Luna Dolezal

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This open access book examines the various ways that shame, shaming and stigma became an integral part of the United Kingdom's public health response to COVID-19 during 2020. As the Covid-19 pandemic unfolded in 2020, it quickly became clear that experiences of shame, shaming and stigma dominated personal and public life. From healthcare workers insulted in the streets to anti-Asian racism, the online shaming of “Covidiots” to the identification of the “lepers of Leicester”, public animus about the pandemic found scapegoats for its frustrations. Interventions by the UK government maximised rather than minimized these phenomena. Instead of developing robust strategies to address shame, the government's healthcare policies and rhetoric seemed to exacerbate experiences of shame, shaming and stigma, relying on a language and logic that intensified oppositional, antagonistic thinking, while dissimulating about its own responsibilities. Through a series of six case studies taken from the events of 2020, this thought-provoking book identifies a systemic failure to manage shame-producing circumstances in the UK. Ultimately, it addresses the experience of shame as a crucial, if often overlooked, consequence of pandemic politics, and advocates for a "shame sensitive" approach to public health responses.

The open access edition of this book is available under a CC BY NC ND 4.0 licence on www.bloomsburycollections.com Open access was funded by The Wellcome Trust.

This article provides an introduction to the special issue "Emotions of the Pandemic: Phenomenological Perspectives". We begin by outlining how phenomenological research can illuminate various forms of emotional experience associated with the exceptional circumstances of the COVID-19 pandemic. In addition, we propose that a consideration of pandemic experience, in all its complexity and diversity, has the potential to yield wider-ranging phenomenological insights. We go on to discuss the thirteen contributions that follow, identifying common themes and points of complementarity.

Through exploring the relation between shame, guilt, and medical error in Ann Patchett's novel State of Wonder alongside author-physician Danielle Ofri's autobiographical reflections in her essay "Ashamed to Admit It: Owning up to Medical Error," this essay considers how fiction and medical nonfiction might contribute to an understanding of the experience of medical error and being a "second victim" from the point of view of the medical learner. We argue that State of Wonder expands the scope of Ofri's work on shame about medical error; the novel presents a more durational examination of an error's consequences in non-medical contexts.

This Editors’ Introduction defines the theme of ’affective technotouch’
as referring to multidimensional embodied encounters with
technologies which can trigger emotional and affective responses,
while also being concerned with social, political, cultural and ethical
dimensions of technological touch. With reference to neuroscience
and developmental studies, we outline how touch is foundational
in human experience. We then discuss contemporary technologies,
such as haptic gadgets and care/companion robots, which illustrate
the complexities of affective technotouch. Finally, we offer critical
outlines of the six contributing articles to this Special Issue on
Affective Technotouch.

In this paper, we analyse the particular phenomena of COVID-19 pandemic shaming. We examine Sartre's account of the undifferentiated other in the experience of 'the look', and his insistence on shame as a foundational relational affect, in order to give a robust theoretical frame to understand how pandemic shaming circulated both online and offline, in targeted and diffuse manners. We focus on two features of pandemic shaming. First, we draw attention to the structural necessity of an audience in acts of pandemic shaming, where the shamer acts on behalf of a community of others, the audience, to perform and enforce a set of standards, values or norms. We turn to the we-experience and collective emotions literature and discuss how the shamer believes themselves to be 'speaking' on behalf of a community who share their outrage along with their values. Second, we discuss how the presumption of a collective emotion was frequently mistaken in acts of pandemic shaming, where shaming frequently led to shame backlashes, where the audience revealed themselves not to share the emotion and values of the shamer, consequently shaming the shamer. We argue that Jean-Paul Sartre's voyeur example is usefully illustrative of the tripartite structure of (1) shamed, (2) shamer and (3) shamer of the shamer that occurs in iterative processes of pandemic shaming, which are accompanied by shaming backlashes. We conclude by reflecting on the socio-historical context for Sartre's accounts of shame and 'the look', namely the German occupation of Paris and Sartre's experience of the French Resistance movement, and how these yield a particular socio-historical framing that makes evident how the extraordinary pseudo-wartime conditions of COVID-19 rendered atmospheres of distrust and suspicion prevalent.

