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SOCIAL PERSPECTIVES IN THE 21ST CENTURY

THE SOCIAL ANALYSIS OF EMOTION AND TRUST

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SOCIAL PERSPECTIVES IN THE 21ST CENTURY JASON L. POWELL - SERIES EDITOR DEAN OF FACULTY, UNIVERSITY OF LIVERPOOL Foucault: Issues and Legacy Jason L. Powell (Author) 2012. ISBN: 978-1-62257-539-8 (Softcover)

Understanding Power and Emotion: An Introduction Jason L. Powell (Author) 2013. ISBN: 978-1-62417-200-7 (Softcover)

Feminism Jason L. Powell (Author) 2012- November. ISBN: 978-1-62257-540-4 (Softcover)

Understanding Risk and Trust: A Short Conceptual Examination Jason L. Powell (Author) 2013- April. ISBN: 978-1-62417-202-1 (Softcover)

Habermas Jason L. Powell (Author) 2012- November. ISBN: 978-1-62257-542-8 (Softcover) Baudrillard and Postmodernism Jason L. Powell (Author) 2013- January. ISBN: 978-1-62257-541-1 (Softcover) Understanding Foucault: For Beginners Jason L. Powell (Author) 2013. ISBN: 978-1-62417-195-6 (Softcover)

From Historical Social Theory to Foucault Jason L. Powell (Author) 2013 – June. ISBN: 978-1-62618-345-2 (Softcover) Rethinking Social Welfare Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-330-9 (Softcover) The Aging Body Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-380-4 (Softcover)

Helping Professions and Aging: Theory, Policy and Practice Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-381-1 (Softcover) Social Philosophy, Age and Aging Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-382-8 (Softcover) Education, Employment and Pensions: A Critical Narrative Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-383-5 (Softcover) Global Aging, China and Urbanization Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-452-8 (Softcover) Key Thinkers in Social Science Jason L. Powell (Author) 2013 - 3rd Quarter. ISBN: 978-1-62808-453-5 (Softcover)

Issues in Sociology Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-211-1 (Softcover) Contemporary Issues in Modern Society Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-212-8 (Hardcover) Symbolic Interactionism Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-213-5 (Softcover) Issues in Crime, Criminal Justice and Aging Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-162808-890-8 (Softcover) Aging, Risk and Globalization Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-902-8 (Softcover) Social Work, Performativity and Personalization Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-903-5 (Softcover)

Aging, Culture and Society: A Sociological Approach Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62808-960-8 (Softcover)

The Social Analysis of Emotion and Trust Jason L. Powell (Author) 2013 - 4th Quarter. ISBN: 978-1-62948-120-3 (Softcover)

SOCIAL PERSPECTIVES IN THE 21ST CENTURY

THE SOCIAL ANALYSIS OF EMOTION AND TRUST

JASON L. POWELL

New York

Copyright © 2013 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers‘ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. Additional color graphics may be available in the e-book version of this book. Library of Congress Cataloging-in-Publication Data The social analysis of emotion and trust / editor, Jason L. Powell (University of Central Lancashire, UK). pages cm Includes bibliographical references and index.

ISBN:  (eBook)

1. Emotions--Social aspects. 2. Trust--Social aspects. I. Powell, Jason L., 1971BF531.S625 2013 302--dc23 2013034672

Published by Nova Science Publishers, Inc. † New York

CONTENTS Chapter 1

Introduction

1

Chapter 2

The Social Analysis of Emotion Structure, Rationality and Gender Interactionism and Symbolism Conclusion

3 6 12 17

Chapter 3

Emotion, Trust and Professional Relations Introduction Navigating the Conceptual Complexity of Trust Linking Professional Authority with Trust and Governmentality Constructing professional authority through governmentality Conclusion

19 19 21 25 29 32

References

35

Index

73

Chapter 1

INTRODUCTION This book analyses the ways in which emotion and trust are shaped, organised, sustained, experienced and transformed. Although some theoretical analysis of emotions has been developed, it is still rather on the edge than at the centre of social theorising (Barbalet 2002). There are strong intimations of theoretical understanding of emotions that are latent in both classic and contemporary social theories identified in this book: in the rise of Enlightenment philosophy and consequences for emotion with Kant‘s analysis of rationality. The idea of controlling the unstable and irrational emotions in order to enable the superior rationality to take place gains ground in a context where science and scientific reasoning was proving its power to control nature; in Weber's concerns for legitimation, status, charisma, tradition and rationality; in Durkheim's theory of social solidarity, moral force, and symbolism; in Marx on alienation, class consciousness, and conflict mobilisation; in Freud‘s work on the mind and relationship to repression of memory; in G.H. Mead‘s and Goffman‘s theories of symbolic interactionism on taking the role of the ‗other‘ and on the internalization of the generalised other in constituting the individual mind and social contexts. In order to examine emotion and its relationship to social practices in everyday life, the book also explores its relationship to trust. In particular, the book traces emotion and trust in professional relations and explores the conceptual and epistemological implications and possibilities for a critical social science.

Chapter 2

THE SOCIAL ANALYSIS OF EMOTION In contemporary social theory, there exists a body of knowledge that can revisited to highlight how social theory can make sense of emotion: in Parsons‘s (1957) structural functionalism and Luhmann‘s (1989) systems theory which assumes that emotions are in concord with social systems; in Giddens‘ (1990) theorising on ontological insecurity and risk; in Bourdieu‘s (2000) theorisation on how individuals are constantly opened to and in relation with the world in order to strive, cope, and carry on with life‘s daily emotional contingencies; in Feminist theorising emotion is seen as gendered and shaped by ideas and forces of patriarchy (Marshall and Witz 2004); in relationship of discourse and governmentality to the management of emotion (Foucault 1977; Dean 2007); and in Postmodernism in how emotions are becoming ‗simulated‘ in hyper-reality (Baudrillard 2005). By using ‗emotion‘ as a key theme to reflect on a variety of social theories identified, it is hoped that a critical orientation toward social theory in particular and social interaction in general can illustrate the central paradox in social relations: how history makes people as much as people make their own history. This can clearly relate to the beauty of the ‗sociological imagination‘ (Mills 1959) that is the ability to look at the everyday world and understand how it operates in order to make sense of people‘s lives and experiences. It is a state of mind, which enables social analysts to think critically about and understand the society in which they live, and place in that world as individuals and as a whole. An understanding of the sociological imagination is ‗a quest for sociological understanding‘ involving ‗a form of consciousness for understanding social processes (Mills 1959: 76). It is a pathway for a person to look at their life as a result of their interaction with society.

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The ‗sociological imagination‘ requires an engagement to the study of an individual‘s biography but to place that biography in the wider social context of the history and tradition of the society in which an individual lives. Mills suggests that a useful way of understanding this 'imagination' is to use the 'fruitful distinction' between on the one hand 'the personal troubles of milieu' and on the other, 'the public issues of social structure'. (Mills 1959: 14). For Mills the all too common misperception on the part of many individuals is that they perceive their own biographies as just personal and private. Far too often there is a failure to see their own biographies as being interwoven and interrelated to the wider public and political 'stage' of society. Thus an ‗emotion‘ is a ‗private trouble‘, however for Mills the individual needs to recognise that it is one not unconnected with wider social forces of ‗public issues‘. For example, Elias (1994) has a similar configuration to Mills (1959) in his analysis of individual/public issue dualism. For Elias (1994) individual control as well as public regulation of emotions is interpreted as central part of the process of the civilising process. There is much debate as to how to conceptualise emotion. It has been collapsed into some category – as an adjunct to rationality, as a form of behaviour or as an aspect of bodily physiology (Harré 1986). Emotions are also linked to role identities through their common affective representation and quality. In this way, emotional lives of people are a function of the confirmation of their identity-situated selves in social interaction. For example, in 1997 when Princess Diana died the mass media suggested that the British population were ‗weepers‘ and ‗were all traumatised‘ that she had died (Layder 2004). The media played a key role in defining the emotionality expression of ‗public issues‘ through normative means. Expressions of emotion such as ‗distress‘, ‗passion‘ and ‗desire‘ have marked out a territory that is alien to the surfaces of modernity and posed difficulties to the Enlightenment project since its inception. Emotions may be seen to be integral to everyday life playing a role in ‗communication, commitment and cooperation with others (Giddens 1992: 202). Within some traditional societies, the coding and regulation of powerful emotions was (and still is to an extent) closely linked to spiritual belief and religious practice. Such forms of emotionality may be seen to have fragmented within the transition to modernity. As rationality replaced organised spirituality as a guarantor of social order, emotionality, no longer tied to social constructions of spirituality, presented itself as a threat: a powerful force that threatened to scandalise reason and undermine running of modern society (Layder 2007). Not only was

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emotion potentially disruptive to the sway of rationality it had the capacity to carry messages about the operation of injustice and discrimination: A very large class of human emotions results from real, anticipated, recollected or imagined outcomes of power and status relations. (Kember 1984: 371)

