What a White Shame: Race, Gender, and White Shame in the Relational Economy of Primary Health Care...

What a White Shame: Race, Gender, and White Shame in the RelationalEconomy of Primary Health Care Organizations in England

Shona Hunter

Social Politics: International Studies in Gender, State and Society,Volume 17, Number 4, Winter 2010, pp. 450-476 (Article)

Published by Oxford University Press

For additional information about this article

Access Provided by University of Leeds at 06/02/11 8:40AM GMT

http://muse.jhu.edu/journals/sop/summary/v017/17.4.hunter01.html

http://muse.jhu.edu/journals/sop/summary/v017/17.4.hunter01.html

SHONA HUNTER

What a White Shame: Race,Gender, and White Shame inthe Relational Economy ofPrimary Health CareOrganizations in England

Abstract

This paper considers the relationship between white shame incontemporary UK health care contexts and historically idealizedforms of white pride derived from nineteenth-century Britishcolonialism. It uses excerpts from qualitative interview materialto highlight the contemporary figures of the “white worriedman” and the “white women savior” and the relationshipbetween them. Through this, it explores how shifts from whitepride to white shame reflect shifts in the focus of whitenessaway from civilizing the racialized Other to civilizing the whiteself. Through this analysis, it further complicates shame theoryarguing for an understanding of [white] shame as constitutedthrough a relational economy, differentiated through class andgender as well as race.

Winter 2010 Pages 450–476 doi:10.1093/sp/jxq015# The Author 2010. Published by Oxford University Press. All rights reserved. For permissions,please e-mail: [email protected] Access publication October 25, 2010

Social Politics 2010 Volume 17 Number 4

Introduction

Dominant white identity . . . operates melancholically as anidentificatory system based on psychical and socialconsumption-and-denial. This diligent system of melancholicretention appears in different guises. Both racist and whiteliberal discourses participate in this dynamic, albeit out ofdifferent motivations. The racists need to develop elaborateideologies in order to accommodate their actions within official. . . ideals, while white liberals need to keep burying the racialothers in order to memorialize them. . . . Both violent vilifica-tion and the indifference to vilification express, rather thaninvalidate, the melancholic dynamic. Indeed melancholia offersa powerful critical tool precisely because it theoreticallyaccounts for the guilt and the denial of guilt, the blending ofshame and omnipotence in the racist imaginary (Cheng 2000,11–12 italics in original).

A revived academic interest in white shame is driven by the desire tobetter understand white identities as characterized by the interdepen-dence of dominance and loss. It extends important work on white-ness as the strategic denial of privilege deployed to maintain socialpower, whether materially (Allen 1975; Harris 1998; Roediger1991; Wellman 1993), symbolically or linguistically (Martin et al.1999; Nakayama and Krizek 1999; Steyn 2001; Ware and Back2002), or as a function of everyday experience and biography (Byrne2006; Frankenberg 1993). Instead it views white disavowal as a signof struggle to forget elements of the self which are in conflict withthe desired image of self. In this way, such academic work followsthe broader academic interest in shame as a means to thinkingthrough the relational nature of identification (Crozier 2008; Kulikand Klein 2003; Lindquist 2008; Scheff 2000; Sedgwick and Frank1995). It reconsiders the duality of the self, recognizing the constitu-tive nature of the Other in the construction of the self as simul-taneously both loving and aggressive and both good and bad. Thus,it sees whiteness psychosocially as a relational location which hasmaterial, discursive, and psychic dimensions (Gunaratnam andLewis 2001; Hunter 2003, 2009a; Raey 2008). It is lived out ineveryday identities and practices, at the intersection of the individualand collective; constituted through multiple and intersectingrelations of power and inequality; and through complex and contra-dictory feelings of resistance and desire (in this case, I focus onshame and pride).

What a White Shame V 451

In this paper, I consider what these ideas have to offer for reconsi-dering the identities of welfare professionals in contemporary post-colonial English health care settings. I am particularly interested inexploring what expressions of white shame in the narratives ofEnglish health and social care professionals can tell us about chan-ging discourses of whiteness in these contexts. The paper draws onempirical research carried out between 2000 and 2003 in threeEnglish Primary Care Trusts (PCTs)1 undergoing the “moderniz-ation” process instigated after the 1997 election of the New Labourgovernment. This fieldwork was qualitative, including observationand serial biographic narrative interviews (Hunter 2005a; see alsoGunaratnam 2004; Hollway and Jefferson 2000; Wengraf 2001)with a range of white medical professionals including GPs, nurses,social workers, and hybrid medical professional-managers. The aimwas to generate in-depth narrative data on identities and experiencesat work which could give insight into the discursive structures ofmedicine and allied professions,2 and their more recent developmentin the context of “modernization.” By discursive structures, I referto the gendered and racialized professional cultures shaped throughdynamic processes of social formation. These discursive structuresprovide the socially coded frameworks through which professionsproduce narratives about themselves, what they are, how theyoperate, what they seek to accomplish, and how they define theiridentity. They frame the institutional subject positions (Padamsee2009) of nurse, doctor, social worker, which define the limits andrange of possibility for thinking, speaking, and acting for individualswho respond to the call to position themselves within a given pro-fessional discourse in a given institutional context. But like othersubject positions, professional identities are constituted through mul-tiple, often competing and contradictory discourses both within andmarginal to the universe of available discourses (in this case, thoseavailable within the institution of the English NHS).

I begin the paper by considering the ways in which British welfar-ism (and the NHS as pivotal to this) has been intricately linked tocontradictory productions of whiteness through the changing inter-sections of gender, race, and class in nineteenth-century colonialism.In particular, I consider the role of English medicine in producingcolonial whiteness as an inspirational identity; an identity to beproud of. Thus, I position the social construction and reproductionof whiteness as an important part of the discursive structure ofEnglish medical culture and what it means to be a medical pro-fessional. I then use contemporary shame theory (Ahmed 2004;Probyn 2005; Sedgwick and Frank 1995; Thandeka 1999) toanalyze interview data from my research with health and social care

452 V Hunter

professionals. Taking seriously the premise that shame alerts us todiscursive dilemmas and contradictions between self and Other, Iexplore how shame in new health care contexts relates to an appar-ent inability to live up to the new discursive ideal of the modernpublic service professional. This new ideal views professional successand good-quality service provision as achieved through contempor-ary practices of liberal whiteness, associated with flexibility, diver-sity, communication, and holistic care as well as economy efficiencyand accountability. I argue that, in such contexts, one way ofreading these feelings of shame, is as shame related to not “beingwhite enough.” Through this analysis, I argue for an understandingof white shame as constituted through a relational economy, differ-entiated through class and gender as well as race. This more differ-entiated analysis enables an understanding of how shamingdynamics can work to challenge, but simultaneously reproducedominant discourses of whiteness.

Medicine, Empire, and Modernization

Critical historical analyses of state systems of welfare provisionprovide reminders as to their complex and contradictory trajectories.They present another side to the view of welfare regimes as benignor even benevolent purveyors of social citizenship. Such accounts ofthe English universal welfare state regime, with the NHS as its cor-nerstone, analyze the ways in which Imperial elsewheres under-pinned the development of health policy and practice “at home,” aspart of racially structured patriarchal capitalism (Williams 1989).These elsewheres created its raced, gendered, and classed discursivestructures, but also an ongoing material and cultural legacy in termsof the circulation of bodies and practices in contemporary Englishhealth care contexts.

