Introduction

1 The idea of a clinic of the social seems contradictory at first glance, as the first term is synonymous with attentiveness to that which is individuated, singular, unique, whereas the social refers more to collective, generic, reiterated aspects. And yet, although it would be an exaggeration to speak of a “clinical trend” in the social sciences, for thirty years it has been impossible to ignore the increasingly widespread use of the term “clinic” in these fields, to the extent that we may detect a kind of convergence. How can we account for such a rise, precisely at a time when the medical clinic (in somatic medicine and psychiatry) is going through a multifaceted crisis? Actually, the phenomenon started in the early 20^th century and, with the notable exception of the legal clinic (which was inspired by casuistry), [1] the source must be sought in psychology. My hypothesis is that this extension of the expression does not just correspond to an application and particularization of the medical clinic or of clinical psychology, and therefore to a subdivision in the study of certain human phenomena, in particular from a pathological perspective (children’s clinics, psychogerontology, clinical phonetics, etc.): it also denotes a specific attitude (“spirit” or “method”). Thus the dimension of specialization does not exhaust the meaning of this spread. To present this meaning, I will first study the progressive extension of the clinic to social psychology and its spin-offs, before emphasizing sociology’s original claims to independence, and anthropology’s concern for its own self-sufficiency.

The Emanations of Social Psychology

2 Here is not the place to recall how psychology became clinical, or to recount how a social psychology, legitimized by the existence of psychic aspects in cultural and social phenomena, gradually took shape. The question is rather to understand how the surprising project of a clinical social psychology came to be, a project that then paved the way for a greater, and somewhat puzzling, spread of the notion to other disciplines: clinics of education, work and activities; clinical criminology, etc. [2] The connection took place via the term “interaction,” which exposes the individual psyche to the social. [3]

3 The natural object of clinical social psychology is the subjects’ experience of a connection, individually or as a group, through their social inscriptions (conflict, crisis, etc.) [4] The emphasis is therefore on the concrete individual, alone or with others, with an individual’s ideas and affects, situated socially and participating in a psychic economy. The goal is not to grasp the social as an invariant reality whose components must be inventoried, but rather to apprehend the subjective and social constructs in their movement and tension (the dialectics of inside and outside), and to bring to light the processes according to which social dynamics take on meaning for the subjects experiencing them – which is why a multidisciplinary approach is required. By stressing the contextualized intersubjectivity of a “meaningful” research framework, the experimental approach that sets out to produce objective, impersonal knowledge is rejected. Moreover, dealing with psychosocial constructs in terms of dynamics makes it possible to consider them as potentiality and encounter, and therefore according to a varied and complex (non-linear) causality. The intrication of the psychic and the social breathes life into some notions (“social subject,” “social drive,” “anthropological prohibition,” and “significant social units”), and allows for the development of the notions of crisis, the social imaginary, or the subjective and social experience of sexuality. [5]

4 The use of the term “clinic” has also seen a marked expansion in the areas of education, training and apprenticeship. The expression “clinical pedagogy” came into use at the end of the 19^th century, but psychoanalysis was primarily responsible for legitimizing the idea during the interwar period. [6] Thinking in this area then drew inspiration from the departments of psychology that were appearing in universities. Clinical pedagogy seeks to determine the characteristics of the learning subject, as well as the theoretical and methodological conditions behind the development of those characteristics. The clinical approach is defined by a necessary level of involvement, work on the appropriate intersubjective distance and an emphasis on the complexity of living organisms. Its aim is not necessarily a therapeutic one, as it also allows itself to examine ordinary (non-pathological) behavior, and systematically brings sociology and psychology together to deepen the reciprocal influences of the subject and the world. It reflexively suspends action in order to get a better, more dynamic understanding of the relationship the subject has with their objects, with intersubjective relations, and with the social institutions (and the values and ideas they represent) that play a role in the subject’s behavior. [7] From the perspective of its operative modes, the clinic first takes an interest in singularity (subjects, situations or activities, but also groups or institutions), which it studies in a natural context, in (non-exclusive) contrast with an experimental framework. Consequently its approach is interdisciplinary, comprehensive, casuistic and holistic, striving to account for a variety of realities (social, institutional or psychic) in terms of processes, configurations or arrangements, conflicts or ambivalences – and not just by variables or factors, as with the statistical approach. In addition, the tools at its disposal (listening, dialogue, comparison, writing) are not used to defend itself from what happens, but to remain open to the new: the words that are blurted out in the moment are not those of an investigation via interviews and questionnaires. Next, the clinical approach proceeds by typologization: moving beyond (monographic) specialization and reiteration, it generalizes through inclusion rather than juxtaposition. The point is that theoretical conceptualization is not in conflict with the singularization of the gaze: it makes it possible, since the clinical framework is based on a reciprocating movement between abstraction and practice. As a result, instead of applying the theory mechanically, it is reassessed. Finally, the clinic has a twofold vocation of intervention and research. Of course, this involves a professional, whose interpretations are validated by the internal dynamics of their job, and by the possibility for subjects and collectives to recognize and sense the relevance of those interpretations (in increased meaningfulness and effectiveness). But by emphasizing the singularity of the situations that are analyzed, whose uniqueness and newness requires a renewed creative effort, the clinic justifies the fact that one may also (paradoxically) consider it as a field of knowledge.