Acknowledging stigma has become very useful in healthcare. It helps both practitioners and patients make sense of the social impact of an illness or condition. Stigma can reveal how the experience of ill health may coincide with a range of negative social events, such as discrimination, judgement, social exclusion, vilification, ostracism, labelling, loss of status, prejudice and unfair treatment, among others (Link and Phelan, 2001). People with a number of illnesses or conditions, such as obesity, HIV or lung cancer, are commonly stigmatised for their association with purportedly 'negative' lifestyle habits. Infectious diseases are also heavily stigmatised because of fears around contamination and infection, while many other conditions are stigmatised merely because they deviate from widespread standards regarding what is 'good', 'healthy' or 'acceptable'. However, it is important to note that stigma in the clinic may not be at all health-related, but nonetheless be health-relevant. Stigma associated with low literacy levels, poverty, social deprivation, food insecurity, homelessness, criminal justice, sexual violence, domestic abuse or other traumas may be highly relevant in healthcare contexts. Overall, the negative impacts of health-related stigma are serious and directly affect health and health outcomes. As Corrigan and Penn (1999) noted: 'Stigma's impact on a person's life may be as harmful as the direct effects of the disease.'

Experiences of shame are not always discrete, but can be recurrent, persistent or enduring. To use the feminist phenomenologist Sandra Lee Bartky's formulation, shame is not always an acute event, but can become a "pervasive affective attunement" (Bartky, 1990: 85). Instead of experiencing shame as a discrete event with a finite duration, it can be experienced as a persistent, and perhaps, permanent possibility in daily life. This sort of pervasive or persistent shame is commonly referred to as "chronic shame" (Pattison, 2000; Nathanson, 1992; Dolezal, 2015). Chronic shame is frequently associated with political oppression and marginalization. In chronic shame, it is the potentiality of shame, rather than the actuality, that is significant. In other words, the anticipation of shame (whether explicit or implicit) comes to be a defining feature of one's lived experience. Living with chronic shame has important socio-political consequences. Thus far, chronic shame has eluded simple phenomenological analysis, largely because chronic shame often does not have a clear experiential profile: it is frequently characterised by the absence rather than the presence of shame. The aim of this article is to provide a phenomenology of chronic shame, drawing from Edmund Husserl's formulation of the 'horizon' as a means a to discuss structural aspects of chronic shame experiences, in particular how chronic shame is characterised by structures of absence and anticipation.

This article explores the dynamics between fat shaming, neoliberalism, ideological constructions of health and the 'obesity epidemic' within the UK, using the UK Government's recent Tackling Obesity campaign in response to Covid-19 as an illustration. We draw attention to how fat shaming as a practice that encourages open disdain for those living with excess weight operates as a moralising tool to regulate and manage those who are viewed as 'bad' citizens. In doing so, we begin by outlining how the ideological underpinnings of 'health' have been transformed under neoliberalism. We then

Since its foundation in 2010, the annual philosophy thematic edition of this journal has been a forum for authors from a wide range of disciplines and backgrounds, enabling contributors to raise questions of an urgent and fundamental nature regarding the most pressing problems facing the delivery and organization of healthcare. Authors have successfully exposed and challenged underlying assumptions that framed professional and policy discourse in diverse areas, generating productive and insightful dialogue regarding the relationship between evidence, value, clinical research and practice. These lively debates continue in this thematic edition, which includes a special section on stigma, shame and respect in healthcare. Authors address the problems with identifying and overcoming stigma in the clinic, interactional, structural and phenomenological accounts of stigma and the ‘stigma-shame nexus’. Papers examine the lived experience of discreditation, discrimination and degradation in a range of contexts, from the labour room to mental healthcare and the treatment of ‘deviancy’ and ‘looked-after children’. Authors raise challenging questions about the development of our uses of language in the context of care, and the relationship between stigma, disrespect and important analyses of power asymmetry and epistemic injustice. The relationship between respect, autonomy and personhood is explored with reference to contributions from an important conference series, which includes analyses of shame in the context of medically unexplained illness, humour, humiliation and obstetric violence.

