I'm sometimes asked by people from the world of mental health about the work of Erving Goffman. Regrettably I’ve never been asked about Howard Becker. Yet together they are the source of many of the taken-for-granted ideas in mental health practice today.
The attention paid over the last fifty years to stigma, discrimination, and the social consequences of a psychiatric label (not to mention the existence of a ‘time to change’ campaign) would have been unlikely had these two men not met as graduate students in 1947 and shared an education in the Department of Sociology at the University of Chicago. Goffman died in 1982, but his reputation has continued to grow. Howard Becker is still very much with us.
Like Goffman I hang around cafes and street corners a lot. The social situation of the café and the performances given within that space by the providers and clients of a service formed the heart of his approach. He was, first and last, interested in the contrast between what he could observe of a social interaction and the ‘definition of a situation’ given by the individual participant - in the space between the two lay the performance (Goffman 1971:13-27). The degree to which you allow your world view to be questioned by those around you is the degree to which you are grounded. The more interpretivist your approach however, the more idiosyncratic your form of presentation is likely to be and therefore potentially less understandable. It’s been said you either love or hate Goffman’s writing. He wrote long discursive essays offering novel conceptualisations on every other page, hugely rewarding to read - but it does require effort. Some say his work has proved impossible to ‘operationalise’ - well, all you really need to do is read him in a café, lift your head every few minutes, and watch!
He’s famous for his ‘dramatological’ approach to the analysis of everyday interactions across a whole variety of modern settings. However it’s worth recalling where, for him, it all began. Whilst a postgraduate he managed to escape to Edinburgh in 1949 for a year or so, and hence to the Isle of Unst, one of the Shetland Isles, to undertake fieldwork amongst what was then the last complete crofting community - well almost! Their window on the outside world, and the outside world’s window on them, was through the Isle’s only hotel. Goffman became a semi-permanent guest, finding himself watching the occasional tourists every evening, having spent the day amongst the islanders. It was there that the ‘front of house’ performance (one side of the swing door) of the crofting family who ran the hotel began to fascinate. Behind the door they remained crofters, keeping to their peasant (subsistence agricultural) lifestyle, including a diet of root vegetables as staples, with meat restricted to ‘feasting and flavouring’. Coming through the door they were transformed in dress, speech and manners; carrying generous servings of meat, a variety of vegetables and desserts - accommodating the expectations of their wealthy middle class, often English, guests. See the footnotes in The Presentation Of Self In Everyday Life published first in 1959 (Goffman 1971).
In 1955 Goffman worked for about eighteen months in a psychiatric hospital, the 7000 bed St. Elizabeth’s Hospital in Washington DC.
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‘ “trimming” and “programming” to describe how “the new arrival allows himself to be shaped and coded into an object that can be fed into the administrative machinery of the establishment, to be worked on smoothly by routine operations” (p.229)
…“secondary adjustments,” to refer to “practices that do not directly challenge staff but allow inmates to obtain forbidden satisfactions or to obtain permitted ones by forbidden means”
…a variety of “personal adjustments,” such as “situational withdrawal”, which (he notes) psychiatrists might call “regression” ’ (p.230)
‘Goffman used his linguistic inventiveness to name things in ways that evaded conventional moral judgements and therefore made scientific work possible. (p.236)
When I look again at Asylums I can’t help but see an equivalence between those huge institutions and our equally large, confining and impersonal rule-governed bureaucratic mental health organisations. Mental health law is as strong as ever. Illness maybe thought of as episodic for most clients, but there is still the social phenomenon of a ‘revolving door’; and being shoved from ‘pillar to post’ becomes a reality when your behaviour is thought undesirable, persistent or enduring. One can see diagnosis itself as part of the identity ‘stripping’ process, the restrictions of the Mental Health Act as leading to a denial of ‘personal space’; if you are sent under section ‘out of area’, away from your community, surrounded by strangers, under the authority of staff whose language you don’t comprehend - isn’t that ‘asylum’?
Also in 1961 the book Encounters first appeared containing two essays on social interaction in general. In one he writes about ‘role distance’ (Goffman 1961:85-152), the extent to which an individual is able to distance themselves from the rules and expectations of a social situation. The problem is often seen in ‘tongue in cheek’ like behaviour - but when applied to those who are confined, physically or psychologically, it can be seen as the degree to which an individual can escape a role prescribed by others and establish an independent identity. The problem arises when someone has come to have some attachment to there situation at the same as being disaffected or resistant to it. ‘A full twist must be made in the iron law of etiquette: the act through which one can afford to try to fit into the situation is an act that can be styled to show that one is somewhat out of place. One enters the situation to the degree that one can demonstrate that one does not belong.’ (p109) Yet it can’t be called role distance if a person has completely refused a role;
‘…for the special facts about self that can be conveyed by holding a role off a little are precisely the ones that cannot be conveyed by throwing the role over.’ (p.108)
‘Should the subordinate exercise role distance, this is likely to be seen as a sign of his refusal to keep his place (thereby moving towards greater intimacy with the superordinate, which the latter is likely to disapprove), or as rejection of authority, or as evidence of low morale. On the other hand, the manifestation of role distance on the part of the superordinate is likely to express a willingness to relax the status quo, and this the subordinate is likely to approve because of its potential profitability for him.’ (Goffman 1961:129)
Then in 1963 came Stigma. First Goffman seeks to turn our reasoning around from individuals with attributes which are stigmatising, to seeing situations - constructed relationships in which stigma is made and reproduced. This led to his famous assertion: ‘The central feature of the stigmatised individuals situation in life can now be stated. It is a question of what is often, if vaguely, called “acceptance”.’ (Goffman 1968b)
Also in 1963 Howard Becker’s Outsiders: Studies In The Sociology Of Deviance was first published. The word ‘deviant’, before it became corrupted, simply meant any individuals or groups who acted in ways other than the currently accepted norms of society. Becker’s study included prostitutes, drug addicts, criminals, jazz musicians, gypsies, hobos and winos - to name but a few!