Yet if we are to see emotion as having a social relational component, we need to consider to what extent this is socially shaped in the dialectical relationship between human behaviour and social structure. Bendelow and Williams (1998) argue that there is a need to 'bring emotions back in' to social theory in a more concrete way, as they have always been present implicitly in the work of previous theorists. Williams (2000) believes that emotions have a ‗deep sociality‘ in that they are embedded in and constitutive of social interactions, and following Bourdieu (1984) he suggests that possessing the right sort of 'emotional capital' can help us to distinguish between different groups in society. Thus if a person appears to be highly anxious, tense and embarrassed around others, we might interpret their emotional state as being ‗shy‘, and this can have significant implications for our reactions to them, in terms of social inclusion or exclusion. Furthermore, we can suggest that emotions are ‗embodied‘: we do not simply have feelings that are 'all in the mind', but rather we express our emotions through bodily signs and 'symptoms', which in the case of existential characteristics such as being ‗shy‘ or ‗embarrassed‘, for example, might include ‗blushing‘, ‗shaking‘, ‗gaze aversion‘ (Layder 2006). As Denzin (1984) argues, emotions are temporarily embodied, situated self-feelings (1984: 49) which are highly dependent on our perceptions of others and their (imagined) perceptions of us. Emotional practices can therefore be seen as social acts which are significant in revealing the complex interrelationships between the individual and society via the body (Layder 2004). This is also reflected in the culture of late modernity, in which talk about emotions is almost as important as the emotions themselves; Mestrovic (1997) claims that we are living in a 'post-emotional society'. Lupton (2006) further argues that these discourses about emotion are extremely powerful in shaping our understandings of what certain emotions are, and may be nothing more than linguistic categories used to differentiate between different social groups. Emotion may be seen as a socially constructed and socially structured force

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playing a role in the maintenance of social relations. It is the missing link between Mills‘s (1959) personal troubles and public issues of social structure. Although there are significant areas of overlap, a reflective way to examine ‗emotion‘ is in terms of diverse approaches we introduced earlier in the book. By revisiting some of the theories and their main suppositions sheds light on an increasingly important, yet under theorised, social variable. The following discussion attempts to understand emotion by looking at three broad approaches that captures and pulls together some of the theorists and theories identified: rationality, emotionalism and social structure (that includes Durkheim, Marx, Freud, Weber, critical theory and feminism); social interactionism (that includes some of the influential themes drawn from Garfinkel, Goffman and Mead); and (social constructionism that includes Foucault, Bourdieu and Baudrillard). The exercising of the ‗sociological imagination‘ is in its ontological flexibility to accommodate both micro/macro debates about the construction of biographies and relationship to history of the present. Emotion is a key vehicle that can be used to shed light on its epistemological gaze and ontological understanding. Is emotion regulated through structure? How relevant is micro analysis to it explanation? Can we articulate discourse, embodiment and hyper-reality as conceptual tools to illuminate its complexity? The answers to these questions illustrate the relationship between micro levels of interaction amongst people (personal troubles) and structures (public issues). We begin our discussion with emphasis on how emotion can be theorised by social structural approaches.

STRUCTURE, RATIONALITY AND GENDER Social structural approaches assess the interpenetration of emotions and sociocultural phenomena by understanding that emotions emerge from the operative social structure in a situation, and emotions allow people to sense that structure, as well as the social consequences of actions. Moreover, because displays of emotion broadcast a person's subjective appraisals to others, emotions contribute tacitly to sharing views about social structure and to synchronization of rational action and feeling within a group. Both Durkheim and Marx are relevant here. Durkheim (1895) proposed that rituals hold society together by producing sacred objects and moral constraints, and Collins (1990) expanded on Durkheim's theme by proposing that a common emotional mood generated in rituals creates social solidarity and diffuses charismatic emotional energies

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The Social Analysis of Emotion

that preserve and disseminate normative group patterns. Profaning a symbol usually will elicit anger and conflict between groups or between group factions, but reaffirming symbols generates positive emotion and synchronization within the group. The inherent emotionality of even commonplace interaction rituals is the glue that holds society together such as religion (Durkheim 1895). Conversely, Karl Marx (1843) saw society in terms of a conflict between economic classes that created ‗alienation‘. A dominant class (the bourgeoisie or 'capitalist' class) owns and controls the means of production; an industrial working class, the 'proletariat', is exploited by them. Marx (1843) claimed that revolution was ‗inevitable‘ because of the oppression of the working class. For Durkheim (1895) for members of modern society who did not feel part of the collective conscience could be led to anomie, a state of normlessness. For Marx to prevent alienation is to engender what could be called ‗emotional consciousness‘ to unite against the capitalist system. Although they did not explicitly speak about emotion, both Durkheim and Marx saw the problem of modernity was a recognition of alienation and normlessness that impinges on the regulation of individual behaviour. Rationality was also a major concern of Freud. Freud was struck by the way that people could be more or less rational most of the time, but that they, on occasion, behave in very irrational ways. For Freud, this was very much to do with the tensions between, on the one hand culture, and on the other, instinct. For Freud the condition of humankind is in part a product of the fact that we live in a modern ‗civilised‘ world. That is, Freud believed that ‗civilization‘ was a modern phenomenon, and involved the development of control over individual emotions. A Freudian viewpoint would see the emotional contents of the unconscious are not easily available to consciousness because they have been repress well out of reach of our awareness because they are painful and in some sense dangerous. This unconscious is dynamic - it contains memories, perceptions, fantasies, impulses, conflicts that must be pushed back or repress in order to make life less conflictual. For Freud, this defence strategy would be un-costly for most people but for some people it leads to the development of ‗neuroses‘: Freudian theory is more than a theory of dualism, it is a theory of contradiction and struggle. (Kristeva 1999: 327)

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Following Freud, Lacan developed a concept of ‗desire‘ that originated of processes of emotional identification with significant others and then became encoded within systems of symbolic representation, as an infant, for example, became inducted into the world of language and discourse. At the point when a child is able to speak and think as ‗I‘ he or she is cut off from all of the flows of his/her emotional experience. Lacan (1992) presents a stark choice; the price to be paid is that for social power to be gained by entry into the world of language is having to submit to the rules of operation of the symbolic order and hence to lose touch with much of one‘s previous experience of desiring. This perspective can be seen as maintaining the absolutist of the rationality/emotionality dualism. We can say that rationalisation is the process by which rational action becomes predominant in the social action of individuals and rationality becomes predominant in the patterns of action which are institutionalised in groups, organizations, and other collectivities. Max Weber (1883) was particularly interested in the rise of instrumentally rational action among individuals and formal rationality in organizations that crushed any form of human emotionalism in western modernity. When we talk about rational-legal authority, and bureaucracy, we are talking about instrumentally rational action as institutionalised in the formal rationality of modern social organisations. This rationalisation of social life involves an ever-greater development of technical means and a progressive relegation of the ends towards which these means are supposed to lead. An example may make this clearer. Weber argues, in The Protestant Ethic and the Spirit of Capitalism, that Calvinist religion represented a rationalisation of human behaviour, which focussed people's constant attention on the relationship between their everyday activity and their hope of salvation. This obsession with making the most of each minute, with the rationalisation of everyday life, particularly economic life, gradually came to take complete precedence over the intended goal, of demonstrating to oneself that one was likely to be destined for salvation equates with working hard now and reap future emotional rewards of post-physical happiness in heaven. Weber's analysis of the development of bureaucracy is similar. Bureaucracy, for Weber, is simply the most technically efficient means of rationalisation. This means that increasingly bureaucracy takes on a life and a logic of its own which may engender an ‗iron cage of rationality‘ (rules, routines and regulations) from which there is no escape. Weber held a view where humans are seen as pursuing a variety of ends, not always in a rational manner. The most important of these ends is the power to affect decisions of authorities.

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Norms and values are internalised to the extent that authorities have legitimacy. Legitimacy can be obtained by personal charisma: ―Claiming special knowledge and demanding unquestioning obedience with power and privilege. Leadership may consist of one individual or a small group of core leaders‖ (Powell and Moody 2001: 4). Charismatic leadership has its dark side (i.e.,) Hitler. The goal was to kill as many people as possible in the most efficient manner, and the result was the ultimate of dehumanisation (cf. Bauman, 1989) - the murder of millions of Jewish men, women and children. Similarly, Adorno and Horkheimer sought other strategies for a critical theory of modern society relevant to understanding the positioning and detachment of emotions. Horkheimer and Adorno (1949) book Dialectic of Enlightenment believed that reason had been instrumentalised (see Weber‘s influence) and incorporated into the very structure of society. Thus reason was being used to strengthen rather than transform the system. Enlightenment had turned into its opposite and turned from being an instrument of liberation to domination. Enlightenment had always been infused with myth, and the project of dominating nature, of using reason to control and dominate the world, was being applied to humans in oppressive and monstrous ways (Adorno and Horkheimer 1949; Bauman 1989). The Nazi rationalisation of death in the concentration camps and the rationalization of war during World War II raised deep questions concerning the progressive force of reason and the efficacy of immanent critique in the light of such powerful social systems. This takes a view of what Mestrovic (1997) labels as ‗post-emotionalism‘ whereby rational means are the only manner to objectify human behaviour. In systems theory the concept of emotions is related to theorising in the context of anxiety/angst-communication regarding environmental issues (Luhmann 1989). In risk-communication the special characteristics of angstcommunication is understood as a kind of communication that cannot be reduced by rational argumentation or scientific analysis, and reproduces and amplifies itself easily. Even attempts to reduce angst by information strategies rather support the amplification of angst than its reduction (Luhmann 1989). The emotional impact of angst-communication seems to be self-evident contrary to the binary coded functional systems (economics, science, justice) and cannot be reduced by the logics of economics, science or law itself. Angst communication narrows the societal perspective on negative aspects of risks and therefore fades out the positive gains. Such negative emotional communication is understood as being risky as far as it blocks necessary societal decisions and developments of knowledge. Emotion is also linked to the concept of trust. However, maintaining emotions is not necessary for

