Microsoft Word - Humphriescorrectedfinal.docx Corresponding Author: Joan M. Humphries Email: humphriesj@camosun.bc.ca Journal of Applied Hermeneutics August 7, 2012 The Author(s) 2012 Like A Melody It Passes: Dasein and Perinatal Well-Being Joan M. Humphries Abstract In this paper, the text found in Johannes Brahms’ Wie Melodien Zieht Es (Like a Melody It Pass- es) serves as a metaphor for selected key ideas that comprise Heidegger’s Being and Time. Heidegger’s conceptualization of Dasein (including Being and Temporality) is examined in the context of the poetry and applied to understandings of maternal emotional well-being. There is potential for increased insight based on analysis of these selected key concepts, which are de- scribed and related to the experience of becoming a mother. There is also significance in examin- ing birthing because of current realities involved in Maternity Care, which include standardized approaches to care. The poetry of Wie Melodien Zieht Es guides the flow of ideas that are out- lined during the paper. The need for enhanced authentic interactions between nurses and women in the perinatal period is exposed, engaging Heideggerian thought as a framework for possible enlightenment. Keywords birthing, Brahms, breastfeeding promotion, Heidegger, hermeneutics, perinatal health, poetry Who can say why we connect ideas in the way that we do? Hermeneutic scholar David Jardine (2012) wrote of the “crisscrossing” that occurs when memories collide with cur- rent impressions, and create profound reso- nance. With that, there can be a suggestion of something transpiring that is pre-ordained, perhaps having to do with an understanding that seems as though it was meant to unfold in the form of a realization, and which pre- sents itself joyfully. All of this occurs en route to a process of “becoming” and an “opening into" what may already be (Jardine, 2012). I had such an experience when reading Heidegger’s Being and Time (1927/2010) for the first time, because during that pro- cess, I could not ignore the other influences in my life that permeated my understanding of Heidegger’s work. It happened, for ex- Humphries Journal of Applied Hermeneutics 2012 Article 9 2 ample, that at the same time as I was intro- duced to Heideggerian thought, I was study- ing a piece of vocal music, written by Jo- hannes Brahms (1833-1897) entitled Wie Melodien Zieht Es Mir, or, Like a Melody it Passes. In the context of my exposure to Heidegger, the text of the song (written by the poet Groth) appeared to me with unex- pected freshness. More importantly, the meaning of the poetry aligned with my evolving understandings of Heideggerian thought as reflected in Stambaugh’s transla- tion of Being and Time (Heidegger, 1927/2010), the edition of that work that is referenced in this paper. The perinatal experience and the emo- tional well-being of women in the perinatal sphere are never distant in my attention as I engage in academic inquiry. The term “well- being” takes on a new significance follow- ing exposure to Heidegger’s work, in which embedded underpinnings of Being permeate understanding and thought. In the perinatal field, emotional well-being of women is of- ten contextualized by care providers to con- form to the accepted wisdom of bio-physical standards that distinguish “baby blues” from clinical depression. Evidence-based assess- ment tools, such as the Edinburgh Depres- sion Scale, are often employed to ascertain which women fall into the category of clini- cal depression as compared with those whose feelings are deemed less worrisome (Beck & Watson Driscoll, 2006; Nicolson, 1998). However my history in working with women points towards a notion wherein there is more than a medical diagnosis, or lack thereof, to value about a woman’s emo- tional well-Being, and her experience of her birthing. Reading Heidegger, in particular his attention to the unique histories that we live through, reinforced a thread of under- standing about the magnitude of meaning that exists for a woman about her birthing experience, connecting with the central ideas of Being and Dasein that Heidegger de- scribed. So, the fusion of three apparently dispar- ate bodies of thought has presented as a “criss-crossing” around Heideggerian phi- losophy, art song, and the birthing experi- ence. In this paper, I use the poetry of Wie Melodien Zieht Es to guide a beginning ap- proach to Heidegger’s Being and Time, con- necting the very deep and central human ex- perience of birth with Heidegger’s notions of Being, Dasein, and other key concepts that are central to that work. I describe how the interweaving of Heidegger, Brahms, and women’s experience of birth has influenced my impressions about current approaches to nursing care in the perinatal setting. Initial Reflections Throughout the reading of Being and Time, I was aware of gleaning insidious understand- ings as the reading progressed, often in ways that were (and remain) difficult to articulate, but in ways that would flood my conscious- ness at unexpected times in my everyday life. The significance of these everyday awaken- ings has meaning, for according to Heidegger, our lives are intelligible only through the interpretation of the everyday (Dreyfus, 1992). However, Paley (1998) speculated that Heidegger’s views on real- ism and