Facultatea de Sociologie i Asisten Social

Sociologie (Seria 2 Avansati 2)

ASYLUMS
THE MORAL CAREER OF THE MENTAL PATIENT

Prof. Coordonator: Claudia Ghioiu

Student: Vasile Ana-Maria Alexandra

Universitatea Bucureti
Anul 2016

Ervin Goffmans book, Asylums: Essays of the Social Situation of Mental Patients
and Other Inmates talks about the total institution in America. The term total institution is a place
of residence, sometimes work where a great number of similarly situated people , cut off from the
wider community for a considerable time1, because they developed some deviant behaviors, in
this case.This institution is divided in two section: the people who need to be separated from the
society and the people who mantain order in the institution and have the power. Goffman studies
is based of certain accounts and observations in many mental hospitals, asylums from America in
the 60s. In Goffmans point of view a mental institution is very similar with another institution
who in fact gather several people, with some issues in order to reabilitate them and if this is not
possible anymore, the staff control the life of inmates in the institute.The sujbect of the book is a
painful true and it shows that many people who are forced or just stuck in some kind of institute
dosent have a chance of life anymore, if this posibility was still available, and in many cases
people who suffer for mental illness become more troubled and sick.
The book is very well structured in four essays that talks about:
I.

The Characteristics of Total Institutions - This capther talks about how a total
institution can enter in a person life and how some total institutions works. The

II.

majority of this institutions abused their patients and degrade their life.
The Moral Career of the Mental Patient The second chapter talks about the like of
a patient in a total institution like a mental hospital or an asylums and why are the

III.

phases that a person became a patient and loose the connection with the his social life.
The Underlife of a Public Institution: A Study of Ways of Making Out in a Mental

IV.

Hospital
The Medical Model and Mental Hospitalization: Some notes on the Vicissitudes of
the Tinkering Trades

The total institution can be classified on five main categories:

1 Frank, Jacquelyn (2002). The paradox of aging in place in assisted living. Greenwood
Publishing Group. p. 44

1) Institutions designed to take care innocent people who can not take care of themselves
because they are old or have some disabilities an no one to help them. In this area of
institutions are: asylums or orphanages.
2) Institution for people who take care of people that are a danger for society and can be
controlled because they have some psychosis. Sanatoriums or hospitals for mental healtth
for example.
3) Institution for those people who can be a social danger and have discernment for their
deeds. These institution, prisons, concentrations camps or war camps intended to protect
the society.
4) Institution that allow different activities for the good of society like schools and boarding
schools.
5) Institution that are fully committed to religion and preserve religious laws like
monasteries.

I chose to talk about The Moral Career of the Mental Pacient because this part of the book is in
my oppinion the one who focus on the people who arrive to live in a mental hospitall, how much
influence has this institution it institution for the ill ones and if the people are actually helped in
here. The chapter begins with the term career who is used in this context to show how a mental
ill can be read like a straight profession.
The term (career) is coming to be used, however, in a broadened sense to refer to
any social strand of any person's course through life2
Goffman talks about the concept of career in two-sidedness. First side is the career that follow
things that the human keeps inside of him, internal matters such as the image of himself and his
indentity, two things very important and cherished by the human. The secons side talks about the
official position, juridical matters and style of life and is part of a publicly accessible

2, Goffman, Ervin (1961). Assylums: Essays on the Social Situation of Mental Patiens and Other
Inmates. Anchor Books. p.127

institutional complex3. In conclusion we can see in both sides, in the side of human self (the
personal matter) and in the side that targets the society where the human is living.
The term of mental patient has an important way of understanding because it became important
too late when the social life is already alterated and the person is cataloged sick or crazy and
hospitalized. Sometimes people with mental issues can be controlled outside of a mental hospital
with drugs or shock but there are other situations when the person entered in the circle of mental
hospitals. Many persons who became mental-hospital patient dont get along with the diagnosis
and dont think this is just a tremendous mistake. The majority of pacients has a lack of
carelessness because they dont think they are ill and this is not the because of the mental illness,
its just a normal attitude that every human would have it. Students who take notes in mental
hospitals discover that the sick behavior everybody has once is hospitalied it caused by the
social distance and the situation that the patient is in and is not primarily a product of mental
illness.4
The career of the mental patient grows in three principal phases: the period before the person
enter in the hospital system and this phase is called the prepatient phase; the period when the
person is actually in the mental hospital and lives here, the inpatient phase and the phase when
the person is no longer in the hospital, the ex-patient phase but Goffman refferes in his book
just the two phases.
I find very intersting while reading that the actually study has being very hard for
the sociologists because every inpatient is a person instable in many ways and the observastion
and taking notes its the only way to understand the fight between acceptance and refuse. Many
inpatients have been taking from their homes by police for example, some inpatients were
influenced by family and just a few inpatient realise the problem who need to get a special help.
Many inpatiens need to be supported by their families and other need a next-of-relation how
Goffman said.
3 Goffman, Ervin (1961). Assylums: Essays on the Social Situation of Mental Patiens and Other
Inmates. Anchor Books. p.127
4 Goffman, Ervin (1961). Assylums: Essays on the Social Situation of Mental Patiens and Other
Inmates. Anchor Books. p.130