In practical terms, medicine preserved the health of overseas troopsand the expanding British colonial administration. Ideologically, itconstituted a form of “medical government” (Bashford 2000). It insti-gated the very categorization of bodies into races used to justifyslavery and imperialism (Bhopal 2001, 934, see also Gilman 1985)and was an integral part of the Christian “civilizing mission” in thecolonies where the provision of medicine was used to break downopposition to colonial rule (Doyal and Pennell 1994, 249–55). Thiscivilizing process worked two ways, civilizing the white self as muchas the colonized Other because it was pivotal to producing whitenessas more than skin color. It was about “how one lived, how onearranged one’s moment by moment existence in space and time: dailyroutine, exercise, diet, leisure and mental diversions” (Bashford 2000,


266). In other words, colonial medicine was crucial to enactingwhiteness as a form of accumulating cultural capital whose powerrests on the binary oppositions constructed between colonizer/colo-nized (Fanon 1986; Lopez 2005; McClintock 1995), being devel-oped/being underdeveloped (Heron 2007), First World/Third World(McClintock 1995).

It is because whiteness is accumulated as a form of material andsymbolic capital that it is better to think in terms of whitened ratherthan white people. Through European colonial expansions, race andmedical science were mutually reinforcing myths in the pursuit andexpression of Empire and in the construction of whiteness as a “uni-versal ideal and the peak of humanity”(Bonnett 2000, 42), thebearer of “Western civilization.”3 Moreover, whiteness is con-structed through interlocking systems of race, class, gender, andsexuality. White women have historically supported and enabled theconstruction and reproduction of white masculinity through theclassed and racialized “cult of domesticity.” Following McClintock(1995), this cult operated to merge domesticity and empire throughdistinction between the public/civic/political and private/home/natural, constructing this division as crucial to the white liberalmiddle-class male identity. Thus, white masculinity is defined by itsenterprising nature constituted through, energy, dynamism, heroism,will-power, far-sightedness, and control of self and Other, includingwomen and “natives.” White men are constructed as natural bornleaders, with Imperialism giving this character its logical expression(Dyer 1997, 30–32); they have the right, indeed the duty to civilize.

Medical expertise increasingly confirmed the salubriousbenefits of European camaraderie. . . . White prestige becameredefined by the conventions that would safeguard the moral,cultural, and physical well being of its agents, with whichEuropean women were charged. Colonial politics lockedEuropean men and women into routinized protection of theirphysical health and social space in ways that bound the racialcleavages between “us” and “them” (Stoler 2002).

The colonial medic then, in his leadership role over the constructionof colonial whiteness as well as blackness, was in many senses theepitome of this white masculine ideal. He embodied the dynamicand heroic spirit and practice of Empire.

Whereas imperial pasts may appear to be clearly structuredthrough relations of white dominance and minoritized subordina-tion, contemporary postcolonial English welfare contexts are charac-terized by the more subtle differential inclusion of Black and Asiansubjects into the nation. Gail Lewis (2000) uses this notion of

454 V Hunter

differential inclusion to acknowledge the paradoxical, complex, andcontested position of Black and Asian subjects who have struggledagainst racism in welfare provision and employment to create aplace for themselves within the professional structures of service pro-vision. Despite these gains, inclusion is predicated on terms whichcontinue to construct these professionals as Other, the ones to beintegrated or encompassed into Britishness or Englishness, the onesto be melded into “us” (Henry 2007; Raghuram 2007; Smith andMackintosh 2007). From this perspective, multicultural claims to“value difference” and “work with diversity” constitute part ofthese relations of differential inclusion. Rather than presenting astraightforward challenge to the hierarchically ordered relations ofracialized domination and subordination, these claims to liberal tol-erance serve to reconfigure the boundaries of inclusion and exclusionthrough the creation of new categories of legitimate national andorganizational belonging.

Elected in 1997, the English New Labour government prideditself on its incorporation of tolerance, diversity, and equality as partof its core left-wing commitment to social justice with the newright’s commitment to efficiency, effectiveness associated with thenew public management. Both were crucial planks for its moderniz-ation agenda linking issues of social equality in employment andorganizational practices with issues of service quality, efficiency, andeffectiveness. Within the NHS, this commitment to diversity andequality was viewed as directly linked to improving the quality ofpatient care. As core to NHS modernization, PCTs were to consti-tute organizational contexts where challenges to traditional hierarch-ical organizational cultures could thrive, and ripe for doing“pioneering work” “in embedding equality within their structuresand activities from the outset” (National Health Service Executive2000, 43). They were to represent the broader “changing Britishmood” (DoH 2003, 8) in the health services through the fusionbetween quality and equality.

In spite of these hopes at the inception of PCTs, the findings frommy study (see Hunter 2009b) suggested widespread concern about theongoing gendered and raced inequalities and the intrusion of whatwere considered to be “old fashioned” masculinist ways of workingin the context of PCTs. Good professionals, no matter what their pro-fessional positioning, were considered to be those who conformed tothe new modernized organizational ideals of quality/equality, pre-senting a challenge to “old fashioned” masculinities characterizingtraditional public service working cultures. Where PCTs were con-sidered to be “failing” in quality/equality terms, the “cause” waslocated in the residual machismo of male practitioners and in


particular GPs. Thus, the existence of “old fashioned” machismowithin what were otherwise viewed as changed working culturescame to represent a failure to fully modernize health and social care.While this failure was often unsurprisingly attributed to male GPs asthe ongoing bearers of “medical dominance,” it was couched in termsof broader malaise around the ongoing existence of hypermasculinebehaviors in the context of the PCT, other health contexts, and in thegeneral culture. This finding is suggestive of the other side of thecurrent postcolonial moment identified by Gail Lewis (2000). Thisother side relates to the fracturing of the illusion of white masculinedominance, which is part of the more complex and ambivalent discur-sive dynamics where racialized victims and perpetrators are less easilyidentified and separated out one from the other. In the followingsections of the paper, I am interested in considering what this discur-sive shift toward more explicitly fractured whiteness tells us about thecontemporary complexities and fragilities of dominant white position-ings, and what this says about the potential to contest dominantdiscourses of whiteness in health and social care.

Living White Shame

Writing about the United States, Thandeka (1999) adopts a rela-tional understanding of the self to explore the construction of thewhite self as a moral project. Her work shows how the constructionof a “good” white self relies on the paradoxical existence of a “bad”white self, and that the very recognition of the existence of the latter,puts the white self in crisis. This is because this recognition highlightsthe fantasy nature of whiteness, threatening to expose the materialand symbolic work (such as that involved in the forms of medicalgovernment described above) necessary to constructing white peopleas the appropriate bearers of “Western” civilization. It is because ofthis mutually constitutive nature of “good” and “bad” that:

[N]o one can be fully White, but people yearn to be so. It is inthis sense that whiteness is itself a fantasy position and a fieldof accumulating whiteness. It is by feeling qualified to yearnfor such a position that people can become identified as White(Hage 1998, 58).

What Hage points to here is that the material and symbolic pro-cesses necessary to accumulating and maintaining whiteness are alsoreliant on psychic processes which serve to create the ideal image ofthe white self as a meaningful subject. Again, following Hage (70):“fantasy gives meaning and purpose to the subject’s life and themeaning and purpose which makes life worth living is itself part of

456 V Hunter

the fantasy.” This white supremacist fantasy structures whitepeople’s lives, but this does not mean that all white people activelydefine themselves through this fantasy. Rather, some whitenedpeople “inhabit fantasy spaces of which they are part” (70).

