The examples mentioned above are concerned with physi-cality, encounters with age and death, occupational identity, the societal position of care work, and the need for personal and professional recognition. The themes refl ect the fact that the care work concerns three basic dimensions in most peo-ple’s lives. Firstly there is always a social dimension in a care relation, since the relation is intrinsic to one of the parties’
work in such a way that social status and peace of mind are at stake. Secondly there is a psychodynamic dimension, since conscious as well as unconscious drives are affected. Thirdly there is an existential dimension, since the care touches on questions related to fear of death, dependency, and meaning of life (cf. Schibbye 2005).
In a wider perspective the three dimensions—people’s rela-tions to work, desire, and death—encompass the entire range of themes, which I found via empirical analysis of the care workers’ understanding of themselves and their work. In my in-depth hermeneutical interpretations the comments from
the participating care workers demonstrate that a good deal of struggle is brought to bear on problems associated with paid care work, including the question of occupational identity and societal recognition (of a low wage occupation tradition-ally associated with a woman’s job, but as a paid work to a great extent evaluated within the status paradigms associated with male symbols, refl ecting a medical world. The women are thus split between on the one hand experiences gained in a life history of good care performance, and on the other hand those aspects, which give status and support the efforts to bring professionalism into the care paradigm).
My research has also shown that there is a great struggle to deal with the psychodynamics and existential challenges as-sociated with care relations, i.e. more or less conscious, am-bivalent, and tabooed emotions, which arise in the contact sphere with old, ill, and dying bodies, as demonstrated in the fi rst example. This problem is reinforced through expec-tations that the care worker, as woman and professional per-son does not harbour negative feelings towards these issues, and that she without any problems can control and ignore her own emotions and needs. I am particularly interested in the consequence that both the giver and the recipient of care are positioned in what I call a ‘state of existential loneliness’.
By this term I mean that both parties in the relation come to ignore, repress, and distort perhaps the most important issue in their relationship, namely the experience of deterioration, bodily decay, dependency, and death, and that this happens at the cost of the possibilities of applying the relation to clar-ify existential questions and personal development. In other words, my contention is that both parties in the relation are let down, because problems and emotions are individualised, tabooed, negated, and levelled out in such ways that the care personnel is afforded very limited possibilities of personal ex-pression via dialogical presence and recognition. In short and general terms I ascribe the existential loneliness to the fact that the tasks, roles, and relations of the care worker as well as the care recipient are defi ned and valued in ways, which
do not involve the concern for existential questions (cf. the investigation carried out by Borg et al. (2005), which indi-cates that care personnel to a great extent experience a de-mand that they hide their feelings). The important questions, which are a good point of departure for learning and personal development in care education and work, will often concern relations which involve anxiety, confl ict, taboos, and ambiva-lence. Such learning processes are obviously diffi cult to organ-ise. However, perhaps these themes offer an ideal opportunity to learn more about oneself and each other.
According to Honneth (2003b) the learning associated with such themes occurs through the articulation of impulses to take action. This requires anxiety free settings. This means that one should give care personnel the possibility to express and process the feelings and needs, which guide their actions at work. I agree in principle, however, I do not think that one can completely circumvent anxiety. As already mentioned, we are not transparent to ourselves. For this reason each and every one of us is an inexhaustible source of anxiety. Instead of attempting to create anxiety free learning environments, one should attempt to create environments, which can con-tain anxiety, i.e. by talking about it, and countering it with open attempts to understand it, while also providing support for creative exploration of individual and collective motives for action. Such processes should, however, not develop into therapy as such. Anxiety free articulation of impulses for ac-tion is a pedagogical ideal, and a point of orientaac-tion for sig-nifi cant learning processes. It is, however, not a project that could be honoured completely. A concrete plan of action could involve the establishment of learning situations, based on the understanding that progression and regression are two sides of the same coin. This means that supervisors, teachers, and others, who have a responsibility in the fi elds of educa-tion and working life, should not only accept the students’
will and engagement. Supervisors and teachers must also be able to relate to and understand those learning potentials tex-tured in the students’ resistance and lack of motivation. There
should also be room for ambivalent emotional expressions, where the learning ambitions are not to make the feelings of anxiety go away, but to diminish the fear of getting in con-tact with anxiety.
In my view it is a fundamental assumption that any care relation involves invaluable potentials for learning that pro-vides insight and change. These potentials can unfold, when care personnel are encouraged to show interest and openness to the challenges created by the shared interface. This pre-supposes that those responsible in the fi elds of education, as well as in the daily practice, understand and support the fact that learning in a relation is a reciprocal process. This means that if the care in any way honours ideals such as equality and humanity, the care work changes both parties in the rela-tion (Dybbroe 2006). Furthermore the potential stresses that the caregiver’s, as well as the care recipient’s lifelong learning and development should be supported. By doing so, one takes into consideration the motives that inspire care workers and encourage them to remain in the fi eld.
The learning potentials to which I am referring here are embedded in the nature of the care relation, i.e. in the meet-ing occurrmeet-ing between two people located in widely differmeet-ing situations, but who to some extent share the practical and cul-tural circumstances of caring (one of them because care giv-ing is an occupation and an identity, and the other because he or she is dependent on the care and is defi ned by virtue of this need). The meeting provides both parties with an op-portunity to learn something new about themselves and the other. Learning processes with the potential to create change should provide increased insight into subjective as well as in-dividual relations and into the historically constructed care conditions. The learning processes should (as part of the in-sight) liberate disciplined and disciplining psychic energy.
This means that care personnel individually and as a group should be offered assistance to liberate some of the bound up psychic energy blocking their insight into their own feelings and attitudes in the care relations, a block that impedes their
nuanced and critical insight into guiding cultural, social, and existential aspects of the care work.
Insight into the complexity of care, as well as liberation of psychic energy, presuppose that you, or anyone directly or in-directly implicated in the possibilities of learning, accept that the subjective meanings of concrete experiences from every day life, including emotional ambivalences, are very impor-tant sources for relevant learning for care workers. One has to accept that the learning processes should afford the care work-ers the opportunity to gain insight and create change in their own (occupational) lives. If the learning does not (also) target the care workers themselves, their quality of life, their experi-ences, their emotional and physical relations, there will be a risk that the learning translates to instrumental actions and empty or distorting rhetoric. At the same time the learning should be brought into the care relations partly as an inher-ent quality with a focus on the care personnel’s competences for taking concrete action, and partly as learning potential for care recipients as well. The latter statement is intended to con-vey the fact that the competences, which the care workers at-tain, should be a part of the care relations in such a way that the recipients of care also become a part of this learning, i.e.
that both parties are learners as well as teachers.