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trusting, which could be detached from the original emotions. Trust as linked to emotion is understood as rational irrationality (Luhmann 1989). Where learning by trial and error is not possible (for example, nuclear power, genetically modified food) progress and decisions are only possible with regard to trust (Powell, Wahidin and Zinn 2007). When expectations are not institutionalised or habitualised expectations can only be based on the subject and its emotions. Therefore in the viewpoint of Luhmann (1984: 365) a modern society, characterised by a higher amount of dynamics and changes is ‗endangered by emotions‘. Giddens (1990) implicitly links the problem of emotions to the concept of ‗ontological security‘. The emotion of ontological security is based on the unconscious and linked to routines of everyday life: Ontological security and routine are intimately connected, via the pervasive influence of habit. … The predictability of the (apparently) minor routines of day-to-day life is deeply involved with a sense of psychological security. When such routines are shattered—for whatever reason—anxieties come flooding in, and even very firmly founded aspects of the personality of the individual may become stripped away and altered. (Giddens 1990: 98)

Giddens points out that with growing risks in modernity notions of fatefulness would return in a secularised world which he understands as managing its problems successful by rationality (1990: 133). New risks would strain the emotional secure basis in late modernity and thereby the personality/identity of people. Because new risks and uncertainties cannot be solved ultimately, they must be handled in several ways. Giddens distinguishes four coping strategies (pragmatic acceptance, sustained optimism, cynical pessimism and radical engagement Giddens (1990:134-37). Pragmatic acceptance is a response to the insight that many things in the outside world cannot be controlled individually. Therefore in this perspective there is a priority to manage everyday problems. The life threatening dangers of nuclear power or terrorism are suppressed for the prise of psychological costs. Sustaining optimism stands for a sustaining faith in science that things can still be managed as in the past. Religious concepts of the world can come close to this kind of belief that things will become good. In contrast to pragmatic acceptance cynical pessimism manages the lack of control regarding the future and the involved anxieties actively for example with the help of ‗dark

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humour‘. Radical engagement sticks to the necessity to do something actively towards the perceived sources of danger. The ‗McDonaldization‘ thesis picks this point up but takes it in a different trajectory. It is also a very popular formulation in social theory influenced by Weber with three characteristics (Ritzer, 2004) - efficiency means choice of efficient means to achieve specified ends (includes assembly-line philosophy of Macs, drive-throughs, making the customer work to assemble own burgers and dispose of waste), calculability of process and product (quantification of meals, portion, times), predictability (standardised meals and Mcworkers all over the world - trained by the Hamburger University), non-human technology - factory farms, microwaves, computerisation e.g., cash tills, drinks dispensers - and robot workers) (Ritzer 2004; Ritzer and Ryan 2007). Clearly, what is efficient for the company is not necessarily so efficient for consumers. The downside of the organisation and its alleged negative effects - cruelty to animals, harmful components, poor health safety, worker tedium and exploitation. Ritzer has gone on to suggest there are possible ways in which rationalisation will triumph. Ritzer takes the case of Japan and hyperrationality - a fusion occurs between rationality of companies and what people want in life. Examples of this are fast food and its growth, the credit card; and Disney, shopping malls, package tours, convergences in ‗McWorld‘ equate with virtual tourism. Emotion becomes detached from any connection with the experience of real emotions and has been Mcdonalized able to be synthesised within theme parks and heritage centres (Ritzer 2004). For Feminists, playing out the dichotomy of modernity in terms of rationality and emotion may also be seen in the public/private split that constructed the family, for example, as an oasis of emotionality, ‗a haven in a harsh world‘ (Watson 2001). In this picture, emotions are seen as central to the rationalisation of family life whereby women are situated, discursively and economically in positions where they may be given a ‗duty‘ to care emotionally for others – children, older relatives and men. However, as Marshall and Witz (2004) points out this emotion bargain may actually be more complex than it appears. Women and men may enter ‗partnerships‘ on an unequal basis in terms of material relations and this can serve to reinforce gendered inequalities in emotional relations: Women have been put in a position of being economically dependent within patriarchy but the relationship between economic dependency and emotional dependency is not straightforward. Although this is not usually made explicit within the relationship, mens dependency needs are most often

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Jason L. Powell met within marriage and their emotional worries by their wives. No equivalent place exists for women. (Eichenbaum and Orbach 1985: 86-7)

Thus womens unequal social position may place them in the contradictory position of feeling dependent on men but actually being depended on by men for the servicing of their emotional needs. In the context of eurocentricity of emotions, Franz Fanon (1986) analysed the emotional alienation of black people within racist and colonial social orders, being given little choice but to taker on and live within a white worldview whilst being inferiorised within it.

INTERACTIONISM AND SYMBOLISM Social interactionists approach the interpenetration of emotions and social phenomena by understanding that emotions are both constructed and determined. The interactionist model points to a certain paradox; a feeling is what happens to us in terms of private troubles. Yet it is also what we do to make it happen. (Goffman 1959) Emotions erupt during social interaction. Then they are judged for suitability according to cultural and ideological standards, and managed to effect culturally acceptable displays that yield social accord. Employing a symbolic interactionist perspective, emotion can be conceptualised in a number of ways. Foremost, emotion can be considered more than merely a biological act of procreation or pleasure or pain (Gane 2005). It is a complex social interaction between two or more people. It is the dynamic interaction not only between one's own personal values, attitudes, personality dispositions, cognitions, wants, desires, and behaviours, but, more importantly, the interaction between these entities and those of others (Layder 2004). For example, sexual behaviours, including acts of ‗courtship‘ can be interpreted not simply as means to ends, but as acts invested with meanings that are interpreted differently by different people (Layder 2004). Both G. H. Mead and Goffman propose that people construct and understand social action so as to have important symbolic meanings affirmed by impressions generated in manifest behaviour. People credit themselves and others with specific identities during social encounters. They then engage in physical and mental work so that events create impressions that maintain sentiments attached to their identities, as well as to other categories of action

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(i.e., behaviours, settings, and emotions included). We may wish to ask what happens to the emotions in the context of social interaction? Freund (1998) argues that individuals try to regulate their feelings to fit in with the norms of the situation, and that if there are conflicting demands upon us, people may feel 'dramaturgical stress'. So people may feel ‗sad‘ or ‗happy‘ because a particular social situation requires that we act in one way while inside their minds and bodies individuals may feel a different way. Put together, these two oppositional motivations can leave people feeling ambivalent and uncertain (Layder 2004), as well as ill-equipped to deal with the situation, and this in turn leads to greater self consciousness: we all believe that everyone else knows and understands the 'rules' governing social interaction, even though nobody ever talks about them explicitly, and so we might be forgiven for thinking that we 'ought' to disguise our ignorance with a show of confidence. (Hochschild 1983: 87)

This emotion work (Hochschild 1983) forms part of everyday lives, both in the private world of the self and in the public spheres of interaction where individuals learn socially appropriate ways of acting and expression management. Hochschild referred to these codes as 'feeling rules' and argued that they were historically and culturally specific; in contemporary Western societies, the emotions had become commercialised and were often found to be 'sold' in the form of marketable services. The personal and the normative systems unite when group members are deeply committed to their group identities; in that case, people spontaneously emote and act according to group norms in order to experience affirmation of self through the reflected appraisals of others (Burke and Reitzes 1991). The two systems diverge when a person maintains multiple definitions of a situation simultaneously, and the actor's deepest commitment is to an identity other than the public identity. In that case, emotion management is required to prevent the display of emotions appropriate to the private identity, and to authenticate one's supposed commitment to the public identity as a public issue.