For Thandeka, white shame is the emotional display of the“hidden civil war” that ensues for whitened subjects through thenecessary denial of their difference to the dominant ideal form ofwhiteness. She claims that, in the American context, this dominantideal is constructed through the historical legacy of English colonial-ism and slavery which served to create interdependent systems ofclassism (racial strategies devised to hide and thereby promote orprotect economic class interests) and racism (racial strategies devisedto hide feelings of racial shame either by diverting attention to thesupposed racial flaws in others or by calling attention to oneself asracially superior) reliant on interdependent economic and psycho-logical uses of race. Thandeka uses this distinction to trace how his-torically the upper-class economic ploy to accord white racialprivileges to the lower classes (classism) became a lower-classpsychological need (racism) to distinguish the previously indenturedwhite lower-class self from the Black slave, in order to constructsimilarity to the white slave owner (Thandeka 1999, 42). Theimpact of the historical legacy of slavery on the white self is that“white self consciousness is filled with a darkened self-contempt forlower-class weaknesses and vulnerabilities to upper-class interests”(Thandeka 1999, 133).

Thandeka’s work on shame is useful in highlighting the subjectiveinstabilities and contradictions in whiteness. It is also suggestive ofthe ways in which various whitened subjects, such as the urbanworking class and poor and a range of immigrant groups like theIrish and the Jewish, have at different times and in different contextsbeen considered shameful (Bonnett 2000, see also O’Connel in thiscollection), providing a necessary foil for the production of “good”white subjects. However, the more interesting aspect of her work formy discussion is the way in which it explains how race shame moreusually associated with racially minoritized subjects works for whitesubjects too. It is manifest in the feeling that there is something fun-damentally wrong with the white self, which has had to be hidden,repressed, and forgotten. From this perspective, self identificationsoutside of the parameters of what is deemed acceptable to thewhite-middle-class bourgeois ideal are forbidden by the wider whitecommunity because they threaten to expose this white ideal as animpossible to achieve fantasy. In turn, this means a crucial com-ponent of white shame is “the necessity of concealing one’s owntrue feelings from view,” where these feelings challenge the white


supremacist status quo, for example where white subjects disagreewith racism (Thandeka 1999, 76). These feelings must be concealedin order to avoid attack and exile from the broader white commu-nity, which ensue when its unspoken norms and codes of conductare broken. It is the complex reactions to these contradictory desiresto break, but also sustain codes of whiteness that Thandeka thinksof as white shame. The paradox of this sense of shame then is thatdespite its centrality to self consciousness, it is rarely acknowledged.It is always accompanied by an “acute momentary need for uncon-sciousness” (Lewis 1990, 234). It is this “teetering between theknown and unknown” (Cheng 2000, 16) which characterizes thepeculiar narrative of loss in white racial melancholia.

Researching White Shame

From a feminist psychosocial approach (Hunter 2005b, 2009a),biographic narrative interviews like those conducted in my PCTstudy constitute dynamic relational encounters between participants(researcher and researched) multiply positioned through material,social, and psychic experience. First interviews proceeded from aninitial open question inviting participants to tell me about theirworking lives. However, unusually for psychosocial approaches, insubsequent interviews, participants were invited to position them-selves as gendered and raced. In other words, they were explicitlycalled on by me to take up a position in gendered and raced dis-courses. The choice to intervene in such a direct way in interviewswas intended to take seriously the claim that those who are posi-tioned dominantly within discourses of gender and race often find itdifficult to recognize themselves within gendered and raced relationsof power, this, of course, includes me as a white woman researcher.Dialogue between researcher and participants around these position-ings is encouraged in order to challenge such silences; it is also con-sidered crucial to analyzing the multiple and changing dynamics ofpower between research participants. This sort of approach meanspaying as much attention in analysis “to what we don’t say, andhow we avoid saying it” as to “what we do say and how” (Hunter2009b, 141–42; see also 2005a, 2005b).

According to the psychoanalyst Helen Lewis, the “turning away”from shame can be discerned in breaks in the “natural flow” ofspeech which flag-up moments of critical consciousness where thereare doubts about the self. This turning away from shame is experi-enced in two ways, as overt, but unacknowledged, or as bypassed.The first experience involves clear expression of discomfort, butthere is a failure to identify this as shame. The second experience ofbypassed shame involves less overt displays of discomfort.

458 V Hunter

What does occur in awareness is ideation about the shame event,specifically thoughts, (mainly doubts) about the self-image seenfrom the “other’s” viewpoint. These sometimes escalate into aninternal auditory colloquay about the shame-connected event.The person cannot seem to stop thinking (obsessing) about theshame-connected event (Lewis 1990, 243).

I want to use this insight to claim that “worries” over white mascu-linities in PCTs represent a form of bypassed collective shame whichis also racialized as white. These worries were about recognizing theongoing existence of gendered and raced inequality, but placing itelsewhere, outside of the responsibility of the currently idealizedwhite professional self.

Following this sort of approach, in the analysis that follows Iconnect up moments of self doubt (including some of my own) anddominant discourses of white masculinities and femininities withinthe interview narratives of health and social care practitioners whoparticipated in my study. It is important to recognize that I am notseeking to reduce any one individual’s subjectivity to white shame,rather my argument is suggestive, pointing to moments of whiteshame intruding into participants’ narratives. My aim is to under-stand the contested meanings of this shame and what it tells usabout the reproduction of whiteness as an organizational ideal inEnglish health and social care.

Worried White Men

Data generated with white male health and social care prac-titioners reflected the sort of critical consciousness Lewis associateswith bypassed shame. Rather than the cut and thrusting, vibrant,self-assured narratives one might expect from men at the top of con-temporary public sector organizational hierarchies, male participantsoften displayed open discomfort in interviews. Shifts in tone, towarda more halting, sometimes even confused form of expression, weremost pronounced when participants were discussing more overtlymasculine behaviors within health care contexts. Male participantswere “uncomfortable,” “worried,” “concerned” “when malesexhibit true or, you know, classic male behaviors,” “cor blimey gov-ernor.” They were “staggered,” “puzzled,” and startled by mascu-line “testosterone”-fueled behavior, head on “clashes” in meetingsbetween “inflexible” and “didactic” [male] GPs and “macho man-agers” “RUDENESS!” and conflict. As one regional social workmanager put this: like a “real overhang from the old days, anINCREDIBLE individualism, and you know nothing wrong withwhat we do, you know, we cover everything and we do it great.”


Bill4 is one of these white men, fifty years old, a senior whitehealth services manager, chief executive officer of a PCT. Althoughhe is a member of the professional managerial classes now by virtueof his occupation, he grew up in a traditional working class family inthe North East of England, commonly known as the “white high-lands” (Nayak 2003). He describes himself wryly as “upwardlymobile.” Bill was one of the white male participants most overtlycritical of the hypermasculine organizational cultures still operatingwithin a contemporary UK health care context; his account was inter-esting in that while he related this to ongoing cultures of medicaldominance, he also had specific concerns as to the “new breed” ofhealth services manager ushered in by New Public Management.While critical traditional hierarchical cultures, this new form of ideal-ized masculinity continues to reflect competitiveness, risk-taking, andthe domination of space and other individuals (Hopton 1999). In ourdiscussion of his own positioning within that set of relations, he talksat length about the difficulties of being a “new man.” But when histhoughts turn to ethnicity at work, he has more difficulty in articulat-ing his position.

Bill

[Bill] I mean official statistics, definitions often say WHITE,they then don’t break it down to British areas, you gowhite, Pakistani, which well, white isn’t an ethnicgroup, I mean I have, I worry about that, um, but therewas just this arrogant [male] managerial assumptionthat there was white people and then there were otherpeople, and you could break the other people down,into Swahili’s and Pakistanis and whatever, which isincredibly arrogant. So there’s still that sort of elementof culture {pause} being British? It’s embarrassing isn’tit?