5 The strange metaphor of the “work clinic” has been in use since the 1990s to examine career paths and analyze professional experience as a source of both psychic tensions and job skills. [8] As a branch of industrial and organizational psychology (which is itself a branch of experimental psychology), it studies individual cases and groups, in a real-world context, through a field approach, [9] and not only through the analysis of pathological situations (although the study of accidents is an important aspect of its activities). Its method is therefore intensive (in-depth) and interactive (dialogic), individualized (particular cases) and global (interpretations encompass all behavior patterns). This is in contrast to experimental approaches (studying hypotheses) or epidemiological ones (studying factors), which set out to identify the role of determining elements in activity via data processing, often statistical in nature. However, the discipline is more of a wide-ranging tendency than a consistent school of thought, encompassing activity clinics, the psychodynamics of work, psychosociology, ergonomics, clinical sociology, and even ethnomethodology, not to mention occupational health. The very expression “clinic” is subject to debate in this context. Does it refer to the examination of subjectivity in its relationship to work and organizations? In that case, its focus would essentially be to analyze (understand, present, even reveal) the connections between the subjective experiences of individuals and the organization of work, without taking the (later) transformation of subjectivity into consideration. Or does it transcend traditional research into the signs of alienation? For the advocates of “activity,” [10] the work clinic is located at the intersection between perspectives from occupational psychopathology and cultural-historical theory, studying the way in which the subject takes the constraints of their environment into account, making those constraints the sources of their personal and professional development. For these advocates, therefore, the work clinic encompasses a specific action taken by the subject as well as the overall picture as analyzed by the researcher. Work is then seen as an ordeal over which the clinic seeks to have leverage in order to make life tenable again (normativity, in Canguilhem’s sense of the term). The clinic supports the development of work by transforming it when it is inhibited, in an attempt to make workers rediscover all of the unused potential of reality, thereby giving a new direction to the activity that had lost its appeal. Hence the effort – conditioned by the authenticity of the dialogue on work, a committed examination of the problems the workers encounter, and the exchange of surprises and emotions between them and the clinician – to enrich the panoply of possible gestures by restoring the power to act that has been impeded (at least when the hierarchical power permits it). The question also concerns the critical dimension of the clinic: does it only reveal the hidden mechanisms of oppression, or does it also claim to act (locally) upon the world (alongside the workers, or even the bosses), by transforming the organizations and institutions, [11] at the risk of euphemizing domination and its excesses? [12]

The Independence of Clinical Sociology

6 Clinical sociology differs from the sociology inspired by psychoanalysis, [13] the sociology of the singular, [14] and even the sociology of psychological objects, [15] while maintaining the possibility of intersecting with these variants. It represents a recent tendency, which appeared fleetingly in the United States, [16] and which truly came into its own in France in the early 1990s, before spreading rapidly throughout the world. It was the product of several influences: the work of Freud, the comprehensive approaches of Dilthey and Weber, the first Chicago school, thinking on affect (Simmel, phenomenology), the French Collège de Sociologie of the 1930s and the ideas of the Frankfurt School on the authoritarian personality. [17] It revisits some of the formative questions in the field that had been neglected, not to say repressed: the psychic, affective, subjective and emotional dimensions of social relations. [18] A qualitative and humanist vein of American sociology (Kurt Lewin, Carl Rogers, Jacob Levy Moreno) – centered on action research, group dynamics and psychodrama – thus influenced French psychosociology (Max Pagès), which, from the 1960s on, developed outside of the academic world, as it was too psychological for sociology and not experimental enough for social psychology.

