Strategy-at-the-edge is one on the four things needing to be kept in balance in a collaboration, involving sustaining a focus on the through-life needs of a patient’s condition. This involves sustaining a focus on the ‘otherness’ of the other:
- The patient is ‘other’ in the sense of being at the other end of a relationship. The ‘otherness’ of this other is that which you do not understand about the patient, which is both familiar and not familiar – the unheimlich. To experience this is to experience an asymmetry.
- An ‘edge’ arises wherever there is such an asymmetric relation to a ‘demand’ – to be distinguished from boundary or perimeter, both of which assume symmetric relations to a ‘demand’. ‘Edge’ implies that something more is needed in the situation presented by the patient.
- The experience of an edge always involves the third dilemma – affiliation vs alliance (elaborated on in the dilemmas of ignorance). To work at the edge means working collaboratively in relation to a social object.
- This social object is that which is experienced as problematic in the situation. For example, something not working right with the way a patient is receiving care. A collaboration is always around a social object.
- The third dilemma is about experiencing a double challenge, presented by needing to go beyond the dictates of the identities of those participating in the collaboration in order to meet the demands constituted by the social object. The social object is social because it is defined more by a common way of experiencing the situation than by anything ‘objective’ about the situation itself.
- Experiencing each of the three dilemmas involves crossing a threshold between two “states of being”, or rather two ways of being-in-relation-to what-is-going-on (wigo)… in other words, there is a shift demanded by each crossing in the way identity is defined. The first shift involves facing facts about the situation (top-down vs bottom-up), the second involves accepting a limit to what can be worked out by rationality alone (the espoused vs the unthought known), while the third involves trusting the ‘pull’ of the social object to take the collaborators beyond their existing institutional perimeters.
- Because this trusting is situationally based, these thresholds are not crossed once, but repeatedly in the sense of having to be repeatedly re-learnt in each situation – the temptation being always to pretend-it’s-simple since it makes the present moment pass so much more easily! And so, insofar as we choose to live the dilemmas, we find ourselves on a journey. This is the inherent nature of the diasporic way.