Informed Consent -- Boundaries of the Body/Mind and State

By Diane Hull
Volume 11, Number 1 (Fall 2000)
Issue theme: "America's porous borders"

O hear my song thou God of all the nations,

A song of peace for their land and for mine.

This is my home, the country where my heart is;

Here are my hopes my dreams, my holy shrine.

- Finlandia

Attachment to the land of one's birth is everywhere present - a virtually universal response based on biology and natural law. Human beings need a place of their own for nurture and safety, so border security, in more than the literal sense, has profound psychological meaning for everyone.

When Mexican President-elect Vicente Fox said he looked forward to open borders with the United States, even our most Mexico-friendly politicians did not sound enthused, and we can question whether the Mexican people themselves are really so anxious to erase the boundaries between us. That boundary is too permeable now for a feeling of security, yet somehow we cling to the illusion of containment. Jorge Castenada, one of Mexico's most talented writers, describes the "‘ferocious differences between our two countries" - differences so profound, he says, "that they reach into the deeper realms of the soul, history and society."(1)

Americans have reason to wonder who among our own leaders are pondering the future of America's soul, or making much of the fact that we have a soul of our own - and a history, a vision and a national "personality" worth carrying forward. Advocates of the multicultural state may deny that an American "spirit" exists, but outsiders, beginning with "the age of discovery," have always attributed much that is uniquely magical and mystical to us.

The name "America" first appeared on a world atlas in 1507, at a time when maps were elaborately illustrated - embellished with pictures of ships, waterways and imaginary creatures, revealing the human emotions stirred up by geography. In the 18th century, Giovanni Tiepolo's paintings portrayed America as a beautiful, half-nude woman, surrounded by ravishing girls in feathered headdress - all crossing a river riding on crocodiles.(2)

Nations are credited with nurturing attributes, a projection of the wish to be held in the bosom of the "motherland." Geography is replete with images of craggy coasts, bridges, waterways and secret islands in the ocean - all symbolic of the human voyage. In this way "place" was revealed as entwined with the psyche, which in turn guides the relationship between man and his environment.(3) From Machu Pichu to Plymouth Rock, every group tries to preserve memories of its history and sacred sites, whose meaning is tied to that sense of belonging - being part of and encompassed by a special terrain, architecture, tradition and national essence. Without boundaries and gates, it can all leak away in the back and forth flow of a borderless place.

The United States, the country of our attachments, IS slipping way - obliterated, not by generational change, but by a change in the origins of the replacement population. Gone now are many reference points that anchor Americans to their past. Disappearing landmarks are the likely reason that tiresome abstraction called the "American Dream" is evoked continually, claiming that it represents some universal wish to be part of an imagined America.

While people in other places may yearn for an experience they never had, Americans are really the ones who are doing the dreaming - clinging to dreams of a past life they actually knew and whose loss they are grieving and where their attachments to people and place were born. Mass immigration brings a new line of succession - people succored in a different national "bosom," who experienced a different past. Recent arrivals now "mark" our communities to announce a shift in the locus of control. That is the message of graffiti, foreign language signage, assaults on our ears - all a loss of defensible space - a boundary defeat that is followed by the out-migration of Americans in search of a place to feel comfortable; 300,000 people left California last year.

As American surroundings are being erased and fewer reference points remain, we experience a process of "denationalization." This encourages even assimilated minorities to opt for separatism, as the seemingly opposite pulls of globalism and separatism work in tandem against national unity. It's no wonder we suffer from indistinct focus and seem unsure of our right to a country of our own.

Psychohistorian Henry Ebel (4) wrote that before borders are stable, in the legal sense, they must be a real in the minds of the people they divide. Once established mentally, borders become part of personal identity, like other aspects of place. So what happens psychologically when the reality of that border is threatened?

Psychogeographers suggest that response depends on the average body boundary integrity of the people at risk and national differences are striking. (5) For example, anxiety about the body being too open and exposed is compensated for in the Arab world by covering part of the faces of women and most of the extremities. Flowing garb that disguises the figure underneath is one response to hot climates, whereas elsewhere loin cloths suffice.

Feelings about our bodies - whether their boundaries are secure or vulnerable, are projected onto the outside world, and conditions in the outside world are internalized. We need borders politically because we need them psychologically. Consciousness of our bodies is the "ground" of our being and normal people experience themselves as physically intact. Yet multi-cultural propaganda tries to dampen uneasiness about boundary losses - feelings that have roused us in the past to act protectively.

We need secured external boundaries in the same way we require a stable interior environment so physiological systems can function. Indeed our bodies are the very model of nuanced border regulation, with guardians at the gate of every critical system, regulating the permeability of cells, oxygen exchange, the skin and the valves of the heart.

Our body systems are alert to any trespass and replete with mechanisms for regulation and containment. The immune response, individuation and even sanity are all based upon recognizing the difference between what pioneer immunologist Sir Macfarlane Burnet called the "self" and "non-self."

Humans, like all creatures, fine tune their adaptive capacities to survive in a variety of natural environments from friendly to formidable. The unique characteristics of "place" influences every group's physiological and cultural shaping and each group in turn shapes their environment.

There is a similar reciprocal relationship between geographical place and the body/mind. Psychogeographers study the complex emotional ties between people and their surroundings and interpret their affective attachment to their group's boundaries as coming from the need for an anchor in the universe.