7 The ambiguous expression “clinical sociology” does not allude to an analysis concerning health: it is a practice or a method that reorients the researcher’s attitude. [19] The image of a sickbed conjured up by the word “clinic” invites the researcher to work in close contact with the daily lives of individuals and groups, and the practical functioning of social institutions. The emphasis is therefore not on the therapeutic aspect (although the investigation may produce certain effects), and still less on a prognosis, but rather on the diagnostic dimension. The point is to study people in their everyday social context, in all its multidimensional complexity, which cannot be reduced to a set of simple factors. [20] This approach, which avoids strictly disciplinary logics, is constantly concerned with linking participant and structure, individual and society, and aspects both existential (notably via psychoanalysis) and collective, the better to account for the psychosocial intrication of reality. It consequently examines the social by taking the imaginary, drive-oriented and symbolic aspects of institutional phenomena into account, by focusing on the subjects in their singularity (their involvement in the dynamics that are observed), and by considering itself as a necessary prerequisite to any critical ambitions. For the participant and the researcher, the focus is on developing a joint thought process by means of listening, empathy, the collaborative construction of hypotheses and the comparison of theoretical, practical and experiential knowledge, whose truth is revealed along the way. This is because every individual contains a portion of otherness – a collective one in particular – whose analysis is sociology’s job. Moreover, it is because the subject participates in the various stages of the process of acquiring knowledge that this sociology is referred to as “clinical.” It tackles a great variety of themes, from the sociology of work (solidarity economy) to urban planning (the Brazilian favelas), always emphasizing the subjective effects induced by structures, the construction of personal identities, and the participants’ ability to reflect on themselves (on their emotions in particular). For example, in the case of the effects of neoliberalism on work, clinical sociology analyzes the self-constitution of the “achievement-subject”; the colonization of subjectivities by the mindset of individual success; ill-being; and disaffiliation.

8 The epistemological relevance of the clinical approach is subject to debate. Categorized as one of the sociologies “of everyday life,” it is accused of theoretical weakness, which is attributed to its “subjectivism,” as well as its indulgence toward anecdotal events and the feelings of the participants. And yet, although the presence of concepts is often implicit, they are by no means absent, whatever stages of the work are considered: problematization, interviews, analysis, or writing. In fact: (i) clinical sociology, which is based on listening, is intended as a process of acquiring knowledge, separate from a concern for treatment. By stressing the contextualized intersubjective journey, with its mediations (ideas, affects and fantasies), it allows the subject to enter into the complexity of their individual and social history in order to get a close look at its configurations, dynamics, conflicts and contradictions. Since it intervenes after lived experience, it encourages the subject to recapture that experience to clarify and reflexively reenvision it, and even to transform it. In this “openness to what emerges” – an active approach, not merely passive availability–attentiveness plays a main role. (ii) Here, meaning is the result of a joint process, which involves a deconstruction of the surfaces of phenomena, revealing hidden or unacknowledged connections. Thus the clinic is a specific form of knowledge focused on the singular, which can transcend it, but never neglect it. (iii) Since worldview and self-image are correlative, clinical sociology studies the processes of internalization in order to identify first the significant associations that have been formed and are still being constructed, then the stimuli external to the subject on the basis of which those associations were made. Contrary to a vision of development as an unbidden, spontaneous progression, socialization is understood as a deliberate process of self-actualization, a mixture of subjective events (événements) and manifestations (avènements). The concepts of the collective imagination, and of “socio-mental” or “paradoxing” (paradoxant) systems, [21] issue from it. (iv) As with the “narrative clinic,” [22] clinical sociology includes the biographical dimension in its project of knowledge, in order to account for the transformation of the subject, who recreates the situation, actualizing it in a self-presence constituted by intersubjective experience, and extends it imaginatively so as to envision actually modifying it. (v) Clinical sociology establishes a flexible relationship with abstraction. The path to theory does not depend above all on the quantity of data that is gathered, but on listening closely, observing carefully, and analyzing scrupulously. There is a permanent feedback loop between the empirical approach and the construction of concepts, giving rise to a confrontation that resists the temptation to reify and constantly leaves extra room for the object, which always exceeds its conception and drives thought forward. [23] The result is that one may speak of clinical knowledge, in the scientific sense of the term: knowledge that is not experimental but conjunctive (empathic). [24] (vi) The researcher’s subjectivity participates in the construction of scientific knowledge, by grasping both what the individual misunderstands, and that individual’s relation to a universe of rules and institutions in which they must find their place. Therefore the very process of research is at stake in the interaction between the subjectivities of the participant and the researcher. For Georges Devereux, it is a game of transference and counter-transference; for Jeanne Favret-Saada, [25] it is a matter of gazes that meet. The transition to writing plays a role in this elucidation, as it does not merely convey the dynamic of the researcher’s participation, nor is it a pure mode of preservation and transmission.

