Asylums: Essays on the Social Situation of Mental Patients and Other Inmates

Goffman is the master of understanding the way the self is constructed in social interactions. In this work he takes on 'the Asylum' the mental institution that is like a prison in being 'total' in its effort to shape, define, repress the self. Goffman has always been sympathetic with the lone self and how it withstands social pressures. In the Asylum the shaping forces are very strong, and there are no counter- social networks to help the inmate create and sustain an alternative independent self. This is one reason why Goffmann opposes such institutions as they do not truly prepare the inmates for the life outside, the life in a wholly different kind of social reality.

As a Nurse Lecturer I recommend this book to all my mental health students. I first read it as a first year trainee psychiatric nurse and it saved my career. There I was sitting in a care of the elderly ward in a mental hospital thinking "what the (*&^ is going on here!?", ready to pack it in, and then I started to read this book. As I progressed through the book it all began to make sense and Goffman became my hero! What a man, what a researcher, what a writer. His theory is punctuated here and there with anecdotes and as such his writing is highly accessible. Fortunately, the world I experienced as a student and that Goffman wrote of is dying, but its vestiges linger and this book is still useful today. This book will one day become a historical account, but will always stand a a testimony to the need for and effectiveness of covert qualitative research.

I'm not a sociologist, a student of sociology or really, even that interested in sociology. I read about this book in David Orland's, Prisons: Houses of Darkness, where Orland often referred to Goffman's work in this book. I was not disappointed.

Goffman uses a mixture of field observation and references to literature to describe and critisize the theory and practice of the "Total Institution". As the reviewers note below, a "total institution" is an elastic concept. Goffman focuses on "strong" examples of T.I.'s: the mental hospital, prison, a 19th century man of war, monastery. Through these "strong" examples he fairly describes the concept and applies it well.

Less clear is the implications of Goffman's concept to those institutions which are either "weak" total institutions or non-total institutions with total institution tendencies. After reading this book, I saw aspects of "total" institutions in almost every institution I cared to think about: schools, churches, courts, etc.

I think it is fair to say that "All institutions dream of being total institutions." Therefore, this book has application beyond the world of "strong" total institutions. I recommend it highly.

Summary:
The contents of this book are really far too complex to summarize, but I will do my best. There are two major points made in this text. The first is the development of the concept of the total institution. Goffman gives the following characteristics of total institutions: (1)  all aspects of life are conducted in the same place under the same authority; (2)  the individual is a member of a large cohort, all treated alike; (3)  all daily activities (over a 24-hour period) are tightly scheduled; (4) there is a sharp split between supervisors and lower participants; (5) information about the member's fate is withheld.  (p. 436) The basic examples of total institutions are mental hospitals, prisons, and military boot camps, though there are numerous other institutions that could be considered total institutions as well. Goffman doesn't leave his discussion of total institutions at a simple definition, he also describes nearly every aspect of total institutions, focusing primarily on the life of the inmates of the institutions (he also discusses the roles of the staff, but that isn't really the focus) and the effects of the institutional environment on the selves and identities of the inmates.

The second major point in the text is Goffman's criticism of total institutions, which is really limited to the very last section in the book (though you could easily see an underlying criticism throughout). Goffman's basic argument is that the total institution does several things to inmates (I should note that he is speaking specifically of mental hospitals here, though some of this could likely be applied to other institutions): First it stigmatizes the inmate, preventing them from being able to ever completely reintegrate into society afterwards. Second, it forces a 'sick' identity on the inmate. For some inmates, any problems or disorders they may (or may not) have are actually encouraged and/or emphasized in mental hospitals because of the culture and environment inside. In a sense Goffman is actually arguing that total institutions create more problems then they solve by turning relatively normal people into mentally unhealthy people (a good fictitious example of this would be One Flew Over the Cuckoo's Nest).

Goffman's basis for his discussion and analysis is a period of time he spent in a mental hospital. As an academic work, the book is also filled with references to previous literature and explanatory notes.

My Comments:
I was actually introduced to Goffman in an advanced social theory course but it wasn't until I thought about applying the concept of total institutions to one of the institutions with which I am familiar that I actually read the book. In researching the topic it appears that very little work has actually been done on total institutions (labeled as such) since Goffman's treatise (a lot of work has been done on prisons but it is in the criminology literature and does not generally refer to prisons as total institutions). I did find several examples of papers applying this Weberian 'ideal type' to different institutions, including: Indian Reservations, Graduate School, and others.

I think the reason why there is so little work following Goffman's treatise is because he is generally right, very clear, and remarkably insightful. If he has pushed the concept to its limits then there really isn't any point in trying to push it any further. In this sense, this book is comprehensive and very, very insightful.

But one of my reviews would not be complete without a criticism or two. The only real criticisms I have are the length of the book and the organization. The book is very long and, despite using a surprisingly large font, it takes quite a while to dig through the entire thing. There is quite of bit of information that could potentially have been left out, but if he had, perhaps this wouldn't be the masterpiece it generally is considered to be. Also, and Goffman recognizes this and apologizes for it in the beginning, the organization is kind of strange. Rather than organizing the book as a book with distinct chapters it is actually just a compilation of 4 papers that he had previously published. Some of the papers are massive (over 100 pages), but the problem is that there isn't a perfectly clear logic to the organization and there is absolutely no transition from one chapter/paper to the next. This really is forgivable as an academic work, but it does make things a bit awkward for the reader.

Overall this book is superb. Not only is it well-written (though perhaps at a rather advanced level) but it is incredibly insightful. Obviously Goffman caught the essence of the concept because no one has really challenged his understandings since. If you are looking for the sociological Symbolic Interactionist perspective on total institutions (mental hospitals specifically) or are just interested in what mental hospitals are really like (though this book is likely a bit dated), then look no further than Asylums. I highly recommend this for anyone interested in these topics.

I based a sociological study and wrote a very well received paper - A Study of an English Open Prison as a 'Total Institution' - as part of my studies in 1994, in the form of a reappraisal of the books main points measured against covert observational findings. 'Asylums' was recommended to me and proved invaluable in understanding behavioural data from a symbolic interaction theoretical perspective. I was impressed with the work then and remain so now - to the extent that I am frequently drawn back to it still. It was still relevant at that time and it has lost none of that relevance. I heartily commend it!