at the same time, provides a seductive respite from the stresses of caring with love. Thus, anticipatory care exacerbates the difficulties inherent in caring with love.