Through the studies reported in the book Becker became the principal developer of labelling theory, but he was quite clear that his studies were about society’s response to perceived difference, rather than what might actually constitute ‘otherness’ itself (Becker 1991). Society labels the individual or group, they are then treated differently as a consequence of the label. ‘When I was working on the theory of deviance, I wanted to argue that when others labeled someone as a deviant, that identification often became the most important thing about the person so labeled…’ (Becker 1985:142). Becker is also a jazz musician, and was aware of the drug culture from a young age, he studied and wrote about it in the post-war period but the political climate of 1950’s America was such that it didn’t get published for many years - he received his PhD in 1951 for a study of schoolteachers.
When I worked as a volunteer in a mental health centre in 1989, the clients knew my background of mental health problems, when it became clear I had secured a place on a psychiatric nursing course one client (during a conversation where I wasn’t present) apparently reacted in amazement - exclaiming ‘they’ would not allow it. He concluded I must have covered-up my background and lied at the interview!
The view I take now on the stigma and labelling of mental health problems was formed at that time when I was briefly a student nurse, and informed by both Goffman and Becker. However I expressed it someway differently. For to be completely stigmatised, you must be prepared to accept the label. It is also possible to not only define yourself by a stigma, but also come to depend upon it for your own identity. It can grant a special status with certain rewards. To be labelled may exclude you from one community, but allow incorporation into another. There seemed to be, and I see no reason to change what I wrote back then now, four general types of relationship.
1/ I see myself as OK and so does society; this is a relationship of normals, of acceptance and incorporation in like-minded communities.
2/ I see myself as not OK and so does society; this is also a relationship of acceptance and incorporation, someone who accepts the ‘sick role’ and is in long term care.
3/ I see myself as OK but society does not; this is a relationship of rejection and exclusion (on both sides). Someone who does not consider themselves ‘ill’ in anyway whilst those around them do.
4/ I see myself as not OK but society sees me as OK; this is also a relationship of rejection and exclusion; anyone who is ‘screaming’ but not heard.
At various times, before and since, I have embraced all of these roles.
In the last twenty-five years Howard Becker has turned his attention to how academics think, write and undertake research on social behaviour. He has produced three widely acclaimed books, Writing for Social Scientists (Becker 1986), Tricks of the Trade (Becker 1998) and Telling About Society (Becker 2007) - which sadly the world of mental health and health research in generally seem unaware of.
Since the subject of much of my writing is fear, I’ll end with a couple of quotes from Becker on the events that led him to write about social researchers. In the late 1970’s he offered a series of writing seminars for graduate students, with the explicit intention of bringing greater clarity to sociological writing, but what he uncovered was an alarming array of writing ‘habits’ - amongst his students, and the other more senior faculty members who seemed to gravitate to his seminars (Becker 1986:1-25).
‘From one point of view, my fellow participants were describing neurotic symptoms. Viewed sociologically, however, those symptoms were magical rituals. According to Malinowski, people perform such rituals to influence the result of some process over which they think they have no rational means of control.’ (p.3)
‘They feared, to summarize the long discussion that followed, two things. They were afraid that they would never organise their thoughts, that writing would be a big, confusing chaos that would drive them mad. They spoke feelingly about a second fear, that what they wrote would be “wrong” and that (unspecified) people would laugh at them’ (p.4)
References
Becker, H. S (1986) Writing for Social Scientists University of Chicago: Chicago
Becker, H. S (1991) Outsiders: Studies In The Sociology Of Deviance The Free Press: New York
Becker, H. S (1998) Tricks of the Trade University of Chicago: Chicago
Becker, H. S (2007) Telling About Society University of Chicago: Chicago
Goffman, E (1961) Encounters; two studies in the sociology of interaction Bobbs-Merrill: New York
Goffman, E (1968a) Asylums: Essays on the Social Situation of Metal Patients and Other Inmates Pelican: London
Goffman, E (1968b) Stigma: Notes on the Management of Spoiled Identity Pelican: London
Goffman, E (1971) The Presentation Of Self In Everyday Life Pelican: LondonGoffman taught me how to think, Becker how to write - though I suspect that if either were reading this they’d shout: ‘They’re the same thing dummy!
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