Smile, nod, smile, nod. There is both sincerity and effort in these offerings. After all, behaviors affect thoughts affect emotions affect behaviors. How quickly, it seemed, that the childhood version of myself learned to blur the lines between what I felt and what others expected me to portray. How quickly that appropriate outward presentation became a critical responsibility and expectation with age.
For many, this effort to bridge raw inner experience and outward presentation, or “emotional labor,” is a daily demand. The term was first conceptualized by Hochschild as “the management of feelings to create a publicly observable facial and bodily display (p.7);” and introduced to me in my musing and eventual research on healthcare clinician wellness. As literature exploring the concept has grown, another way to understand the phenomenon has been described as the process of managing feelings and expressions to fulfill the emotional requirements of certain roles, often without acknowledgement or compensation (Grandey).
As a healthcare and mental health clinician, woman, and mother, the pressure to portray the supportive, quintessential caretaker seems threefold. In healthcare, emotional demands are high, to provide a presence of empathy, comfort and a source of calm. As a woman, one is similarly held to standards of empathy, nurturing, and kindness (Stepler). In motherhood, the same is true for societal ideals for emotional resilience and stability (Dean et al.). How does one navigate the weight of emotional labor, while continuing to strive for “success” in multiple roles that seem to compound its demand?
Recently, reflecting on an excellent read, Hello, Beautiful, by Ann Napolitano, prompted further thoughts on how the burden of appearance can weigh heavily on relationships and health (Napolitano). Napolitano’s work follows the journeys of sisters, Julia, Sylvie, Emeline, and Cecilia Padavano through girl – and womanhood -, and thoughtfully depicts and explores the role each plays in the family unit (and with invited family member, William). Julia’s efforts to present as the responsible, capable caretaker; Sylvie’s to serve as thoughtful confidante; Emeline’s to grace the family a quiet stability; Cecilia’s to display a confident independence – all speak to a toil towards emotional management, often largely for the benefit of others. The novel asks its readers to reflect upon many things, but family, trauma, and the meaning of enduring relationships emerges as a dominant theme. Certainly, there is much to be admired in the sisters’ self-sacrifice for family unity. Concurrently, there is also much to be learned about when emotional labor may or may not be an adaptive method for furthering relational goals.
In wellness literature, we see that one pathway for emotional management linked to adverse health outcomes is surface acting, or displaying a demeanor according to external expectations or demands, without regard for one’s true feelings (Bagdasarov and Connelly; Hülsheger and Schewe). When used frequently, surface acting can take a grating toll on sense of identity and confidence in personal convictions. Healthcare clinicians often work in contexts that require good management of one’s own emotions in service of enhancing patient comfort or rapport (Fouquereau et al.; Yeh et al.). To help achieve rapport, clinicians, especially female clinicians, often strive to engage with amiability, even in instances when patients are expressing high distress or displeasure. Similarly, in many households, mothers are tasked with the emotional labor of maintaining positivity in one’s own emotions while simultaneously working to meet the emotional needs of family members (Dean et al.). If surface acting is the method predominantly used to achieve these role expectations, emotional labor can quickly become a consistent source of debilitating stress (Gray). In contrast to surface acting, the term deep acting has been used to refer to a striving for alignment between outward expressions and internal emotions and recognized as a more effective method in the engagement of emotional labor. Cognitive reframing or continued practice of tapping into more genuine emotions through alternative perspective-taking may be pathways to develop this approach (Bagdasarov and Connelly).
Napolitano’s detailing of her Padvano sisters’ efforts to hold family intact captures moments when the protagonists engage in both surface and deep acting in their practice of emotional labor. In particular, Julia’s story details determined attempts to reconcile inner motivations (both sincere and discrepant) with outward presentations. From early in the novel, the reader follows Julia’s transitions between deep and surface acting, as she finds herself spiraling from embodying a confident, ambitious college student, fully convinced in her commitments, into a capable-appearing, young wife, secretly overwhelmed and shaken by family upheavals. In a tense moment caught in an argument between her increasingly distant mother and fiery, younger sister, Julia voices a responsible and amiable, “Do you have everything you need for your flight?” while dismissing inner struggles of feeling like a “bouncy ball in the middle of a gunfight” (p. 105).
