Erving goffman's - asylums

University of Bucharest

Department of Sociology and Social Work

An I, Seria 2

ERVING GOFFMAN'S

ASYLUMS

The publication of Erving Goffman's Asylums gathered four essays on institutions: On the Characteristics of Total Institutions, The Moral Career of the Mental Patient, The Underlife of a Public Institution and The Medical Model and Mental Hospitalisation. The result is a book that treats on its whole "institutionalized" people as a result of the authors' three year research in St. Elizabeth Hospital, by means of participative observation. Although published in 1961, there are many aspects of life that are immortalized in his book that haven't lost their contemporary character not even nowadays, after almost half a century. Asylums is based on timeless truth, on general knowledge, on empiric research to such an extent that the ideas that are to be found in it do not seem to grow old, to fade over the years. There are five types of institutions that Erving Goffman (1922- 1982) talks about: asylums for the old people or orphanages, mental hospitals, boarding schools, prisons and monasteries. The labeling is based on the type of people that is dealt with by each of these categories. However, the book is mostly based on the second category - the institutions created for the people unable to take care of themselves but who represent a threat for the society (even unintentionally) - such as mental hospitals.

First of all, Goffman highlights the idea that "any institution captures a part of the time and interest of its members and offers them a sort of world; shortly, it has restrictive tendencies."[1] This means that the rules and restrictions imposed to its members are most of the times overwhelming for the "institutionalized". Not being allowed to leave the asylum, nor to receive visits can seem for some inmates too much but, any attempt to leave unofficially the institution is dispelled by the "first line of defense" - the building itself.

To most of the people who are "hospitalised" in such an institution, it comes as a shock the fact that the medical personnel treat them as inferior. Their rights are restricted as they are not allowed sometimes to talk to the doctor when he comes to see the patients. ".it seems that the patients without noticeable symptoms, (.) were not allowed to see the doctor unless Doctor Baker asked to see them."[2] The employees of the institution have a sense of superiority and create a category for every group of patients. This form of identification could be considered quite abnormal, especially because the nicknames given are sometimes offensive. This form of labeling can be seen as a ritual, a way of integrating the new-comers, a form of acceptation. It is the signal that they overcame the passing ritual. Unfortunately, once the new-comers are accepted into this society, they become just numbers; they lose their identity and become a file among many others, marking the beginning of a re-socialisation which will influence their future life. However, the patients assume their new status and they are re-socialised inside the institution. For instance, on the annual ceremonies the patients "mix" with the care persons and spend their time together as friends. It seems that there is a tacit convention as, the following day, everything turns to its normal and natural state. As in any family (for this is what an institution becomes for its patients), there are ceremonies that mark the most important moments of the society's life. "This modifies temporarily the usual relation between the personnel and the inmates, showing that the difference between the two groups is not that inevitable"[3] therefore, a ceremony is somehow the moment when the gap between the two categories becomes minimized despite the clearly role rules they have. It seems that after the ceremony they start playing again the same "play", as anybody cannot afford breaking the rules. It is not clear yet what problems these ceremonies resolve but it is clear what they indicate". Also in the first essay, Goffman shares his views on the world of the institution's employees. He says that "a frequently official objective is the reformation of the inmates towards an ideal standard."[4] If I took into consideration that normality is subjective, and that individuality is one of the most important characteristics of every human being, then, this procedure seems to be a brutal intrusion in a person's intimacy. This procedure also involves the "estrangement" from the before-the-asylum life. What is more, the patient is submitted to a constraint of self. On the other hand, the medical personnel are not to become emotionally involved in their work as they might become subjective. Furthermore, the diffusion of self means that the person becomes more easy influenced by the people around them. This way, the communication between the authorities and the inmates is more easily established as there is no reminder of the pre-institutional life. However, the inmates' social behavior depends on the type of institution they inhabit. The differences depend on each institution. What is always the same, to my mind are the attitudes of the personnel and even more, the attitude of these people's families when they are to be taken home. Most patients lose their credibility and respect in front of their friends or families. For example a mental hospital or another similar mental resort will always be seen as a scar on a person's life. From the moment they have been taken there, there is no chance to be accepted in the society as they were before. Unfortunately, the label follows them outside the institution and people have to deal with the constraints of the society due to a narrow thinking. These people are not given any chance to show that they have the abilities to work although they are rightfully skilled for a job for example. In this case it is clearly that one's health is not as important as the social prejudice and stereotypes. Not being able to decide for themselves can have a negative effect on people's morale. They may feel they do not belong to their own personality and enter a state of an extreme artificiality and lack of awareness. This means that they become confuse and they lose contact with the reality.