9 Finally, clinical sociology has a critical ambition – and not just by way of its anti-positivist thrust. By involving individuals in the construction of knowledge, it focuses on their actual emancipation, and the ideologies and processes of domination (whether based on class, race, or gender). In particular, by analyzing the conflicts associated with the contradictions of the social world, it allows subjects to invent responses to the paradoxical injunctions that traverse them – with conflict seen not as a malfunction to be eliminated (as in functionalism), but as an indicator of unresolved contradictions and tensions that are often implicit, even unconscious. By the same token, the clinic also entails an interventionist aspect: the researcher’s involvement corresponds to the ambition to identify the participants’ vulnerabilities and capacities, in order to give them the possibility of changing their quality of life. In so doing it reveals its kinship with action research, whose methodical approach focuses on practical effects, obliging the researcher to consider their own involvement. Still, it does not make any a priori assumptions about meaning: on the contrary, by offering a framework for its co-production, it copes with the contingency of meaning, by exposing the analysis to the uncertainty of personal choices.

The Autonomization of Clinical Anthropology

10 Anthropology’s relations with psychology combine fascination with reticence. Taking its inspiration from the psychoanalytic “ultra-clinic,” the ethnopsychiatry of Georges Devereux [26] studies culture’s relationship to psychic disorders, community care practices, and even the systems for interpreting psychic life, with ethnopsychoanalysis as its method. Defamiliarization (in the study of the shamanic cure of a Mojave tribe member) seeks to avoid the trap of cultural relativism, giving priority to therapy founded on the patient’s own insight [27] into their condition. The intrication of a universal human psyche and cultural “specificity” explains the repression that forms the personality traits shared by the members of a single group. But although this “complementarist” theory demonstrates a concern for the singular characteristics of each case – by asserting both the absolute autonomy of discourses (psychological, ethnographic, etc.) and their interdependence – it occasionally runs the risk of a relativist reading, and overlooks the importance of multidisciplinary teamwork. On the other hand, Ignace Meyerson developed a psychological anthropology without a clinic, based on the result of actions (human endeavors). [28] He maintained that psychology must not limit itself to examining the simplest facts and faculties – lending itself to the application of methods from the physical sciences – but should also study complex human achievements (languages, myths, religions, arts, sciences), whose history clarifies the construction of psychological functions. However, this ambitious approach remains an impersonal form of psychology, despite its historical (documented) and comparative (casuistic) orientation. Between these two extremes, there is a logical place for a more measured clinical alliance between anthropology and psychology: such a combination would not merely consist of an anthropology of health (the ethnomedical description of health care techniques, forgetting that any health model expresses an ideology), [29] and may adopt a twofold form.

11 (i) The term was first taken up in the wake of the project that extended the approach of clinical psychology to all of the social sciences. The epistemology of psychoanalysis makes it possible to problematize the notion of culture, which is too often seen as a stable model, for example in studying the psychic impact of political violence, the ruptures in history (Frantz Fanon), and the exclusions and disaffiliations affecting the subject, or in analyzing the intergenerational transmission of the psyche. [30] The project relied on the original anthropological ambitions of psychoanalysis, which was also interested in the collective psyche (established groups, crowds, masses). Since the unconscious is an intimate but also a transindividual reality, the study of anthropological structures legitimately leads to the question of the social bond and the political sphere. One cannot therefore reduce anthropology to a science of the collective and psychoanalysis to the practice of individuality. In order to avoid the risk that the clinician may burden the patient with cultural representations from the ethnological sphere or that the ethnologist may deny the role of fantasies in a given cultural formation, it is necessary to pay attention to the complexity of hybridizations. This is the sense behind the “clinic of exile,” which does not claim to imitate the rituals of the culture of origin, instead trying to comprehend the collective imagination in order to deal with the patient’s specificity, and the reality – and transmission – of their fantasies. [31] This method avoids the pitfalls of transcultural psychiatry and cultural relativism, because it always focuses on the singularity of the suffering patient. It is a rigorous intercultural approach to the connections and dislocations involving identity and otherness, which studies them in a flexible fashion, countering any fetishization of origins. The clinic is not, therefore, a sub-discipline of anthropology (alongside social, cultural, religious, etc. anthropology): it undertakes a critical and individualized examination of existential categories, in particular fictions of identity “that are revealed within the large rifts (déchirures) in an individual life as in collective life,” contrary to any abstract, neutral or asexual vision of the human being. [32]

