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Defending the Self in a Total Institution: Staff Prompting and Patient Burlesque

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Author(s): Karen Bettez Halnon

Journal: Sociology Mind
ISSN 2160-083X

Volume: 02;
Issue: 04;
Start page: 465;
Date: 2012;
Original page

Keywords: Stigma | Normalization | Underlife | Total Institution | GOFFMAN | Mental Patient | Mental Retardation

ABSTRACT
This paper offers an analysis of forms of social interaction between direct care staff and patient members of a state institution for the “Mentally Retarded” (MR) and dually-diagnosed (MR with a mental disorder diagnosis) located in the northeastern United States. This work’s significance is that it updates and extends Erving Goffman’s (1961) classic study of the underlife of total institutions. It does so by delineating a sub-type of secondary adjustment to total institutions, termed ancillary adjustment. Ancillary adjustment is defined as performances of patient role that undercut the institution’s official prescription for patient identity toward normalizing direct staff member identity. It is shown how ancillary adjustment arose as an unintended consequence of the institutional reforms of the 1970s, or how, under a professionally reformed and bureaucratized “New School”, direct care staff members experienced themselves as disempowered and discredited as “normal” professionals and defensively and repeatedly cued hyper-stigmatized comedic spectacles through types of staff-patient interaction termed staff prompting and patient burlesque. This paper is based on a three-year fieldwork study entitled Defending the Self in an Institution for the Mentally Retarded that utilized Glaser and Strauss’ (1967) and Strauss and Corbin’s (1990) grounded theory methods for qualitative research.
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