Levinas on managed care: The (a)proximal, faceless third-party and the psychotherapeutic dyad

Journal of Theoretical and Philosophical Psychology 32 (2):86-102 (2012)
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Abstract

Emmanuel Levinas gave an account of radical, asymmetrical responsibility for the Other that is phenomenologically sensible in the proximity of face-to-face relation. This original arrangement, however, is not interminable. The approach of the third party equalizes and creates distance between self and Other by introducing ontology and epistemology. It is a necessary process of totalization that moves from a primordial ethics to justice and institutional fairness. However, Levinas was aware that the third party's presence brought with it a possible forgetting of the Other and a covering over of radical ethics. In this presentation, we propose that the psychotherapeutic process represents a context that bears the proximal dimension described by Levinas while also representing an institution that is, in definition and purpose, totalizing. Furthermore, using a play on words that represents a significant issue in contemporary psychotherapeutic practice, we explore the common presence and impact of third-party payers on the therapeutic relationship, and how third-party payers are disingenuously a-proximal and constantly approximating; faceless and consequently effacing the patient's august dignity, causing a forgetfulness of the justice to which Levinas called institutions. Lastly, we suggest some strategies by which therapists may recover the never-absolved proximity to the Other in a profession susceptible to the a-proximal effects of third-party economics. 2012 APA, all rights reserved)

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