12 (ii) From a completely different perspective, clinical anthropology strives to place a coherent interdisciplinarity in the service of a human and scientific psychiatry. The starting point is then an acknowledgment that contemporary psychopathology is in a state of crisis, torn between the contrary tendencies of the naturalization of mind and social constructionism, [33] from which many ills result. The clinic has lost its way, divided into specialisms whose interactions are problematic, retreating to functions to the detriment of meaning, and prioritizing control and evaluation at the expense of the suffering patient and their experience. Science has regressed (the positivist orientation of the social sciences; neuroscientific tendencies). Political risks have grown (the increasing individualization of the relationship to illness; the atomization of the social sphere; the efforts to influence public action). The challenge is then to invent a psychiatry that is specifically human, interacting with the natural sciences, but without reductionism (of a neurological, nosographic, pharmacological, or other nature).

13 (1) This psychiatry is constructed in a circular relationship between the clinic and symbolic anthropology. Jacques Schotte has contributed to the development of a psychiatry that is both human and rigorous. [34] Retaining Freud’s ideas on drives and the dialectical link between the pathological and the healthy, and Viktor von Weizsäcker’s views on the emotive and critical dimension of every human being, Schotte’s anthropopsychiatry builds upon Binswanger’s work through a nosological approach (moving beyond classifications based on symptoms that are grasped haphazardly) and an epistemological one (defining itself in its intrinsic specificity, instead of merely being a disordered mass of disciplines) – hence its effort to construct a clinical science of the human being, which takes into account the originality of its object (the “anthropological difference”). However, the framework that is adopted remains limited by its exclusively psychoanalytic and phenomenological grounding. It therefore needs to be completed by a semiotic anthropology, [35] acting at the crossroads of cultural studies and cognitive science and reflecting on the instituting role of signs in social exchanges (“culturalized” cognition). Anthropology then studies the modes by which collective values (whether social, aesthetic, religious, scientific or technical) are established by the group’s transactions and habitus. The organic dimension of the body is also incorporated into perception, in the form of the body proper, which is itself traversed semiotically. The concept of the symbolic economy enables the conjunction of the practical, the fictitious, and even the mythical dimensions of social interactions, the ritualization of behavior going hand in hand with the formation of semiotic schemas. This perspective presents the epistemological advantage of associating the neurosciences with the cognitive sciences, combining language, social practices, techniques and ethics, as shown by the analyses of synesthesia and the inner voice. [36]

14 (2) The paradigm of clinical anthropology establishes a real interdisciplinary dialogue, [37] for three reasons.

15 (a) First, it enables the conception of the continuity between the biological and the social. The notion of symbolic form brings mental pathologies into contact with all of the levels at which they function (neurobiological, instinctual, cognitive, sociocultural), and facilitates clinical interventions that respect the singular universes of individuals, by incorporating the anthropological aspects that determine them

Table summarizing the characteristics of clinical anthropology

Table summarizing the characteristics of clinical anthropology

16 On the semiotic level, the ambient world includes the symbolic forms that mediate sensations in different areas. This includes language and its idiomatic expressiveness, and all of the artistic activities that, in turn, create sensations, enabling the access to meaning by the expression of what one feels. The subject-object field is a dialectic that is accessed via techniques. The field of norms regulates the relationship to desire, to the possible, to what is wished and what is forbidden (a field in which linguistic negation and –indirectly – art and the sciences participate). The field of the person comprises literary uses (narration) and systems of kinship.

17 The somato-neuro-psychic level corresponds to what semiotic anthropology expresses in terms of the incarnation of semiosis and the anthropopsychiatry of drive vectors: Attachment defines the psychic occupation of the world (progressively thematized by reflection after the infant’s inability to distinguish inside from outside). Polarization structures the progressive differentiation between self and non-self, as does inhibition (the child discovers that they are inhabited by an inner world and become capable of deferred imitation, shared intentions, and secretiveness). Self-identity constructs autobiographical narratives, on the basis of lived interactions, according to previous or future experiences (in addition to the phantasmal world, there is the dialogic relation with the narrative’s addressee).

