Asylums

Essays on the Social Situation of Mental Patients and Other Inmates

Erving Goffman

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351327749
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

A total institution is defined by Goffman as a place of residence and work where a large number of like-situated, individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life. Prisons serve as a clear example, providing we appreciate that what is prison-like about prisons is found in institutions whose members have broken no laws. This volume deals with total institutions in general and, mental hospitals, in particular. The main focus is, on the world of the inmate, not the world of the staff. A chief concern is to develop a sociological version of the structure of the self.

Each of the essays in this book were intended to focus on the same issue--the inmate's situation in an institutional context. Each chapter approaches the central issue from a different vantage point, each introduction drawing upon a different source in sociology and having little direct relation to the other chapters.

This method of presenting material may be irksome, but it allows the reader to pursue the main theme of each paper analytically and comparatively past the point that would be allowable in chapters of an integrated book. If sociological concepts are to be treated with affection, each must be traced back to where it best applies, followed from there wherever it seems to lead, and pressed to disclose the rest of its family.

1
On The Characteristics of Total Institutions¹

Introduction

I

Social establishments—institutions in the everyday sense of that term—are places such as rooms, suites of rooms, buildings, or plants in which activity of a particular kind regularly goes on. In sociology we do not have a very apt way of classifying them. Some establishments, like Grand Central Station, are open to anyone who is decently behaved; others, like the Union League Club of New York or the laboratories at Los Alamos, are felt to be somewhat snippy about who is let in. Some, like shops and post offices, have a few fixed members who provide a service and a continuous flow of members who receive it. Others, like homes and factories, involve a less changing set of participants. Some institutions provide the place for activities from which the individual is felt to draw his social status, however enjoyable or lax these pursuits may be; other institutions, in contrast, provide a place for associations felt to be elective and unserious, calling for a contribution of time left over from more serious demands. In this book another category of institutions is singled out and claimed as a natural and fruitful one because its members appear to have so much in common—so much, in fact, that to learn about one of these institutions we would be well advised to look at the others.

II

Every institution captures something of the time and interest of its members and provides something of a world for them; in brief, every institution has encompassing tendencies. When we review the different institutions in our Western society, we find some that are encompassing to a degree discontinuously greater than the ones next in line. Their encompassing or total character is symbolized by the barrier to social intercourse with the outside and to departure that is often built right into the physical plant, such as locked doors, high walls, barbed wire, cliffs, water, forests, or moors. These establishments I am calling total institutions, and it is their general characteristics I want to explore.²

The total institutions of our society can be listed in five rough groupings. First, there are institutions established to care for persons felt to be both incapable and harmless; these are the homes for the blind, the aged, the orphaned, and the indigent. Second, there are places established to care for persons felt to be both incapable of looking after themselves and a threat to the community, albeit an unintended one: TB sanitaria, mental hospitals, and leprosaria. A third type of total institution is organized to protect the community against what are felt to be intentional dangers to it, with the welfare of the persons thus sequestered not the immediate issue: jails, penitentiaries, P.O.W. camps, and concentration camps. Fourth, there are institutions purportedly established the better to pursue some worklike task and justifying themselves only on these instrumental grounds: army barracks, ships, boarding schools, work camps, colonial compounds, and large mansions from the point of view of those who live in the servants' quarters. Finally, there are those establishments designed as retreats from the world even while often serving also as training stations for the religious; examples are abbeys, monasteries, convents, and other cloisters. This classification of total institutions is not neat, exhaustive, nor of immediate analytical use, but it does provide a purely denotative definition of the category as a concrete starting point. By anchoring the initial definition of total institutions in this way, I hope to be able to discuss the general characteristics of the type without becoming tautological.

Before I attempt to extract a general profile from this list of establishments, I would like to mention one conceptual problem: none of the elements I will describe seems peculiar to total institutions, and none seems to be shared by every one of them; what is distinctive about total institutions is that each exhibits to an intense degree many items in this family of attributes. In speaking of “common characteristics,” I will be using this phrase in a way that is restricted but I think logically defensible. At the same time this permits using the method of ideal types, establishing common features with the hope of highlighting significant differences later.

III

A basic social arrangement in modern society is that the individual tends to sleep, play, and work in different places, with different co-participants, under different authorities, and without an over-all rational plan. The central feature of total institutions can be described as a breakdown of the barriers ordinarily separating these three spheres of life. First, all aspects of life are conducted in the same place and under the same single authority. Second, each phase of the member's daily activity is carried on in the immediate company of a large batch of others, all of whom are treated alike and required to do the same thing together. Third, all phases of the day's activities are tightly scheduled, with one activity leading at a prearranged time into the next, the whole sequence of activities being imposed from above by a system of explicit formal rulings and a body of officials. Finally, the various enforced activities are brought together into a single rational plan purportedly designed to fulfill the official aims of the institution.