Goffman says that the mental illness may be a wrongly assumed perception of the world or a problem in the society and that hospitalization may do more harm than good to a patient especially when the patient itself realizes that he has issues[5]. In many cases, the pre-patient is taken to see a doctor, contrary to its will. There are also cases when they are threatened with different "punishments" that are due to make the pre-patient realize his or her condition, although they may not have any need for such a doctor. As it is, the patients are already confronted with a crisis before their official hospitalization. These people are led into the belief that it is something wrong with them, without taking into account the daily stress and the problems they have to face everyday (at their workplace, at home). Once the patient is hospitalized, he or she confronts with the impossibility of maintaining a close view on the reality, on the outside world. They become anonymous as they are taken even the personal belongings. If in the beginning the patient might have found it difficult to deal with all the tasks and to always be looked at as to an outsider, he eventually renounces at his state of anonymity and seems to accept his/her condition. Being able to make new acquaintances is the sign that the patient has become "stable" and is ready for the next step of its "rehabilitation".

By becoming a member of a group, the patient has the opportunity to become whoever he may want with the approval of the others. This is a "play", a game where everybody is an actor in their life story. They are all heroes in their movie and directors too. Therefore, it seems that a group is a miniature of the society as the rules are similar and the patients behave as if they would not be under any moral constraint.

Because it is an issue of utmost importance, Goffman's book has received many criticisms throughout the years. Jason Ditton shows that "Typically, Goffman is cited by many yet examined by few."[6] Two of the writers who have studied the hidden significance of Asylums are Kathleen Jones and AJ Fowles in their book Ideas on Institution. First of all, Goffman's research is "extremely full in documentation and the experiences quoted drawn from widely reading"[7]. Although this might be viewed as an advantage as it enriches the content, Jones and Fowles consider this as having negative effects on the general perception on the subject due to the fact that some of the experiences quoted are subjective and therefore misleading for the readers. Published in 1961 in New York, a period of politic and social instability and changes, the book "outlines an ideal type which is an extreme case". The critics point out the fact that it is possibly for Goffman to have been subjective in his research due to the fact that he could not generalize the situation from the asylum where he did this study and extend the results to the situation from all this type of institutions. Furthermore, as Goffman did not want to become one of the inmates in order to be as objective possibly, he could not experience these people's situation after leaving the asylum, and the discrimination they were confronted with in the "real world".

As far as I am concerned, I believe that the scenery Goffman described is quite cruel if I can put it that way. Goffman presents objectively the life of the inmates in a mental hospital and the processes they go trough as "institutionalized" people.

Reading Goffman's Asylums was an exciting and mind broadening experience that made me reconsider people's roles in an institution. What is even more important, this book changed my views by making me think twice before jumping to conclusions when it comes to total institutions . It seems that stereotypes make people less willing to see beyond the deceiving appearances. I feel it is quite disappointing not to be given the chance to enjoy the cosiness of one's own home in the old age. It is true that some people would rather stay in an asylum in order to be under the care of specialized medical personnel but also in order not to be alone as they grow old. They prefer the companionship of people with the same statuses as they feel they are equal in rights and fortune. Sometimes the patients fall in love with somebody inside the institution and to my mind, this comes as a boost for their morale as they realize they may still get a second chance. It is commonly believed that the patients of these institutions are abnormal and, what is more, people tend to marginalize them.

Furthermore, I consider that the patients of an asylum must be given all the support they need in order to be accepted in the society, in order to gain back the self esteem and their self confidence. Psychology and psychiatry are due to examine whether these people really have mental issues in order to find the best treatment for them. Although their role cannot be denied, I feel that sociology is in fact the only science enabled to bring these people on the right path, to "re-socialize" them. I consider that it is highly important not to judge people on account of their presence in an asylum as this type of criteria can be terribly deceiving. Sociologists can help the inmates regain or develop pro-social qualities so that they may be accepted and given a second chance to a normal life.