Over time, as Julia grows into a primary new role as a mother, she tackles an exploration of and reckoning with her own convictions until a focus on empathy, gained through hard-won experience, begins to drive her actions with greater assuredness. For Julia, it seems the role of mother propelled a clarity about self. Upon the birth of her daughter, Julia is struck that “truths had been inside her all along and were accessible now because she’d given birth… [that she] saw everything so clearly” (p. 107). Julia’s journey continues to include additional life and career roles requiring modulation between inner and outer selves. For a time, the weight of emotional burden becomes so heavy that Julia defied her sisters’ expectations for connection, abandoning her sisterly role, and resorting to isolation from those she endeavored for so long to keep close. Still, as motherhood propels recognition of the importance of roots, connection, and loved others in informing who one truly is, she works to connect these values with stepping more authentically again into place as the eldest Padvano sister.
To endure, thrive even, under the weight of presentation expectations (whether others or self-imposed) as a healthcare clinician, a woman, a mother, it seems the authenticity gap between inner and outer states must be better reconciled. Often, there is a sureness and certainty that emerges in becoming a mother. To know oneself through the experience of bringing another being into the world means taking stock of one’s inner reserves for the love and caretaking that must accompany the role. Motherhood can prompt a more sincere understanding of values, and often, an orientation towards one’s own experiences that generates more empathic connection to others. Through this shift, motherhood may serve more as a catalyst for deep acting than an added role of burden in the presentation pressures that women, that women healthcare clinicians, face. Perhaps one key to thriving, then, even in the necessitated practice of emotional labor as a healthcare clinician, woman, and mother, is to harness how the demands of these multiple roles may foster greater self-knowledge and deeper, more powerful authenticity.
Works Cited:
Bagdasarov, Zhanna, and Shane Connelly. “Emotional Labor among Healthcare Professionals: The Effects Are Undeniable.” Narrative Inquiry in Bioethics, vol. 3, no. 2, 2013, pp. 125–29, https://doi.org/10.1353/nib.2013.0040.
Dean, Liz, et al. “The Mental Load: Building a Deeper Theoretical Understanding of How Cognitive and Emotional Labor over Load Women and Mothers.” Community, Work & Family, vol. 25, no. 1, 2022, pp. 13–29, https://doi.org/10.1080/13668803.2021.2002813.
Fouquereau, Evelyne, et al. “Emotional Labour Profiles: Associations with Key Predictors and Outcomes.” Work & Stress, vol. 33, no. 3, 2019, pp. 268–94. APA PsycNet, https://doi.org/10.1080/02678373.2018.1502835.
Grandey, A. A. “Emotion Regulation in the Workplace: A New Way to Conceptualize Emotional Labor.” Journal of Occupational Health Psychology, vol. 5, no. 1, Jan. 2000, pp. 95–110. PubMed, https://doi.org/10.1037//1076-8998.5.1.95.
Gray, Benjamin. “The Emotional Labour of Nursing — Defining and Managing Emotions in Nursing Work.” Nurse Education Today, vol. 29, no. 2, Feb. 2009, pp. 168–75. PubMed, https://doi.org/10.1016/j.nedt.2008.08.003.
Hülsheger, Ute R., and Anna F. Schewe. “On the Costs and Benefits of Emotional Labor: A Meta-Analysis of Three Decades of Research.” Journal of Occupational Health Psychology, vol. 16, no. 3, 2011, pp. 361–89. APA PsycNet, https://doi.org/10.1037/a0022876.
Napolitano, Ann. Hello Beautiful. 2023.
Stepler, Kim Parker, Juliana Menasce Horowitz and Renee. “2. Americans See Different Expectations for Men and Women.” Pew Research Center, 5 Dec. 2017, https://www.pewresearch.org/social-trends/2017/12/05/americans-see-different-expectations-for-men-and-women/.
Yeh, Shu-Chuan Jennifer, et al. “Emotional Labor in Health Care: The Moderating Roles of Personality and the Mediating Role of Sleep on Job Performance and Satisfaction.” Frontiers in Psychology, vol. 11, 2020, pp. 574898–574898, https://doi.org/10.3389/fpsyg.2020.574898.
Image Credit: Photo by Daniele Levis Pelusi on Unsplash
