PROFESSIONAL
FEELINGS
AS EMOTIONAL
LABOUR
NIZA YANAY
GOLAN SHAHAR
From Journal of Contemporary Ethnography, vol. 27, no.
3, (October 1998) ps. 346-347.
Abstract
Emotional labour is what workers do with their
feelings to comply with organizational role requirements. This article explores the concept in
Professional organisations, examining the psychotherapeutic discourse of
objectivity, neutrality, and care as feeling rules. Based on a study in a residential psychiatric
facility in Israel, the authors found that counselors laboured to display
aspired professional feelings despite the absence of memos, protocols, or
training sessions. Who told them to do
so? How did they know what to feel? The authors claim that therapeutic discourse
constitutes professional feelings through the use of specific concepts and
techniques. However, the term professional feelings disguises a
complicated process of negotiation between different ideologies. The difference between two groups of
counselors indicates that both scientific and intersubjective knowledge
represent modes of emotional control.
The authors claim, thus, that emotional labour in professional service
organisations is the product of contested professional discourse.
Introduction
"YOU'RE
A FAT WHORE:" Ruth, a resident in a shelter for the rehabilitation of
chronic mental patients, stated, bursting with laughter. Ann (all names have been changed), a
third-year psychology student who worked there stood looking bewildered but
calm and restrained. Later, she would
tell us, "I was burning with anger.
All I wanted to do was to hit Ruth.
You know I have a problem with my weight" Yet, she turned very
quietly to Ruth and asked her to leave.
"I couldn't let her see my anger," she explained. Ann rationalised her calm reaction:
"I had to remind myself that Ruth is
schizophrenic, that she cannot always control what she says. Do you remember Dr. Berger's analysis in one
of our group sessions? He said that
Ruth's curses are introjects of shame toward her own body and sexuality, and
that defences of psychotic patients are often very weak. Recalling his words, I could remove myself
from the situation. I even felt
pity."
Ann
was telling us about her emotional work as labour. She transmutes a negative feeling, such as
anger, into pity through a process of "deep acting" (Hochschild 1983)[1] by raising what she saw as professional claims of
reason. Why did Ann choose to control
her anger? Who told her to do so? How did she know what to feel? We shall argue that Ann's emotional conduct
was controlled by her professional inclination and by her anticipation of
becoming a therapist.[2] Moreover, we shall claim that emotional work in
professional service organisations, such as the shelter at which Ann works, is
managed and operated by professional (in this case, psychotherapeutic)
discourse. In our analysis of this
discourse, we suggest that some workers submit to the authoritative norm of
emotional control, while others produce counter narratives to the dominant standpoint
of objectivity and neutrality. In other
words, we aim to reveal the struggles and ideologies that structure the
emotional management of professional workers.
Emotional
labour (Hochschild 1983) is a practice often engaged in by people in the domain
of work. When feelings are underplayed,
overplayed, neutralised, or changed according to specific organizational feeling rules[3] and in order to advance organizational goals, workers
perform emotional labour. Thus, the
concept of emotional labour refers to what workers do with their feelings in
compliance with organizational role requirements. At Delta Airlines, specific feeling rules
(Hochschild 1977) were directly connected to work standards. Anger, aggression, and resentment, even
toward annoying passengers, were prohibited by strict rules and controlled by
the selection of employees, training, and supervision. Workers went through periodic sessions to
learn how to change private anger into public empathy, kindness, and
smiling. Hochschild views such
manipulation of feelings, aimed at giving the company a competitive edge, as a
form of exploitation contributing to worker alienation and loss of emotional
authenticity in the sense that the company, rather than the worker, provides
the "right" interpretations to incidents and events during work. Managerial rather than private
interpretations construct or constitute workers' feelings. Service workers such as flight attendants,
tax collectors, or cashiers who use empathy, kindness, and smiling to encourage
customer commitment and loyalty to the company lose touch with their private
feelings, unless they resist the company's "natural" right to
"possess" their emotions.
In a
similar vein, Kunda's (1992) ethnography in a high-tech corporation opens a window
to the design, development, and maintenance of a high-tech "emotional
culture" engineered to achieve the "right mind-set" and the
"appropriate gut reactions" (p. 93).
In detailed descriptions, Kunda demonstrates how internalised commitment
is constructed and how thoughts and feelings are enlisted to serve the
company's interests. Specific rules (do
what is "right" in each situation) and rituals (presentations,
messages, manuals, and speeches) constitute not only the definitions of
membership, but also of the employee's self - "that ineffable source of
subjective experience" (p. 11).
Corporate culture, Van Maanen and Kunda (1989) argue, claims our hearts
and souls as well as our minds and bodies.
Emotional
work in organisations such as Delta (Hochschild 1983), the high-tech
corporation (Kunda 1992), Mary Kay (Ash 1984), and Disneyland (Van Maanen and
Kunda 1989) produce feelings of warmth, affection, enthusiasm, and
commitment. These emotions are
programmed by managers and practised by employees in order to achieve
organizational objectives. Workers who
successfully internalise their membership roles, conform to the company's
meaning of good work, invest themselves in corporate culture, and use their
personalities as a vocation (Hunter 1993) are rewarded with money and status.
What
happens, then, in professional service organisations that are oriented toward
social and human welfare, such as hospitals, psychiatric institutions,
correctional agencies, social agencies, or nursing homes? These helping organisations are dominated by
professional associations that "serve as the ultimate authorities on those
personal, social, economic, cultural and political affairs which their body of
knowledge and skill address" (Freidson 1994, 33; see also Abbott 1988). Freidson (1994) argues that, in professional
service organisations, knowledge is dominated by professional jurisdiction that
monopolises the definition of work; unlike industrial organisations,
professional service organisations 'remove or withhold from the hands of
management authority to create and direct the substance, the performance and
even the goals of the work itself' (p. 62).
In Bourdieu and Wacquant's (1992) terms, individual performers in these
organisations (the practitioners) are the agents of a specific field of
knowledge. Therapists, for example,
represent in their practice the dispositions of the field of psychotherapeutic
discourse.
Studies
of medical and psychiatric institutions (Abbott 1988; Freidson 1988; Smith
1992; Smith and Kleinman 1989) show that, like Hochschild's flight attendants,
employees in the helping professions manage their feelings as part of the work
requirements. Confronted on a daily
basis with strong emotions of pain, suffering, aggression, bewilderment, and
neediness, professionals (doctors, nurses, social workers, psychiatrists,
psychologists) control emotions of anger, anxiety, and dislike and express
empathy, calmness, optimism, and kindness.
