Help! tell plz as Asylums: Essays on the Social Situation of Mental Patients and Other Inmates by Erving Goffman direct link price prewiew online text

Help! tell plz as Asylums: Essays on the Social Situation of Mental Patients and Other Inmates by Erving Goffman direct link price

Book description

Book description
Just in passing - the edition I read had a much better cover, the black and white photograph of a womans hands covering her face with a cigarette between her fingers pretty much summed up my feelings about this book.There is a sentence in Moab is My Wash Pot where Stephen Fry, at least, I’m nearly positive he’s not quoting someone else, says that it is easier for someone who has been to a public boarding school to be in prison than it is for anybody else in society. Not the most endearing advertisement for public schools, but then, neither are most people that seem to have attended one. The point is that both prisons and English public schools are examples of total institutions and these are precisely what Goffman is looking at here.I really like Goffman – he has the keenest of eyes for little paradoxes and quirks. I was telling a friend over dinner the other week that I wouldn’t be at all surprised if he was really from Mars, or an alien at least. He seems to see the things that the rest of us miss because we take them for granted – you know, like that invisibility shield in Hitchhiker’s Guide – an SEP shield, somebody else’s problem, an invisibility shield that immediately tells you that whatever you are looking at is someone else’s problem and so makes it immediately and completely invisible to you. Somehow Goffman is able to see past this invisibility shield and show us exactly what is normally hidden.A total institution is one where your whole life is going to be spent there, at least for a time. Prison, boarding school, monastery, mental asylum or the military are all examples. These are not always places of punishment, and they are not always identical, but they have very many similar characteristics and they generally have a ‘purpose’ as an institution. What Goffman does is look at this purpose from the perspective of the actors that play out their various roles within these institutions – or rather, he looks at the roles played in mental asylums as an example here, as this was where he performed his research.These asylums are institutions that were designed for a number of purposes – firstly, to remove people from society that were considered to be behaving in ways that make them not appropriate to remain at liberty within society and secondly, to treat and eventually cure these people - the second of these purposes is the one the institutions themselves tend to stress. In one of his other books, Stigma, the possibility of effecting such a cure – given the ongoing stigma associated with having been in such a place (and therefore of having to be in such a place) would probably be enough to ensure a kind of alienation from society for the rest of ones life anyway. In many ways, being in such a place is proof enough of needing to be in such a place. But Goffman is really interested in the relationships that occur between people, particularly people with different roles in these places.The first essay is concerned with being inducted into a total institution and there is a lot of very interesting things said about the physical and mental ‘stripping’ that occurs when one enters such an institution. Like the scene in A Clockwork Orange where Alex is brought to prison and the guards index his belongings and place them in a box – you are often stripped naked as part of the induction into these institutions. The forsaking of all previous belongings as a mode of entering this new life seems to be an important aspect of these rites. But if you think about it, this is a very strange thing to do to a mental patient. The taking away of all markers of their previous identity isn’t an immediately obvious means of bringing them back to normality – whatever that might be. The other thing is that it is often someone very close to the patient that has brought them to the hospital for treatment. The patient is unlikely to be terribly happy about being brought to such a place – these places sound about as close to hell on earth as is possible to get outside of one of the US torture prisons – and the patients have generally been brought there by someone who claims to ‘love them’. This is likely to lead to awkward moments between these people, to say the least. But the other problem is that if the person is to get out they are likely to have to at least appear to be reconciled to this person that has imprisoned them – otherwise, isn’t that an instance of their continued lack of mental health? These catch-22 situations are endless, as anyone who has read One Flew Over the Cuckoo’s Nest would already know. We like to imagine that the central fact of our society is our love of individual freedom and individual identity – but to be insane is to behave in particularly ‘individual ways’. If the fundamental dichotomy is between the individual and society, then surely the existence of asylums is a kind of victory of society over the individual. And to get back out of these places the individual must act in ways that are highly socially prescribed, in fact, so much so that the ability to suppress one’s inclinations is perhaps as good a definition of ‘getting well’ as any other.The fact of these institutions is that they are always grossly underfunded and as such do more to act as prisons, keeping people off the streets, than as reformatories. But the myth of the institutions is that they are where people go to get well – so, the relationships that are set up, particularly between staff and inmates, are defined according to this fundamental contradiction. The problem is that when the ‘reason’ for an institution so poorly matches its realisation – when we say ‘we’re here to help’ but actually clearly are punishing people, then we humans tend to blame the victim. There is a punishment – so we’d better think up a crime that makes sense of the punishment, that justifies it… otherwise, we would be monsters.I really enjoyed this book – a friend of mine asked me if it wasn’t too ‘heavy’, but while I absolutely understand what she means, and at times, it really was just that, mostly this book could just as easily have been about work in an office or life in a hospital. We still have total institutions and they create little social worlds that are defined by their own needs and their own interrelationships. Right at the end of this one he mentions insane women who got pregnant or people who would bite – and how the institutions would take these people and removed their wombs or pulled all of their teeth. This was said to be in the best interests of the patients, but really, it was designed for the administrative convenience of the institutions. We need people like Goffman in the world, people able to look at the institutions we form and the dehumanising effects these can cause.Some quotes:A chief concern is to develop a sociological version of the structure of the self. p. xiivAll of these restrictions of contact presumably help to maintain the antagonistic stereotypes. 