positivism have been largely misin- terpreted by nurse scholars, who (according to Paley) have the tendency to frame studies based in Heideggerian philosophy in the paradigm of everyday “lived experience” only, thereby overlooking the realist possi- bilities that Heidegger may have sanctioned. Paley cautioned that any attempt to equate Heidegger’s “everyday” meanings with a movement away from realism is a mistaken Cartesian approach, since that stance would involve splitting experience away from re- ality. Nonetheless I proceed, reasoning that Humphries Journal of Applied Hermeneutics 2012 Article 9 3 it is indeed my everyday lived experience of reading Being and Time that underpins my thinking, without presumption to authorita- tively analyse the intentions of Heideggerian thought in the context of realism, positivism, constructivism, or any other approach to the worldliness that Heidegger envisioned. In this paper, in keeping with the notion of criss-crossing ideas and the experience of making meaning, I share the reflections (in italics) that shape my thoughts and depict a poetic-like interruption. I felt a sense meaning wash over me in this process. It’s not as though I would profess to regurgitate the meaning of Heidegger’s work, but rather his words beckoned me, invited me, to recognize meanings of my own. Sprinklings of fa- miliarity tease me, they trickle ever clos- er, until I welcome the rhythmical drip- drop of revelation within me, infusing my most intimate self with floods of memories of what it is to Be...lying on the grass as a child and gazing at the clouds rolling by.... and thinking “I am.” In hermeneutics, there is an underpinning of understanding concerning the part and the whole. The significance of employing this understanding can be far-reaching, for when considering any phenomena, our attention may be drawn to what may lie beneath, or around, what is easily visible to us. Heidegger explained: Apart from the fact that the moon is nev- er wholly to be grasped even when it is full, the not-yet by no means signifies a not-yet-being-together of parts belong- ing together, but rather pertains only to the way we grasp it perceptually. (2010, p. 234) It follows that as I consider my nursing experience and academic focus, I am acutely aware of the profound challenges that wom- en face in the course of the birthing experi- ence, many of which may not appear with transparency or totality. Among other con- cerns, I wonder how our maternity settings are able to address the complexity of birth- ing. My extensive experience as a Regis- tered Nurse in the Maternal/Child field in Canada fuels my perspective. My impres- sions have emerged over time while func- tioning as a nurse alongside midwives and physicians who share the culture of materni- ty care that currently exists, and who are al- so accountable to the systemic requirements that I describe. Indeed, we live in a time where much of the nursing care has become driven by the desire to “normalize” the event according to a set of institutional policies and practices, which are based on statistical population health imperatives combined with overarching budgetary guidelines, all of which have the potential to be narrowly in- terpreted. I consider the seminal event that birthing represents in a woman’s life, and I wonder in what ways our efficient hospital processes interrupt the potential for access- ing the depth of experience that has occurred for a woman in the course of the birthing event. Jardine (1992) described the desire to understand experience, writing: Understood interpretively, such incidents can have a generative and re-enlivening effect on the interweaving texts and tex- tures of human life in which we are all embedded. Bringing out these living in- terweavings in their full, ambiguous, multivocal character is the task of inter- pretation. (p. 51) Buoyed by Jardine’s urge to expose the mul- tivocal character that I associate with birth- ing, I speculate that any disruption in the communion of the birth experience into Be- Humphries Journal of Applied Hermeneutics 2012 Article 9 4 ing will indeed comprise a woman’s history. Importantly, this history will be lived again and again, tempering a woman’s understand- ings, as her existence unfolds (Bergum, 1989). Being and Dasein I work toward an understanding of Heidegger’s ontological primacy of Being. Heidegger invites us to enter in to this un- derstanding with the unique language that disrupts what may be taken-for-granted meanings. The distinctiveness of Being seeps unapologetically into Heidegger’s re- configuration of the vernacular understand- ings of that word, while making explicit a centrality of human experience that he be- lieves has been overlooked in philosophic thought from the Ancients to today. Heidegger’s focus on Being is an idea that is at once familiar and distant, profound and yet everyday. To contemplate Being a being is to confront the most basal of mysteries in life; that deep, unfathomable awareness of existence (Dasein) that we live with, and live through. Heidegger is clear that Being, in a gestalt-like experience, marks ontologi- cal meaning in its purest, most superior sense. That understanding is distinguished from other philosophic thought by nature of that basic and essential insight. It is through his