Are they following specific feeling rules? Do they subjugate themselves to those rules,
or do they negotiate with them? How does
such a struggle affect their professional selves? Can we conceive their emotion management as
labour? Do they use their emotions as
service? In other words, do
professionals, such as therapists, use professional feelings as their own?
To
answer these questions, we studied the processes through which psychology
students managed their emotions in a psychiatric facility in Israel. We focused on the ways in which students
dealt with their own emotionality in relation to the professional ideology of
emotional self-control. Many studies
take for granted that professionals, and therapists in particular, "manage
their feelings toward clients" (Hardesty 1987, 247; see also Meissner
1996). Such studies, however, rarely
specify how these processes of self-control are achieved. What are the struggles and conflicts involved
in these processes? How do people with
power over the emotions of others (Thoits 1996) use tacit methods to gain
control over themselves? Notwithstanding
the importance of calmness, courtesy, and empathy, we believe that emotion
management as an issue of professional identity deserves further distinction in
order to demystify the processes by which therapists reclaim emotional control. A need to critically examine the power and
limits of the professional discourse of emotional control motivated this study
at the shelter for psychiatric residents.
THE SHELTER
The
shelter is a residential psychiatric facility in Israel. Its three-story building is surrounded by a
small stone yard opening onto the gardens of the county mental hospital on one
side and a large parking lot on the other.
There is nothing particularly pleasing about the building or its locale,
but the atmosphere inside holds the promise that new and innovative programs
often have. The shelter is affiliated
with the county mental hospital but is a financially autonomous unit supported
by the Department of Health.
In
the course of one year (thirty hours each week), we conducted a study, based on
participant observation and in-depth interviews, exploring patterns of
emotional interaction between counselors and residents. Particularly, we were interested in the
reactions and emotional expressions of the counselors. These were third-year students of psychology
who volunteered to work with the residents as rehabilitation role models or, in
the jargon of the institution, as social
guides. At the time of our
fieldwork, the shelter housed about twenty psychiatric residents, one senior
psychologist, two social workers, five nurses, a service manager, a secretary,
and sixteen students of psychology employed as counselors. Turnover among the counselors was high. Therefore, we decided to interview only
twelve students who had worked in the shelter for at least six months.
We
focused our study on this group because the counselors were the largest group
of employees, they carried the burden of service and care, and they were
responsible for overseeing the residents' daily routines. Most important, the decision to concentrate
on their emotional work was based on the contention that psychology students,
who are highly motivated to become therapists but are still novices, experience
the emotional demands of their profession more intensely and consciously. At the early stages of socialisation,
processes of emotion management are more salient and transparent, whereas
expert therapists often manage their emotions automatically, to the extent that
emotional labour becomes "natural" and is forgotten and the
boundaries between private and professional feelings blur.
The
rehabilitation program at the shelter relied on a milieu therapeutic structure
aimed specifically at the "normalisation' of the residents. The overall goal for each participant was
maximum socialisation with minimal medication.
The program espoused functional independence limited only by the
residents' ability to respond appropriately.
The rehabilitation program strove to reintegrate participants into the
community, despite their symptoms, by teaching them social skills and self
care. They were expected to clean their
rooms and various public areas in and around the shelter, get their own food
from the kitchen, wash their laundry, and perform minor repairs. In addition, the residents worked a few hours
in the community and were paid by the hour.
They participated in various learning and recreational activities, such
as news analysis, money management, hygiene, cosmetics, sports, creative
writing, and other expressive activities in order to enhance their
interpersonal skills.
These
activities were guided, mediated, and supervised by the counselors (the
psychology students), who conveyed a youthful spirit and earnestness. According to their job description, the counselors
were to accompany residents to their workplaces, teach them interpersonal and
social skills by taking them on trips to the local mall, run workshops,
supervise the residents' personal hygiene and eating habits, and mediate
between residents and other professional workers at the shelter. Unofficially and against explicit policy,
some students initiated therapeutic - or what they believed to be therapeutic -
interactions.
ORGANIZATIONAL
RULES
AND SUPERVISION
The
students in the shelter were employed primarily as social guides and not as
therapists. Nonetheless, they worked
with mental patients, and often, the students took this opportunity to
"play the therapist." For them, it was an opportunity to "be
close to the profession," to "get experience," and to "get
credit" for their future training.
Obviously, during their work as social guides, they encountered strong
emotional upheavals of anger, love, fear, guilt, empathy, or helplessness, as they
were working for the first time in a mental institution and with mental
patients. Strong emotions and awareness
of emotional reactions characterised their work. Yet, never during our study did the students
participate in training sessions or workshops organised to discuss and exercise
feeling-management practices.
Similarly,
we could not find any written memos or protocols that laid out rules of
emotional display and expression.
Students frequently compared performance and emotions among themselves
to help each other and to socially validate their own feelings, but they were
not guided in how to suppress outbursts or how to show empathy. From time to time, they received short
notices from the management reminding them to attend staff meetings and to be
prompt. However, during these meetings,
only brief reports on specific residents were discussed, and some procedural
business was carried out.
While
the reception of a new resident was carefully planned in detail, both in
written protocols and in practice (for three weeks the new participant was closely
accompanied to teach him or her the habits, behaviors, schedules, and
expectations of the place), new counselors were superficially briefed about
routines and tasks. Nowhere in the
shelter could we find a complete or even partial description of what counselors
ought to do and how they should act or feel.
These
observations correspond with Smith and Kleinman's (1989) conclusions that
stressful emotions related to the treatment of the human body, which are held
by medical students, were never recognised institutionally or acknowledged
openly among the students. There were no
managerial rules or pressures to control strong emotions. Nonetheless, medical students laboured individually
to manage affective neutrality by using various strategies of control.
In
light of the heavy emotional demands in the shelter, on one hand, and the lack
of organizational rules, on the other, we were not surprised to find the
students complaining about the lack of definitions regarding the
"right" emotional display during work. Jacob, one of the counselors, recalled, 'When
I came to the shelter, no one told me what I should be, they just told me to
be. Even our name was problematic. Who are we?
Therapists? Therapeutic
guides?" Lilly, another counsellor, added,
"At first I was very confused, I didn't know what
to do in various situations. With time,
I stopped being troubled by my display of feelings. I learned that. But inside me, I didn't. I don't know if over-identification or anger
are feelings which people in such roles usually experience. When you have no one to consult, you just do
your best."