[AUTHOR] Well {laughing} I don’t know.[Bill] I’d say to be perfectly honest.[AUTHOR] In what sense?[Bill] Um, because of this {pause} what do people from other

places think of the British? Well they think you know,shaven heads, bare chests, lots of beer, and I’ve beenround, you know, I’ve been round, I’ve been to a lot ofcountries and you know I’d rather go on holiday wherepeople there aren’t British people, quite embarrassingat times . . .

460 V Hunter

Despite hesitation and confusion at the beginning of this extract,it becomes clear that Bill’s “worry” is over white dominance: “theydon’t break it [white] down,” “there was white people and thenthere were other people,” and in particular this is a worry aroundthe privilege of remaining unmarked. Early on, he attaches this privi-lege to the arrogant managerial practices he has identified earlier asemblematic of contemporary masculine organizational cultures. Ashift occurs in the extract where he begins to ponder “embarrassing”Britishness. The image Bill invokes here “shaven heads, bare chests,lots of beer” conjures the common stereotype of parochial, mascu-line, shaven head “larger lout” Britishness. This caricature of theclassed male subject is offered here in contrast to the middle-classmanagerial subject. However, both white male positions are worri-some to Bill; they are either arrogant or ignorant, both of which per-petuate white dominance. The difference in tone from worried toembarrassed conforms to the classic pattern of bypassed shameidentified by Lewis. Bill’s initial references are to worry, suggestinghis own shame at his association with white middle-class arrogancethrough his current occupational status as manager. His much moreexplicit and vividly symbolized embarrassment is related to the waythat others still potentially see him—“what do people from otherplaces think of the British?”—as a working classed subject, hisshame in this instance triggered through association. While racism isonly ever euphemized as either arrogance or ignorance, Bill’s posi-tioning as a worried onlooker enables him to distance himself fromwhite racist behaviors located in these two different constructions ofmasculinities. Overall, the excerpt serves to position men as intoler-ant, excessive, uncouth, and oppressive through either arrogance orignorance. But, it exemplifies how different masculinities constitutea locus for shameful whiteness, arrogant “middle class” managerialmasculinities, and white working classed, “laddish” (overtly hetereo-sexualized) masculinities. This suggests a more differentiatedaccount then than the one described by Thandeka above of therelationship of whiteness to shame in that it is cross cut by multipledifferently classed masculinities.

A close analysis of Bill’s account is suggestive of the racializedmeanings of broader collective worry over masculinities across nar-ratives and the melancholic dilemma within which contemporarywhite masculine professional subjects find themselves. This collectiveworry alerts us to shame produced through male practitioners inassociation with white masculinities by virtue of their positioningwithin gendered and raced discourses. This shame arises because dis-courses of white masculinities are positioned so far away from newmodernized organizational ideals of equality, communication,


respect, etc. In this analysis, pathological constructions of masculi-nity and whiteness feed off and into each other. Male subjectivitiesin this scenario appear deterministically split between two forms ofmachismo. There is contemptuous dissociation from humiliating,embarrassing, and classed traditional and working classed whitemasculinities, coupled with ongoing concerns around arrogant per-formances of white middle-classed masculinities. Neither positioninginvites unproblematic take-up by male subjects. The potential resultis another version of the eternally lost, “failed” white male subject,unable to take responsibility for [himself] or his actions within gen-dered and raced social relations (Yates 2000).

Differentiating White Shame

Elspeth Probyn (2005) inspired by the psychologist SilvanTomkins posits a more differentiated approach to shame thanThandeka. She suggests that shame is neither simply negative, norsimply positive rather, because it is dependent on encountering bar-riers to excitement or enjoyment, it is more ambivalent than this,and it is always in some sense productive.

Shame illuminates our intense attachment for the world, ourdesire to be connected with others, and the knowledge that asmerely human, we will sometimes fail in our attempts to main-tain those connections (Probyn 2005, 14).

This means that although they both view shame as relationally con-structed, Probyn presents a contrast to Thandeka’s emphasis onmoral development. Instead, she interprets shame more openly toencompass a broader range of multiple qualitatively different rela-tional possibilities than simply good or bad (see also Sedgwick andFrank 1995).

According to Tomkins, the feeling of shame is one of indignity,defeat, transgression, and alienation, lacking in dignity or worth.However, this feeling varies in its intensity, manifestation, and itsconsequences. This leads Tomkins to think in terms of a shame–humiliation continuum including shyness, shame, guilt, and self con-tempt. For him, there are two components to the multiplicity ofshame. First shame is:

. . . at once a measure of civilization and a condition of civiliza-tion. Shame enlarges the spectrum of objects outside of [theself] which can engage [people] and concern [them] (Tomkins1995, 162).

This means that:

462 V Hunter

To the extent to which the individual invests his [sic] affect inother human beings, in institutions, and in the world aroundhim, he [sic] is vulnerable to the vicarious experiences ofshame (Tomkins 1995, 159).

Shame is therefore experienced vicariously at the shameful behaviorof others with whom the self identifies. This can be because theother feels shame, but also because the other does not, but wherethe subject feels that they should. In the second case, shame is felt atthe shamelessness of another, so it is the failure to feel shame, ratherthan the shameful act, which provokes shame in the onlooker.

Second, when considering variations in shame along the shame–humiliation continuum “it is the differences in the other components. . . which are experienced together with shame” (Tomkins 1995,159) which make the different experiences distinguishable. Thus,shame is the “underlying affect” (Tomkins 1995, 159), the startingpoint for multiple possibilities for potentially reparative action. It ispart of what Tomkins calls a multidimensional affect theory “a sim-plified and powerful summary of a larger set of affect experiences”(Tomkins 1995, 165). Therefore, shame relates to and draws in arange of objects, ideas and other affects, operating as part of whatSara Ahmed (2004) calls an “affective economy.” Within affectiveeconomies, emotions are not entities, but produced interactively as aform of action, they:

work as a form of capital: affect does not reside positively inthe sign or commodity, but it is produced as an effect of its cir-culation. Objects of emotions circulate, or are distributedacross a social as well as psychic field (Ahmed 2004, 45).

Furthermore, for Tomkins, affects produce other affects; it is theorganization of affects within an affect theory which is constrainingor enabling of action. From this perspective, the important pointabout emotion is not to define it, but to ask what it does and whatare its multiple effects? Drawing on this insight, I propose an analy-sis of the gendered relational economies of white shame in healthand social care workers narratives, with a view to exploring shamingdynamics and their implications for challenging dominant discoursesof whiteness.

White Women Saviors?

A common theme generated in interviews with womenprofessionals was their desire to go into health care, whether it bemedicine, nursing, or social work in order to “fight for the under-dog,” “stick-up” for users and present a user perspective. Their


professionalism is at least partially constructed through identificationwith and care for a variety of others, including caretaking throughjourneys of organizational change and upheaval such as the currentdrive to modernization. The skills and values claimed by womenprofessionals such as communication, openness, honesty, and flexi-bility, positioned them as the standard bearers of modernization andorganizational quality. This is in stark opposition to the worryingperformances of hypermasculinities so apparently out of sync withthe current health care contexts.5

Constructions of women as safeguards for organizational qualityare hardly surprising, mirroring familiar gendered constructions ofwoman as benevolent, kind, caretaker. Such gendered constructionshave long been played out in colonial narratives of women as figuresof conscience and as stabilizers for overzealous heroic masculinities(McClintock 1995; Stoler 2002). But, constructions of whitewomen’s sexuality coupled with her fragility position her as vulner-able and in need of protection as much as she is positioned as pro-tector (Dyer 1997; Ware 1992). This dual role has always placedwhite woman in a more obviously contradictory relation to racia-lized power than white men, both as its victims and perpetrators.