attempt to explicate Being that Heidegger is said to have altered the direc- tion of philosophic thought, since his ap- proach transcends historic tendencies to characterize knowledge and reality based on, for example, rational and perceptual binaries (Blattner, 2006; Caputo, 1987). Heidegger was also antagonistic towards ethics as an uncontested entity, seeing them as embed- ded with value-laden and prescriptive rules for conduct (Caputo, 1987). One appreciation pervades my quest to gain further understanding of Being and Dasein. That is, I recognize that Heidegger’s Dasein is described as though personified, and yet explained as ontologically constitut- ed of self and Being (Blattner, 2006). Dasein seems to assume a muse-like presence that is paradoxically integrated into self, into Being. Caputo (1987) noted: Everything in Being and Time turns on getting this initial projection right. Dasein must be cast in the appropriate terms, projected upon the Being which lets it be the being which it is, lest the whole subsequent discussion founder. (p. 66) The possibility of this Dasein, as though ex- istence has a personality and a will of sorts unto itself, is an intriguing and playful ap- proach, and sustains a thread of coherence for me. Heidegger made a defining state- ment, however, when he wrote: “However, the ‘substance’ of human being is not spirit as the synthesis of body and soul; it is rather existence.” (p. 114. Italics and quotation marks in original). In this statement, he in- terrupts any potential misconception that Dasein could represent some form of dualis- tic presence. Rather, we are invited to incor- porate notions of Dasein into a unified pres- ence with self-and others-in-the-world (Blattner, 2006). The Song My exposure to many of Heidegger’s Ger- man words in Stambaugh’s translation of Being and Time made the study of the text of Wie Melodien Zieht Es all the more capti- vating. The initial insight was overwhelming as I practiced the song in preparation for my weekly singing lesson. I wonder, in retro- spect if my exposure to German terms, in combination with the concurrent reading of Heidegger, served as some kind of “pre- understanding.” In any case, when learning a Humphries Journal of Applied Hermeneutics 2012 Article 9 5 piece of music that is set with a text that is foreign to me, it is necessary for me to ap- proach the somewhat onerous process of memorizing and pronouncing words in a language that I do not speak. As is the case for any music student, it was important to understand the translated version of the po- etic text to the song, and it was in that pro- cess that I became awed as the translated words to the piece assumed a multi-faceted possibility for enhanced understanding of a deep human experience (See Appendix 1). The following description summarizes the piece briefly: The message of a tear-filled eye is the subject of Wie Melodien zieht es mir, by Klaus Groth (1819-99). Before closing on A major, the song's three varied vers- es each end on a different harmony, showing Brahms' predilection for devel- oping variation. (“Johannes Brahms. 5 Lieder,” 2008) The poet Groth lived before Heidegger, but exposure to Groth’s poetry prompted a certain resonance with the experience of reading Heidegger’s Being and Time. By this, I mean that in both cases, some kind of understanding about the core of human ex- perience entered into my personhood-my Being-in ways that were surely authentic and deep within me. When encountering Heidegger’s work, I was required to re-read many passages before I was able to grasp a sense of significance. The same repetitive energy was required in reading Groth’s text. The beauty of Braham’s melody, too, erupts after many exposures, with its twists and turns of musical splendour, linking the piano accompaniment inextricably with the lyric. All of it creates the potential for true ensemble, true unity, yet with unexpected harmonic resolution between the singer and the pianist. In reference to unity, Heidegger stated: “In the everyday ‘just passing through life’ that takes care, Dasein never understands itself as running along in a con- tinuously enduring succession of sheer ‘nows’” (2010, p. 390). In that statement, Heidegger cautions that unity of meaning demands something more than mere atten- tion to sequence. Rather, the stretching of perceptions of time and events must always be interpreted by Dasein in the fullness of its existence, much like appreciation for the finality of melody in the context of its com- posites. For example, within any melody, there are notes that make up the phrase, and phrases that make up the melody, signifying a musical part that contributes a mysterious temporality, and lingers en route to the whole of the melody and the song. Each note comes and goes quickly, each one re- placing the last, while on its way to the whole phrase. The unity of melody is emerg- ing. How fascinating is the miracle of me- lodic creation, replete with so many facets of individuality, sensibility, historical style, and other characteristics that speak to us, and access our experience of Being! The above explanation of Wie Melodien, with regards to the predilection for creating variation in harmony, also resounds with meaning as I consider the meaning of my exposure to Being and Time. There were