Asylums Mental Institutions

It is well established that in person-centred counselling the relationship between the client and the practitioner is the primary intervention in the client’s journey towards well-being. By closely examining Erving Goffman’s essay ‘The Medical Model and Mental Hospitalization’, this chapter will give a broadly Rogerian critique of the ideas of this
perennially influential and unorthodox sociologist. After half a century, in an extended metaphor of good and bad ‘client-server’ relationships, Goffman’s satire continues to raise highly controversial points about the organisation and function of mental health institutions in the United States, and about the dominating role of the ‘total institution’. Casting his acerbic gaze upon the function and conduct of the psychiatric relationship, he generally ascribes the universal failure of the medical model to its inability to provide and maintain an ideal ‘service relationship’ with its clients. He suggests that this break-down in service is because the client-server relationship, rather than being organised to meet the needs of its clients or patients, serves the greater interests of the institutions and society. In the same year that Goffman presented his uncomfortably illuminating analysis of medical service relationships, humanistic psychologist Carl Rogers published his own approach to the therapeutic relationship, which vests agency in the client. In On Becoming a Person, Rogers, drawing from his overarching theory of the fully functioning person, specifically outlines a growth-promoting person/client-centred relationship. Effectively altering the dynamics of the traditional expert-led medical relationship, Rogers’s approach to the therapeutic service relationship makes sure that the client is acknowledged as the expert in his or her own life. As a contemporary of Goffman, Rogers’s philosophy and clear understanding of how to establish the ideal conditions for an effective therapeutic relationship, provide an alternative perspective from which to view Goffman’s report of the therapeutic client-server encounter. Similarly, Goffman’s ironic observations, so influential in changing America’s mental institutions, remind us of the important contribution that the client-server ideal continues make to effective client interactions and therapeutic outcomes.

Ce mémoire porte sur la mise en œuvre de la politique d’institutionnalisation de la folie en milieu asilaire durant la seconde moitié du XIXe siècle à Québec. L’étude se penche plus spécifiquement sur l’Asile de Beauport, premier asile permanent de la province de Québec. Cet établissement fut dirigé par trois générations de propriétaires, de son ouverture en 1845 jusqu’à ce qu’il soit pris en charge par les Sœurs de la Charité de Québec en 1893 selon un système qu’on appela l’affermage. L’accent de cette recherche est mis sur l’expérience et les interactions entre les différents acteurs - les propriétaires, membres du personnel médical et non médical, l’État, la famille et la communauté des patients - présents dans le processus d’institutionnalisation de la folie. Cette manière d’appréhender l’histoire de l’Asile de Beauport permet d’examiner une réalité parfois différente du cadre légal, réalité née de l’adaptation des acteurs en présence à un système dont l’objectif thérapeutique céda la place à celui d’une entreprise lucrative. Ce modèle de gestion à des fins lucratives s’est répercuté de manière manifeste à chacune des étapes de l’institutionnalisation asilaire, à savoir l’admission, l’internement et la décharge des patients.

Resumen: A partir de una etnografía realizada en Barcelona y Tarragona entre 2013 y 2014 se problematizan las interacciones y relaciones de personas diagnosticadas con trastorno mental grave y sus familiares en el espacio doméstico. A través de una comparación de las dinámicas y lógicas del hospital mental extraídas de las etnografías del custodialismo y las del espacio doméstico, se pone de relieve la proyección y reproducción de dinámi-cas manicomiales en el ámbito familiar. Desde una lectura cultural del espacio doméstico, los ejemplos etnográficos sirven para argumentar que el modelo de externalización actual perpetúa la cronificación y la hospitalización doméstica de los pacientes. Abstract: Based on an ethnography carried out in Barcelona and Tarragona between 2013 and 2014, this article problematizes the interactions and relationships of people diagnosed with severe mental disorder and their relatives at home. Through a comparison of the dynamics and logics of the mental hospital as described in classic ethnographies of mental asylums and those of domestic spaces, the projection and reproduction of asylum features at home are highlighted. From a cultural perspective of the domestic space,

Following the deaths of fourteen children at a children’s residential facility in Froissy in November 1968, a moment of national interest in France in the challenges facing disabled children led parents’ associations to press for systemic reform. Concomitantly, social critiques following the protests of May 1968 focused on poor institutional conditions as evidence of society’s failures. Though government inquiry into the incident placed the blame on the proprietors, media reports and advocates asserted the failure of the French government to protect the disabled. This viewpoint aligned with the rhetoric of reformers seeking to dismantle institutions to instigate social change. However, an alliance of reformers and parents’ groups did not materialize, even after the important reforms of the law of 30 June 1975. That law articulated the government’s commitment to the equality of disabled citizens, but it had limited impact due to its failure to address conditions for the mentally disabled.