Lilly,
like Jacob and most other students, believed that the therapeutic interaction
dictates a specific emotional state and a display of emotions that are endemic
to the therapeutic role. She believed in
a "professional way of feeling." This belief partly explained the
distress and confusion some students expressed as a result of receiving no
training or instructions about "the proper way to feel," 'how to
control emotions," "what to do with anger, disgust and love,' or
"how to show empathy even when you don't feel it."
At
early stages of professional socialisation, the need to control uncertainties
(Light 1980) generates a need for regulation.
In Lilly's words,
"Each of us saw things from his or her point of
view. We are not professionals, and we
did not relate to each other as such.
So, I had my opinion, someone else had his, and no one had the
truth. If only there were someone
professional, from above, with more experience ... things would have been
different. Consultation with someone
professional would have helped."
Lilly was upset about having to rely on intuition
alone:
"I felt rage, and then doubts as to whether I had
chosen the right occupation. Do I fit
in? Why do I need all this? What have I done? At first, I used to tell myself: "OK, I
am not going to be overly sensitive." I wouldn't let things shake me. Then I became angry about not having someone
to consult. When I understood that
things are not going to change for the better, I felt helpless. Work became meaningless."
Like
others, she felt that professional feedback in the form of supervision would
have given her access to the truth - to a unified knowledge without which work
was meaningless. Lilly's anxiety changed
to anger because she was not receiving what she hoped to get out of her work at
the shelter: 'real" knowledge. This
did not mean school material and theories, which Lilly could read in books; for
her, as for others, it meant objectivity gained by training and mastery of her
feelings.[4]' Lilly's anger is understood if we recognise her
motivation: it reflects her need to be trained as a therapist in a place that
defined her role as a social guide.
Emotional
labour requires training and practice.
The students in the shelter believed that supervision would unlock the
secrets of the profession and cause the practice of professional feelings to
become habitual. These ideas were rooted
in their vague knowledge of the discipline and were based on what they had
learned, heard, and imagined. After
three years of studying psychology, they hoped for "real" training in
the form of supervision, and they were extremely disappointed and annoyed by
its absence.
Although
an essential goal of supervision is to secure and monitor clients' care, one of
the consequences of supervision is that trainees are socialised into a
profession and develop a sense of professional identity (Bernard and Goodyear
1992, 7). The role of the supervisor is
to "help the supervises to examine aspects of his or her behavior,
thoughts and feelings that are stimulated by a client, particularly when these may act as barriers to the work
with the client" (p. 5). In other words, supervision creates a
competent practitioner who learns to react to clients in line with the rules
and methods known to the field. To put
it more strongly, supervision is the place where discourse is realised as
practice and where professional authority is exercised. Experts who represent the logic of
therapeutic discourse initiate beginners into the field not only by shaping
their knowledge, skills, and attitudes, but also by reconstructing their
emotions. This perspective of emotional
"taming" is hardly discussed in the literature; nor was it recognised
by the students as problematic. They
wanted answers to troubling questions: what to feel - what is right and what is
wrong, what to show during work with patients, and how to build the right
emotions. For them, supervision was the
ideal solution to unsettling feelings.
In fact, it was the only answer they could conceive of to solve the
problem of uncertainty and confusion.
PROFESSIONAL
SELF-CONTROL
OF EMOTIONS
Doing
one's best, as Lilly put it, signifies a rhetoric of control. Students of psychology adopt a rhetoric of
emotional control early in their schooling.
They understand that members of the therapeutic profession are not
people with 'regular' feelings. They are
professionals, and as such they ought to display professional feelings. Too much affection or too much anger, the
counselors claimed, is inappropriate. Control was a key word among them.
This
in itself is not unusual. Various groups
talk about control as a way to assert and exercise power (Lutz and Abu-Lughod
1990). However, therapists, we claim,
identify the concept of control with professional identity. The director of the shelter, Dr. Berger,
believed that the good clinician is a professional. His typical advice to students was to treat
residents from "a professional rather than a personal point of view."
The distinction between the personal and the professional represent the essence
of the therapeutic role. The personal,
he claimed, is to experience raw feelings, whereas the professional way is to
perceive the resident's provocative behavior (e.g., cursing) as representing
his or her psychopathology:
"If you cannot see a resident through the eyes of
the clinician, you cannot help him, because then your reaction resembles the
reaction of a non-professional who responds with raw feelings. Raw feelings impair professional
intervention. Raw feelings are the most
dangerous enemy to the good clinician.
They keep him or her from using all the knowledge, training and skill
which we received."
This
belief was shared by the students in the shelter, who often voiced the logic
that anger, hate, or disgust belong to the realm of the private, or the wild,
and are therefore illegitimate emotions.
This distinction between professional knowledge and "raw
feelings" suggests adoption of the standard medical model (Smith and
Kleinman 1989). The view that raw
feelings are against the rules of good therapy derives from the wide consensus
to keep the therapist's feelings under control or outside of the room by
objectifying techniques that draw the line between the clinician and the
non-professional. The definition of
professionalism as the skill to react emotionally to patients through
recognition of their pathology, or in a particular way (Greenberg 1996), rather
than with spontaneity, suggests that emotional labour is a necessary part of
the work that therapists do.
Notwithstanding
this distinction between the professional and the personal, Dr. Berger seemed
to be unaware of the students' need to learn the process by which affective
neutrality (Smith and Kleinman 1989) is acquired. In fact, he insisted on not teaching them,
because the good clinician, he believed, internalises the codes and secrets of
emotional control through experience. In
Dr. Berger's view, emotional competence is gained through a long process of
learning and practice, and emotional knowledge is part of becoming a
professional. It was therefore his
belief that each practitioner would eventually find his or her own techniques
for controlling personal feelings:
"Experience helps to internalise a sense of
competence and emotional security which derives from knowledge and
practice. Professional therapists learn,
with experience, to cope with their own anxiety. They can anticipate patient's reactions and
therefore are usually not surprised or frightened. The students are still young in a
professional sense; they are not yet secure in their reactions or their
competence to do what is necessary."