many twists and turns and forays into unex- pected thought as the reading progressed, with all of them leading back to the perfec- tion of Dasein and Being. Indeed, these ide- as offered something of a conceptual resolu- tion for me, a return to something familiar, as is found in the unexpected but relieving sense of harmonic resolution that Brahms offers in Wie Melodien. When considering my own musical sensibilities, it is often those unexpected harmonic resolutions that constitute any sense of beauty that I associ- ate with a piece of music. So, too, is the sense of awe that unfolded for me in the Humphries Journal of Applied Hermeneutics 2012 Article 9 6 reading of Heidegger, nudging me to con- template yet again the miracle associated with that moment when birth occurs. The inevitable wonder surrounding the first cry and the marvel of a process that allows a woman’s body to house and release a new human life - - a new being - - reveals itself each time as an extraordinary experience. How can I describe the sense of unity that overcomes me? So many ideas, so many fragments to incorporate! But it cannot be about the conscious putting together, it must be about the moment- the gasp of recognition-the lightning bolt. There is surely mystery in all of this. Heidegger and Poetry A wonderful symmetry exists between poet- ry and Heideggerian thought (Heidegger, 1971). It seems that Heidegger valued poetic thought and the exquisite possibility for the deepest of human expression that lies therein. The primacy and meaning that Heidegger ascribed to art and poetry is exposed in Heidegger’s (1971) work Poetry, Language, and Thought. Heidegger said: “Art happens as poetry. Poetry is founding in the triple sense of bestowing, grounding and begin- ning” (p. 75). He also wrote: Singing and thinking are the stems neighbor to poetry They grow out of Being and reach into its truth. (p. 13) As I read these words, I speculate that his words capture the trinity of connections that I make between poetry and mothers’ Being that exist alongside song and the act of singing. I wonder further what personal truths about women’s birthing experience have the potential to be revealed. I consider the possible barriers to harmonious experi- ence that results for both women and nurses based on the models that are currently con- ceptualized and practiced. Groth, Heidegger, and Mother’s Meaning Revealing and Concealing; A Mother’s Experience Wie Melodien zieht es mir leise durch den Sinn, Wie Frühlings Blumen blüht es, und schwebt wie Duft dahin Like a melody it passes softly through my mind, Like the flowers of spring it blooms, and floats on like a fragrance The opening words to the poem are intri- guing and invite further conjecture. The suggestion of something passing through one’s mind, such as a melody, invokes a sense of mystery. When contemplating the experience of melody, I am transfixed by the awareness of pattern that evolves in the pro- cess of melodic creation, harkening back to Heideggerian references to the part and the whole. In the process of contemplating mel- ody, there is indeed a sense of mutuality be- tween the individual notes and phrases, and the composite melody that transpires as a result. I have come to consider that one of Heidegger’s conceptual underpinnings is the notion of revealing and concealing, which suggests disclosedness, or sense of revealing (enthullen) that emerges from that which is hidden, constituting our being-in-the-world. In the context of my ruminations, the revela- tion concerns understanding, mood, and lan- guage. We are primordially familiar with our world, a situation that Heidegger ex- presses as “primordial truth” (Blattner, Humphries Journal of Applied Hermeneutics 2012 Article 9 7 2006). According to Blattner, “Primordial truth is the world disclosive function of our basic familiarity” (p. 13). Heidegger posited: But what remains concealed in an excep- tional sense, or what falls back and is covered up (Verdeckung) again, or shows itself only in a disguised (Ver- stellt) way, is not this or that being but rather, as we have shown in our forego- ing observations, the being of beings. It can be covered up to such a degree that it is forgotten and the question about it and its meaning altogether omitted. (2010, Authors’ italics, p. 33) Women’s experience of giving birth can be likened to a primordial and transforma- tional way of experiencing Being. However, there is much that is revealed and concealed along the way. Within Groth’s poetic refer- ences to flowering and spring, too, there are suggestions of revealing and concealing, when considering that flowering reveals the potential of the bud, or that the inevitability of spring is hidden in the bleakness of winter. So too, the advent of motherhood may well uncover new and tender emotions toward the infant, reminiscent of Groth’s suggestion of the flowering of something fresh and lovely, rife with the birth and re-birth that is associ- ated with spring. Bergum (1989) suggested: “The woman is changed by the experience of bearing a child. She is not a mere vessel, but is an active, growing, changing partici- pant” (p. 154). “Woman” becomes “mother” (Bergum, 1989). With that unfolding, that revelation, a new mother may also experi- ence the bleak fear associated with expecta- tions for