Stigma has been associated with delays in seeking treatment, avoiding clinical encounters, prolonged risk of transmission, poor adherence to treatment, mental distress, mental ill health and an increased risk of the recurrence of health problems, among many other factors that negatively impact on health outcomes. While the burdens and consequences of stigma have long been recognized in the health literature, there remains some ambiguity about how stigma is experienced by individuals who live with it. The aim of this paper is to elucidate the phenomenology of stigma, or to describe how it is that stigma shows up in the first-person experience of individuals who live with stigma and its burdens. Exploring the relationship between shame and stigma, I argue that shame anxiety, or the chronic anticipation of shame, best characterises the experience of living with a health-related, or health-relevant, stigma. Understanding the experiential features, or phenomenology, of shame anxiety will give healthcare professionals a greater sensitivity to stigma and its impacts in clinical settings and encounters. I will conclude by suggesting that ‘shame-sensitive’ practice would be beneficial in healthcare.

In this article, we outline and define for the first time the concept of shame-sensitivity and principles for shame-sensitive practice. We argue that shame-sensitive practice is essential for the trauma-informed approach. Experiences of trauma are widespread, and there exists a wealth of evidence directly correlating trauma to a range of poor social and health outcomes which incur substantial costs to individuals and to society. As such, trauma has been positioned as a significant public health issue which many argue necessitates a trauma-informed approach to health, care and social services along with public health. Shame is key emotional after effect of experiences of trauma, and an emerging literature argues that we may 'have failed to see the obvious' by neglecting to acknowledge the influence of shame on posttrauma states. We argue that the trauma-informed approach fails to adequately theorise and address shame, and that many of the aims of the trauma-informed are more effectively addressed through the concept and practice of shame-sensitivity. We begin by giving an overview of the trauma-informed paradigm, then consider shame as part of trauma, looking particularly at how shame manifests in post-trauma states in a chronic form. We explore how shame becomes a barrier to successful engagement with services, and finally conclude with a definition of the shame-sensitive concept and the principles for its practice.

The affective climate often associated with HIV prevention and care practices is often dominated by negative emotions such as shame, fear and suspicion which arise because of HIV's historical stigma. This article explores the experiential consequences of this affective climate and the continued stigma associated with HIV, through a focus on the experience of shame anxiety which can be understood as the chronic anticipation of shame or shameful exposure. Exploring firstperson narratives of gay men living with HIV, the article gives an account of how shame anxiety is central to understanding how stigma causes harm, especially in experiences of chronic illnesses such as HIV. Using a philosophical framework, through phenomenology, it will be demonstrated how shame anxiety manifests in bodily lived experience through the structure of the "horizon". The article will finish with reflections on how shame anxiety can act as a barrier to the effective delivery of health services for those with stigmatised chronic illnesses and, furthermore, why the experience of shame anxiety might be useful to consider when delivering health services.

The Pandrogeny project was a collaboration between the artists Lady Jaye Breyer and Genesis POrridge that used cosmetic surgery, hormone therapy, cross-dressing, and altered behavior in an effort to merge their two separate identities into a third, singular " pandrogyneous " character called " Breyer POrridge. " This essay critically explores the practices and theories that comprise the Pandrogeny project, contrasting its use of cosmetic surgery to ORLAN's pioneering Reincarnation of Saint-ORLAN performance art series. We argue that there is potential for performance artists to critique and interrogate the normative frameworks of gender, appearance, and embodiment that guide the cosmetic surgery industry. However, artists and patients both undergo surgery within these frameworks, and thus their outcomes are shaped by the limits of the cosmetic surgery industry.

