Spiritual_Wellness_Holistic_Health_and_the_Practic

182 Philosophical Foundations of Health Education
Even if we confine our use of empower to its intransitive meaning, there are different
subjects: professionals and their clients. When professionals empower intransitively,
they claim more power for themselves. If they do so with the intent to transform
oppressive social structures, rather than to advance self - interests, this mutually empowers
professionals and their clients. Many frontline health workers are relatively powerless
in their organizations, and need to claim legitimacy for themselves in order to be
effective in their work with less powerful individuals and groups. Schon (1983) warns
that when such workers are not granted professional status, they have great “ difficulty
in establishing a reflective [empowering] contract with their clients ” because they lack
“ enough voice in the situation to be able to do so ” (p. 298). Much of the disabling
power - over tendencies within professional practice may simply reflect a projection
of professional disempowerment (Finne, 1982), or the self - evident truth: One must
have power in order to share it.
When clients or community groups empower intransitively, the professional
ensures that power can be taken. Professionals generally do have more power (status,
legitimacy, access to or control over resources) than their clients. How is this power
shared or given up in ways that do not patronize? How is power taken from those in
empathy with relatively powerless individuals or groups in ways that do not become
stuck in anger or resentment? These questions surround all social justice struggles that
exist simultaneously at the interpersonal and social (intergroup) levels, for example,
between women and men, indigenous and colonizing peoples, economic or status -
defined social classes. Empower in these struggles is both transitive and intransitive; it
exists only as a relational act of power taken and given in the same instance. The tension
this invoked in professional practice became indentified as “ power over ” and
“ power with. ” Power over relies upon the reality of things — diseases, health behaviors,
risk factors. These things are important, but they can lead to what McKinlay (1990)
refers to as “ terminal hardening of the categories, ” in which professionals get the
answers they want to hear by virtue of the questions they ask. Power with looks to
the reality of lived experiences in the language, images, and symbols that people use
to give voice to them. Power over tolerates others ’ views. Power with respects others ’
views, trying to understand them within the context of the others ’ life. Power over tries
to educate others to his terms, his ways of viewing the world. Power with tries to find
some common ground between what she knows, and how she talks about it, and what
communities know, and how they talk about it (2).
The act of naming one ’ s experiences is essential to an experience of self - efficacy
or empowerment. This does not mean that how one interprets one ’ s experiences is
true, or necessarily empowering. As Fay (1987) cautions, there is still the problem of
false consciousness, of viewing one ’ s life through the internalized and distorting conceptual
lenses of those who hold power over one. The power of the word nonetheless
draws attention to the professional need to respect how people identify their own health
concerns an4 issues. If health workers fail to “ start where people are ” (Nyswander,
1956) they risk being irrelevant to the lives and conditions of many persons, further