There is a divergence in opinion as to whether this contradictorypositioning enables white women to challenge the exercise of racia-lized power. On the one hand, commentators such as Dyer (1997)suggest that constructions of feminine conscience coupled with pas-sivity in the face of the white masculine cruelties of Empire meanthat women can neither exercise agency effectively nor challengemasculine oppression. Catherine Hall (1992) too, highlights Englishwomen as the bearers of shame for eighteenth-century slavery, butstill unable to challenge the “triumphant definition” of whitemiddle-class manhood constructed in part through their ownsupport for the “family enterprise.” Vron Ware in contrast suggeststhat white women are in a potentially productive position throughtheir symbolic distance and difference between black and white,between ruled and rulers (Ware 1992, 231–33). Of the three figuresshe identifies as traditionally constructed through colonial narrative,the good, the bad, and the foolhardy, it is the foolhardy woman,with feminist nonconformist inclinations, who offers the most poten-tial to work this distance, because their transgressive behavior threa-tens to upset the whole system of racist and masculinist domination.

In this final section of the paper, I engage with these debates toconsider the claim that white women professionals’ shame is poten-tially productive in challenging racialized power. The followingexcerpt comes from the account of Janet, a fifty-two-year old whitewoman social worker who characterizes herself as “bolshy,”6

464 V Hunter

knowing from a young age that she wanted to fight social injustice.The short excerpt below follows on from her reluctant move to pos-ition herself as a “probably seen to be privileged” white woman.This was in response to my invitation for her to situate herselfwithin gendered and raced social relations.

Janet

But [anti-racist work] is part and parcel, you know you can’tpick which BITS of OPPRESSION you’ll challenge . . . Well Idon’t feel that you can, I can’t say oh I’ll be anti-ageist, but Iwon’t give a monkeys about racism {long pause} I’ve had tochallenge . . . on the Professional Exec Committee, the oneperson that I nearly got hold of and throttled because of theirRACIST remarks, but, ur, I didn’t. And I think ‘oh, God’, so Idid question myself over the issue as I said ‘you should havesaid, you should have tackled that, and that’s not on.’

Janet’s opening comments immediately position her as identifiedwith social justice in its broadest sense. Combating racism is “partand parcel” of this broader fight for social justice. She can be ana-lyzed as one of Ware’s Good white women, with a “spiritual opposi-tion to all forms of oppression and unfairness,” “destined to sufferbecause she feels deeply about the injustice of a political systemwhich she is powerless to change” (Ware 1992, 232). Indeed, Janet’sself doubt—“Oh God” “I did question myself”—occurs at herfailure to challenge overt expressions of racism. Similar to Bill,shame, in her account, is also a product of not being good enough,“you should have tackled that,” she says to herself. However, in con-trast to Bill, rather than a failure of identity by association withracist masculinities, the failure for Janet is not to fulfill a particularidentification which rests on care for the other. For her the failureoccurs because she does not police the overt reproduction ofinequality on the PCTs’ Professional Executive Committee. Shame,then, in this extract, is produced through a perceived failure to actwhen that act was possible. Rather than there being “nothing I cando,” as for Dyer’s colonial heroines, for white women professionalsin contemporary health care settings there is the possibility ofaction. The failure to act then can constitute a failure to live up tothe ideal of white femininity as protector of the vulnerable.

Taking up the possibility for action is the key point of contrastbetween the following extract from Mazie, a fifty-three-year oldwhite woman community nurse, and the previous one from Janet.


Mazie’s comments below follow a discussion around the challengesof creating a socially representative workforce.

Mazie

[Mazie] I think that overall we can learn an AWFUL lot aboutour neighbours, colleagues and this, this asylumseeking7 [that I was talking about before], it saddensme, and I’ve come across so much racism, and peopleare openly racist, and I do get angry. I actually said tosomebody at a party the other day, and it wasn’t a bigparty, it was a small one, and I actually said ‘will youstop please, or else I will have to leave,’ and myhusband just looked at me and I said, ‘because you’vegot your views but I just think you’re very racist and Iwon’t tolerate, and I can’t tolerate listening to you anymore,’ and the shock in the room, and I mean, he’dpreviously gone against, gays, and somebody said ‘butits an old image,’ and I said ‘no it’s not’, I said, andeverybody’s sniggering, and some of them afterwardssaid ‘well we didn’t agree with him but what do youdo?’ and I said ‘well you don’t laugh, you know youwere laughing and I can’t tolerate that,’ so {pause} youknow. That’s what I say, ‘I don’t want to be rude, but Ireally CAN’T listen to this, because I think this is SOunfair to an enormous number of people that you’venever met’. And I said ‘you have your right for a view,but if it continues, I will have to go home, becausestaying here, I feel as if I’m agreeing with you.’

[AUTHOR] Yes, and that’s it isn’t it, because then you get thosefeelings of guilt.

In this extract, shame and anger over racism are intertwined forMazie. “[I]t saddens me” slips very quickly into “I do get angry.”Her sadness can be read as a form of shame in Tomkins’s terms, inthat it is related to the feelings of alienation she suffers because ofracism. This alienation is as a consequence of the barrier racismposes to her enjoyment of work, in terms of the way it reduces thepotential to learn from “our neighbors and colleagues,” and becauseof the barrier it creates between her and the other partygoers. LikeJanet, Mazie’s shame is vicarious—“because staying here, I feel as ifI’m agreeing with you.” This vicarious shame is for the male party-goer’s racism, associated with traditional, “old image,” and trouble-some—“he’d previously gone against gays”—masculinity. But this

466 V Hunter

shame is also for the lack of shame displayed by the other partygoers“I said ‘well you don’t laugh, you know you were laughing.’” Incontrast to Janet however, the combination of shame and anger isproductive for Mazie. It enables her to act; “I actually said” “willyou stop please?” It enables her to publicly confront racist speech inthe context of the party, ignoring the disapproval “and the shock inthe room” from her husband and the other partygoers. Shame circu-lates through Mazie’s anger. It is through the expression of angerto the racist male partygoer in her story that Mazie’s shamebecomes the shame of the other partygoers. Their “sniggering” ather challenge to the male partygoer suggests the humiliation andembarrassment the others experience because of the way Mazie’schallenge highlights their own complicity with his racism.

In mounting this sort of a challenge to the partygoers, Mazie isalso defying models of bourgeois white femininity in which womendo not speak out against white solidarity, at least not in public(Moon 1999). In contrast to the complicity of the other partygoers,she refuses the role of good white woman. While any longer-termimpact from Mazie’s challenge is not clear from the extract, thereare parallels between her interventions and those of Ware’s (1992)foolhardy white women whose transgressions threaten to challengethe whole system of racist and masculinist domination. Gunaratnamand Lewis (2001) draw on the work of Audre Lorde (1984) to showhow anger can be linked to a project of transformation in at leastthree ways. One of which is:

As a precursor to a recognition that racial oppression damagesoppressor as much as, even if differently from, the damage itdoes to those it oppresses. Such an anger would be directed atthe diminishing effects of structures of racial thinking and prac-tice (Gunaratnam and Lewis 2001, 144).

