UNIVERSITATEA BUCUREȘTI

FACULTATEA DE SOCIOLOGIE ȘI ASISTENȚĂ SOCIALĂ

FINAL ESSAY SEMESTER 1

ASYLUMS ( ERVING GOFFMAN)
CHAPTER: THE PREPATIENT PHASE

Coord.Științific: Student:
Lect.Univ.Dr. Claudia Ghișoiu Voivozeanu Aurelia Monica

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Erving Goffman was among the most important authors in the post-war period in the social
sciences. He is part of the symbolic interactionist movement and the founder of dramatic
sociology1. His thoughts and ideas have been extraordinarily well regarded in society and
have been known to a great many people.

The book I read is called Asylums and is by Erving Goffman.Erving Goffman put his work
together in a year of field research at St. Elizabeth's Hospital in Washington. 2 Goffman
described the hospital as an institution where every aspect of daily life was dominated, and
people admitted there were not allowed any means of individual expression.

The chapter I have chosen to write this essay about is called "The Pre-Patient Phase." In this
chapter, Goffman describes the states and stages that a mentally ill person goes through
before they are admitted and automatically become a patient and the states they go through
when they become a patient. He talks in detail about each situation, what the pre-patient
encounters and not least about the people who are near the pre-patient and guide him in the
decisions to be made.

Goffman is of the opinion that some of the people who are on the verge of committing
themselves to a psychiatric hospital do so of their own free will because they believe it is
better for them and their psyche, or they are pushed to do so by family members who have
noticed strange behaviour in them. Goffman says that "This self-concept may seem one of the
most threatening things that can happen to the self in our society, especially as it is likely to
occur at a time when the person is sufficiently disturbed anyway to exhibit the kind of
symptoms that he can see for himself."3

Most of the time, the prepatient has a person behind them who influences them to go to the
hospital, Goffman considering that this person is often the person closest to the prepatient, a
relative or a specialized person who can also be a mediator. During the stages that the
prepatient goes through, various feelings are formed that make him believe that the person
closest to him has betrayed him and he has the impression that everyone is against him and
wants to get rid of him, putting him in hospital, forgetting him or visiting him very rarely.
Goffman believes that as the pre-patient becomes a patient, the person closest to the patient
becomes the legal guardian and the rights that the patient had before being admitted to the
hospital are lost and become represented by the guardian. Goffman says of pre-patients that
1
(Anon., 2016)
2
(Gambino, 2013)
3
(Goffman, 2022)

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for a time they feel that hospitalisation is the worst thing that can happen to them and that this
method is a deprivation of freedom or a way for the family to get rid of them forever. .
Prepatients are always trying to convince outsiders that they are right and something totally
unfair is happening to them. Sometimes their words are believed by outsiders and people try
to help them. "If the guardian is happy with what is happening to the new pecient, the world
should be happy too".4

Sullivan says that "What we find in the ego system of a person undergoing alterations or
schizophrenic processes is, in its simplest form, an extremely powerful confusion marked by
fear, represented by the use of generalized and highly refined referential processes by which
the individual attempts to confront what is essentially the failure to exist as a human being,
the failure to have those selves that he could respect and consider worth having."5

With this paragraph, Sullivan wants to convey his view of people who experience certain
problems and who at some point go through a certain schizophrenic episode. He believes that
these people are confused, don't know exactly what is going on with their minds and are often
surrounded by the sense of fear that dominates the schizophrenic behavior they are
experiencing. More often than not, fear causes schizophrenic behaviour.

In 2018 Andy James released an instrumental track called "Asylum" 6 .Through this song,
Andy James wanted to convey to the listeners the feelings of sadness, fear, melancholy and
loneliness that people in an asylum go through. The video of this song is shaped by Andy
James playing the guitar in a gloomy and empty room and another person who is the so-
called patient in the asylum, an empty, sad and closed person in a room that inspires death.
Andy likens the person in the video of his song to an asylum inmate, and the room he plays in
resembles the inside of an asylum. People who listen to this song will feel the sadness of the
song and the feelings it brings with it.

Artists who write songs like this want to convey to some extent the feelings and states of
mind of people in a care home.

From my point of view, people who get into a situation in life where they do not know what
is happening to them and do not find themselves in anything anymore always need help, but
this help must be sincere without further degrading the psyche of the person. My opinion of
what Erving Goffman conveys in this book is quite broad.
4
(Goffman, 2022)
5
(Goffman, 2022)
6
(James, 2018)

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First of all, I believe that a person who is to be placed in an institution such as an asylum is
subject to a lot of risks and negative effects on himself. People who feel they need to be
admitted are quite traumatised with what is happening to them and see admission as the only
way to get better, but they do not know from the start what they are going to go through or
what inpatient life is like and the risks it comes with. Sometimes people who think they need
to be admitted are very depressed and see it as the solution to their problems, but there are
many other ways to get rid of the trauma they are going through without being admitted.

On the other hand, I believe that the people close to the pre-patient play a very important role
throughout the events that take place before the patient is admitted. Most of the time the
person close to the patient encourages the pre-patient to commit, claiming that this will help
them, without knowing what this implies. Once admitted, patients lose many of their rights
and become unrecognisable. An example to support my argument is even a story from my
own family. Five years ago, my uncle went through a divorce and was going through a very
difficult period in his life, he became aggressive and lost his mind and we suffered as a result.
After a very tumultuous period, my uncle decided to commit himself, but this decision was
the worst choice he could have made. Once in hospital, he was left without many rights. All
his personal belongings were confiscated, his name had become a simple number that set him
apart from the other patients, and the authorized people who were supposed to care for him
had become his enemies. With the help of his family, he was able to discharge himself from
hospital and see a psychiatrist who helped him regain his normality.

In conclusion, as I said above, the solution for many problematic people is not always to be
admitted to a hospital like a nursing home because this brings other problems to the future
patient and sometimes they are scarred forever.

Bibliography
Anon., 2016. Wikipedia. [Interactiv]
Available at: https://en.wikipedia.org/wiki/Erving_Goffman
[Accesat 28 12 2022].

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Gambino, M., 2013. PubMed.gov. [Interactiv]
Available at: https://pubmed.ncbi.nlm.nih.gov/23656762/
[Accesat 27 12 2022].
Goffman, E., 2022. Asylums. s.l.:Penguin Classics.
James, A., 2018. YouToube. [Interactiv]
Available at: https://www.youtube.com/watch?
v=hthpbaLZWPE&ab_channel=UrbanYetiRecords
[Accesat 25 12 2022].

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2023