perfect mothering (Wolf, 2010). I wonder if the deep and central need for women to assimilate and take-in the experi- ence of birth has been overlooked by adher- ing to practices such as early discharge poli- cy or “rooming-in” practices (wherein the infant stays in the mother’s room in spite of traumatic birth or caesarean section). I ques- tion how our hospital environments allow for revealing the difficulties associated with emotional recovery following a traumatic delivery. A woman’s recuperation from a post-partum hemorrhage, for example, or other complications of the birth experience, is linked with an increased incidence of post-partum depression (Thompson, Roberts, & Ellwood, 2011; White, 2006). Do those images further the notions of blossoming (the revelation of a flowering into mother- hood) or do they “float” on some elusive odor, inclined to conceal and sublimate such possibilities as an emerging depression? In keeping with the attempt to envision the to- tality of a woman’s experience, whether a clinical depression has been diagnosed or not, it is reasonable to suspect that a woman will incorporate any distressing aspect of her birthing into her own history and continue to process its meaning for a long time to come. As I consider the current culture of ma- ternity care, I think of other taken-for- granted practices that consume the efforts of nurses working in the perinatal field. The attention to the protection of breastfeeding practice underpins much of the support that is given to women by nurses in the hospital setting as well as the community. The rheto- ric of breast milk superiority is revealed as the most important consideration for women in the early mothering experience, but what may be concealed is the need for considera- tion of individual contextual considerations around infant feeding decisions (Humphries, 2011; Humphries & McDonald, 2012). Where rooming in is concerned, the ad- vantages are exposed as being important to a new mother’s ability to learn about her in- fant’s cues so that mothering and breastfeed- ing can be supported. While elements of this strategy are certainly important for many women, other advantages of the policy are not as easily revealed. For example, women Humphries Journal of Applied Hermeneutics 2012 Article 9 8 may share a room with another mother whose infant is up at night crying, minimiz- ing the hope of sleep for all concerned. This in turn may motivate a woman to request discharge before she is quite ready in order to get home where she imagines she will be better able to cope. She might then be dis- charged before her transitional milk supply has been established, leaving her to face the unexpected feeding challenges associated with those adjustments in isolation. Also, there are expectations for a practitioner re- garding discharge parameters, for it is ex- pected that women will be discharged as soon as is deemed medically appropriate (Sadeh-Mestechkin, WalWsch, Zeadna et al., 2007). The importance of emotional up- heaval and sleep deprivation that accompany the early days following birth can be there- fore concealed, undermined, and dismissed as part of the normal experience. The possi- ble advantages to enhancing a woman’s ca- pacities for coping by nurturing her and supporting her healing for a longer time pe- riod are trumped by budgetary imperatives for early discharge that may subvert the wishes of nurses and mothers who recognize a need for enhanced support. I have outlined the very external applica- tions (or, ontic applications, as Heidegger may describe them) of the words “revealing” and “concealing” as a way of describing my musings about women’s experience of birth in maternity settings. However, what may be closest to Heideggerian thought, as well as the poetic notions of Groth, involve what is transpiring on a very deep level - - a level that reflects what is revealed and concealed closer to a woman’s Being- -about the trans- formation into motherhood. Oenning- Hodson (2007) offered insight into the com- plexity of maternal Dasein when referring to a healthy Third Space that may exist be- tween mother and infant, enabling each to develop a unique sense of self. In the con- text of this discussion, it is possible to con- nect that healthy sense of self with Dasein. Personal truths will reveal the meaning that a woman makes about motherhood, and that meaning will be profound and long lasting. The fragrance of her birth experience, whether that fragrance is sweet or pungent, will be inhaled and re-inhaled, with revela- tions punctuating the meaning of her exist- ence--her Dasein--over a lifetime. Nurses’ encounters, too, will participate in the criss-crossing that will ultimately shape their impressions, as well as the im- pressions of the women they care for. Ber- gum (1989) asked: “What does it mean to be a health care professional in the midst of women’s transformative experiences?” (p. 15). In partial response to Bergum’s ques- tion, I suggest that women very often re- member their nurses during the pivotal time of birthing. They recall the kindness or the insensitivity, or any number of nursing in- teractions, and they will incorporate their shared history with nurses into a Dasein that becomes inextricably linked with the birth experience. Indeed, a woman’s encounter with nurses in