Some
of the counselors, particularly those who strongly envisioned psychotherapy as
their future career, did attempt to control their emotions in what they viewed
as a professional manner. Jacob
explained, "It is, in my view, illegitimate to feel anger or hatred. Residents are like foreigners in our
world. It's hard on them, their dynamic
processes are less controlled, their behavior is less intentional, they are
less rational." When he felt angry he occasionally talked to himself about
"what is right and what is not." He labelled his mode of thinking
"intellectualisation," but what he was doing was a version of what
Hochschild cable deep acting. By
perceiving the residents as 'ill,' 'not responsible,' or 'not logical,' he was
able to turn what he believed to be professionally illegitimate emotions into
therapeutic feeling such as empathy and, by such cognitive manipulation of th
emotions, assert his control. This point
becomes clearer when Jacob fails to perceive a particular resident as mentally
ill:
"I used to scream at Joel. I couldn't see him as a psychiatric
patient. I used to treat him as a
regular person, despite his manipulations.
I didn't inhibit my feelings toward him.
With him I gave myself all the freedom in the world to scream, to be
angry, to fight with him, because as far as I was concerned, he was reacting
like any normal person."
Jacob
turned Joel into a person like himself.
With this change of judgement, his field of emotional dispositions
changed. He was then himself a regular
person, not in the role of social guide or counselor. He could be out of control, 'natural.'
Somewhat differently phrased, but still presenting a similar theme, Ann,
another counselor, claimed,
"I can be angry at a nagging resident if I don't
believe him or her. There are some
residents who are less ill in my view.
They are more aware of the things happening to them. When they nag and I know they can control
themselves, I get very angry. But when they
are really helpless, even when they nag, I feel pain for them, I can understand
them."
Both
Jacob and Ann controlled their emotions with an inner talk about illness. The thought of how seriously ill certain
residents are constituted their emotional tendencies and mediated the
management of display.
COMMITMENT TO
THE PROFESSIONAL IDENTITY
Most
students who worked as counselors were strongly motivated to becoming
therapists and hoped that the work in the shelter would help them get into
graduate school in clinical psychology because it demonstrated their commitment
to and serious intentions regarding the field of therapy. Some volunteered in order to try out the
field. Thus, even though the shelter was
not a therapy-oriented rehabilitation center, and intervention was mostly based
on social training, for the students the work there was an opportunity to
"play therapist' and they resisted such limitations. In the words of one participant, "One
day a notice was circulated prohibiting students from therapeutic relations
with patients. That's good for the
books, but unreal for us. If I cannot
talk with a resident about his suffering, what am I doing here?"
We
can also learn about the inclination and motivation of the counselors from the
daily reports they wrote as part of their job.
The reports were written in a special notebook and used by the students
to instruct each other. There were
comments on routine and unusual events that occurred during their shifts
("Rebecca was absent the whole afternoon," "Please note that
Tova forgot her medication," "Zvi needs clean clothes") and some
references to clinical interpretations and diagnoses ("Levi feels very
tense and nervous," "Shlomo showed paranoid delusions; all morning he
isolated himself.") In addition, students regularly added personal
comments, drawings, jokes, and questions.
These personal missives reflected their moods, frustrations, and
struggles, revealing a strong need for coherence and professional
guidance. They were also a common
vehicle to mediate disagreements and conflicts.
THE
PSYCHOLOGISTS
Commitment
to professional identity was not equally strong among all the students. Some clearly anticipated becoming therapists
in the future; others were unsure.
Students who strongly identified with the therapeutic role were more
troubled by issues of emotional control and articulated more strongly the wish
to be supervised by a professional psychologist.
Noah,
who was recently accepted into a graduate program in clinical psychology, gave
us a good clue as to how students with strong professional inclinations manage
their feelings. From the moment he approached
the shelter, he said, a transformation of feelings began. As he entered the door, he was already a
different person:
"When I get to work, I immediately enter the
shoes of a very defined role. Noah at
home is not Noah at work. When I am at
work, I don't allow myself to express emotions.
I can show some empathy, but even this is not necessarily true; I act.
In addition, Noah tried ways to "universalise
[his] role as a psychologist beyond the specific place of work." By
reading literature on abnormal and developmental psychology, he came to the
conclusion that "pathological reactions are disconnected from specific
therapist-patient interaction." This conclusion helped him 'treat symptoms
in an objective way." By being "objective," which he uses
interchangeably with being rational, Noah meant that he can absorb insults and
attacks from residents, without projecting back anger or anxiety, and maintain
a "poker face," which he believed was the image of a professional
psychologist. Just like the Shetland
Islanders who watched "the visitor drop whatever expression he was
manifesting and replace it with a sociable one just before reaching the
door" (Goffman 1959, 8), Noah replaced whatever he was feeling with a
balanced and detached emotional demeanour.
Unlike the Shetlanders, however, Noah was practising not cultural
habits, but a specific professional self, or what he thought to be so.
The
commitment to professional behavior and emotions was perhaps most salient in
Jacob's rhetoric. Jacob experimented
dangerously with clinical situations, in clear defiance of accepted shelter
policy. He was also the most vocal in
his complaints of not receiving enough training, guidance, or supervision and
of not having enough talks, discussions, or workshops. He said, "in order to protect your
feelings, you must be connected to some social standard in order to have a
reference point. You must comply with a
standard and react accordingly." Not knowing what to do, Jacob sought his
"social standard" in the books. Referring to a specific case, he explained,
"I read in order to ease my feelings. I went to the library and read about
borderline cases: what does it mean, how do you reach a borderliner, what do
they feel and how do I react to that? I
wanted to understand the case objectively.
It gave me meaning in the emotional sense."
Jacob
talked continuously about his need to be rational and to control his
feelings. 'Who said you should control
your feelings?' we asked. "No one
in the shelter," he answered. "I
think it's part of the myth of what it means to be a psychologist. Part of the symbols of what therapeutic work
is in general." From the position of playing psychologist, he related the
following story:
"Al, a borderline patient, defecated in his pants. I escorted him to his room and stayed with
him while he was changing.... I was appalled by the smell, it was
disgusting. It's not easy... this case
was clearly good for both of us. I was
exposed to his most sensitive place ... his homosexuality, his penis."
Jacob
was aware of the fact that a clinical psychologist may not have accompanied AI
to his room nor stayed there while he was changing. This incident, however, gave Jacob an
opportunity to act out his fantasy, to play therapist. He continued,
"We talked about ah ... about the fact that AI
goes at night to find sexual partners in public gardens. I asked him what kind of sensation he has
when he feels the urge to go out. After
three days AI came to me with an answer.
He said he feels arousal in his anus.
OK, I said, let's buy you a bicycle.
