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


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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Halnon, K. (2012). Defending the Self in a Total Institution: Staff Prompting and Patient Burlesque. Sociology Mind, 2, 465-476. doi: 10.4236/sm.2012.24060.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Adorno, T. et. al. (1950). The authoritarian personality. New York: Harper.
[2] Berger, P., & Thomas, L. (1966). The social construction of reality: A treatise in the sociology of knowledge. New York: Anchor Books.
[3] Becker, H. S. (1963). Outsiders: Studies in the sociology of deviance. New York: Free Press.
[4] Bilken, D. (1989). Purposeful Integration inherently equal. Exceptional parent, 19, 62.
[5] Bogdan, R. (1988). Freak show: Presenting human oddities for amusement and profit. Chicago: University of Chicago Press.
[6] Coser, R. L. (1959). Some social functions of laughter. Human Relations, 12, 171-187. doi:10.1177/001872675901200205
[7] Coser, R. L. (1960). Laughter among colleagues. Psychiatry, 23, 81-95.
[8] Dear, M. J., & Wolch, J. R. (1987). Landscapes of despair: From deinstitutionalization to homelessness. Cambridge: Polity Press.
[9] Derber, C., & Yale, M. (1988). The pursuit of attention. In C. Clark, & H. Robboy (Eds.), Social interaction: Readings in sociology (pp. 131-143). New York: Martin’s Press.
[10] Durkheim, E. (1997). The division of labor in society. New York: Free Press.
[11] Dworkin, A. (1989). Pornography: Men possessing women. New York: Plume.
[12] Glaser, B. G., & Anselm, S. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine de Gruyter.
[13] Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs: Prentice Hall.
[14] Goffman, E. (1961). Asylums: Essays on the social situation of mental patient and other inmates. New York: Anchor Books.
[15] Goffman, E. (1959). The presentation of self in everyday life. New York: Anchor Books.
[16] Grob, G. (1995). The paradox of deinstitutionalization. Society, 35, 51-59. doi:10.1007/BF02693338
[17] Gubar, S. (1997). Racechanges: White skin, black face in American culture. New York: Oxford University Press.
[18] Isaac, R. J. (1990). Madness in the streets: How psychiatry and the law abandoned the mentally ill. New York: Free Press.
[19] Johnson, & Braden (1990). Out of bedlam: The truth about deinstitutionalization. New York: Basic Books.
[20] Kaplan, H. B. (1980). Deviant behavior in defense of self. New York: Academic Press.
[21] Kip, K.-S. (2000). The community care movement in mental health services: Implications for social work practice. International Social Work, 43, 33-48.
[22] Lederer, W. (1968). The fear of women. New York: Harcourt, Brace Jovanovich.
[23] Lemert, E. M. (1951). Primary and secondary deviation. In E. Rubington, & M. S. Weinberg (Eds.), The study of social problems: Seven perspectives (pp. 192-195). New York: Oxford University Press.
[24] Lofland, J., & Lynn H. L. (1984). Analyzing social settings: A guide to qualitative observation and analysis. Belmont: Wadsworth.
[25] Malik, K., & Elaine, M. S. (1979). Jobs and self-sufficiency: Goals of the project, ‘technical support services to the developmentally disabled, region III’,” Final Report, October 1976 to September 1979. Washington DC: Rehabilitation Research and Training Center.
[26] Martin, D. (1976). Battered wives. Volcano: Volcano Press.
[27] Mechanic, D. (1990). Deinstitutionalization: An appraisal of reform. Annual Review of Sociology, 16, 301-327. doi:10.1146/
[28] Micale, M. S. (1995). Approaching hysteria: Disease and its interpretation. Princeton: Princeton University Press.
[29] Mills, C. W. (1961). The sociological imagination. New York: Grove Press.
[30] Martineau, W. H. (1972). A model of the social functions of humor. In J. H. Goldstein, & P. E. McGhee (Eds.), The psychology of humor (pp. 101-125). New York: Academic Press.
[31] Pogrebin, M. R., & Poole, E. D. (1988). Humor in the briefing room: A study of the strategic uses of humor among police. Journal of Contemporary Ethnography, 17, 183-210. doi:10.1177/089124188017002003
[32] Scull, A. (1989). Social order/mental disorder: Anglo-American psychiatry in historical perspective. Berkeley: University of California Press.
[33] Scheff, T. J. (1984). Being mentally ill: A sociological theory. Chicago: Aldine de Gruyter.
[34] Strauss, A., & Julie, C. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park: Sage.
[35] Strauss, A. (1972). Language and identity. In J. G. Manis, & B. Melzer (Eds.), Symbolic interaction: Reader in social psychology (pp. 379- 385). Boston: Allyn and Bacon.
[36] Taylor, S. J., Robert, B., Douglas, B., & Dianne, F. (1989). Qualitative evaluations of exemplary programs. Journal of Rehabilitation Research & Development, 26, 467.
[37] Whitman, C. (1995). Heading toward normal: Deinstitutionalization for the mentally retarded client. Marriage & Family Review, 21, 51-64. doi:10.1300/J002v21n01_04
[38] Wiley, J. (1988). Role blurring in a holistic therapeutic community: An intermediary response to institutionalization and deinstitutionalizetion. Journal of Contemporary Ethnography, 17, 3-39. doi:10.1177/0891241688171001
[39] Wolfensberger, W. (1972). The principle of normalization in human services. Toronto: National Institute on Mental Retardation.
[40] Wolfensberger, W. (1980). The definition of normalization: Update, problems, disagreements and misunderstandings. In R. J. Flynn, & K. E. Nitsch (Eds.), Normalization, integration, and community services. Baltimore, MD: University Park Press.

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