Asylums - Erving Goffman (1961)

Extract

[...] Therefore the treatments are seen as humiliating only to an external observer, patients do not view them as such. Goffman shows that inmates adapt to the institution, by trying to maintain a sense of their identity and redefining their social role, in 2 different ways. He distinguishes, the primary adjustments, consisting in obeying the rule and accepting the treatments, which gives the right to certain privileges. And the secondary adjustments by which inmates "employ unauthorized means, or obtain unauthorized ends, or both, thus getting around the organization's assumptions as to what they should do and get and hence what they should be". [...]

[...] Lastly, staff and inmates share an antagonistic and limited relationship. Each group's vision of the other is reduced to a sum of stereotypes. The group of inmates is much larger than the staff and restrict their commination with their supervisors as much as possible. The staff tend to feel superior to the inmates and has developed a special way to speak to them The inmates receive limited information from the staff, and the exterior world, and are excluded from the decisions concerning their fate. [...]

[...] 5 The feeling of betrayal and the attitude of patient described by Goffman have been challenged by surveys. Indeed, in 1968 Linn conducted a survey over 185 state hospital patient in which he confronted those patients with Goffman's claims. He found that the majority said that they wanted to come to the hospital, they did not feel betrayed by their friends or family and they saw the hospital as an opportunity to access services that were not available elsewhere One can also point out the omissions of the author, as he paints a harmful image of mental hospitals because he never associates them mental illness. [...]

[...] To study the functioning of total institutions Goffman used mostly qualitative methodology. To learn about the social world of the mental patient, he occupied the fictive job of director's assistant during one year in the psychiatric hospital St Elizabeth in Washington D.C. To collect data he used the method of participant observation which allowed him to gain a close familiarity with the patient's group and a direct observation of their practices and their environment. He, therefore, brought a new light on mental hospital, indeed most of the studies before him were conducted by psychiatrist who had an "exterior" vision of patient's life. [...]

[...] Then Goffman identifies the 5 different groups of total institutions. There are: the institutions established to take care of incapable and harmless people, the institutions which purpose are to take care of individuals presenting a threat to society, it is the case of mental hospitals. The institutions who aim at protecting society, in which inmates' welfare is not a priority, like prisons, the next group are institutions established to pursue a work like task, such as boarding school or army camp. [...]