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Discourse, Embodiment and Hyper-reality A social constructionist literature on emotions has been steeped in the Cartesian tradition which treats emotions as an awkward mix of physical/physiological processes, on the one hand, and personal experiences on the other, with the bulk of attention given over to the analysis of the latter (Layder 2004). More recently, social constructionist theory has more plausibly tried to minimize the experiential element in emotion and emphasis the construction of the social setting and role that discourses play in constructing truth games impinging on the social construction of emotions. Within early modernity, emotions could be interpreted as ‗romance‘, ‗sentiment‘, or spiritualism. In late modernity, emotions have become commodified that may be consumed, induced or traded within an, to misparaphrase C.W Mills, ‗emotional industrial complex‘: From psychiatrists to Agony Aunts, psychotherapists to GPs, social workers to self help manuals, we are increasingly advised or cajoled on how to manage our emotions, resolve our troubles and make the most of our lives, thereby achieving full potential. (Williams 2001: 10)

Foucault‘s (1965, 1977) approach to the interpenetration of emotions focuses on understanding the expression of emotions as personal conduct and contrived according to power and discourses so as to effect desired interpersonal outcomes. In this perspective, displays of emotion are not uncivilized eruptions coming from deep within individual psyches, but rather amount discourse that is employed to influence others (Foucault 1977). Discourses are a set of statements, labels and assumptions that operate to ‗pin‘ ―true‖ definitions on what is or what is not the case. For example, the power of psychiatry in defining ―mental illness‖ (Foucault 1965). The power to label an individual as ‗mad‘, ‗psychotic‘, ‗anxious‘, ‗phobic‘, ‗schizophrenic‘ and ‗neurotic‘ and the process of pinning such discourses to people reveals a complete lack of power from being defined as ―mentally ill‖. Foucault (1973) has further argued persuasively that the birth of the medical profession brought with it a different way of seeing illness and well-being related to structural and personal spaces. Most notably, the sick other became an object to be modified (Powell and Biggs 2004). Under the ‗medical gaze‘, a process of normalisation

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is engendered in that people become their bodies, bodies disaggregated into a series of dysfunctional parts (Foucault 1983). The Foucault inspired ‗governmentality approach‘ sees emotion as an expression of a specific style of governance, typical for neo-liberal societies which use statistical risk calculation (as in epidemiology and (social) insurance) and tend to ascribe risks to individual's decision making in order to govern populations (Foucault 1991). Individuals become object of governmental strategies not as a person but as a bearer of indicators or factors (Dean 2007). Because governmentality relies on the governmental, institutional, and medial construction of social reality, emotions are included too. But emotion and affect are conceptually subordinated under the moral technology of governmentality. Subjectivity comes in sight as far as it is addressed and constituted by governmentality. Governmental strategies use people's enthusiasm by opening opportunities and stressing towards them how much better their life would be if they took up those chances (Rose 2006). Bourdieu‘s interpretation of emotions rests on the assumption that there is a continuous process of embodiment, whereby individuals are constantly opened to and in relation with the world in order to strive, cope, and carry on with life‘s daily emotional contingencies. According to Bourdieu, social agents experiences of embodiment differ, because they are in a way situated in a different place in the world (Bourdieu 2000). One can easily see such differences when one considers gender, social class, sexuality, ethnicity or age. This approach is best illustrated through Bourdieu‘s space of social positions, where each social position – which in his case is often defined by economic and cultural capital – is associated with a distinctive view-of-the-world that regulates emotional spaces (Bourdieu 1984; 1998). It is through the embodied practices of everyday life that social agents are in a relation to the world, that they give meaning to it and that they comprehend it (Bourdieu 2000). The habitus provides such a practical understanding through the action of practical sense, a notion that refers to the unconscious adjustment of social agents practices to the constraints and opportunities imposed or offered by their emotions (Bourdieu 1990). The emotional body for him is an individuals way of being-in-the-world: ‗the body is in the world but the social world is in the body‘ (Bourdieu 2000: 152). It is as much a social construction, where social structures are internalised, as the site of experience, desire and creativity. Similarly to Merleau-Ponty‘s phenomenological bodily schema, which showed how the body adapts to its environment through a system of sensory and motor relations (Detrez 2002), Bourdieu contends that ‗we learn bodily‘. Often

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unconsciously, the body becomes attuned to the world by being exposed to its regularities (Bourdieu 2000). As emotional individuals, we have the built-in capacity of being opened to the world and of being modified by it. This is exemplified in Distinction (1984), where Bourdieu focused on the body of social classes (Bourdieu 1984) and in Masculine Domination (2001), where he applied his approach to the ‗gendered body‘. These studies have shown that distinctive bodily forms are reproduced by agent‘s practices, which themselves are the product of the internalisation of social spaces. The body, for Bourdieu a core entity for the reproduction of power relations and social order. For postmodernists such as Baudrillard (2005) in the postmodern medialaden condition, we experience something called "the death of the real": we live our emotions in the realm of hyperreality that is simulated, connecting more and more deeply to things like television sitcoms, music videos, virtual reality games, or Disneyland, things that merely simulate reality. In his book On Seduction, he traces social construction of love. He suggests that seduction is artificial and symbolic, involves flirtations, double entendres, sly looks, and whispered promises. It involves the manipulation of signs like makeup, fashion, perfumes/after shaves and gestures to achieve control over a symbolic order. On top of each of these modes is now layered the ‗cool‘ seduction of media images disseminated by television, radio and film. In his work Cool Memories, Baudrillard (1993) has claimed that the Gulf War I did not happen, it was only a representation of reality of what the media told us that happened; that reality is simulation (he points to the side example of TV programmes with canned laughter and on cue applause to suggest to viewer when to laugh and when not to). In western culture, claims Baudrillard (2005), we take ‗maps‘ of reality like television, film, etc. as more real than our actual lives and these ‗simulacra‘ (hyperreal copies) precede our lives. According to Baudrillard (2005) individuals communicate by e-mail, and relate to video game characters better than friends and family. Charles Lemert makes the point that individuals drive on freeways to shopping malls full of identical chain stores and products, watch television shows about film directors and actors, go to films about television production, vote for ex-Hollywood actors for president (Lemert 2006) – the death of the emotional social. In fact, individuals get nervous and edgy if they are away too long from computers, email accounts, or texting on mobile phones (Powell, Wahidin and Zinn 2007). In response to the criticisms of the project of modernity made by postmodernists, Habermas wishes to consolidate the ‗project of modernity‘ and further argues that we should not completely abandon the possibility of a

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rational pursuit of truth and happiness of which emotion is shaped (Steuerman 1992: 107). He defends modernity and argues that what is needed is more philosophical discussion, not less (Steuerman: 1992, 113). Habermas states that through the use of communicative action, language and rational dialogue, the Enlightenment aims of truth, justice and freedom are still attainable alongside social consensus (Powell and Moody 2004).

CONCLUSION The discussion in this chapter relates to Mills‘ (1959) ‗sociological imagination‘. We focused on viewing differing perspectives that can be applied to understanding emotion – we highlighted how emotion shifts the focus of our attention away from the idea of individual, private worlds of emotion to the wider context of social relations and the way in which language is used with power to identify subject positions. Themes in the epistemological excursion of revisiting C. Wright Mill‘s (1959) sociological imagination and emotions are inextricably linked to ‗private troubles‘ (micro/agency/ individualised) and ‗public issues‘ (macro/systemic/structural) in both classic and contemporary social theories: in Weber's concerns for legitimation, status, charisma, tradition and rationality; in Durkheim's theory of social solidarity, moral force, and symbolism; in Marx‘s analysis of consciousness to class alienation; in Mead on taking the role of the other and on the internalization of the generalized other in constituting the individual mind; and in the discursive, habitus and hyperreal of postmodernity. If this chapter is about looking back and reflecting on the ways different approaches could be mobilised to illuminate an understanding of emotion, the next chapter looks forward to rethinking social theory in relation to taking a second theme seriously, namely, that of trust. We ask a critical question that needs addressing if trust make us rethink the dynamic between relations at every level in society.

Chapter 3

EMOTION, TRUST AND PROFESSIONAL RELATIONS INTRODUCTION Trust receives a great deal of pubic exposure grounded in the assumption that the level of trust placed by the public in particular people, offices, professions, institutions or systems is critical to its continuing authority. There are increasing attempts to conceptualize the notion of ‗trust‘ in social theory as a pivotal dimension of modernity (Giddens, 1991). Trust, either personal or impersonal related to emotion (Misztal 1996), can be viewed as fundamental to inter-personal informal relationships (Brownlie and Howson 2005), to the working of organizations (Morgan 2002), and to professionals (Gilbert 2001) all fundamentally linked to the occidental world of modernity (Delanty 2005). The early observation that ‗social science research concerning trust has produced a good deal of conceptual confusion regarding the meaning of trust and its place in social life‘ continues to have relevance today (Lewis and Weigert 1985 quoted in Powell, 2005, 76). On the one hand incompatible with complete ignorance of the possibility and probability of future events, and on the other hand, with emphatic belief, which excludes the anticipation of disappointment. Trust has provided the essence for a range of contemporary debates within the social sciences although these have taken different foci. A deal of theorising has taken place against a backdrop of concerns over the weakening of community bonds and the challenges this holds for democratic institutions. In one conceptualization as ‗social capital‘, trust can be seen as synthetic providing a form of glue or binding of individuals in communities

