Erving Goffman's asylums and institutional culture in the mid-twentieth-century United States.

Sociologist Erving Goffman based his seminal work Asylums (1961) on a year of field research at St. Elizabeths Hospital in Washington, DC. Goffman described the mental hospital as a "total institution," in which regimentation dominated every aspect of daily life and patients were denied even the most basic means of self-expression; rather than promote recovery, such conditions produced the sorts of disordered behavior for which men and women were ostensibly admitted. A closer look at the changes transforming St. Elizabeths around the time of Goffman's research reveals a far richer portrait of institutional culture. Group therapy, psychodrama, art and dance therapy, patient newspapers, and patient self-government-each of which debuted at the hospital in the 1940s and 1950s-provided novel opportunities for men and women to make themselves heard and to take their fate into their own hands. While these initiatives did not reach all of the patients at St. Elizabeths, surviving documentation suggests that those who participated found their involvement rewarding and empowering. Goffman explicitly set out to describe "the social world of the hospital inmate." His failure to appreciate fully the capacities of his subjects, however, appears to have led him to underestimate the importance of these developments.