Through exploring some of the foundational and structural aspects of the experience of home from a feminist perspective, this article will draw from Iris Marion Young's reflections on home, female experience and embodiment to argue that home is central to our ontological and subjective constitution. While acknowledging that home can be a problematic concept in the socio-political realm, particularly for feminist thinkers, this article contends that a feminist reading of the phenomenology of home is crucial to understanding some of the foundational features of human subjectivity. In doing so, it will explore aspects of some existing phenomenologi-cal accounts of home and dwelling which posit that home is an ontological structure, outlining a feminist phenomenology of home that explores three interwoven aspects: (1) home as forming an ontological ground of human subjectivity; (2) home as a gendered space; (3) and pregnant embodiment as the " first home. " Dans cet article, nous explorerons quelques aspects fondamentaux de l'expérience du « chez-soi » dans une perspective féministe, ins-pirée par les réflexions d'Iris Marion Young à propos du chez-soi, de l'expérience féminine et du corps vécu. Nous affirmerons que le chez-soi est au centre de notre constitution ontologique et subjective. Tout en prenant acte du caractère problématique du « chez-soi » dans le champ sociopolitique, et ce, tout particulièrement pour les philosophes féministes, nous soutiendrons qu'une approche fé-ministe de la phénoménologie du « chez-soi » est nécessaire pour comprendre plusieurs aspects fondamentaux de la subjectivité hu-maine. Pour ce faire, nous présenterons d'abord quelques théories phénoménologiques existantes du chez-soi et de l'habitation [dwel-ling] qui considèrent le chez-soi comme une structure ontologique. Ensuite, nous insisterons sur trois aspects entrelacés d'une phéno-ménologie féministe du chez-soi : (1) le chez-soi comme fondation ontologique de la subjectivité humaine; (2) le chez-soi comme un espace genré; et (3) l'expérience corporelle d'être enceinte comme le « premier chez-soi ». 102 Symposium, vol. 21 no. 2 (Fall/Automne 2017)

Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms. Second, we postulate that shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health, that it is imperative that its vital role in health, health-related behaviours and illness be recognised and assimilated into medical, social and political consciousness and practice. In essence, we argue that its impact is sufficiently powerful for it to be considered an affective determinant of health, and provide three justifications for this. We conclude with a proposal for a research agenda that aims to extend the state of knowledge of health-related shame.

Through positing that our capacity for physical vulnerability is at the core of original shame, Sartre's account in Being and Nothingness reveals shame as an essential structure of human existence. Reading Sartre's ontological account of 'pure shame' alongside recent writing about shame in early child development, particularly Martha Nussbaum's account of 'primitive shame,' this article will explore the inherent links between shame, the body and vulnerability, ultimately positing that our human need for belonging is the fundamental driving force behind shame, and what gives it its ontological status. In short, this article will argue that shame is not merely about a painful awareness of one's flaws or transgressions with reference to norms and others, but about a deeper layer of relationality through our bodily vulnerability.

Self-presentation is a term that indicates conscious and unconscious strategies for controlling or managing how one is perceived by others in terms of both appearance and comportment. In this article, I will discuss the phenomenology of self-presentation with respect to the phenomenological insights of Edmund Husserl and Merleau-Ponty regarding the visibility of the body within intercorporeal relations through ‘behaviour’ and ‘expression.’ In doing so, I will turn to the work of the Canadian sociologist and social theorist Erving Goffman. Goffman’s account of self-presentation suggests why embodied subjects adopt certain styles of ordered bodily behaviour as determined by the broader social order, giving existential and social significance to the ontological structures of intercorporeal bodily communication. Following Goffman, I will suggest that the embod- ied subject is continuously—and constitutionally—engaged in implicit and explicit strat- egies to manage how the body is presented to others. In articulating self-presentation as a feature of intercorporeality, my aim in this article is to use Goffman’s insights to extend Husserl’s and Merleau-Ponty’s accounts of bodily communication by demonstrating that bodily communication that is instantiated at the level of intercorporeality is always expressed through social life with its various historical, cultural and linguistic dimensions.