Individually, these features are found in places other than total institutions. For example, our large commercial, industrial, and educational establishments are increasingly providing cafeterias and free-time recreation for their members; use of these extended facilities remains voluntary in many particulars, however, and special care is taken to see that the ordinary line of authority does not extend to them. Similarly, housewives or farm families may have all their major spheres of fife within the same feneed-in area, but these persons are not collectively regimented and do not march through the day's activities in the immediate company of a batch of similar others.

The handling of many human needs by the bureaucratic organization of whole blocks of people—whether or not this is a necessary or effective means of social organization in the circumstances—is the key fact of total institutions. From this follow certain important implications.

When persons are moved in blocks, they can be supervised by personnel whose chief activity is not guidance or periodic inspection (as in many employer-employee relations) but rather surveillance—a seeing to it that everyone does what he has been clearly told is required of him, under conditions where one person's infraction is likely to stand out in relief against the visible, constantly examined compliance of the others. Which comes first, the large blocks of managed people, or the small supervisory staff, is not here at issue; the point is that each is made for the other.

In total institutions there is a basic split between a large managed group, conveniently called inmates, and a small supervisory staff. Inmates typically live in the institution and have restricted contact with the world outside the walls; staff often operate on an eight-hour day and are socially integrated into the outside world.³ Each grouping tends to conceive of the other in terms of narrow hostile stereotypes, staff often seeing inmates as bitter, secretive, and untrustworthy, while inmates often see staff as condescending, highhanded, and mean. Staff tends to feel superior and righteous; inmates tend, in some ways at least, to feel inferior, weak, blameworthy, and guilty.⁴

Social mobility between the two strata is grossly restricted; social distance is typically great and often formally prescribed. Even talk across the boundaries may be conducted in a special tone of voice, as illustrated in a fictionalized record of an actual sojourn in a mental hospital:

"I tell you what,” said Miss Hart when they were crossing the dayroom. “You do everything Miss Davis says. Don't think about it, just do it. You'll get along all right."

As soon as she heard the name Virginia knew what was terrible about Ward One. Miss Davis. “Is she the head nurse?"

"And how,” muttered Miss Hart. And then she raised her voice. The nurses had a way of acting as if the patients were unable to hear anything that was not shouted. Frequently they said things in normal voices that the ladies were not supposed to hear; if they had not been nurses you would have said they frequently talked to themselves. “A most competent and efficient person, Miss Davis,” announced Miss Hart.⁵

Although some communication between inmates and the staff guarding them is necessary, one of the guard's functions is the control of communication from inmates to higher staff levels. A student of mental hospitals provides an illustration:

Since many of the patients are anxious to see the doctor on his rounds, the attendants must act as mediators between the patients and the physician if the latter is not to be swamped. On Ward 30, it seemed to be generally true that patients without physical symptoms who fell into the two lower privilege groups were almost never permitted to talk to the physician unless Dr. Baker himself asked for them. The persevering, nagging delusional group— who were termed “worry warts,” “nuisances,” “bird dogs,” in the attendants' slang—often tried to break through the attendant-mediator but were always quite summarily dealt with when they tried.⁶

Just as talk across the boundary is restricted, so, too, is the passage of information, especially information about the staff's plans for inmates. Characteristically, the inmate is excluded from knowledge of the decisions taken regarding his fate. Whether the official grounds are military, as in concealing travel destination from enlisted men, or medical, as in concealing diagnosis, plan of treatment, and approximate length of stay from tuberculosis patients,⁷ such exclusion gives staff a special basis of distance from and control over inmates.

All these restrictions of contact presumably help to maintain the antagonistic stereotypes.⁸ Two different social and cultural worlds develop, jogging alongside each other with points of official contact but little mutual penetration. Significantly, the institutional plant and name come to be identified by both staff and inmates as somehow belonging to staff, so that when either grouping refers to the views or interests of “the institution,” by implication they are referring (as I shall also) to the views and concerns of the staff.

The staff-inmate split is one major implication of the bureaucratic management of large blocks of persons; a second pertains to work.

In the ordinary arrangements of living in our society, the authority of the work place stops with the worker's receipt of a money payment; the spending of this in a domestic and recreational setting is the worker's private affair and constitutes a mechanism through which the authority of the work place is kept within strict bounds. But to say that inmates of total institutions have their full day scheduled for them is to say that all their essential needs will have to be planned for. Whatever the incentive given for work, then, this incentive will not have the structural significance it has on the outside. There will have to be different motives for work and different attitudes toward it. This is a basic adjustment required of the inmates and of those who must induce them to work.

Sometimes so little work is required that inmates, often untrained in leisurely pursuits, suffer extremes of boredom. Work that is required may be carried on at a very slow pace and may be geared into a system of minor, often ceremonial, payments, such as the weekly tobacco ration and the Christmas presents that lead some mental patients to stay on their jobs. In othe...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Table of Contents
• Introduction to the Aldinetransaction Edition
• Preface
• Introduction
• 1 On The Characteristics of Total Institutions1
• 2 The Moral Career of the Mental Patient
• 3 The Underlife of a Public Institution1
• 4 The Medical Model and Mental Hospitalization1