Each time you feel the sensation, go for a ride on the bicycle ... that
was just an experiment, I didn't know exactly ... well it was pretty
clear. The meaning of it was that every
time he rides the bicycle he is having intercourse with me ... that the
bicycles are me ... that was based on the idea that the analogy between the
bicycles and me is something that will connect him to transference and me to
countertransference in the sense that I will acknowledge the sexual tension
between us ... the fact that he courts me.
This was very difficult ... very difficult ... in the emotional sense
... if I just had some training.... In supervision I could have worked on it, but
I couldn't by myself."
Jacob
told this story to demonstrate the way in which he controlled his feelings of
pity and disgust. This incident also
revealed his attitude against just "being yourself' and reacting
spontaneously to Al's embarrassing episode.
He wanted an interaction of a therapist and patient. His need for training and supervision
reflected his belief that there is essentially a right therapeutic response
that he ought to learn and follow and that his emotional responses could and
should be planned in advance, follow a certain logic, and entail specific
techniques.
Jacob's
story points out the unique nature of emotional management in the mental health
setting. Neutrality was not a sufficient
stance. Unlike medical students who
worked hard to establish emotional distance and uninvolvement (see Smith and
Kleinman 1989), Jacob aspired to transform pity and disgust into empathy and
care. Indeed, the idea of care and its
place in the psychotherapeutic discourse reverberates in Jacob's story. Therapists, as much as lay people, conceive
the capacity to care as a natural gift and a personality skill. However, the idea of care is a "thought
collective" (Douglas 1986) of psychotherapists. Moreover, the normative belief that
therapists must be empathy directed and fundamentally interested in people and
their problems implicitly influences the selection, training, and evaluation of
'the good" therapist (Light 1980).
Spurling and Dryden (1989), who interviewed several prominent
psychotherapists on the process of becoming a therapist, found that
understanding, empathy, and the drive to repair appeared as a dominant calling
in the lives of those who talked about their occupation in a distinct
"tribal' language, creating a therapeutic world like the worlds of
science, art, or music.
We
were not surprised, then, to find students like Jacob who adopted the language
of care as part of their professional self identities. Natan, another counselor, talked, for
example, about love: "it is the kind of love that you feel toward people
who you must help. It is also the kind
of love that comes with the role. The
definition of our role is that you must be empathic and caring." Natan's
sense of "must" reflects the common belief that role taking emotions
(Shott 1979), such as care and empathy, are necessary dispositions of
therapists.
Another
story demonstrates the importance that students at the shelter ascribed to
their control of anger and other "unwarranted" feelings. This story focuses on the failure of empathy,
the shame, and the deep sense of inadequacy that followed it. Dan, who saw himself as a novice in the field
of psychology, but who had great ambitions "to be good," related the
following sad incident:
"I arrived at my night shift.... We have a
patient whom, I believe, should have not been in the program. Then from 1 1 P.m. until 6 in the morning she
drove me crazy in every possible way: she started by asking for a piece of
bread, which we customarily don't give so as not to fixate such habits. I explained to her reasonably that I cannot. But she came back, not so much for the bread,
just to annoy me. So, I gave her a piece
of bread. From that moment the whole
situation began to deteriorate. Every
other minute she came back, saying: "OK, I am going to sleep, I am going
to sleep." If I could, I would have given her a slap in the face. I could hardly control myself. The situation just slipped from my
hands. Now-the anger, you just seek to
throw it on someone, because you can't be angry. I wanted to understand, but there was nothing
I could do. The problem is that she is
diagnosed as obsessive-compulsive. I
can't be angry at her. Yet, I am so
angry. At whom should I be angry? At the hospital? Myself?
I tried every possible way to deal with her. Finally, I wrote three pages of case
report. I tried to look at the case
objectively, and I let out my anger through writing.... I was swept away by the
situation.... I became part of the situation, which I know I am not supposed to
do."
Dan's
presentation of the case was not the whole story. As his written report indicated, during that
night he also yelled at the patient and threatened her, finally removing all
the tokens patients receive for good behavior from her door. As a result he felt, in his words, 'sick' and
'like an idiot.' His relief came only by 'transferring all this to writing.'
Dan knew that he was "not supposed to feel and express anger," but he
could not control himself. In Dr.
Berger's words, he was "too young in a professional sense" to know
how to do that. As a consequence, he
experienced low self-esteem and shame.
The incidents we heard from Dan and Jacob, although different
emotionally, suggest that both had a clear image of the "good
therapist," and that included emotional work in a way that was yet hidden
from them.
At
the same time that they worked to control their anger against patients, the
"psychologists" appeared to use their anger at the lack of
supervision and training to promote their professional identity. As Clark (1990) notes, emotions often
generate a micro hierarchy of status claims (p. 316). Through anger, the students claimed a place
and identity for themselves. Moreover,
they could blame Dr. Berger, the place, and the program, overlooking the fact
that some of their problems derived from playing therapist. Dr. Berger claimed that his door is always
open and that he is available to help the students whenever they feel anxious
or cannot solve an emotional problem, but few students took advantage of his
open-door policy. We suspect that the
students were not making use of this open-door policy in order to keep their
anger to themselves. Holding on to the
anger gave them a sense of power and difference.
THE GUIDES
Ora
looked on her role as counselor from a different perspective than Jacob and Dan
did. She believed that her task was
"to be as human and natural as possible." She saw clearly the tension
between these two perspectives-being professional and being human:
"Look, I relate to residents as human
beings. People, as you know, are
sometimes nice and you love them, and sometimes are irritating and you feel
like yelling at them, as I do. if our goal is to rehabilitate people, to enable
them to function outside the hospital, then they should be prepared. In the outside world people are not always
soft and tolerant. When they are
annoyed, they yell. After all, we are
human beings. It is true we are also the
guides, and this is our role, but we work with people, and when people provoke
you, you tend to react."
Ora was resistant to students who played, in her
words, the role of the "perfect therapist" and who 'supposedly knew
what a good therapist was." "What do you mean by playing
therapist?" we asked. "Playing
therapist," she explained, "means not to laugh at funny things because
it is not therapeutic or ethically correct, to be always the one who
understands, accepts, explains and never gets angry." As she got more
aroused, her anger became more blatant:
"Psychology students came with the pose of the
"psychologist'. .. then you don't hate, but you don't love either... no,
you don't show emotions. I am sure that
they had a lot of feelings inside them, they had residents that they loved and
others that they hated, but the norm of the "psychologist" would not
let them display it or talk about it. It
is a shame to touch life from the pose of the "psychologist.""