Exploring the potential of posthumanism for disability and feminist politics, this article will consider the case of Aimee Mullins as exemplary of malleable posthuman embodiment. It will be seen that the use of the posthuman in mainstream visual culture is rich with possibilities for bodily diversity and transgression regarding essentialising bodily categories, especially with respect to representations of disability and femininity. However, interrogating representations of Mullins’s posthuman embodiment from the avant-garde fringe to mainstream advertising reveals cultural anxieties that arise with respect to humanity’s continuing relationship with technology and a certain moral economy regarding bodies, bodily integrity and normative values. As a result, through considering the case of Aimee Mullins, it will be demonstrated that the transgressive potential of the posthuman is diffused as it is appropriated into the mainstream.

Exploring the phenomenology of remote practices made possible by recent technological advances, such as telesurgery, will reveal the role of proprioception in agency and ownership of action and furthermore delimit the possibility of re-embodiment through technological interfaces. An understanding of the lived body, viewed through the philosophical paradigms of theorists Husserl and Merleau-Ponty, will demonstrate the role of the corporeal schema and intercorporeality in an agent’s interaction with the
immediate environment and hence elucidate the limits of achieving a seamless remote interaction as good as the “real thing.” These considerations are fundamental for grounding the bioethical, legal, and epistemological issues that arise in remote
interaction, particularly in the case of telesurgery.

This paper will examine the experience of and drive for bodily invisibility in women through the theoretical approaches of phenomenology and social constructionism. An examination of the social disruptions of bodily invisibility and the compulsive avoidance of such instances, particularly with respect to the fastidious maintenance of body comportment and appearance within the narrow parameters afforded by social norms, will lead to an exploration of the conflation of biomedicine with the beauty industry.

As a philosophical approach which takes as its starting point the existence of an individual, existentialism has long been concerned with moods, affective states and emotions. An emotion which features predominantly in existential philosophy is shame. This is a negative self-conscious experience which arises not merely from our relationship to the world, but also as a result of our necessary entanglement with others. Jean-Paul Sartre theorises shame as a necessary part of our experience of being-in-the-world and also of being-with-others. As a result, shame plays a central role in Sartre’s existential account of the human existence, where the capacity for self-knowledge and self-reflection is mediated through shame before the Other. Despite his interest in objectification and shame, in Being and Nothingness Sartre does not consider how these experiences are inherently related to power relations, where the ability to objectify and shame others, and conversely to be objectified and shamed, is intrinsically related to one’s position in the social hierarchy. Taking up Sartre’s ideas about objectification and shame in social relations, Frantz Fanon writes about his experience of being a black body in a ‘white world’ under the legacy of colonial power relations dominated by the enduring logics of slavery. Fanon illustrates that the experiences of objectification and shame are by no means uniform across human subjects, but bound up to power relations and one’s relative social position. He demonstrates how socially subordinated individuals do not have the freedom to resist objectification and shame. Likewise, Simone de Beauvoir points to the shame that women and young girls experience as a structural feature of unjust social relations, where female shame is intimately connected to being seen (and judged) by others, particularly men, where women’s bodies are already positioned as deficient, deviant and shameful.