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(Phillipson, 2005) involved in a myriad of apparently independent social relationships (Giddens 1990, 1991, Putnam 1993, Fukuyama 1995, Misztal 1996, Lane 1998, Seligman 1997, Sztompka 1999, Uslaner 1999). In part, these discussions were provoked by and consequentially exposed the limitations of rational choice models and the post-emotionalism thesis as a means of explaining human behaviour (Taylor-Gooby and Zinn 2007; Dean 2007). ‗Trust‘ itself is an essentially contested concept. Trust can extend to people with a sense of shared identity (Gilson 2003, Tulloch and Lupton 2003). Individuals produce trust through experience and over time. It cannot be immediately and with purpose be produced by organizations or governments without dialogical interaction with people on issues affecting their lifestyles and life-chances such as care, pensions, employment and political representation (Walker and Naeghele, 1999). Möllering (2001) takes the relational theme further by distinguishing between trust in contracts between individuals and the State in areas such as pension provision; trust in friendships across intergenerational lines; trust in love and relationships, and trust in foreign issues associated with national identity. There is a multiplicity of ways that trust has been defined but the central paradox is how to creation of the conditions of building conditions of trust across personal-organisationalstructural tiers in an increasingly uncertain world. Seligman‘s (1997) theorising of trust identifies important conceptual issues concerning the relationship between trust, confidence, faith and familiarity. Trust is unconditional while confidence enjoys more certainty than trust. We can have confidence in systems and roles but trust only in persons. Seligman suggests trust differs from faith, as unconditionally is secular and not related to deity while familiarity is a mechanism for maintaining confidence and ontological security. Alternatively, Sztompka (1999) provides a model of a trust culture that has five conditions for trust: normative coherence; stability of social order; transparency of social organisation; familiarity of social environment and accountability of professionals and institutions. His model gives a lot to tradition in the production and maintenance of trust. In addition, he suggests that social stability is compatible with social change so long as change is gradual, regular, predictable and consistent. Discontinuous change and the fragmentation of tradition forms of authority result in a parallel disintegration of trust. Conditions all too familiar as characteristics of post-modern society (Rose 1996, 1999) leading to the conclusion implicit in Sztompka‘s own discussion that this model is incapable of explaining trust in post-modern society underpinned by unpredictability.

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We consider the implications of theorizing trust and suggest that it provides analytical and experiential insight into the dynamics of health and social care professional relationships in contemporary society. We caution that in order to full embed ‗trust‘ in theoretical analysis we need a ‗way forward‘ (Sibeon 2004) that synthesises discussions of trust with the conditions set by governmentality analysis. We suggest that Michel Foucault‘s (1978) concept of ‗governmentality‘ enables the exploration of the relationship between different conceptions of trust, the mechanisms for managing populations and the production of self-managing professionals who are, in this sense, trusting. According to Foucault governmentality comprises three tiers: it is the result of transformations within the modern state; it is a tendency to institutionalize a particular form of power, and it is the ―ensemble formed by institutions, procedures, analyses and reflections. . .calculations and tactics‖ (pp.102-3) that enable the exercise of power directed towards the regulation of a population using various apparatuses of expertise. Indeed, we aim to demonstrate the deployment of particular rationalities supporting trust and trust-based relationships as tactics of government. For without trust, activities reliant on co-operation between families and communities with future orientated expectations have no satisfactory basis on which they might be established. By drawing out the cost and benefits of trust-based relationships, identifying the way the facework of experts maintain the legitimacy of systems and promotion social cohesion, is part of the process of constructing professional authority. Whilst it is analytically audacious to articulate trust with governmentality in the light of professional expertise in health and social care, it provides an important reference point that raises rich conceptual questions about nature and meanings of attachment related to trust. We begin the next section by attempting to highlight the levels of trust that impinges on social relationships at: individual, community, organisational and systemic levels.

NAVIGATING THE CONCEPTUAL COMPLEXITY OF TRUST Trust: Individuals, Organisations, Community and Systems The first key focus for theorising trust has been the interpersonal qualities of the individuals involved. Sztompka (1999) challenges theorists who consider interpersonal forms of trust as the primary form based on face-to-face encounters while subordinating all other forms of trust, collectively referred to

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as social trust. Rejecting any differentiation between interpersonal trust and social forms of trust, he proposes that the ever-increasing impersonal nature of relationships in systems is underpinned by our experiences of trust in face-toface relations. This reliance on the interpersonal aspect of trust suffers from similar problems to Giddens (1990) use of ‗ontological security‘, a product of early childhood experiences, as a prerequisite for individuals being able to form trusting relationships. This conservative element leaves those without positive childhood experiences stuck in a psychoanalytic mire with no potential for trusting, or by implication being trustworthy, while also failing to offer any means of recovery. A number of theorists (Davies 1999, Giddens 1991, Mechanic 1998) note the expectations lay people have of experts or professionals while at the same time this interpersonal level provides the human aspect or ‗facework‘ for more impersonal forms of trust. Expectations of professionals include the following: specific competencies, specialised areas of knowledge and skills, disinterestedness and disclosure. Of particular importance are communication skills and the ability to present complex information. Alongside, run role expectations that demand experts act ethically and with integrity as true agents of their clients, requiring them to put personal beliefs and interests aside and acting to maximise benefit and to do no harm. Creating specialized spaces reinforced by fiduciary norms arising from: the custody and discretion over property, the opportunity and possession of expertise and the access to information; regulates the power/knowledge relationship between expertise and laypersons (Giddens 1991, Shapiro 1987). The second level of trust is at community level. Evidence exists of a positive correlation between levels of interpersonal trust and levels of social capital (Putman 1993, Rothstein 2000), leading in part to calls for increasing the levels of civility and community responsibility in everyday life. However, while theorists (Misztal 1996, Putman 1993, Taylor-Gooby 1999, 2000, Sztompka 1999, Rothstein 2000, Dean 2003) support the idea of social norms and values overriding rational models of human behaviour, they say little about how these norms and values become established. Rothstein claims that the link between interpersonal trust and social capital is weak, as are propositions about the direction of community relationships. Rejecting functionalist explanations linking norms to the established configurations of power, he proposes a theory of ‗collective memories‘ creating social norms in communities as a strategic political process. The essential ingredient is the creation of conditions of community relationships built on common values. The third key issue is on trust and organisational context. Challenges to the ‗trustworthiness‘ in organisations, regardless of whether they are public or

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third sector organisations, can have profound effects on confidence in that system. Producing increased demands for regulation, information and transparency; that is, increasing the demands for distrust. The fourth major area of concern for theorising trust has focussed on the declining trust in both state mediated social systems such health and social care and the professions embedded therein (Davies 1999, Phillipson, 1998, Welsh and Pringle 2001). Conceived as impersonal or systems trust (Giddens 1990, 1991, Luhmann 1979) this form of trust is developed and maintained by embedding expertise in systems that do not require the personal knowledge of any individual by another. Such systems employ a range of techniques of distrust i.e., audit processes, target setting and third party inspections to demonstrate trustworthiness (Gilbert 1998, 2005).

Implications of Trust in Health and Social Care Part of the confusion concerning the different levels of trust rests, according to Möllering (2001), with the failure to distinguish between the functional properties of trust and the foundations of how trust is created in health and social care. The former are the outcomes of trust i.e., expectations, concerning issues such as: order, co-operation, reducing complexity and social capital. While the latter concern the nature or bases of trust, which, due to the assumption that they are rational, become lost and therefore not explored. Moreover, individuals make decisions on partial knowledge, a mix of weak inductive knowledge and faith regarding the consequences of an action. Möllering suggests that in some circumstances relational aspects producing either confidence or reciprocity might support decision-making. However, this knowledge moves us close to confidence, which according to Seligman‘s (1997) is a different quality. Nevertheless, building on Möllering‘s theory, Brownlie and Howson (2005) argue that trust is relational and impossible to understand in isolation. Trust occurs as individuals extract the known factors while bracketing off or suspending the unknown factors to avoid confusing decisions with uncertainty. Gilson (2003) takes up this relational aspect of trust and claims that relationship issues provide the main challenges for health services. Making the link between systems and social capital, she compares UK and US health systems. Concluding that the general acceptance by the UK population of the altruistic element of the UK health system stands in stark contrast with the distrust, which accompanies health care in the USA where there is a belief that

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the system is organised to maximize the benefits for the medical profession. Gilson argues that trust involves both cognitive and affective elements. The former relates to a risk calculation where the costs and benefits of an action are calculated alongside of the degree of uncertainty derived from the dependency on the actions and intentions of another while the latter is linked to the generation of emotional bonds and obligations. Altruism provides a special case of trust where trusting and trustworthiness promote the social status of those involved in giving. Consequences for those dependent on giving remains a key question. For as Giddens (1990) notes trust is a very specific case of dependency: a dependency on expertise. Providing circumstances that discredit the rationalities supporting governmental strategies, challenging expertise and consequently public trust is lost. In this sense we might consider the examples of; the Bristol Babies scandal (Davies 1999), the controversy around the MMR vaccine (Brownlie and Howson 2005); the pensions crisis (Lunt and Blundell 2000, Price and Ginn 2003), or more vividly, child safety and paedophilia (Bell 2002). Other writers draw distinctions between trust and hope. Both Sztompka (1999) and Gilbert (1998, 2005) discuss trust and hope, with hope representing a situation of relative powerlessness, a situation exemplified by Gilbert who concludes that trust is a discourse of professionals and experts while hope is a user discourse. Seligman argues that trust, conceived as it is in this debate, is unique to modernity. In traditional societies, trust has quite different bases. Moreover, sociological theories, which suppose a general change in modernity (cf. Beck, 1992, Giddens 1994), assume that with the erosion of traditional institutions and scientific knowledge trust becomes an issue more often produced actively by individuals than institutionally guaranteed. To resolve these tensions we propose Foucault‘s Governmentality thesis as the means to identify the role of trust, along with the mechanisms for the deployment of trust and the role of professional expertise. Social institutions such as health and social care disseminate a particular ethic of the self into the discrete corners of everyday lives of the population. Supported by a discursive framework promoting cooperative relations between people, communities and organisations this ethic is future orientated and promotes qualities and values that sustain trust-based relationships and forms of action. In the process of building co-operative relations, the role of professionals and professional authority is established. The next section carefully examines the conceptual possibilities for articulation of trust and governmentality.

