This section indicates that Esther has the capacity to reclaim her autonomy from Doctor Gordon outside of the institutional setting. Goffman (1961), in his sociological study of the 1950s, focuses more on the social environment of the asylum, although he also records ECT being given to control behaviour. In. Claire Hiltons journalistic review “An exploration of the patient’s experience of electro-convulsive therapy in mid-twentieth century creative literature: A historical study with implications for practice today”, the author writes that, among other novels, The Bell Jar by Sylvia Plath is “compatible with [Goffman’s] sociological scenarios of coercion and deprivation of personal autonomy and lack of therapeutic environment in asylums.” (10). The same research “…focuses more on the social environment of the asylum, although he also records ECT being given to control behaviour.” (Hilton 10). This points to an important distinction in the care Esther receives: she receives ECT as an outpatient therapy. This provides her with the freedom to remove herself from the environment and care of the physician that abused the patient-provider relationship and removed Esther’s autonomy over her own body through the welding of medical knowledge. Furthermore, this indicates that had Esther been seeing Doctor Gordon inpatient, she would have been further subjected to the misuse of ECT as a method for behavioral control and capital punishment instead of for psychiatric therapy. Overall, the ability of Esther to terminate her patient-provider relationship with Doctor Gordon points to the importance— for those suffering from mental illness— to continue to exist functionally in the community for as long as is safely possible, as it protects their autonomy and allows them the ability to transgress without fear of medicalized punishment.
