31st October 2023

Sociology of Institutions

Erving Goffman

Sociologist Erving Goffman is well known for his 1950s and 1960s work on the sociology of total institutions. Total institutions are places where the residents are cut off from the outside world, and the organisation of their lives occurs from within the confines of the institution itself. Common examples of total institutions are care-homes, prisons, cruise ships, monasteries, orphanages, boarding schools and, of course, asylums.

Though there has been a shift towards care in the community for both old age care and mental illness, it is worth considering how this work still impacts our care settings. In institutions like care homes, time is structured for residents and decisions are made through the organisation’s policy. This is known as bureaucratic control.

This type of control arises through a process of institutionalisation that Goffman calls ‘mortification of the self’. This self-mortification is a dismantling of a person’s autonomy. There are 7 aspects of it:

• Role dispossession – A person loses their role (their job, motherhood, being a spouse) and takes on the sick role.
• Identity trimming – The person is reduced to data: for example, ‘the lady in room 3’ or their NHS number.
• Dispossession of property, name, and one’s ‘identity kit’, i.e. those artefacts that identify who we are.
• Imposition of degrading postures, stances, and deference patterns often justified by the power imbalance between those receiving care and caregivers.
• Contaminative exposure – This occurs when the organisation offers little or no private space so that our private activities are hard to conceal. This could be seen in single sex wards
• The disruption of the usual relationship between the individual and their actions/behaviours. For example, a person can no longer choose when to make a sandwich because they need a member of staff to monitor them while they are using a knife.
• Restrictions on self-determination, autonomy, and freedom of action. It becomes difficult or impossible to develop and pursue interests, make choices or associate with others of one’s own choosing.