Goffman 2 - The Pre-Patient Phase Flashcards
What does Goffman mean by the “Moral Career of the Mental Patient”?
The sequence of changes a person’s social role as patient plays in their framework of judging the self and others
What moral aspects typically mark the beginning of the career as mental patient? Which factors of the pre-patient phase enforce these feelings? (after admitting oneself or being convinced to admit oneself to the hospital).
Explained further on other cards. Just list.
The career typically begins with experiences of abandonment, disloyalty, embitterment.
–> Next-of-relation playing role of complainant (betrayal)
–> Feeling as though one is ganged up on or alienated by mediators (usually psychiatrists) and trusted next-of-relation (embittered)
–> The Presence of the mediator as a witness to the betrayal
–> “Betrayal Funnel” which often begins with the next of relation.
–> Creation of guardian role fortifies mistrust in next-of-relation
Describe the retroactive realization of the pre-patient career.
The pre-patient career only becomes such after the person becomes a patient. Therefore the life before hospitalization with be scrutinized and picked apart as evidence of mental illness rationale for hospitalization by staff.
The patient may also do so as a way to maintain the decency or well meaning feelings of the next of relation they feel betrayed by. In this way, the patient themselves begins to retroactively scrutinize their now “pre-patient career”
How does the patient develop the feeling that a coalition has been formed against him between psychiatrist and next-of-relation/complainant? How does this affect his moral career?
Disinclination on the part of the pre-patient might be met with threats or stressors that lead him to agree to the interview, already disrupting trust in the relationship.
By speaking with the third party or by setting up an interview with them, the NOR establishes themselves as a the responsible person to whom pertinent findings can be divulged (pre-guardian) and the other as a patient. When these roles become apparent at the interview, the patient already feels alienated. The moral experience of being alienated can embitter the patient.
Outside of feeling as though a coalition has been formed against him, how might the third party’s existence contribute to feelings of betrayal during the pre-patient phase?
Feelings of humiliation are increased by a third party witnessing the “betrayal”. The creation of the coalition and the witnessing of the betrayal can be described a degradation ceremony.”
What does Goffman mean when he describes a “Betrayal Funnel”?
As the personal passes to the role of patient, each individual mediator might act as though the next stage will not involve degree of loss of right or autonomy that it actually does. This way, the patient is slowly introduced to their loss of rights and may only begin to feel embittered after they look back over the actual progression versus what they were told it would look like.
These lies might be told to maintain equanimity or complacency in the person.
How does the creation of the guardian role contribute to feelings of betrayal in the patient?
The guardian, who used to the the NOR and someone the pt turned to for help, is the same person who mediators and administrators turn for authorization for hospitalization or further loss of rights.
The patient might come to the sense that the closeness of a relationship tells nothing of its trustworthiness.
There is a circuit of agents and agencies that participate in the passage from civilian to patient during the pre-patient phase. What is meant by next of relation?
The person who the patient sees as most available and he should trust and who should be able to save him from his approaching hospitalization.
There is a circuit of agents and agencies that participate in the passage from civilian to patient during the pre-patient phase. What is meant by complainant?
The person who retrospectively appears to have started the person on his way to the hospital. This if often a layperson rather than a specialist or official.
Frequently, the complainant is also a next-of-relation. This interdigitation is more prevalently considered embarrassing in the upper classes.
There is a circuit of agents and agencies that participate in the passage from civilian to patient during the pre-patient phase. What is meant by mediator?
The mediators or a sequence of agents that the prepatient is referred to on his way to the hospital.
These are often officials or specialists with some professional distance, such as police, clergy, medical practitioners, social service workers, etc.
There is a circuit of agents and agencies that participate in the passage from civilian to patient during the pre-patient phase. What is meant by guardian?
While the person is gradually transformed into the patient, the NOR is gradually transformed into the guardian. Some of the patient’s civil rights can be transferred to him, sustaining the legal fiction that the now patient has sustained them.