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 the 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. p9There are other reasons for being interested in these establishments, too. In our society, they are the forcing houses for changing persons; each is a natural experiment on what can be done to the self. p12On admission to a total institution, however, the individual is likely to be stripped of his usual appearance and of the equipment and services by which he maintains it, thus suffering a personal defacement. Clothing, combs, needle and thread, cosmetics, towels, soaps, shaving sets, bathing facilities – all these may be taken away or denied him, although some may be kept in inaccessible storage, to be returned if and when he leaves. P20As a result, the inmate tends to feel that for the duration of his required stay—his sentence—he has been totally exiled from living. P68Many total institutions, most of the time, seem to function merely as storage dumps for inmates, but, as previously suggested, they usually present themselves to the public as rational organisations designed consciously, through and through, as effective machines for producing a few officially avowed and officially approved ends. It was also suggested that one frequent official objective is the reformation of inmates in the direction of some ideal standard. This contradiction, between what the institution does and what its officials must say it does, forms the basic context of the staff’s daily activity. P74The personal possessions of an individual are an important part of the materials out of which he builds a self, but as an inmate the ease with which he can be managed by staff is likely to increase with the degree to which he is dispossessed. P78One of the arguments advanced by officers of the Navy in favour of corporal punishment is this: it can be inflicted in a moment; it consumes no valuable time; and when the prisoner’s shirt is put on, that is the last of it. Whereas, if another punishment were substituted, it would probably occasion a great waste of time and trouble, besides thereby begetting in the sailor an undue idea of his importance. p79-80An important part of the theory of human nature in many total institutions is the belief that if the new inmate can be made to show extreme deference to staff immediately upon arrival, he will thereafter be manageable—that in submitting to these initial demands, his ‘resistance’ or ‘spirit’ is somehow broken. P89The visiting room in some total institutions is important here. Both décor and conduct in these places are typically closer to the outside standards than are those that prevail in the inmate’s actual living quarters. The view of inmates that outsiders get thus helps to decrease the pressure these outsiders might otherwise bring to bear on the institution. It is a melancholy human fact that after a time all three parties—inmate, visitor, and staff—realise that the visiting room presents a dressed up view, realise that the other parties realize this, too, and yet all tacitly agree to continue the faction. P102Visitors can easily take the loyalty and social skills of these receptionists as a sample of the character of the entire inmate group. P103The display of photographs in the lobbies of total establishments, shown the cycle of activities the ideal inmate goes through with the ideal staff, often has extremely little to do with the facts of the institutional life, but at least a few inmates spent a pleasant morning posing for the pictures. P105It is an odd social fact that free places are often to be found in the immediate vicinity of officials, part of whose function is to exercise surveillance over broad physical regions. For example, winos in small towns sometimes congregate on the lawn of the county courthouse, enjoying some rights of lounging assembly denied them in the main streets. P237 footnoteThe study of underlife in restrictive total institutions has some special interest. When existence is cut to the bone, we can learn what people do to flesh out their lives. Stashes, means of transportation, free places, territories, supplies for economic and social exchange—these apparently are some of the minimal requirements for building up a life. P305We now turn to the medical version of the tinkering-services model. Our giving our bodies up to the medical server, and his rational-empirical treatment of them, is surely one of the high points of the service complex. Interestingly enough, the gradual establishment of the body as a serviceable possession—a kind of physicochemical machine—is often cited as a triumph of the secular scientific spirit, when in fact this triumph seems in part to have been both cause and effect of the rising regard for all types of expert serving. P340The client finds he must consider not how well he has done with the server, but rather how much worse he might have done without him, and with this understanding he is led to accord the ultimate tribute to esoteric skill: cheerful payment of the fee in spite of the loss of the object that the server was hired to save. P343Further, to rest immobile in bed is, after all, defined as what one does in our society when one is sick P347But there is still a more fundamental issue, which hinges on the applicability of the concept of ‘pathology’. Ordinarily the pathology which first draws attention to the patient’s condition is conduct that is ‘inappropriate in the situation.’ But the decision as to whether a given act is appropriate or inappropriate must often necessarily be a lay decision, simply because we have no technical mapping of the various behavioural subcultures in our society, let alone the standards of conduct prevailing in each of them. p363The ideological or interpretative implications of management’s activity seems to focus on two issues, the nature of the patients and the nature of the hospital’s activity, in both cases bolstering up the medical-service definition of the situation. P374The response of the patient to hospitalisation can itself be nicely handled by translating it into a technical frame of reference, whereby the contribution of the hospital to the patients trouble becomes incidental, the important thing being the internally generated mode of disturbance characteristic of the patient’s conduct. Interpersonal happenings are transferred into the patient, establishing him as a relatively closed system that can be thought of as pathological and correctable. P375Thus, to cite a relatively extreme example, I have seen a therapist deal with a Negro patient’s complaints about race relations in a partially segregated hospital by telling the patient that he must ask himself why he, among all the other Negroes present, chose this particular moment to express this feeling, and what this expression could mean about him as a person, apart from the state of race relations in the hospital at the time. P376-7The patient’s presence in the hospital is taken as prima facie evidence that he is mentally ill, since the hospitalization of these persons is what the institution is for. P380In all of these cases, the medical action is presented to the patient and his relatives as an individual service, but what is being serviced here is the institution, the specification of the action fitting in to what will reduce the administrators management problems. P383A crime must be found that fits the punishment, and the character of the inmate must be reconstituted to fit the crime. P384…the further one’s claims diverge from the facts, the more effort one must exert and the more help one must have to bolster one’s position. p386
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