the perinatal period assumes a large profile in the meaning she makes of the perinatal experience (Humphries, 2011). As a result of the relational interaction that occurs between nurses and women in the perinatal setting, women may enter into an everyday blossoming that unfolds with feel- ings of successful and blessed mothering. However, if nurses do not handle breastfeed- ing difficulties sensitively, or fail to recog- nize an emerging depression, there can be movement towards a concealed state, where- in a withering, or retreat occurs, and an ero- sion of self-confidence transpires (Hum- phries, 2011; Humphries & McDonald, 2012; Wolf, 2011). For some nurses, there can be a sense that adherence to guidelines for institutional Humphries Journal of Applied Hermeneutics 2012 Article 9 9 efficiency and best-practice guidelines con- ceal a personal opportunity for sensitive and individual advocacy. In fact, this notion was revealed to me after decades of floating on the odorous sensibility of efficiency and ev- idence-based practice, which is generally thought to offer excellence for nursing care in the perinatal setting. The screams of her birthing had been si- lenced by the cries of her infant, born blessedly healthy and now voraciously hungry. I encouraged her, I uplifted her, and I gave her confidence. “Your milk will come in, the baby will latch, don’t give up,” was my assurance. The des- peration of the labor was now surely forgotten-it had been, after all, three days since her emergency cesarean birth. I was cheerful and informative as I skill- fully removed the staples from her ab- dominal wound, preparing her for dis- charge that day, not thinking until much later about the lost look in her eyes. Perinatal Worldliness, Mood, and Language Doch kommt das Wort und fasst es und fuhrt es vor das Aug‘, Wie Nebelgrau er blasst es und schwin- det wie ein Hauch But the word comes and seizes it and brings it before my eyes Like the gray mist it pales then, and van- ishes like a breath. The metaphor of the melody continues to be engrossing as it relates to Heidegger’s dis- cussion of language and its complicity with both specific and broad constructs of lin- guistics and meaning. Heidegger’s thoughts about language indeed add a further dimen- sion to the notion of melody since language, like melody, is made up of individual parts that achieve meaning only in the complete- ness of the whole. According to Blattner (2006), Heidegger embraced “linguistic con- stitutivism,” (p. 98) a view that is shared by many 20th century philosophers, and one that acknowledges the centrality of language to our being-in-the-world. Heidegger implied, however, that there is more to language than mere linguistics, and that any meaning asso- ciated with discourse must include the broader sense of the term language, and acknowledge the way that we speak (Blatt- ner, 2006). At the same time, then, the inten- tionality of language towards communica- tion can be realized through art, dance, into- nation, speed of speech, and other de- scriptors (Blatter, 2006). I believe the tem- porality of language is thus revealed, by considering the complexity, contradiction, and possibility for alternative presentation that exists in the moment around language, but for which there is always a sense of completion that incorporates the history as well as the novelty of that moment. It is the completeness of communication that will shape the history of the birth event, aligning with the fundamental position that is as- sumed by language, understood in a broad sense, during the perinatal experience. In the passage above, Groth’s poetry suggests a touch of the interrupted. Some- thing has been seized by the word, and I am infused with a sense of the authoritative voice. The melody is now disrupted by the lyrics. Interweaving my thoughts around the perinatal encounter, it seems there are many words and messages that embody birthing, and many of them take on authoritative sig- nificance. There are written and unwritten words and messages that manifest through the guidelines and policies (as have been described) that underpin nurses’ approach to care. These words spring forth from the Humphries Journal of Applied Hermeneutics 2012 Article 9 10 posters on the wall about breastfeeding su- periority, seraphic images of women breast- feeding their infants, information about how to care for the infant safely, words of cau- tion from pre-natal education and a myriad of online influences that accompany a wom- an to her birth experience. There are also very important words that are not present, and equally influential, by nature of the fact that images or posters of bottles, latex nip- ples and formula are forbidden in maternity settings, in alignment with Baby Friendly Initiatives (Breastfeeding Committee for Canada, 2011). Indeed, many women arrive at their birthing with a high level of anxiety around the responsibilities that await, after a pregnancy that has included a rigorous ex- pectation of specific abstinences, avoidances, and worries over the health of the unborn infant brought on by increasing technologi- cal proficiency (Wolf, 2010; Wynn, 2002). Is it possible that these experiences of preg- nancy set the stage for an interrupted assimi- lation of the fetus into the mother’s Being? Is it possible that