Yet Americans have fewer territorial rights than endangered butterflies to protect their habitat from encroachment, and no legal tools to resist being pushed out of environments to which they have adapted after generations have gone into their shaping. Now globalist thought has reversed the hierarchy of territorial rights. Freedom of movement for those outside of developed societies now override the ownership interest of citizens in western nations - a point of view that has not been seriously challenged as yet.

Acceptance of this idea does not come naturally, so it's difficult to analyze how this happened without more resistance since it cuts against the grain and defies our earliest training. The importance of sturdy outer walls is affirmed by all the classic tales we read in childhood, like the wolf who breaks into an unsecured dwelling. When he huffs and puffs mightily, he can blow the house down and the next generation receives instruction about the need for walls that are sturdy.


While the government is negligent in protecting the national borders, they are diligent now in protecting the body. We can hope that the linkages will dawn on them soon. Between 1974 and 1983, various U.S. commissions refined the legal prohibitions concerned with the violation of personal boundaries of body or mind in medicine and research. The new ethical imperatives required full disclosure of risk to patients and the need for consent before penetration of the body by surgery or drugs. There are 17 U.S. government reports and appendix volumes that analyze informed consent into its components parts.

We can only recommend that the body politic be protected in the same way a patient would be from the surgeon who performs an operation without following disclosure rules. If our national borders were protected like our bodies, the government would have to explain, in detail, all the risks and possible negative outcomes to opening up the nation and we could refuse unacceptable boundary violations that we thought were too dangerous or not in our interest.

In the language of one court decision in a landmark informed consent case, "the patient's right of self-decision shapes the boundaries of the duty to reveal." (6) What better directive could there be to a government presiding over a people who consent to be governed?

There is a continuum of border issues that flows logically from the skin to the dwelling and then to the community and the nation. We are psychologically involved at all of these levels but have concrete ownership interests that diminish abruptly when we get past the door of our dwelling and the grounds of our property.

The house is a "castle" in theory, but government can tax and can dictate its uses and in what manner it can be replaced and repaired. But the dwelling is still the outermost boundary acknowledged as appropriate for individual or group ownership, and the last outpost that government will defend as a private domain.

The house is less private than the body, but contiguous with "place" which is part of the community and nation - all incorporated into the mind like the dimensions and condition of the body. Thus we have as big a stake in maintaining the integrity of the "places" we are connected to, as we do in assuring the security of our person.

Sociologist Winifred Gallager (7) wrote that we would be far better off if we approached larger increments of territory as we do our own homes. She was certainly aware that crossing the threshold of home does not sever emotional ties to one's surroundings.

There is a "sanctity" of place because it is the cradle of all non-inherited personal and cultural traits. There the members of a group maintain an ongoing cognitive and motivational togetherness that was first described by Anthony A.C. Wallace as mazeway equivalence. That means a shared cognitive content that has to do with self-evaluation, language and morality. Yet all of this community connectedness is put at risk by the rapidly changing composition of local communities.

Since over long periods of time characteristics of the environment can influence the gene pool, there should be no doubt of its power to fashion deeply entrenched group traits that can be maladaptive or destructive in other surroundings.

Mass immigration creates significant intrusions into established communities, putting both immigrants and established populations at great risk for cultural conflict and social upheaval.

This is done absent any consent from the governed who believe that America is a national entity with a character that emerged from its geography, its history and its people.

When government cooperates with border penetration, it brings the nation to a melting at the edges - a weakening that spreads into the heartland. Could there be reasons other than the obvious economic and political ones that are driving the wish to change our shape while shedding the national "skin"?

In his book Body Consciousness, Professor Seymour Fisher identifies risk taking individuals, like LSD users, that are strangely attracted to the loss of their personal boundaries. A more pervasive socio-pathology might induce a nation to wish for its own dilution and final disappearance through merger with the rest of the world.

Adolescents also find boundary-dissolution tempting and so do psychotics who have lost a sense of who and where they are. But most people, Professor Fisher maintains "battle day and night to keep the borders of the mind and body intact and struggle to maintain control over their separate chunk of the world's space." To them personal boundaries are coextensive with the geopolitical boundaries of their group, so "place" demands protection. It is as sacred a vessel for life and well being as the mind and the body.

Cultural historian Jacques Barzun calls our culture "plagued by doubts," despite our many triumphs. Not surprising when we are encouraged, indeed coerced, by the majority of religious and secular authority figures to suppress our intuitive knowledge and deny our fundamental attachments.


1. From Jorge Castenada's article about Mexico in The Atlantic Monthly, November 1995.

2. From Stein, Howard E., and Neiderland, William G. (Eds), Maps From the Mind: Readings in Psychogeography, University of Oklahoma Press, Norman, Oklahoma, 1989.

3. American Psychoanalyst William G. Niederland first proposed the term "Psychogeography" in 1978 as a way to explain the associations people have to the shape of the natural world. He went on to publish hundreds of monographs on this subject.

4. From Chapters 9 and 10 by Henry Ebel, in Stein and Neiderland's Maps of the Mind.

5. From the work of S. Fisher and S.E. Cleveland in Body Image and Personality, Dover Press, New York, 1968. Although little systematic research has been done on this subject, there is some evidence that national differences in feelings about body boundary security do exist.

6. Canterbury v. Spence, 464 F2d at 780,1972.

7. Gallagher, Winifred, The Power of Place, HarperCollins Publishers, New York, 1994.