Ora's
criticism raised a distinction, common among the students in the shelter,
between those students who controlled their emotions - here, called the
psychologists-and those who freely engaged in emotional episodes of love and
anger - the guides. Her attitude reflected the lay belief
that there are two kinds of emotional ethics: professional and human. Her role as a guide, she believed, was 'to be
real.' She said: 'Our role is to be guides, not therapists. As guides, our role is to construct real-life
situations in the shelter. In real life,
you sometimes love, sometimes are angry, sometimes laugh, sometimes are sad.'
Like Ora, Avi saw himself as a guide and not as a therapist. To sit with residents in their rooms, drink,
laugh, and take walks with them was, he believed, part of being human. In his interview, he defined the borders
between himself and the residents as illusory.
'Only one step separates me from the residents,' he said. 'I can hide my paranoid thoughts, while they
cannot.' To our question about displaying emotions, Avi answered,
"I show them everything. I don't get out of control, but I tell them
what I feel whether it's good or bad. I
do that intentionally, in order not to represent a role model which is either
always good and affectionate, or bad and tough.
They should see me as a real person who sometimes gets angry and
sometimes smiles."
Other
students fell somewhere between Jacob the therapist and Ora the guide. Natan, for example, admitted to being an
emotional person with extreme motivation to help and express love:
Interviewer: Don't you feel like shouting at residents
sometimes?
Natan: Yes, sometimes.
Interviewer: Do you?
Natan: Yes, if it is constructive. If I believe that it might be therapeutic.
Interviewer: Don't you yell at residents without
therapeutic intentions, just because you feel like it?
Natan: No. I control myself.
Interviewer: Is it forbidden to yell?
Natan: No, I don't think so.
Interviewer: Is it allowed or forbidden?
Natan: Allowed.
Interviewer: Even if it's not a therapeutic act?
Natan: Even so.
After all you are a person, and if someone torments you, you are
permitted to yell.
Interviewer: Then why aren't you yelling?
Natan: It's a personal hang-up. But I also believe that the role obligates
you to be in emotional control and to avoid strong emotional reactions which
are not constructive from a therapeutic point of view.
In
his position, Natan was aware of the schism between the personal and the
professional. He was also aware of the
gap between his attitude (yelling is permitted) and his behavior (yelling is
only allowed if therapeutic). Natan
perceived himself as a guide but practised emotional control as a therapist,
perhaps because he had not yet internalised a clear identity role. It is clear that his spontaneity was modified
by what he saw as the therapeutic point of view. Natan's reaction is a good example of the
tension between spontaneity and institutional (or discursive) control of
feelings (Gordon 1990, 168). By
believing in spontaneity, he made a claim to the place he desires (Clark
1990). His behavior, however, marked him
as a psychologist.
THE ECONOMY OF
PROFESSIONAL FEELINGS
Students
who clearly saw their work in the shelter as part of their professional
socialisation and took it as an opportunity to participate in the 'tribal
act" of therapy (Light 1980) spoke of emotional self-control as an
obligation. They incorporated the
personal ("being real") and the professional ("being a
therapist') into a single moral identity role (Sarbin 1995), overcoming the
tension and inconsistency between these two identities by their strong
motivation to be professionals. The
guides, on the other hand, adopted the personal. They laughed when something was funny and got
angry when insulted or maddened.
Although the psychologists did not confront this attitude with direct
animosity or open conflict, in private talks among themselves they often
criticised the tendency of the guides to disregard professional emotional
boundaries. The psychologists created,
through various social and rhetorical activities, an aura of importance and
exclusivity. They often talked about
their uniqueness as a group, in both the shelter and the university. Clearly, the psychologists perceived
themselves as more adept, serious, and responsible than the guides were.
Surprisingly,
they were also treated in this light by the administration, even though they
were the ones who challenged the policy not to play therapist. When an administrative decision was made one
day to divide the residents and staff members into three groups, each located
in a different area of the building, Dr. Berger chose those students who we
considered the leading figures among the psychologists to serve as group
supervisors of the counselors. In this
way, the administration gave tacit support, legitimacy, and power to the
psychologists and their attitude. This
incident illustrates the vulnerability of groups outside the dominant discourse
(i.e., the guides). At the same time, it
also suggests that the counter narrative of emotional self-disclosure and
interpersonal meanings poses a threat to the professional order.
The
distinction between the psychologists and the guides reflects two possible
competing approaches of emotional work in organizational environments:
scientific management and work feelings (Putnam and Mumby 1993). Putnam and Mumby use scientific management to refer to the scientific language of objectivity,
rationality, detachment, and control that workers use to talk about emotional
interactions at work. Work feelings, in contrast, allude to
emergent feelings through the negotiation of interpersonal meanings.
"Work feelings are those emotions that emerge
from human interaction rather than being imposed by instrumental goals and
bureaucratic rationality .... That is, work feelings aid in negotiating
meanings about roles and relationships rather than in conforming to
predetermined display rules or to prescribed norms." (pp. 49-50)
Although the
students who took on the role of guides could not negotiate meanings on an
equal basis with the residents, as Putnam and Mumby's (1993) concept of work
feelings would require, they nonetheless used personal life experiences and
real-life responses as their criteria for regulating emotional display, showing
anger or annoyance when the situation warranted. In contrast, the students who identified
themselves with psychologists relied on their knowledge from classes, books,
and discussions with professional therapists.
Their motivation to mask, distance, or change feelings of anger and
aggression reflected their occupational aspirations and their professional
anticipation. They wanted to act as
psychologists, not as lay people.
Although their knowledge of psychology in general, and psychotherapy in
particular, was still uncritical and idealised, they believed wholeheartedly
that their attempt to hide and control negative feelings would draw them closer
to real therapeutic work and place them higher in the hierarchy of professional
practice (Clark 1990). The point we wish
to make is that students who played psychologist were not as free as the guides
to exercise their emotions as individuals.
They "knew" from the
little they had learned, that therapists must discipline their emotional
display and that one day they would be paid to do so (Fineman 1993). Their notions regarding the nature of
exchange between patients and therapist coincide with Fineman's (1993)
conclusion that professional workers-doctors, nurses, or social workers-believe
that "they are to look serious, understanding, controlled, cool, empathic,
and so forth with their clients or patients" and that they ought to
protect themselves from 'private feelings of pain, despair, fear, attraction,
revulsion, or love; feelings which would otherwise interfere with the
professional relationship' (p. 19). They
also match Putnam and Mumby's (1993) concept of scientific management of
feelings: the students believed that rules, techniques, and strategies
rationally regulate the therapist's feelings in order to reach objectivity in
treatment.
