Sunday, September 07, 2014
While still in college and working as a volunteer at a 5,000 bed state hospital, I read Erving Goffman's Asylums. His descriptions of St. Elizabeth's Hospital matched what I was observing each Saturday afternoon during the 3 or 4 hours that I spent with a few of the 200 men housed on a so-called Cottage Ward. I accepted Asylums as the gospel. Recently I read a short article titled "Erving Goffman's Asylums and Institutional Culture in the Mid-twentieth Century United States" by the historian Mathew Gambino, which takes a second look at Goffman's classic book. Gambino reviews materials, such as a patient edited newspaper, that were available to Goffman. Where Goffman saw indoctrination, Gambino hears the voices of patients. Even after more than fifty years he was able to locate statements by patients that suggested that they were quite active in shaping their lives at patients. Indeed, Gambino points out that for all the time Goffman spent as a participant-observer at St. Elizabeth's, he presented no interviews with patients. The difference in orientation between Goffman and Gambino suggests an evolution in our attitudes towards the mentally ill. While Goffman saw the patients as victims, Gambino asks us to consider these patients as agents. This does not suggest to me that we simply rewrite the history of asylum treatment in the United States. At the very least there is no way that I can erase my experiences with patients at a state hospital in the 1960s. It does suggest that when we write about the mentally ill we should not forget that they are people struggling not only with their illnesses, but with the institutions that shape their lives. Gambino's article should be required reading in classrooms where students are asked to read Asylums.