Tag Archives: Erving Goffman


Sometimes we can’t help but be part of an interaction pattern that can turn toxic.

Interactions with others can be hard to reduce to formulas.  But there are forms of interaction that can be identified readily, one of which is a pattern of exchange sometimes known as “teaming.”  We can often find it in groups, where most of the individuals know each other. As the seminal sociologist Erving Goffman noted, teams are several people who work to create a shared “definition of a situation,” “performing” a point of view that emerges as distinct from the view held by a holdout. This happens by accident or design, usually when one person in a group of three or four people is singled out and seemingly out of step. Those in agreement emerge as an ad hoc “team” that identifies and usually attempts to change the non-compliant individual. We have probably been on both sides of this equation in the long trajectory of our interactions, sometimes as part of a team, and sometimes as the outsider.

Friendship can protect us against teaming.

Bullying can be one form of this. It’s easy to imagine school days when it seemed like even friends took sides in a one-against-the-rest series of transactions. The apparent unanimity of those engaging in this kind of “micro-aggression” are encouraged by their numbers; agreement with others can easily become comfortable. By contrast, the person who is the object of the challenge may still hold fast to their view, but with probably with less comfort and a degree of isolation. Friendship obviously provides some protection. The implicit compact with make with friends is that they will be considerate and loyal, mostly avoiding conversational space that might open up and feed a feeling of abandonment.

We can imagine a scenario of a group of teens, who can so easily construct and destruct personal identity over the simplest of choices. Perhaps the scene is where three want to go on an amusement park ride that terrifies a fourth. Pressing the holdout rather than accepting their fears is a form of teaming. No wonder adolescence is likely to produce our first efforts to protect our sense of self from others.  I suspect this is why many young males find themselves to be their own best company.  They have yet to figure out how to deal with being provoked into unwanted conformity.

Teaming is an ongoing sport in office politics.  The stakes surrounding a proposed course of action may seem bigger. Egos can easily align with a given outcome.  And it is common practice to abandon the idea of a common approach to a problem that may leave at least one apparent holdout. Maybe those in the team have good reasons to hold fast. But to the holdout, the exchange can look like duplicity. The resulting feeling of betrayal is a predictable workplace complaint that some members of families are likely to share at the end of the day.

An effective leader may step in before teaming makes a decision or attitude look like a binary choice. Their goal may be to help the holdout save face.  Even better, and on an important decision, the leader may take a page from Quaker doctrine and withhold a final decision until everyone can comfortably endorse. Negotiating differences always sounds good, but may not be possible, especially if an office bully is after a firm “win.”

This dynamic of interaction is relatively obvious. But the idea is useful for two reasons. First, having a name for it helps us see it. Only then—which gets to my second point—can we query this dynamic for its negative effects a community member’s sense of self.  We’ve mentioned harms. But teaming can also be done for therapeutic reasons, is in an “intervention” intended to confront a friend with a destructive addiction. Even so, the person who is the subject of this pressure may view it differently: as a kind of ganging up, where all of the burden for significant change falls on them. Who wouldn’t experience some psychological wounds, even if the group is motivated by altruism?

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The Rise of Telehealth

Well down the path of protecting health care workers with vaccines and masks, it remains for insurance companies to decide whether to still cover virtual visits.

Just a few years ago most people who studied health communication expressed doubts about the value of remote health “visits.” A phone or video appointment with a professional might be fine for a patient or client isolated in a remote location. But more recently, the more typical telehealth “visit” has gone local, with patients talking to a provider just a few miles away, usuallly via some version of Zoom.  Indeed, no person with symptoms of COVID was really welcome in a typical medical office, especially when vaccines were still months away.  Rates of virtual visits for all types of care are now at about 35 percent.

I certainly was among the skeptics, believing that a live face to face encounter is far preferable. And health professionals note that if they take time to notice, they may learn more about a patient’s condition in the small ways they present themselves during an in-office examination. But COVID obviously made telehealth “visits” a safer alternative.

Now, well down the path of protecting health care workers with vaccines and masks, the question remains for insurance companies whether to continue to fully reimburse health providers for virtual visits. And since states pitch in for federal insurance, many are grappling with what they will reimburse. Some state leaders have expressed concern that virtual visits are easy to abuse, and maybe little more than a glorified phone call. Then, too, it takes some planning and skill  to do exams remotely.

The behavioral health therapists I know bridle at the suggestion that they do any less for a virtual visit. Some argue that they often achieve more because they have to listen closely to a patient’s or client’s descriptions of their world and concerns. Not surprisingly, a face on a flat screen sometimes gives away very little. With video, the work and the payoffs are ironically in the process of active hearing and listening: something we are less apt to do in the presence of a lot of visual stimulation.


The Human Glitch of Required Video

There’s also an unexpected glitch with a mandate that specifically requires video visits. Many older patients  and clients are hardly in the position to use a computer or smart phone to connect with a professional. What is second nature to most of us is often awkward for a senior with limited abilities. They may not be able to pull off a video chat, with all the normal prerequisites of finger dexterity, access codes, Wi-Fi connections, and basic management of the software. And, to be frank, there aren’t enough staff around these folks to stand by and help.

For these seniors, phone visits are often adequate and preferred. They’ve grown up with telephones. So far, through much of the pandemic insurers have usually allowed calls to be counted as full “visits.” But those who pay our healthcare bills have a hard time imagining that seniors would be challenged to manage Zoom calls. Most surely need a more active imagination to understand why what is essentially video conferencing is poorly suited to an assisted living or nursing home situation.

There is also an additional advantage to audio-only visits. They allow a person to give up the natural anxiousness that comes with the offering of oneself to the gaze of others. This is no small matter, as anyone with a teen in the house knows. Almost all of us worry about how we will look to others. It’s part of the human condition. Face to face meetings require, in sociologist Erving Goffman’s perfect phrase, “the presentation of self.” Our presence in the same space with others carries the double burden of trying to meet perceived expectations, and implicitly inviting others to judge the-outer most shell of the self.

To some extent that still happens with voice-only messages.  But the so-called “white coat syndrome” is probably reduced. We can retain more of our personal “front,” making it easier to focus on what we are saying. For now, it remains to be determined how routine medical visits will look in the coming years.