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LINKING PROFESSIONAL AUTHORITY WITH TRUST AND GOVERNMENTALITY Conceptually there are tensions but also interesting theoretical possibilities between late [high] modern and post-structuralist conceptions of society. Both identify the fragmentation of traditional forms of authority and expertise, and acknowledge the increasing complexity this produces through the availability of multiple sources of information and different lifestyle choices. As noted earlier late [high] modern conceptions of trust, acknowledge uncertainty and risk as the basis for necessitating trust and point to the failure of rational choice theories as evidence of the existence of social trust. Likewise, governmentality theorists, discuss risk and uncertainty at length (Rose 1996, 1999, Osborne 1997, Petersen 1997), but leave the discussion of [social] ‗trust‘ to an observation that trust, traditionally placed in authority figures, has been replaced by audit (Rose 1999). The problem of creating co-operative relations between individuals and within groups and communities, both in the present and for the future, is left unresolved. Foucault‘s summary of the working of the state provides a useful starting point for this discussion: ―it is the tactics of government which make possible the continual definition and redefinition of what is within the competence of the State and what is not, the public versus the private , and so on; thus the State can only be understood in its survival and its limits on the basis of the general tactics of governmentality.‖ (Foucault 1979:21)

Our contention is that the ‗governmentality thesis‘ as it has been developed by writers such as: Rose and Miller (1992), Burchell (1991), Rose (1996, 1999), Osborne (1997), Petersen (1997) holds the potential to overcome many of the problems experienced in theorising trust. It provides a means of extending the critical debate over trust. Linking discussions concerning the bases of trust: the conditions Möllering (2001) describes as essential for trust to happen with discussions focusing on the outcomes of trust i.e., social capital, systems or impersonal trust and interpersonal trust (Putnam 1993, Seligman 1997, Luhmann 1979, Giddens 1990, 1991, Sztompka 1999, Rothstein 2000).

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Moreover, governmentality provides the means for identifying the mechanisms for deploying particular rationalities across the social fabric. In particular, the interplay between state intervention and the population that institutionalizes expertise as a conduit for the exercise of power in modern societies (Johnson 2001). Institutionalizing expertise establishes a range of specialized spaces: at once both hidden and visible, providing opportunities across the social landscape for a range of professionals. Experts who work on individuals inciting self-forming activity and individual agency, producing the self-managing citizen central to neo-liberal forms of government, 'enterprising subjects' or what Burchell (1991: 276) terms 'responsibilisation'. Thus enabling an explanation of trust that avoids resorting to a functionalist argument or an overly deterministic approach limited to either class action or the meaninggiving subject. Furthermore, governmentality can overcome the condition laid by Sztompka (1999) that trust cannot exist in conditions of discontinuous change. Indeed, in the context of discontinuous change, particular rationalities and their associated technologies become politicized, leading to increased conflict in the relationship between the state and expertise making trust an evermore valuable commodity. In analysing the activities of government, Rose and Miller (1992: 175) argue, we must investigate 'political rationalities' and technologies of government - 'the complex of mundane programmes, calculations, techniques, apparatuses, documents and procedures through which authorities seek to embody and give effect to governmental ambitions'. In this case, rationalities, operating as discourses and social practices embodying a particular practical ethic, work to reproduce the norms, values and obligations associated with trust. Producing a subject position that values trustworthiness as both a personal characteristic and a characteristic sought in others. Both experts/professionals and the user/customer of health services emerge as the self-managing ethical subjects of neo-liberal rule (Miller 1993, Davidson 1994, Rose 1999). For governmentality theorists an analysis of neo-liberal regimes reveals individuals as inculcated with values and objectives, orientated towards incorporating people as both players and partners in marketised systems including health and social care. Participation in markets along with the potential for unbounded choice are inextricably entwined with a creative tension, an ethical incompleteness, where private [selfish] desire and public [selfless] obligation produce the rational self-managing actor of neo-liberal rule. In a dialectical relationship that works to form individual identity through the exercise of a modern consumerist citizenship (Miller 1993). Such regimes

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exhort individuals; indeed expect them to become entrepreneurs in all spheres, and to accept responsibility for the management of 'risk'. Government is concerned with managing the conduct of conduct, the processes through which people 'govern' themselves, which includes an obligation to manage one‘s own health (Petersen 1997). Theorists of modernity such as Putman (1993), Sztompka (1999) and Rothstein (2000) leave trust to arise organically through the interaction of individuals within groups and communities. The idea that increasing the levels of social interaction to effect a positive consequence on the levels of social and individual trust has a benign attraction, but it tells us little about how or why these norms, values and obligations associated with trust exist in the first place. Alternatively, the analysis of governmentality recognizes these discourses and social practices as the outcome of something more ordered. Not ordered in the sense of designed and managed but the consequence of what Foucault described as strategy: loosely connected sets of discourses and practices that follow a broad trajectory with no necessary correspondence between the different elements (Dreyfus and Rabinow 1982). One tactic, increasingly used within the strategy of government as they struggle with the challenge of managing populations across an ever more complex range of social contexts, is the promotion of co-operative relations within different programmes and technologies. This works to promote, establish and maintain an ethic of co-operation and trustworthiness producing the trusting subject as a version of the disciplined subject, socially valued and malleable. Evidence of this can be found in a range of policy initiatives disseminated by national and local government drawing on communitarian discourses and including an endless array of devices promoting partnerships and active citizenship e.g., Caring about Carers (DoH 1999), Choosing Health (DoH 2004), Independence, Well-being and Choice (DoH 2005). Devices targeting communities and neighbourhoods through initiatives promoting community activities often focussed on a variety of locally based independent and autonomous groups. In areas where co-operative relations have failed and require rebuilding the deployment of discourses of empowerment is evident, inciting ‗damaged subjects‘ to self-manage (Rose 1996). Located in initiatives such as Health Action Zones, Community Development Projects and Public Health activities a range of experts and lay volunteers work on individuals encouraging them to take responsibility for their health and engage in selfforming activities, self-care and self-help (Rose 1999). Alongside this promotion of cooperative relationships, neo-liberal rule increasingly repositions the state as the coordinator of activity rather than the

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provider [cf. Modernising Social Services (DoH 1998), Every Child Matters (DoH 2003b), Choosing Health (DoH 2004) and Independence, Well-being and Choice (DoH 2005)], progressively drawing communities into the provision of welfare and the management of social problems (Clarke and Newman 1997, Rose 1996, 1999). New, often contradictory, rationalities of competition and co-operation, of participation and consumerism, substitute for earlier forms of public provision. Nevertheless, these contradictory rationalities maintain sufficient coherence to provide the basis for state intervention through professional and lay activity. One such example is the restructured relationship between the private health sector and the British National Health Service [NHS] (DoH 2002, Lewis and Gillam 2003). Until recently, the private health sector distanced itself from the NHS arguing quality and choice while those committed to a public health service rejected private sector values. Now, a range of policy initiatives such as the use of private sector surgical facilities, the ability to have particular treatments at a facility chosen by the patient (DoH 2003a) and Private Finance Initiatives [PFIs] have blurred the boundaries between the public and private health sectors. Fixing large sections of the private sector as the reserve capacity of the NHS expanding and contracting on demand without the political consequences of public hospital closures. Furthermore, the use of private capital shifts fiscal liabilities from the present to the future while at the same time distancing the state from responsibility for the maintenance and refurbishment of hospital and other health service facilities and equipment. Such developments suggest a re-articulation of the discursive structure of private, voluntary and statutory sector organisations in what Clarke and Newman (1997) describe as processes of colonisation and accommodation. Alongside State interventions aimed at provoking co-operative and trust-based relationships, such movements point to the way major institutions of society can become repositories of trust, providing both the example and the experience of trusting while also building the capacity for trust-based relationships across the social fabric. However, in contrast to functionalist conceptions of social institutions as repositories of trust e.g., Misztal (1996), we need to identify the dynamic interplay between the state and the means of intervention at its disposal. The challenges faced by the state over the last twenty-five years or so such as the increasing health costs of an ageing population (Rose 1999, DoH 2005) have been matched by rapid social change. One effect of this has been the fragmentation of welfare away from a monolithic state organisation to one coordinated and financed by the state but disciplined by market mechanisms

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such as commissioning and competitive tendering (Clarke and Newman 1997, Lewis and Gillam 2003). Another effect has been the politicization of the technical i.e., professional expertise (Johnson 2001), where a variety of forms of expertise competes for dominance. Under such conditions, trust is also politicized (Gilbert 1998). Trust becomes a commodity for exchange (Dasgupta 1988). Demanding new forms of governance and producing a paradox, autonomy for organisations and professionals released from direct management by the state is matched by ever more-complex forms of surveillance and control (Rose 1999, Gilbert 2001).