There is an argument that this is precisely how shame and angerinteract in Mazie’s account. Shame produces an understanding of thebarrier to connection that racism creates for the oppressor, whichthen facilitates anger directed toward challenging racist practices.

Notwithstanding this important challenge levied by Mazie, differ-entiating white shames in this way produces findings which are inmany senses unsurprising, suggesting familiar patterns to the inter-sections of raced, gendered, and classed social relations. Men are theaggressors, the locus for racist behavior and women the conciliators,reconciling for the “wrongs” of racism. But, as my final commentsto Mazie suggest—“that’s it isn’t it, because then you get those feel-ings of guilt”—there is a further aspect to the dynamics of whiteshame that we are both also involved in. This is where shame and


anger get entangled with guilt and blame “a white complex, a politi-cal muddle of pride, shame and guilt” (Probyn 2005, 46). Whitewomen hold the power to shame and can pride themselves on theshaming of others (men) who do not recognize that they should beashamed. But this can mean that shame has become a means ofwielding power under the guise of moral rectitude, and this is par-ticularly so when shame is avoided in the shamer. According toProbyn (2005), avoiding shame, as Mazie’s account suggests, “ICAN’T listen to this” “I will have to go home, because staying hereI feel as if I’m agreeing with you,” can allow moralistic guilt toflourish. Guilt divides to apportion blame for or against, positioningthe shamer on the side of “right.”8 Sara Ahmed tells a similar cau-tionary tale about the expression of [white] shame. She suggests thatby showing shame for involvement in racism, the white subject candemonstrate themselves to be the “ideal (well meaning) subjects,”where the very expression of white shame becomes a form of pride.She explores how complex moves through the individual to the col-lective can turn shame to regret: as a polite sense of “What ashame” rather than “We are ashamed” or “We regret what hap-pened, but we cannot condemn it, because it was not us” (Ahmed2004, 118). This conversion of shame to pride can then constitutethe very means by which expressions of shame can become a meansof shifting responsibility for racism. While it would be a step too farto suggest that Mazie makes quite this conversion in the extract pre-sented here, there is a related danger in the way shame circulates inher account in the way that shame–humiliation is heaped onshame–humiliation. For Tomkins, the danger here is that:

When the child feels ashamed and discouraged after failure, his[sic] shame is increased by heaping shame or contempt uponshame. He is shamed because he has failed or because he hassurrendered or both. Further, he [sic] may be shamed intotrying again. In this way shame and failure seem to amplifyeach other. In such a socialization self-confidence may be eitherutterly destroyed or consolidated in the crucible of com-pounded humiliation (Tomkins 1995, 173).

Again, it is unclear from the extract which way this situation will gofor Mazie and the other partygoers in the longer term. But there is adanger that the circulation of shame can pose as many problems asit may solve for all of the protagonists.

On the one hand, both of these extracts demonstrate the potentialfor white women to transgress the discursive limits of white bour-geois womanhood to resist racism. On the other hand however,there is a sense in which white women’s power is upheld through

468 V Hunter

the maintenance of their goodness, in their role as the reproducersof white civility. This power is only emphasized by the absence ofminoritized subjects across these extracts. This absence reflects thedynamic of much white antiracist rhetoric where this absence ofminoritized subjects erases their driving force in antiracist resistance.These dynamics coupled with this absence can accrue power towhite women as the saviors of minoritized subjects (the namelessneighbors, colleagues, and asylum seekers in Mazie’s account) in theface of racist white masculinity. They can also enable the removal ofmen’s responsibility for redressing racism relocating this responsibil-ity with white women, meaning that the latter continue to do dispro-portionate civilizing work.

In making this analysis, my aim is not to condemn Janet or Mazie,or Bill as a racist. Nor is my aim to suggest that challenging racism,no matter how momentary those challenges, is a fruitless endeavor. Itis to draw attention to the complexities in these resistances and therole that feelings play in them. Resisting racism is never straightfor-ward. Heron (2007, 154) says “the heroic response is one that weshould consider suspect.” In this regard, the interesting point aboutshame is that it introduces self doubt into discursive encounters. Itcan therefore pose a challenge to the surety in heroic action, provid-ing the hiatus necessary to disrupting dualistic patterns for appor-tioning guilt and blame and creating multiple possibilities forantiracist agency. Mazie’s example is important here because mul-tiple actions flow from her recognition of racialized inequalities,including listening politely, speaking out openly to the person sheidentifies as the locus of racism, challenging silent supporters, andwithdrawing. The failure to reach resolution can be read as astrength, rather than a weakness within the extract. Indeed, it is myfinal comments around guilt, rather than anything Mazie says thatcloses the extract. These comments can be read as a recognition ofthe dangers of trying to reinstate a vision of the uncomplicatedly just,good, progressive. My aim here again is not to critique the desire to“do better” by struggling to position the self within an “antiracistpersonal ethic” (Srivastava 2005) as these participants do. Rather, itis to suggest that this personal ethic will always fit uncomfortablywithin broader discursive organizational and institutional histories.This is why understanding the psychosocial dynamics of shame as atonce a measure and condition of civilization is so important.

Conclusions

What does all of this tell us about (dis)continuities between colo-nial pasts and postcolonial presents? And what does it tell us about


shifts in whiteness in contemporary multicultural contexts and inparticular about the possibility for more reparative forms of white-ness? In the first section of this paper, I demonstrated associationsbetween class, whiteness, and masculinity to be constituent com-ponents of imperial pride and, symbolized in medicine as the pinna-cle of white, male imperial prowess and civilization. I went ontosuggest that one consequence of postcolonial shifts toward thedifferential inclusion of minoritized subjects has been that thesesame sources of imperial pride now constitute sources of shame.However, on the basis of my interpretation of the empirical materialpresented in the second half of the paper, I argue that a “turningaway” from the more overt racist cruelties and violences of Empiredoes not represent a wholesale rejection of colonial civilizing mis-sions; rather, these civilizing missions are changing in nature.Characterized by differential inclusion, the current postcolonialmoment is constituted through less clear-cut divisions between“victim” and “oppressor,” and these ambivalences are evident in theempirical material I presented around shame. From these data, Iwant to claim that one of the key shifts reflected in moves fromimperial pride to individual expressions of shame at the racist conse-quences of imperialisms is the shift from whiteness as constitutedthrough saving the colonized other to whiteness as constitutedthrough saving the white racist self.

My argument in this paper points to developing distinctionsbetween legitimate and illegitimate whitenesses, but suggests that itis the expression of shame, rather than pride which can serve to sani-tize whiteness. Whereas legitimate and idealized whiteness in thepast was based on heroism and civilizing missions in far-off places,legitimate whiteness is now based on the ability to explicitly atonefor past wrongs, the ability to civilize the self at home. Legitimatewhitenesses are constructed not through the displacement andannihilation of blackness, but through the displacement of illegiti-mate whiteness. Expressions of shame then become the marker oflegitimate forms of whiteness. This construction of whiteness ascontrol and mastery of the self is not in itself new. Richard Dyer’s(1997) work highlighted colonial whiteness as achieved through“superhuman” self control as well as mastery of the Other.However, the original element to contemporaneous markers ofwhite self control is shame, and in my account above, an explicitrole accorded to white women in public shaming.