TWO FORMS OF
EMOTIONAL LABOUR
The
differences between the psychologists and the guides, their distinct beliefs,
approach, and identity roles, indicate that the concept of emotional labour
cannot be uniformly theorised even within a particular coherent discursive
field. Every dominant discourse
confronts the challenge of subversive voices.
As often is the case, the differences between the two groups are not
incidental and in some way reflect the debate within the field of psychotherapy
and psychoanalysis over the meaning of objectivity. The debate is particularly acute within theoretical
bounds: how far must therapists control their emotions and in what ways?
In
his lecture on "wild" psychoanalysis, Freud ([l910] 1964) located
psychoanalysis among the sciences, establishing a field of inquiry intolerant
of popular and superficial apprehensions.
Freud's concept of psychoanalytic expertise was based not only on
proficiency of knowledge, but also on a mastery of techniques. His well-known preference to sit behind the
patient clearly demonstrates that techniques are often ideological
strategies. It is not surprising that this
well-thought-out methodological preference "naturally" generated, as
Gabbard (1995) notes, the theories of emotional distancing and neutrality that
have dominated the mental health field.
While
many therapists still maintain that loss of boundaries is unprofessional and
detrimental to therapy, this stance has recently been challenged by a new
psychoanalytic approach known as two-person
psychology (Modell 1984). Within
this developing field of therapy (Mitchell 1988; Stolorow, Brandchaft, and
Atwood 1987), the interaction between therapist and patient approximates
personal relations between two individuals who negotiate their associations,
ideas, and feelings. Understanding the
patient's inner world is viewed as an intersubjective endeavour that is contingent
on the therapist's willingness to use his or her inner world (Bollas 1992),
sometimes to the point of self-disclosure (Ehrenberg 1982).
Even
proponents of two-person psychology do not suggest that method, technique, and
professionalism be discarded.
Questioning the rigidity of boundaries, treating therapeutic data as a
shared creation, and allocating space for the therapist's subjectivity are all
used in the service of cure. It is,
therefore, incumbent upon the therapist, as an agent of change, to practice
these techniques. The two-person
therapist is not exempt from the proper stance or from obeying the rules of
professional feeling.
Going
back to the psychologists and guides, it is clear that the former wilfully
adopted the dominant rhetoric of emotional control in the common meaning of
distancing and neutrality. Most of all,
they wanted to own those objective properties that would change them from wild
analysts to professionals. The
ideological position of the guides was more ambiguous and complicated. They believed in "real feelings"
and in "being a real person." Their insistence on authenticity,
however, did not free them from emotional labour. They, too, as we observed, were struggling to
find "the right way" to deal with their feelings. In their own way, they were also producing a
discourse of emotional control.
CONCLUSIONS
In
this article, we discussed the concept of professional feelings. We claimed that not only workers, patients,
or clients are subjects of emotional manipulation and control. Mental health professionals, who have the
power and the authority to manage the feelings of others by the definition of
their expertise, are likewise subjected to emotional dispositions and feeling
rules. It is indeed common knowledge that
therapists manage their feelings toward clients in order to display neutrality
(Hardesty 1987, 247). However, it is not
obvious how neutrality, emotional distance, or empathy are in fact negotiated
and practised. Do therapists identify or
struggle with the ideology of emotional control and, if so, in what ways? Emotional labour in professional
organisations is not easily identified or recognised, mainly because rules of
regulation and disciplinary practices are disguised as ethical codes,
professional techniques, and specialised knowledge. Our project was, then, to show that emotional
labour in professional fields is not simply the management of neutrality. In the psychotherapeutic field, for example,
emotional labour is a self-regulated process by which the right feelings,
whether anger or empathy, are constituted through discourse. It is a process by which propriety, not only
neutrality, is established, managed, and displayed. Even hatred can serve a point or be helpful
when it is well managed and controlled (Winnicott 1975). This is why, in the process of socialisation,
students yearn for guidelines: when to show or hide anger, how to reduce
emotional uncertainties, and how to enhance emotional competence beyond
strategies of distancing. Their
sentiment is particularly revealing considering that professional institutions,
such as the shelter or medical school (Smith and Kleinman 1989), emphasise
emotional control but deny students full membership through training. As we noticed, students are not interested in
who controls their feelings and what it means to stay calm when feeling
anger. For most of them, mastery of the
"right" feelings signifies professionalism and a professional
identity. Their ability to detach,
displace, transform, and substitute feelings reflects their belief in a
legitimate difference[5] between trained and untrained people, as well as the
legitimate contrast between common sentiments, and the science of emotions.
Learning
to manage professional feelings is, however, connected to ideology. The guides rejected the strategy of
neutralising feelings, believing instead that emotional control actually meant
being personal and responsive without losing sight of their role as mediators. The psychologists firmly believed in neutrality
and objectivity and, as a result, often focused on the "problem"
rather than the individual resident. By
contrast, the guides responded with emotionality, treating the residents as
historical beings and as their equals.
The
difference between the two groups reflects distinct meanings of emotional
labour and the connection between different discourses and the display of
feelings. It is easy to see how a
rhetoric of objectivity acts as a mechanism of control, but it is less obvious
when the practice of control is represented by claims of spontaneity and
humanness. The subversive challenge of
such a position is revealed in the harshness with which it was opposed by the
psychologists (Foucault 1994, 41) and the rivalry between the two approaches to
feeling management. We claim, thus, that
emotional labour in professional service organisations is the product of
contested professional discourse.
REFERENCES
Abbott, A. 1988.
The system of professions.' An
essay on the division of expert labour. Chicago: University of Chicago
Press.
Ash, M. K. 1984.
Mary Kay on people management New
York: Warner.
Bernard, M. J., and K. R. Goodyear. 1992. Fundamentals
of clinical supervision. Boston:
Allyn & Bacon.
Bollas, C. 1992.
Being a character: Psychoanalysis
and self experience. London:
Routledge.
Bourdieu, P., and L.J.D. Wacquant. 1992. An
invitation to reflexive sociology. Chicago:
University of Chicago Press.
Clerk, C. 1990.
Emotions and micro politics in everyday life: Some patterns and
paradoxes of 'place.' In Research agendas
in the sociology of emotions, edited by T. Kemper, 305-33. Albany: State University of New York
Press.
Douglas, M. 1986.
How institutions think. Syracuse, NY: Syracuse University Press.
Ehrenberg, D. B. 1982.