CONSTRUCTING PROFESSIONAL AUTHORITY THROUGH GOVERNMENTALITY One feature of the established order in the last quarter of the last century was one where the institutionalized interests of state professionals were considered to stand in opposition to both the views of particular sections of the state and the newly produced subject position of ‗welfare consumer‘ (Clarke and Newman 1997). Since the 1980s, claims of a decline in the authority of the professions accompanied this process. Public perceptions of failures of professional self-regulation articulate as institutionalized self-interest (Davies 2000), paralleled by the increasing power, or resistance, of health service users and welfare consumers to discipline professional activity. Managerialist techniques such as contracts and demands for transparency in exchanges unite managerial and user based discourses in an uncomfortable marriage (Rose 1999, Shaw 2001, Stewart and Wisniewski 2004, McIvor et al. 2002), frustrating the radical voice of user movements (Clarke and Newman 1997). Alongside, a massive increase in the access to the information, particularly through the internet, further complicates the situation. Specialist information, once the sole privilege of the professions, is now widely available, changing the relationship between professionals and laypersons once again challenging professional authority (Hardey 2005). For Rose and Miller: 'governmentality is intrinsically linked to the activities of expertise, whose role is not weaving an all-pervasive web of "social control" but of enacting assorted attempts at the calculated administration of diverse aspects of conduct through countless, often competing, local tactics of education, persuasion, inducement, management, incitement, motivation and encouragement' (Rose and Miller 1992: 175). This

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web of activity and the specialized spaces created for expertise, work to construct professional authority, condensing the different levels of trust: interpersonal, systems and social capital; into the facework of experts. The fragmentation of expertise, once embedded in the directly managed institutions of the state, has enabled the dispersal of this expertise throughout the third sector leading to a re-articulation of the discourses that support professional activity and trust in expertise. It is notable that despite the conflicts of the 1980s, the professions appear to carry on relatively unscathed leading to the conclusion that the decline in the authority, power and popularity of the professions has been overstated. One key factor is that certain tasks and activities demand professional competence especially in circumstances where the outcome cannot be predetermined (Clarke and Newman 1997). Once again, revealing the paradox of autonomy and increasing regulation in the relationship between the state and professional activity. Returning to the earlier quotation from Foucault, what has occurred in this period is the re-articulation of government objectives and a re-structuring of the realms of professional jurisdiction and authority (Johnson 2001). Regulation and control of expertise through audits and contracts are disciplinary techniques that have modernized the tricky issue of governing professional activity. Accompanied by a re-articulation of professional discourse objectifying the activity of expertise rendering it both manageable (Rose 1999), and enabling the surveillance of professional activity across a landscape no longer defined by institutions and buildings of the poor law. At the same time policy documents such as ‗Choosing Health‘ (DoH 2004) and Independence, Well-being and Choice (DoH 2005) are unashamedly consumerist, demonstrating shifts in the way community and population health is managed. Central to this process is a paradox where the need for experts to manage complex and unpredictable situations has led to trust in professional autonomy becoming almost exclusively located with the management of risk (Rose 1996, 1999, Petersen 1997, Kemshall 2002). Competence in the management of risk is therefore the central basis, which maintains the professional status of health and social care professionals. Failure in this respect can lead to very public examinations of the competence of individual professionals, in particular where there is danger of a legitimation crisis. Professionals who, despite evidence of system failure, experience a form of symbolic sacrifice and public humiliation, recent examples include Dr. Marietta Higgs [Cleveland Child Abuse Inquiry], Lisa Arthurworrey [Victoria Climbie‘s social worker] (James

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2005) and Professor Sir Roy Meadows [expert witness in child death cases (Laville 2005)]. Challenges to traditional or institutionalized expertise by new or nonconventional forms of expertise also demonstrates this re-structuring of the objectives of government and the jurisdiction of professionals. Some problems have persistently frustrated traditional forms of expertise in health care and social welfare at the same time widely dispersed and contract based activity enables entry for alternative approaches. Here again the dynamic quality of Governmentality, demonstrates processes of colonisation and accommodation. Lee-Treweek (2002) explores this process in the context of a complementary therapy, cranial osteopathy, describing how traditional medicine accepts elements of complementary practice on condition that the alternative approach accepts particular rituals and the primacy of the existing medical hierarchy. The need to manage chronic conditions such as skeletal and muscular pain, areas where traditional medicine has failed to provide a reliable treatment, enables a new form of expertise to institutionalise itself with the state. Securing trust in this specialized space enables this form of expertise to contest the hegemony of risk to its advantage. What emerges is a fusion of consumerist, traditional, alternative and complementary discourses articulated with discourses of co-operation, partnership and trust in health and social care providing an matrix of spaces where a wider range of expertise, in both type and numerically, than ever before is embedded. At one level, experts identify risk at the same time as providing a general surveillance of the population, at another level they work within systems legitimated by a myriad of mechanisms of distrust while simultaneously working at another level on individuals to promote a general ethic of trust. Thus, the mechanisms constructing the contemporary authority of expertise are established. Condensing trust in the facework of experts places users of health and social care in a dynamic context. Health and social policy continually redefines previous patterns of social relationships both within health and welfare agencies and between those agencies and their customers. Gilbert et al. (2003) identified professionals in health and social care agencies responding to policy pressures by managing the expectations [trust] of different individuals and groups with potentially conflicting interest‘s e.g., individual users, parents/carers and the local community. These experts engaged in a process of change and consolidation managing conflict while furthering both organisational and political aims related to community care. However, it is important to recognise, that the implementation of social

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policies are varied and policy implementation is highly contingent and uncertain (Lewis 2000, Watson 2000).

CONCLUSION In the discussion of matrix inter-relationship trust, governmentality and professional expertise, we have acknowledged the contribution of a range of theorists to this increasingly important concept in the social sciences and in health and social care. We also note that the conceptualization of trust leads to confusion not only in the distinction between the bases of trust and the outcomes of trust, but also in the definition of what trust is and how trust can be differentiated from allied concepts such as confidence and familiarity. In addition, the recognition of the persistence of social and normatively based beliefs and values that act as synthetic, binding people into relationships that enable future orientated action is central to understanding the limitations of rational models of human behaviour and policy developed thereon. However, this theorising ignores identifying the mechanisms, which establish these trustbased values across the social fabric. These issues are of critical importance in health and social care. To address these pressures we explored Foucault‘s conceptual ‗tool‘ of Governmentality thesis as the means to identify the role of trust in postmodernity, coupled with the processes for the employment of trust and the position of professional expertise in this process. A discursive framework promoting co-operative relations between individuals, communities and organisations consolidated this. This ethic is future orientated and promotes qualities and values that sustain trust-based relationships and forms of action. In the process of building co-operative relations, the role of professionals and professional authority is established. Claims that trust in professionals has declined is not substantiated given the pivotal role professionals continue to play in health and social care rather the reconfiguration of political objectives has changed the relationship between professionals and the state. The fact that some professional groups have found the process traumatic merely reinforces our claim that trust is politized, contested and functions as a commodity. The challenge for research and practice in health and social care is to move away from viewing trust as a benign side effect of human activity. Instead, we should be clear that trust is the intended outcome of a range of social policies and the discourses and practices that underpin those policies whose aim is the management of a population that is useful, productive and self-managing. Therefore, we need to focus on the interplay between social

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policy and the lives of individuals, families or groups and communities. Drawing out the costs and benefits of trust-based relationships, identifying the way the facework of experts maintains the legitimacy of systems while simultaneously promoting social cohesion, and constructing professional authority. We require an analysis the micro-politics of trust, played out in a myriad of interactions between users, carers, volunteers, professionals and administrators, within health and social care. In addition, we have to identify the discourses and practices e.g., the distinction between trust and emotion, that underpin this activity and the consequences of trust-based relationships for those involved.