The white women saviors identified here are also not unique tocontemporary contexts. Elspeth Probyn (2005) goes as far as tosuggest that the more usual construction of women of conscience isa more benign way to view women than as shamers. Contemporary

470 V Hunter

shifts in women’s relationship and access to the public sphere bringthe possibility of changed relationships to organizational power ingeneral and in particular in the context of more feminized, moder-nized contexts of PCTs. The relational economy of shame discussedhere, however, still puts women’s agency to service in the protectionof constructing appropriate white male agency. The first obviousdanger is that this locates responsibility for antiracist change (orwork) with women rather than with men. White women constitutethe container to reprocess organizational shame over the reproduc-tion of whiteness, creating a heavy extra-emotional burden forwomen to bear within modernized organizations.

A second danger is that white shame becomes a form of pro-fessional pride in “diversity proud” organizations (Ahmed et al.2006), such as the NHS. In the current context of English healthand social care, where more feminized ways of working are beingvalued as progressive challenges to traditional medical dominanceand other performances of inappropriate masculinities if this femini-zation is not approached critically and detached from women them-selves; then white women’s shaming risks becoming a means bywhich “the whiteness of organizations gets reproduced at the verymoment the organization embraces diversity” (Ahmed 2007, 245–46). The danger is the performance of rejecting traditional whitemasculinities, which serves to stand in for action remedying insti-tutional failure in relation to women minoritized users and staffexperiences of health care provision. The real failure here would befor organizations to fail to grasp shame’s hiatus as an opportunity todo things differently, more democratically, and less hierarchically.The analysis I present here suggests that through empathic shame asTomkins looks at this, through shame at the actions of another, ordistress caused by what the other has done, or anger in which thecritic seeks redress for the wrongs committed by the other, thesewhitened professionals show the potential for the sort of practicaltransformations necessary to more fully antiracist organizations.

NOTES

Dr. Shona Hunter is Research Council’s UK Academic Fellow in theNew Machinery of Governance in the School of Sociology and SocialPolicy at the University of Leeds. Her work is interdisciplinary and she hastaught in cultural studies, geography, women’s studies, management, aswell as sociology and social policy. She researches the intersections betweengender, race, and profession in education, health, and social care, and hercurrent empirical work examines the relational politics of equalities policymaking at the national and local level. This work develops an approach to


policy analysis which can account for the emotions, identities, subjectivitiesin the policy process and everyday policy practice. She is currently writinga number of related articles and book chapters and drawing together thiswork in a book project, working title “Impossible Governance?”. She sitson the steering committee for the UK Psychosocial Studies Network, isarticles editor for Critical Social Policy, and also publishing in Journal ofSocial Work Practice and Policy Futures in Education, Equal OpportunitiesInternational.

1. PCTs were established by the New Labour Government as new flag-ship organizations for modernized, devolved, and professionally led locallyadministered health care. They are local administrative bodies undertakingmultidisciplinary operational planning and commissioning of integratedlocal primary health and social care services for populations of 100,000–200,000 people. Most PCTs were initially established in 1997 as PrimaryCare Groups (PCGs). These groups were generally the product of collabor-ation between community health care trusts and local consortia of generalpractitioners. The aim was to provide health and social care services in amore corporate and integrated manner and for a graduated move from aPCG to a fully autonomous trust by 2002. Trusts are funded directly by theDepartment of Health, responsible for purchasing as well as providing localhealth care and currently hold 80 percent of NHS budgets. The recent elec-tion of the new Conservative–Liberal coalition government on 6 May 2010heralds the intention to disband these administrative bodies in favor of GPconsortia.

2. I acknowledge the risks in not differentiating between medicine andallied professions, and in particular of including social work in this, whichhas historically constructed itself in opposition to the biomedical model. Itsinclusion here, however, recognizes moves to join the social and medical aspart of the modernization of English primary care.

3. This should not be taken to suggest that it was only in European con-texts that race and medicine were inextricably linked. It was the earlyIslamic empire which established the first public hospital in Baghdad in 809and the work of the Islamic Translation movement established in Baghdadin 812 that provided the foundations for nineteenth-century scientific medi-cine’s widespread use of Latin.

4. All names are pseudonyms.5. These broader collective narratives are an abstraction for the sake of

considering more general gendered processes. They are of course contestedand constituted through multiple axes of identification in practice, whichleads to more contradictory multiple gendered positionings (see Hunter2005a, 2009a).

6. While in contemporary colloquial usage “bolshy” is generally used tomean difficult to manage and rebellious, the term derives from Bolshevikand is also used to mean politically radical or left wing.

7. By this “asylum seeking,” Mazie is referring to the ongoing popularmedia and political debate and controversy around the number and limitsto entry for those people seeking asylum in the UK. Notions of asylum,

472 V Hunter

illegal immigration, and economic migration are conflated within UKpublic debate, often feeding broader racialized hostility.

8. Mary Holmes (2004) recognizes the same dangers with anger, whereangrily blaming oppressors can limit the possibility of developing newviews or compromises.

REFERENCES

Ahmed, S. 2004. The Cultural Politics of Emotion. Edinburgh, UK:Edinburgh University Press.

————. 2007. “The Language of Diversity.” Ethnic and Racial Studies30: 235–56.

Ahmed, S., S. Hunter, S. Kilic, T. Leech, E., Swan, and L Turner. 2006.Integrating Diversity: Gender, “Race” and Leadership in the Learningand Skills Sector. London: Centre for Excellence in Leadership.

Allen, T.W. 1975. Class Struggle and the Origin of Racial Slavery: TheInvention of the White Race. New York: Hoboken.

Bashford, A. 2000. “‘Is White Australia Possible?’ Race, Colonialism andTropical Medicine.” Ethnic and Racial Studies 23: 248–71.

Bohpal, R. 2001. Is Research into Ethnicity and Health Racist, Unsound,or Important Science. In Working for Health, eds. H. Tom, M.Rosemary, S. Moyra, and L. Cathy. London: Sage & Open Universitypress.

Bonnett, A. 2000. White Identities: Historical and InternationalPerspectives. London: Prentice Hall.

Byrne, B. 2006. White Lives: The Interplay of “Race,” Class and Gender inEveryday Life. London: Routlege.

Cheng, A.A. 2000. The Melancholy of Race: Psychoanalysis, Assimilation,and Hidden Grief. Oxford: Oxford University Press.

Crozier, R.W. 2008. “Self-consciousness in Shame: The Role of the‘Other’.” In Emotions: A Social Science Reader, eds. M, Greco, and P.Stenner, 175–79. London: Routledge.

DoH. 2003. Equalities and Diversity Strategy and Delivery Plan to Supportthe NHS. London: Department of Health.

Doyal, L., and I Pennell. 1994. The Political Economy of Health. London:Pluto Press.

Dyer, R. 1997. White. London: Routledge.Fanon, F. 1986. Black Skin, White Masks. London: Pluto Press.Frankenberg, R. 1993. The Social Construction of Whiteness: White

Women, Race Matters. London: Routledge.Gilman, S. 1985. “Black Bodies, White Bodies: Toward an Iconography of

Female Sexuality in Late Nineteenth-century Art, Medicine andLiterature.” Critical Inquiry 12: 204–42.

Gunaratnam, Y. 2004. “‘Bucking and Kicking’: Race, Gender andEmbodied Resistance in Healthcare.” In Biographical Methods andProfessional Practice: An International Perspective, eds. P.


Chamberlayne, J. Bornat, and U. Apitzch 205–19. Bristol, UK: PolicyPress.

Gunaratnam, Y.,, and G Lewis. 2001. “Racialising Emotional Labour andEmotionalising Racialised Labour: Anger, Fear and Shame in SocialWelfare.” Journal of Social Work Practice 15: 131–48.

Hage, G. 1998. White Nation: Fantasies of White Supremacy in aMulticultural Society. Annandale, VA: Pluto Press.