18 This reinvigorated theoretical framework allows for the development of specifically human knowledge that is compatible with the natural and cognitive sciences. Unlike the neopositivist approach via functions, which fragments psychotherapeutic theories and practices (compartmentalizing the suffering that is experienced), this framework anchors all clinical research in the ground of human experience, and makes the pathological a privileged source of knowledge. Within it, clinical facts are inseparable from their cultural and social foundations, which the phrase “all other things remaining equal” cannot gloss over: if suffering exists in every human society, it manifests itself in various forms, and the therapeutic means of dealing with it differ as well, as indicated by the emergence of new disorders. [38] The effective coordination between the numerous clinical approaches (concerning neurobiology, the drives, language, cognition, behavior, social relations, or a sociocultural approach) makes it possible to get beyond some excessively rigid binary oppositions (body/mind, neural/psychic, inside/outside, individual/system, conscious/unconscious, etc.), by means of the epistemological confrontation that distinguishes the different dimensions without separating them, so as not to distort the phenomena under consideration.

19 (b) Clinical anthropology also helps the clinician analyze their patients better, through an improved understanding of the connections between the somatic, the psychic, the social and the cultural within the suffering individual. As studies on sociogenic illnesses have emphasized, [39] the patient’s expression of their condition, via improvisation, adheres to the available patterns in their culture. Clinical anthropology handles these variations: by way of the drive vectors, it links the cultural (symbolic) dimension, in all its variety, to the pathological manifestations captured within a structure that incorporates the four fundamental clinical forms. In so doing, it claims to resolve the diagnostic problem: instead of creating an endless set of nosographic criteria or seeking a structure’s unity, it favors an open system that allows for finding one’s bearings precisely and dynamically on the basis of a limited number of social issues. It thus remains indexed to the contemporary clinical realities that emerged from the recent transformations of Western (or other) societies, such as the current pathologies associated with autonomy (narcissism, fear of abandonment, weariness at having to be oneself). [40]

20 (c) Finally, clinical anthropology is particularly suited for grasping the nature and the modes of psychic interiority within human behavior, whose public and private faces are distinct but inseparable. The collective dimension of symbolic forms, which inextricably interweaves the bestowal of meaning and sociality, shows through in the intrication of drives and fantasies. Sexual myths in children are revisited in the light of a new theory of narration: the myth – at first a conglomeration of sensations, words and stimulations associated with keywords – is then structured by the production of fictions, with the help of the imagination and the constitution of the self in the mirror. [41] Psychic interiority is conceived semiotically and dialectically, at the intersection of myth and language, but on the individual level: the assimilation of external operations by transforming them (the “inner voice”) gradually endows words with inner meaning. In this sense, the magico-sexual myth functions for the child as a particular symbolic form that they believe to be valid for everyone else as well (family myths are generic forms).

Conclusion

21 This journey through psychology, sociology and anthropology has highlighted a gnawing concern in the social sciences regarding the clinic, one that is not so much a matter of a logic of specialization as an original inflection of knowledge. However, this gives rise to a few philosophical quandaries. First, epistemology hesitates between metaphysics and gnoseology. While the clinical orientation seems to privilege the study of the individual as an ontological whole, the object’s uniqueness in the world actually seems to be less important than the method that singularizes knowledge, the concern for distinguishing an entity in its originality, in contrast with all others (exclusive comparison). In so doing, the approach also claims, without contradiction, to apply to groups, as in clinical social psychology. Where will the clinic of the social, driven as it is to make inferences, go next in the realm of theoretical abstraction, and to what end? Does the rise in genericity claim to attain the universal, or merely the general (which allows for exceptions)? And does the result consist of principles or rules? Is it implicit or formulated, definitive or provisional? Finally, what exactly is the connection with the critique of a form of knowledge that often considers itself the prolegomenon to a desire to take action, a kind of scruple about the hope for social transformation? Insofar as contact with the singular regulates the relationship to theory, which becomes a means in the service of a more detailed description and explanation of a situation, does this mean that clinical knowledge is the promise of “bottom-up” action research, no longer decided from a domineering position, as with Le Play’s positivist-inspired social engineering?