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INDEX A access, 22, 29 accommodation, 28, 31 accountability, 20, 43 adjustment, 15 administrators, 33 age, 15 ageing population, 28 agencies, 31 alienation, 1, 7, 12, 17 anger, 7 anxiety, 9 appraisals, 6, 13 articulation, 24, 28, 30 attachment, 21 attitudes, 12 audit(s), 23, 25, 30 authority(s), vii, 8, 19, 20, 21, 24, 25, 26, 29, 30, 31, 32, 33 autonomy, 29, 30 aversion, 5 awareness, 7

B benefits, 21, 24, 32 benign, 27, 32 biotechnology, 62 bonds, 19, 24

Britain, 37 bureaucracy, 8

C cash, 11 challenges, 19, 21, 23, 28 Chicago, 40, 44, 45, 54, 55, 56, 57, 60, 62, 64 childhood, 22 children, 9, 11, 54 China, iii citizenship, 26, 27 City, 45 civilization, 7 classes, 7 clients, 22 coding, 4 coherence, 20, 28 colonisation, 28, 31 commodity, 26, 29, 32, 42 communication, 4, 9, 22 communication skills, 22 community(s), 19, 21, 22, 24, 25, 27, 28, 30, 31, 32 community relations, 22 competition, 28 complexity, 6, 23, 25 conceptualization, 19, 32 configuration, 4

74

Index

conflict, 1, 7, 26, 31 consciousness, 1, 3, 7, 13, 17 Consensus, 41 consolidation, 31 Constitution, 42, 48 construction, 6, 14, 15 consumers, 11, 29 contradiction, 7 coping strategies, 10 cost, 21 courtship, 12 creativity, 15 crust, 63 culture, 5, 7, 20 customers, 31 cynical pessimism, 10

D danger, 11, 30 defence, 7 detachment, 9 dichotomy, 11 directors, 16 disappointment, 19 disclosure, 22 discrimination, 5 distress, 4 dominance, 29 drawing, 21, 27, 28 dualism, 4, 7, 8

empowerment, 27 encouragement, 29 endangered, 10 England, 43 entrepreneurs, 26 environment, 15 environmental issues, 9 epidemiology, 15 equipment, 28 erosion, 24 ethics, 42 ethnicity, 15 Europe, 69, 70 everyday life, 1, 4, 8, 10, 15, 22 evidence, 25, 30 examinations, 30 exclusion, 5 exercise, 21, 26 ex-Hollywood actors, 16 expertise, 21, 22, 23, 24, 25, 26, 29, 30, 31, 32, 55 exploitation, 11 exposure, 19

F

E economics, 9 education, 29 e-mail, 16 Emancipation, 65 emotion, 1, 3, 4, 5, 6, 7, 10, 11, 12, 13, 14, 15, 17, 19, 33 emotional experience, 8 emotional state, 5 emotionality, 4, 7, 8, 11 employment, 20, 32

faith, 10, 20, 23 families, 21, 32 family life, 11 farms, 11 fast food, 11 feelings, 5, 13 feminism, 6 films, 16 financial, 58 flexibility, 6 flooding, 10 food, 10 force, 1, 4, 5, 9, 17 foundations, 23 freedom, 17 Freud, 1, 6, 7, 8, 45, 46, 47, 59, 62 functionalism, 3 fusion, 11, 31

75

Index

G Germany, 54 gestures, 16 glue, 7, 19 governance, 15, 29, 63 governments, 20 growth, 11

H happiness, 8, 17 health, 11, 21, 23, 24, 26, 27, 28, 29, 30, 31, 32, 49, 52, 60 health care, 23, 31, 49, 60 health services, 23, 26 hegemony, 31 history, 3, 4, 6, 42 hope of salvation, 8 House, 69 human, 5, 8, 9, 11, 20, 22, 32, 62 human activity, 32 Hunter, 54

I identification, 8 identity, 4, 10, 13, 20, 26 images, 16 imagination, 3, 4, 6, 17 impulses, 7 Independence, 27, 30, 44 individualism, 53 individuality, 53 individuals, 3, 4, 8, 13, 15, 16, 19, 21, 23, 24, 25, 26, 27, 31, 32 insecurity, 3 inspections, 23 instinct, 7 institutions, 19, 20, 21, 24, 28, 30 integrity, 22 internalised, 9, 15 internalization, 1, 17 intervention, 28

ions, 4 Iowa, 60 iron, 8 isolation, 23 issues, 4, 6, 17, 20, 23, 32, 56 Italy, 63

J Japan, 11 jurisdiction, 30, 31

K Keynes, 37, 41, 45, 52, 64, 67, 68 kill, 9

L lack of control, 10 landscape, 26, 30 lead, 8, 30 leadership, 9 learning, 10, 49 learning disabilities, 49 liberation, 9 light, 6, 9, 21 local community, 31 local government, 27 love, 16, 20

M management, 3, 13, 26, 28, 29, 30, 32 manipulation, 16 marriage, 12, 29 Martin Heidegger, 39 Marx, 1, 6, 7, 17, 35, 42, 46, 48, 58, 59, 62, 63, 65, 66 mass, 4 mass media, 4 matrix, 31, 32 media, 4, 16, 52

76

Index

medical, 14, 24, 31 medicine, 31 memory, 1 mental illness, 14 Merleau-Ponty, 15 messages, 5 microwaves, 11 Minneapolis, 65 mobile phone, 16 models, 20, 22, 32 Modern Age, 48 modern society, 4, 7, 9, 10, 20 modernity, 4, 5, 7, 8, 10, 11, 14, 16, 19, 24, 27 motivation, 29 murder, 9, 54 music, 16 music videos, 16

N National Health Service (NHS), 28, 43, 57 national identity, 20 national strategy, 43 negative effects, 11 neuroses, 7 Nietzsche, 53

O

Q quantification, 11

R

obedience, 9 opportunities, 15, 26 oppression, 7 optimism, 10 osteopathy, 31, 57 overlap, 6

P pain, 12, 31 parallel, 20 parents, 31 personal values, 12 personality, 10, 12

persuasion, 29 pessimism, 10 Philadelphia, 50 physiology, 4 playing, 4, 6, 11 pleasure, 12 policy, 27, 28, 30, 31, 32 policy initiative, 27, 28 politics, 33, 40 population, 4, 21, 23, 24, 26, 30, 31, 32 positive correlation, 22 Positivism, 49, 60 power relations, 16 predictability, 10, 11 president, 16 primacy, 31 private sector, 28 probability, 19 professionals, 19, 20, 21, 22, 24, 26, 29, 30, 31, 32, 33 project, 4, 9, 16 prosperity, 47 psychiatry, 14 public health, 28, 63 public sector, 60

radio, 16 rationalisation, 8, 9, 11 rationality, 1, 4, 6, 8, 10, 11, 17 reactions, 5 reality, 3, 6, 14, 16 reasoning, 1 reciprocity, 23 recognition, 7, 32 recovery, 22 reform, 57 regulations, 8 relatives, 11

77

Index relevance, 19, 50 religion, 7, 8 repression, 1 reproduction, 16 resistance, 29 response, 10, 16 rewards, 8 risk(s), 3, 9, 10, 15, 24, 25, 26, 30, 31, 58 routines, 8, 10 rules, 8, 13

S sacred objects, 6 safety, 11, 24 schema, 15 science, 1, 9, 10, 19, 56, 62 scientific knowledge, 24 security, 10, 20, 22 self help, 14 self-interest, 29 self-regulation, 29 services, 13, 49 sexual abuse, 37 sexual behaviour, 12 sexuality, 15 signs, 5, 16 simulation, 16 social capital, 19, 22, 23, 25, 30 social care, 21, 23, 24, 26, 30, 31, 32 social change, 20, 28 social class, 15, 16 social consensus, 17 social consequences, 6 social construct, 4, 6, 14, 15, 16 social construction, 4, 6, 14, 15, 16 social context, 1, 4, 27 social control, 29, 66 social environment, 20 social fabric, 25, 28, 32 social group, 5 social institutions, 28 social interactions, 5 social life, 8, 19 social norms, 22

social order, 4, 12, 16, 20 social phenomena, 12 social policy, 31, 32, 57, 70 social problems, 28 social reality, 15 social relations, 3, 6, 17, 20, 21, 31 social relationships, 20, 21, 31 social sciences, 19, 32 social status, 24 social structure, 4, 5, 6, 15 social theory, 3, 5, 11, 17, 19, 62 social welfare, 31 social workers, 14 society, 3, 4, 5, 6, 7, 9, 17, 20, 21, 25, 28, 48, 49 sociology, 56 solidarity, 1, 6, 17 spirituality, 4 Sri Lanka, 64 stability, 20 stakeholders, 68 state(s), 3, 7, 17, 21, 23, 25, 26, 27, 28, 29, 30, 31, 32 state intervention, 26, 28 stress, 13 structure, 6, 9, 28 structuring, 30, 31 style, 15 surveillance, 29, 30, 31 survival, 25 symbolic interactionist perspective, 12 symbolic meanings, 12 symbolism, 1, 17 symptoms, 5 synchronization, 6, 7

T tactics, 21, 25, 29, 56 target, 23 techniques, 23, 26, 29, 30 technology(s), 11, 15, 26 television sitcoms, 16 tension(s), 7, 24, 25, 26 territory, 4, 65

78

Index

terrorism, 10 therapy, 31 think critically, 3 tourism, 11 traditions, 63 trajectory, 11, 27 transformations, 21 transparency, 20, 23, 29, 60 treatment, 31 trial, 10 trustworthiness, 22, 24, 26, 27

W war, 9 waste, 11 web, 29 welfare, 28, 29, 31, 49 well-being, 14 western culture, 16 workers, 11 working class, 7 World War I, 9 worldview, 12

U UK, 23 unquestioning obedience, 9 USA, 23

V vaccine, 24 vote, 16

Y yield, 12