these words-these influ- ences- seize the melody of motherhood and distort it into cacophony? Heidegger’s attention to attunement and mood were concepts that took me by sur- prise as I read Being and Time. Heidegger implied that the understanding of mood oc- cupies a crucial place in conceptions of Dasein, and he suggested that fear is an im- portant component to understandings of mood. In his discussion of mood, Heidegger used the term “attunement” to contrast any “turning away” from Dasein. Heidegger de- scribed those two ideas: In bad moods, Dasein becomes blind to itself, the surrounding world of heedful- ness, is veiled, the circumspection of taking care is led astray. Attunement is so far from being reflected upon that, in the unreflected devotion to and giving in to the “world” of its heedfulness, it as- sails Dasein. Mood assails. (2010, p. 133) My surprise arose partially as I considered how mood is often taken up in an everyday interpretation of the word, usually implying a negative or positive judgment about a per- son’s orientation towards happiness. There is also an objectified, medicalized connota- tion that springs easily to mind, especially when considering the onset of a mood disor- der in the perinatal period. It was intriguing to me that Heidegger would attribute so much meaning to mood, an accessible idea that I had not expected to occupy such an intrinsic position associated with Being. In fact, new insights emerge around attunement as a result of Heidegger’s discussion of fear, anxiety, and the “turning away from and to- ward one’s own Dasein” (2010, p. 325) that discloses mood. I see with a new lens the possibilities for meaning around fear and anxiety, as representing inauthentic (or turn- ing away from Dasein) responses to in-the- moment situations, and the implications for mood that ensue. I am called again to exam- ine the potential for regimented and possibly disruptive approaches to birth in the context of “turning away” from the deeply seminal and personal experience that birth is. Heidegger’s reference to mood and its apparent relationship to our human perspec- tives give me pause, and I discern a coherent connection between his words and my rumi- nations about women and their birth experi- ence. In particular, I connect the “grey mist” to which Groth referred, with women’s ex- perience of post-partum depression that I encountered in my hermeneutic study (Humphries & McDonald, 2012). In that study, I explored the experience of women who lived with mood disorders and who were not able to breastfeed their infants. Their experiences had most often included Humphries Journal of Applied Hermeneutics 2012 Article 9 11 valiant attempts to achieve success with breastfeeding, but they had struggled with what Heidegger may equate to the “present- at-hand” notions of breastfeeding (McBride, White, & Benn, 2009). In other words, these women were unable to incorporate the func- tional aspect of the breasts (or what Heidegger may refer to as the “equipment” that breasts may signify) with the act of suc- cessfully breastfeeding. An integrated notion of Dasein was compromised because of spe- cific challenges these women faced, such as a failure to achieve a latch with the infant, or difficulties with achieving satisfactory milk supply from the breasts. In another criss- cross of ideas, I think about the words ema- nating from breastfeeding promotional liter- ature that haunted these women, especially references to the statistically derived ad- vantages of breastfeeding towards enhancing the infant’s intelligence, preventing Sudden Infant Death Syndrome (SIDS) or reducing the risk for a multitude of other diseases. Women suffered significant emotional dis- tress as a result of their exposure to breast- feeding promotional literature when they, themselves could not breastfeed. Heidegger’s resistance to the ethics of mo- dernity (Caputo, 1987) comes to mind as the widespread acceptance of “informed consent” in the context of infant feeding decisions emerges. In other words, it is assumed that by giving women the evidence about risks associated with not breastfeeding, ethical imperatives can be satisfied. Groth’s poetry aligned with my interpretation of women’s confidence withering and “vanishing like a breath” while striving to fulfill expectations created by the language of best practice guidelines enacted by the nurses, and of breastfeeding promotional initiatives that they encountered in their communities. It was difficult to bear the suffering that was part of their experience. The aca- demic language of postpartum depres- sion in no way prepared me to be im- mersed in the pain of a fractured dream of motherhood... and I was left altered. So many of their worries centered on a sense of failure that they couldn’t feed their babies properly-so many words that had led them to their “truth” that by using formula they had damaged their beloved infants forever. Maternal Dasein and Temporality Und dennoch ruht im Reime verborgen wohl ein Duft Den mild aus stillem Keime ein feuchtes Auge ruft. And yet there’s in the rhyme a fragrance deeply hidden That gently from a dormant bud is called forth by tear-stained eyes. I am now able to rest with Groth’s poetry, which concludes in concert with the melodic resolution that is occurring simultaneously, depicting