Hall, C. 1992. White, Male and Middle Class: Explorations in Feminismand History. Cambridge, UK: Polity Press.

Harris, C. 1998. “Whiteness as Property.” In Black on White: BlackWriters on What It Means to Be White, ed. D.R. Roediger 103–17.New York: Schocken Books.

Henry, L. 2007. “Institutionalized Disadvantage: Older Ghanaian Nurses’and Midwives’ Reflections on Career Progression and Stagnation in theNHS.” Journal of Clinical Nursing 16: 2196–203.

Heron, B. 2007. Desire for Development: Whiteness, Gender, and theHelping Professions. Ontario, Canada: Wilrid Laurier University Press.

Hollway, W., and T. Jefferson. 2000. Doing Qualitative ResearchDifferently: Free Association, Narrative and the Interview Method.London: Sage.

Holmes, M. 2004. “The Importance of Being Angry: Anger in PoliticalLife.” European Journal of Social Theory 7: 123–32.

Hopton, J. 1999. “Militarism, Masculinism and Managerialisation in theBritish Public Sector.” Journal of Gender Studies 8: 71–82.

Hunter, S. 2003. “A Critical Analysis of Approaches to the Concept ofSocial Identity in Social Policy.” Critical Social Policy 23: 322–44.

————. 2005a. Negotiating Professional and Social Identities: “Race,”Gender and Profession in Two Primary Care Organisations.Birmingham, UK: University of Birmingham.

————. 2005b. “Negotiating Professional and Social Voices in ResearchPrinciples and Practice.” Journal of Social Work Practice 19: 145–58.

Hunter, S. 2009a. “Feminist Psychosocial Approaches to Relationality,Recognition and Denial.” In Theory and Scholarship in Equality andDiversity, Inclusion and Work: A research Companion, ed. M.F.Ozbilgin, 179–92. London: Edward Elgar.

Hunter, S. 2009b. “Subversive Attachments: Gendered, Raced andProfessional Realignments in the ‘New’ NHS.” In Subversive Citizens:Power, Agency and Resistance among Public Service Users and Workers,eds. M. Barnes, and D. Prior, 137–53. Bristol, UK: Policy Press.

Kulik, D., and C.H. Klein 2003. “Scandalous Acts: The Politics of Shameamong Brazilian Travesti Prostitutes.” In Recognition Struggles andSocial Movements: Contested Identities, Agency and Power, ed. B.Hobson, 215–38. Cambridge: Cambridge University Press.

Lewis, H.B. 1990. “Shame, Repression, Field Dependence andPsychopathology.” In Repression and Dissociation: Implications forPersonality Theory, Psychopathology, and Health, ed. J.L. Singer, 233–57. Chicago: The University of Chicago.

474 V Hunter

Lewis, G. 2000. Race, Gender, Social Welfare Encounters in a PostcolonialSociety. Cambridge: Polity Press.

Lindquist, J. 2008. “Negotiating Shame in the Indonesian Borderlands.” InEmotions: A Social Science Reader, eds. M. Greco, and P. Stenner, 93–100. London: Routledge.

Lopez, A. 2005. “Introduction: Whiteness after Empire.” In PostcolonialWhiteness: A Critical Reader on Race and Empire, ed. A. Lopez, 1–30.New York: State University of New York Press.

Lorde, A. 1984. Sister Outsider: Essays and Speeches. Trumansburg, NY:The Crossing Press.

Martin, J.N., R.L. Krizek, T.L., Nakayama, and L Bradford. 1999. “WhatDo White People Want to Be Called? A Study of Self-labels for WhiteAmericans.” In Whiteness: The Communication of Social Identity, eds.T.K. Nakayama, and J.N. Martin, 27–50. London: Sage.

McClintock, A. 1995. Imperial Leather: Race, Gender and Sexuality in theColonial Contest. London: Routledge.

Moon, D. 1999. “White Enculturation and Bourgeois Ideology: TheDiscursive Production of ‘Good (White) Girls.’” In Whiteness: TheCommunication of Social Identity, eds. T.K. Nakayama, and J.N.Martin London: Sage.

Nakayama, T.K., and R.L. Krizek 1999. “Whiteness as Strategic Rhetoric.”In Whiteness: The Communication of Social Identity, eds. T.K.Nakayama, and J.N. Martin, 87–106. London: Sage.

National Health Service Executive. 2000. The Vital Connection: AnEqualities Framework for the NHS: Working together for Equality.London: Department of health.

Nayak, A. 2003. Race, Place and Globalization: Youth Cultures in aChanging World. Oxford: Berg.

Padamsee, T. 2009. “Culture in Connection: Re-contextualizing IdeationalProcesses in the Analysis of Policy Development.” Social Politics:International Studies in Gender State and Society 16: 413–45.

Probyn, E. 2005. Blush: Faces of Shame. Minneapolis/London: Universityof Minnesota Press.

Raey, D. 2008. “Psychosocial Aspects of White Middle-class Identities:Desiring and Defending against the Class and Ethnic ‘Other’ in UrbanMulti-Ethnic Schooling.” Sociology 42: 1072–88.

Raghuram, P. 2007. “Interrogating the Language of Integration: The Caseof Internationally Recruited Nurses.” Journal of Clinical Nursing 16:2246–51.

Roediger, D. 1991. The Wages of Whiteness: Race and the Making of theAmerican Working Class. London: Verso.

Scheff, T.J. 2000. “Shame and the Social Bond: A Sociological Theory.”Sociological Theory 18: 84–99.

Sedgwick, E.K., and A Frank. 1995. Shame and Its Sisters: A SilvanTomkins Reader. Durham, NC: Duke University Press.


475

Smith, P., and M Mackintosh. 2007. “Profession, Market and Class: NurseMigration and the Remaking of Division and Disadvantage.” Journal ofClinical Nursing 16: 2213–20.

Srivastava, S. 2005. “‘You’re Calling Me a Racist?’ The Moral andEmotional Regulation of Antiracism and Feminism.” Signs: Journal ofWomen in Culture and Society 31: 29–62.

Steyn, M. 2001. “Whiteness Just Isn’t What It Used to Be”: White Identityin a Changing South Africa. New York: State University of New YorkPress.

Stoler, A.L. 2002. Carnal Knowledge and Imperial Power: Race and theIntimate in Colonial Rule. London/Los Angeles: University of CaliforniaPress.

Thandeka. 1999. Learning to Be White: Money, Race and God in America.New York: Continuum.

Tomkins, S. 1995. “Shame–Humiliation and Contempt–Disgust.” InShame and Its Sisters: A Silvan Tomkins Reader, eds. S.E. Kosofsky, andA. Frank Durham, NC: Duke University Press.

Ware, V. 1992. Beyond the Pale, White Women, Racism and History.London: Verso.

Ware, V., and L Back. 2002. Out of Whiteness. Colour, Politics andCulture. Chicago: Chicago University Press.

Wellman, D. 1993. Portraits of White Racism. Cambridge: CambridgeUniversity Press.

Wengraf, T. 2001. Qualitative Research Interviewing. London: Sage.Williams, F. 1989. Social Policy: A Critical Introduction. Cambridge, UK:

Polity Press.Yates, C. 2000. “Masculinity and Good Enough Jealousy.” Psychoanalytic

Studies 2: 77–88.

476 V Hunter

476

What a White Shame: Race, Gender, and White Shame in the Relational Economy of Primary Health Care...

Documents

Transcript of What a White Shame: Race, Gender, and White Shame in the Relational Economy of Primary Health Care...