First is the next-of-relation-the person whom the prepatient sees as the most
available of those upon whom he should be able to depend most in times of
trouble, in this instance the last to doubt his sanity and the first to have done
everything to save him from the fate which, it transpires, he has been approaching.
5
Other than next-of-relation is the complainant a person who convice the inpatient to go to a
mental hospital for help. And last but not least and in my oppinion a very important people, the
mediators the sequence of agents and agencies that prepatient has in the progress of him in the
hospital. At the beggining the prepation is very antisocial and wants to be alone like he tries to
force things and not get the hospital authority to control him. This phase lasts a few days or
weeks but the inpatient begin to be more open to treatment and talk to other people just because
next-of-relation pressed him with other people, like a counselor for example.
Even the work of Goffman dates back to 60s is on the of first sociological examination of the
social situation of mental patiens, the hospital world as subjectively experienced by the pacient. 6
The subject is very popular in the XII century because all the things Goffman observe in his work
are the painful true and the power that a total institution has on the patients. Asylums is also a
starting point of every study who talk about mental health and the social disorders. Unfortunately,
many writers and researchers have argued the perspective took by Goffman in his books an they
said that Goffman was exaggerated and overdrawn.
Not all mental hospitals are total institutions or remotely resemble prisons or
concentration camps. Most patients do not see themselves as inmates who are
coerced, abused, depersonalized, betrayed, or abandoned. Goffman's vision of
mental hospitals without reference to the psychiatric problems of patients is
actually quite myopic, as the two can never be divorced. And his generalizations
about mental hospitals from one unrepresentative case study are suspect.7

5 Goffman, Ervin (1961). Assylums: Essays on the Social Situation of Mental Patiens and Other
Inmates. Anchor Books. p.136
6 Weinstein, Raymond. Goffmans Aylums and the Social Situation of Mental Patients

Weinstein says that the meaning of the term ideal type used by Goffman for organization is a
Max Weber elaboration of the idea of bureaucracy and not all the mental hospitals has been so
strict with the patients and things get to be a little more dramagtic in Goffmans study.
Grob's analysis of the characteristics of institutional populations during the last
century suggests that, contrary to what Goffman says, hospitals were not intended
as instruments of social control. The majority of commitment proceedings
originated within the family, and those persons committed were seldom perceived
as threats to society.8

The treatments in the asylums and mental hospital are a way to desconsider the patinents, in fact i
think that if a patients or inmates, like Goffman reffers to them are treated like objects, the staff
tries to dehumanise them in order to control them better. If an inmate try to escape from the
power of the staff he is marginalized and the few advantages that he has are taken from him and
the inmate is isolated from the rest of inmates.
The advantages that a few pacients has are things that every human need in their
life and not to be given to the patients just because they have a good behaviour. For example,
pacients that behave good are given the chance to socialize more with other patients, to play
different games and take walks outside. The family dosent know the struggle in a mental hospital
and think their love ones is just crazy or sick and dosent understand that this type of life is for
his own good and for a limited time of life.
In my oppinion the study Goffman takes in the 60s it is not longer available with
the institution these days. I understand that a mental hospital or another total institution like a
asylum is a place when a person arrive just when they have serious issues with themselves or are
a danger for the love ones and the strangers but I think the hard treatment and the abuse that is
described in this book is no longer applied. Instead of a good life in a mental hospital that is
7 Weinstein, Raymond. Goffmans Aylums and the Social Situation of Mental Patients. p.272
8 Grob, Gerald N.Rediscovering Asylums: The Unhistorical History of the Mental Hospital.
Hastings Center Report(1977). Pp.33-441

trying to treat your mental illness, the patiens are more anxious and depressive once they are
enter in this vicious centre of the total institutions.

BIBLIOGRAPHY

GOFFMAN, Ervin. (1961). Assylums Essays on the Social Situation of Mental

Patients. Anchor Books.
JACQUELYN, Frank. (2002). The paradox of aging in place in assisted living.
Greenwood Publishing Group.
WEINSTEIN, Raymond. Goffmans Aylums and the Social Situation of Mental
Patients de pe site-ul http://orthomolecular.org/library/jom/1982/pdf/1982-v11n04-p267.pdf
accesat la data de 19.01.2016, ora: 13:14
GROB,Gerald N. (1977). Rediscovering Asylums: The Unhistorical History of the
Mental Hospital. The Hastings Center Report, No. 7