This article explores the potential fruitfulness of an encounter between psychoanalysis and science and technology studies (STS) by examining Perry’s (The Human Nature of Science: Researchers at Work in Psychiatry, The Free Press, New York, 1966) book, and its intellectual and socio-cultural background. From his close observation of experimental LSD therapy in a psychiatric research center in the USA, Perry seminally claimed—a decade ahead of similar claims in STS—the social construction of scientific theory. His work, being idiosyncratic as a hybrid of STS and psychoanalysis in terms of both his research subject and research framework, later sank into complete oblivion. Examined here, first, is the parallel development of the reflexivity concept in both STS and psychoanalysis: Harry S. Sullivan’s pivotal role in introducing sociological reflexivity into the latter is detailed. Second, the predicament of mental institutions in the post-war USA is identified as the important milieu that allowed such diverse approaches as Erving Goffman’s Asylums. The highlighted potential of Perry’s work vis-à-vis contemporary STS is its reflexive ethnography that combines research ethics with emotional dynamics in situ. This contribution is contrasted with its limited applicability to large-scale social issues, another lesson we learn from this historical reflection.

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A look at the scientific validity of the monoamine hypothesis, which provides backing for the biological approach to psychiatry, the feasibility of the serotonin hypothesis, and a study on the credibility of the DSM and the theory of Personality Disorder-(literature or science?).

This paper provides a presentation of the project Ulleråker – funktionsnedsättning och kulturarv funded by the National Heritage Board. The project seeks to investigate the transformation of Ulleråker, a former psychiatric hospital in the outskirts of Uppsala (Sweden). The project will study how cultural heritage is transformed, and formed, during urban development and rebuilding processes, with a particular focus on gender and functionality norms. The project examines different kinds of material in order to illuminate how cultural heritage is articulated and materialized in the area. The material is analyzed using a composite theory of critical heritage studies coupled with crip and gender studies. The purpose of the project is to contribute to develop methods and theories in how to deal with the cultural heritage of psychiatric hospitals during times of transformation.

Adottando l'angolo prospettico delle teorie critiche del diritto, In questo saggio intendo porre le basi per una riflessione relativa a dei chi e dei dove specifici, che trovano il loro elemento unificante nel fatto di richiamarsi, più o meno direttamente, all’ambito della “cura” (considerata principalmente come care) delle persone con disabilità. Nonostante la complessità e interdisciplinarietà del tema non mi consentano di aspirare, allo stato attuale, all’elaborazione di una compiuta riflessione che vada oltre l’individuazione di alcune tra le questioni che paiono più rilevanti, nel corso di questo contributo mi inserirò all’interno di quella prospettiva critica che si propone di “forzare” i confini della cura, con l’obiettivo di “mettere a tema” taluni profili che originano dal profondo mutamento del quadro giuridico e culturale che sta avvenendo in tale ambito. Al riguardo, è certamente opportuno esplicitare che, talvolta, si tratta di questioni solo parzialmente nuove; tuttavia esse richiedono di essere ripensate proprio alla luce dei cambiamenti giuridici, economici, politici e culturali in atto. Procederò in tal senso dopo avere richiamato le coordinate generali del dibattito su soggetti e luoghi (in particolare, nella loro connessione con la libertà), che è una delle cifre caratterizzanti delle teorie critiche del diritto, poiché costituisce l’orizzonte teorico che fa da sfondo alle riflessioni che seguiranno.

MHE'nin (Mental Health Europe) 2018 tarihli Avrupa Dışlanma Haritası (Ocak 2018) yayımlandı. Ruh ve zihin sağlığı alanında 35 Avrupa Bölgesi Ülkesinde kurum bakımı ve toplum temelli hizmetler temelinde veri sağlayan raporda, Türkiye ile ilgili bilgiler de yer almaktadır. Rapor, ruh sağlığı kurumlarının mevcut durumu, zorunlu yatırılma, insan hakları ihlalleri ve tanıklıklar üzerine veriler içermektedir. Avrupa ruh sağlığı çalışmasının Türkiye bölümüne Ruh Sağlığında İnsan Hakları Girişimi Derneği (RUSİHAK) katkı ve kaynak sağlamıştır. Rapor ekte mevcuttur.