the bittersweet conclusion. What is “it” that passes like a melody? The reading and the re-reading of the poem led me through layers of possibility; ones that per- tain to the disclosure of love, or the passage into wisdom, all the while employing the metaphor of the power of melody and lyrics to elicit human emotion. Underscoring all possibilities, I believe, is the possibility for exposing truth. Heidegger conceives of truth as something primordial, which is uncovered, disclosed, or revealed (Blattner, 2006). In Groth’s poetry, the initial fragrance was as- sociated with sweet hopefulness that existed before the linguistic interruption. Now, the hopefulness of spring exists through the lens of a tear-filled eye, suggesting more than one possibility for truth. For example, the tear could represent a loss of innocence and Humphries Journal of Applied Hermeneutics 2012 Article 9 12 the potential for melancholy that will ac- company the revelation of spring; a symbol- ic reference to beginnings, birth, and re-birth. Alternately, the tear may suggest a real and deep unity that has transpired, and in the context of the perinatal experience, a truth that depicts the bliss and splendor of moth- ering, expressed with tears that originate from an altogether experience of Being. The dormant bud is “called forth” with immediacy and timeliness. Heidegger wrote: “Temporality temporalizes the world time, in whose horizon ‘history’ can ‘appear’ as an occurrence within time” (p. 413). In his discussion of temporality, Heidegger identi- fied, once again, that previous philosophic conjecture has not attended to what he con- sidered to be essential: the finitude of Dasein, the rhythmical, predictable and re- petitive coming into and the passing through, as well as the final passing, which is death. Importantly, Heidegger equated temporality with Being, that is, Being is conceived only in context with a temporal structure (Blatt- ner, 2006). The imperative of assimilating history as part of the now, as Heidegger suggested, has immense relevance for nurses who interact with women during essential perinatal moments, for the nurse and the woman will be forever linked in a shared history of that birth. Heidegger’s departure from historically constituted philosophy, and the assertion of Being may have the poten- tial to influence those who offer care in the realm of birthing, for Heidegger insisted that there is an inevitable return to notions of Be- ing. The circuitous revelation that comprises that return can inform nursing practice by keeping us ever mindful about the need to honor in-the-moment interactions, invoking a heightened but familiar sense of Being-in- the-World, even while navigating the envi- ronment of health care, with all its techno- logical and organizational imperatives. Al- ways and repetitively, and in all interactions, there is an opportunity to privilege the won- der of our Dasein-our existence-allowing for revelation and meaning to evolve for each woman and each nurse who together trav- erse the profound experience of birthing. It is in this way that we are able to integrate our Being with others, and conjoin the unique histories that are embedded in each of us. Conclusion Groth suggested that there is potential for the words to soothe and heal whatever inter- ruption has occurred in the melodic stream. In the context of the perinatal experience, however, I am called to ask “which words?” Are they the words of best practice policy and efficiency, of evidence-based guidelines, or are they the words of compassion and at- tention to each woman’s core experience? Are they words of breastfeeding success rates, or are they words of comfort and re- spect for infant feeding decisions that have been tearfully made? How poignant is the loss of innocence, and the inevitable sadness that accompanies any disruption of a wom- an’s assimilation into mothering. My thoughts reside with the primordial experience that permeates the event of carry- ing and giving birth to a child, but I am also drawn to consider the experience of women for whom motherhood is mired in complexi- ty and angst. From a Heideggerian perspec- tive, I wonder whether our health practices promote strength and attunement within no- tions of Dasein and Being for women. If so, the birth experience may draw forth tears of ecstasy and bliss. If not, the profound mean- ings associated with birth will be interwoven with the tear-stained eyes of regret. Humphries Journal of Applied Hermeneutics 2012 Article 9 13 References Beck, C. T., & Watson Driscoll, J. (Eds.). (2006). Postpartum mood and anxiety disor- ders. Sudbury, MA: Jones & Bartlett. Bergum, V. (1989). Woman to mother. Granby, MA: Bergin & Garvey. Blattner, W. (2006). Heidegger's being and time. New York, NY: Continuum. Brahms, J. (n.d.). In S. Kagen (Ed.), Wie melodien zieht es (E. Braun, W. Lyman Trans.). 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Like a Melody It Passes Like a melody it passes softly through my mind, Like the flowers of spring it blooms, and floats on like a fragrance; But the word comes and seizes it, and brings it before my eyes Like the gray mist it pales then, and vanishes like a breath. And yet there`s in the rhyme a fragrance deeply hidden That gently from a dormant bud is called forth by tear-stained eyes.