Re-socialization is not possible without a change in mentality. Stereotypes and one's upbringing make people reject "compromised" people. Reintegrating these people in the society cannot be done only by relying on the personnel's abilities and dedication. Sometimes these people are not "skilled" enough to assume this role. Furthermore, I can say that the personnel of such an institution may benefit from the poor condition of the patients. They may consider themselves better than their peers as they do not suffer from such mental illness. However, they seem to forget that they are paid for this job, what are their duties and that nobody obliged them to do this for a living. This is not a reason to look down on their patients considering them as inferior. Discrimination is a subject that must be tackled carefully in this case as sometimes an unwise intervention may do more harm than good. Here I can give a personal example on the subject. During my college years I took part in a volunteering program in a centre for the abused children. I cannot say that I had a pleasant surprise when I saw the way the medical personnel treated the children. Some of them called them names or tried to make them appear inferior in front of the outsiders. I consider that this had negative effects on the process of reintegrating the four to seven year old children in the society. They may grow up with a wrong opinion on themselves, with a low self-esteem, with a sense of inferiority. This cannot be the image of medical personnel that helps people to recover from traumas or other mental issues. I was really disappointed of what I've seen but, only by reading Goffman's work did I realize that nobody really cares about their peers, that nobody is pro-social without a good reason in a total institution. Conformation, abandon, de-individualization, anonymity, obedience, freedom, stigma, discrimination - whether we like it or not these are the processes that an inmate goes trough as an "institutionalized" person.

The life in an institution has been presented in many books. For example in the contemporary literature, life in such an institution has been described by Marian Keyes in his book entitled Rachel's Holiday. This book is an introspective in an institution's "life" and is moreover an easy reading. With a great social content, Keyes presents the adventure of a girl who is addicted to fun and drugs. Her presence in the Rehab can be beautifully interpreted from a sociological point of view. The rules that she has to obey and all the tasks given to her seem to be too much for her. The image of the inmates is just as Goffman described it. Activities such as playing cards or drinking the tea are ceremonies that everybody attends to. In this asylum there are all kinds of people who have to get along as they do not have the possibility to socialize with somebody else. They are one group but each of them is well individualized from the moment they are accepted by its members. The veterans are presented in comparison to the new-comers who seem very confuse and scared, especially after they are taken the personal belongings and after the personnel's controls. The inmates' group is well bonded as every leave from the group generates sadness among those who have not finished their stay yet. What seemed very interesting to me was that they had to respect a rule after leaving the institution: they weren't allowed to meet nor have a relationship because they were vulnerable. Each of the people who had been institutionalized had to deal with the prejudice of the society as they could not find a job, the family did not want to hear from him/her and the friends had left him/her. This is when they realize their only friends and family is inside the asylum. As Goffman said, there are different categories of people: those who deliberately return because they like to live in the asylum, those who, after leaving the institution try to put their lives back on track and those who, leaving the institution come back only for the ceremonials and gatherings.

To conclude, I feel that, contrary to the critics' opinion that Goffman's point of view may have been spoiled by the historical and political context, Asylums is a book that highlights the changes and moreover the resemblance between nowadays institutions and those of fifty years ago. These institutions have been created to help its patients recover from different traumas or mental illnesses. But, unfortunately sometimes the things are not as they should be and, instead of benefiting from their stay in an asylum, many people suffer a great deal because of the narrow view of the society but also because of a poorly organized rehabilitation system and because of the lack of funds. As Goffman once said, "Society is an insane asylum run by the inmates", I cannot but agree with this view. In fact, how can a sane person resist in a crowd of insane people? The answer is that he cannot. He will be socialized accordingly to the society's changing rules.

Bibliography:

Erving Goffman, Asylums, Iasi, Polirom Press, 2004

Kathleen Jones and AJ Fowles, Ideas on Instituition, Taylor and Francis Group, London

Marian Keyes, Rachel's Holiday, Iasi, Polirom Press, 2006