'Posthuman' is a multivalent and multidisciplinary term that references a complex, sometimes conflicted reconceptualization of the body and subjectivity resulting from developments in biology, technology and ecology, which highlight human animals as fundamentally relational and mutable. Biotechnology, genomic and transplantation sciences, microbiome research, climate science, cybernetics, and a host of other research areas have effectively cast doubt on the integrity and unity of 'the human' as a discrete material and

Posthuman parenting is fast becoming a reality with the development of technologies such as artificial wombs and childcare robots. Debates and concerns about these technologies often centre around questions of the risks and benefits of increased technological intervention into pregnancy and child rearing, while also circling around enduring feminist concerns regarding whether these technologies herald the liberation of women from biologically-determined motherhood, or whether they herald a dystopian age of patriarchal reproductive control. Our chapter seeks to move beyond practical ethical estimations to consider the potential significance of the experiential dimensions of ectogenesis and robot childcare as imagined in a range of media. We take a phenomenological approach that considers the particular, material implications of such technologies and the complex relational networks they are designed to replace and/or augment. We will do this by focusing on the phenomenon of machine/human touch as speculated in depictions of technological gestation and robot childcare. Examining news reports, press releases, as well as science fiction literature and film, we suggest that these technologies, as projected, predicted and imagined, assume a biocentric model of the human that overlooks the relationality of being, treating humans animals (even in infancy) as autonomous, hyper-individual cognitive subjects. In doing so, we question just how far technology can intercede for 'maternal' touch.

Shame seems to have become ubiquitous is public life. Public shaming through tabloid news outlets, social media, and even criminal justice has become commonplace. We seem to have become inured to the spectacle of shame on reality television, along with the threat of shame that lurks in advertising, fueling insecurity-consumption cycles. We are all very familiar with the contours of this contemporary shame: the pervasive sense of inadequacy; the dread of exposure; the fear of being caught out for not being enough: good enough, rich enough, healthy enough, educated enough, white enough, and so on. However, despite the seeming ubiquity of shame, many recent discussions about shame in contemporary life and politics, in fact, lament its absence. Contemporary commentators, politicians, critics, along with some philosophers, argue that a lack of shame pervades contemporary culture. They contend that the confessional shame spectacles we routinely witness are a symptom of a pervasive shamelessness where declining moral values, consumeristic hedonism, and rife secularism have eroded the principled, respectful shame that in the "good old days" served to protect common decency, self-restraint, and civility. This nostalgia for shame as a regulating moral force within social relations and politics has become widespread, and points to a series of tensions regarding the contours of shame within social life and democratic citizenship. Shame is ambivalent. It is necessary; we (as individuals and collectively) cannot live or grow without it. However, at the same time, shame can also be deeply harmful and pernicious; it routinely leads to (and is a symptom of) political injustice, marginalization, and discrimination. Jill Locke's recent book Democracy and the Death of Shame: Political Equality and Social Disturbance tackles head-on the ambivalences of shame as they are implicated within contemporary shame nostalgia, or what she refers to as "The Lament That Shame Is Dead. .. a nostalgic story of an imagined past that represents a longing for a mythical place and time when shame secured and regulated social life" (18). In this book, Locke offers a genealogy of The Lament tracing it through the ancient Cynics, to revolutionary France, right through to nineteenth-and twentieth-century political thought. The far-reaching scope of her analysis serves as a foundation from which Locke offers a novel theory of a form of democratic action that she terms "unashamed citizenship" (37), a response to recent critiques of identity and recognition politics that, in part, depend on the public confessions of wounded subjects as a means for emancipation and political empowerment. Democracy and the Death of Shame is an important contribution to the feminist literature on the politics of shame, and my overall of assessment of the book is positive: it is persuasive, well-written, well-researched, informative, and nuanced. Locke has clearly engaged with the contemporary philosophical and political literature on shame, and her theoretical insights negotiate a complex terrain of competing accounts regarding shame's positive and negative potentials. My primary reservation about the book regards the wide range of examples that Locke discusses to make her point. The chapters range from an account of the Cynics' "shameless" rejection of inherited hierarchies in ancient Greece, to Rousseau and the entrance of "literary low life" into the revered "republic of letters" in eighteenth-century France, to nineteenth-century American politics and the ascent of the "ill bred" man in Andrew