Psychoanalytic engagement: The transaction as primary data.
Contemporary
Psychoanalysis 18:535-55.
Fineman, S., ed. 1993.
Emotion in organisations. London: Sage.
Foucault, M. 1994.
Genealogy and social criticism.
In The post modem turn: New
perspectives on social theory, edited by S. Seidman, 39-45. Cambridge, UK. Cambridge University Press.
Freidson, E. 1988.
Profession of medicine: A study in
the sociology of applied knowledge.
Chicago: University of Chicago Press.
Freidson, E. 1994. Professionalism reborn. Chicago: University of Chicago Press.
Freud, S. [1910] 1964.
Concerning 'wild' psychoanalysis.
Standard Edition, vol. 11,
221-27. London: Hogarth.
Gabbard, O. G. 1995.
When the patent is a therapist: Special challenges in the psychoanalysis
of mental health professionals. Psychoanalytic Review 82:709-25.
Goffman, E. 1959.
The presentation of self in
everyday life. New York:
Doubleday.
Gordon, S. L. 1990.
Social structural effects on emotions.
In Research agendas in the
sociology of emotions, edited by T. Kemper, 145-79. Albany: State University of New York Press.
Greenberg, J. 1996.
Psychoanalytic interaction. Psychoanalytic Inquiry 16:25-38'
Hardesty, M. J. 1987.
The social control of emotions in the development of therapy
relations. Sociological Quarterly 28:247-64.
Hochschild, A. R. 1975. The sociology of feeling and emotion:
Selected possibilities. In Another voice, edited by M. Millman and
R. M. Kanter, 280-307. New York: Anchor.
Hochschild, A. R. 1977. Emotion work, feeling rules and social
structure. American Journal of Sociology 85:551-75.
Hochschild, A. R. 1983. The
managed heart. Berkeley: University
of California Press.
Hunter, 1. 1993.
Personality as a vocation: The political rationality of the humanities.
in Foucault's new domains, edited by
M. Gane and T. Johnson, l53-92. London:
Routledge.
Kleinman, S. 1996.
Opposing ambitions. Chicago: University of Chicago Press
Kunda, G. 1992.
Engineering culture. Philadelphia: Temple University Press.
Light, D. 1980.
Becoming psychiatrists: The
professional transformation of self. New
York: Norton.
Lutz, C., and L. Abu-Lughod. 1990. Language and the politics of
emotions. Cambridge, UK: Cambridge
University Press.
Meissner, W. W. 1996.
Empathy in the therapeutic alliance.
Psychoanalytic Inquiry 16:38-53.
Mitchell, S. 1988.
Relational concepts in
psychoanalysis: An integration. Cambridge, MA: Harvard University Press.
Modell, A. H. 1984.
Psychoanalysis in a new
context. New York: International
Universities Press.
Putnam, L., and D. Mumby. 1993. Organisations, emotion and the myth of
rationality. In
Emotion in
organisations, edited by S. Fineman,
36-57. London: Sage.
Sarbin, T. R. 1995.
Emotional life, rhetoric, and roles.
Journal of Narrative and life
History 5: 213-20.
Shott, S. 1979.
Emotion and social life: A symbolic interactionist perspective. American
Journal of
Sociology 84: 1317-34.
Smith, P. 1992.
The emotional labour of
nursing. London: Macmillan.
Smith, A. C., and S. Kleinman. 1989. Managing emotions in medical school:
Students' contacts with the living and the dead. Social
Psychology Quarterly 52:56-69.
Spurling, L., and W. Dryden. 1989. The self and the therapeutic domain. In On
becoming a psychotherapist, edited by W. Dryden and L. Spurling, 191-214. London: Tavistock/Routledge.
Stolorow, R. D., B. Brandchaft, and G. E. Atwood.
1987. Psychoanalytic treatment., An intersubjective approach. Hillsdale, NJ: Analytic Press.
Thoits, P.A. 1989. The sociology of emotions. Annual
Review of Sociology, 15:317-42.
Thoits, P.A.. 1996.
Managing the emotions of others. Symbolic Interaction 19: 85-109.
Van Maanen, J., and G. Kunda. 1989. 'Real feelings':
Emotional expression and organizational culture. In Research
in organizational behaviour, edited by L. L. Cumming and B. M. Stew,
43-103. Greenwich, CT: JAI.
Winnicott, D. W. 1975.
Hate in the countertransference.
In Through paediatrics to
psychoanalysis, 194-203. New York:
Basic Books.
NIZA YANAY is a senior lecturer at the department of behavioural
sciences at Ben Gudon University in Israel.
Her current research focuses on the relations between national
discourses and emotional identities. She
has written several articles on the social construction of hostility and
national hatred.
GOLAN SHAHAR is a graduate student in clinical psychology at Ben
Gudon University in Israel. He is
currently writing his Ph.D. dissertation on vulnerability to depression.
NOTES
[1]
Deep acting is a form of emotional labour entailing a
change of the inner world. One prompts
oneself to feel or not feet certain emotions or to change the interpretation of
the situation by either raising emotional memories or manipulating 'as-if'
images. In contrast, surface acting is
restricted to facial and body language.
It is important to note that surface acting was much more dominant in
the shelter than deep acting was. A
possible explanation is the duration of work with the residents. The longer one works with people, the harder
it is to maintain as-if images.
[2]
Here, Merton's concept of anticipatory socialisation
(Merton and Kitt 1950) comes to mind. In
the current study, psychology students adopted empathy, neutrality, and
objectivity as 'emotion norms' (Thoits 1989) to affiliate themselves with the
group of professional therapists.
[3]
Hochschild (1975) defines feeling rules as norms and standards that reconstruct inner
experiences in cultural, social, or organizational settings. Feeling rules, she writes, 'define what we
should feel in various circumstances' (p. 289).
Such rules differ from culture to culture, indicating what is
appropriate and desirable.
[4]
Smith (1992) reported similar findings in her
fieldwork on nurses' emotional labour.
Nurses at public hospitals expressed more self-confidence and
satisfaction when they received training in expressing feelings with patients
and their families, disguising pain, and radiating optimism. Smith observed that emotional uncertainty led
to frustration, distress, and serious doubts about adequacy.
[5]
We were inspired by Kleinman's (1996) notion of
legitimate alternative, which indicates that professionals are concerned with
standards, conventions, and boundaries even within alternative
organisations. Moreover, her work
demonstrates that emotions play an important role in creating work standards
and legitimacy.