Is racism an illness? Psychiatrists and psychologists are debating the issue. The forthcoming Oxford Handbook of Personality Disorders, due for publication in August 2012, will include a chapter on identifying and assessing pathological bias. This is the form of racism that could lead supremacists to violently and randomly maim or massacre those of another race. Meanwhile, a team of British psychologists recently announced they had stumbled upon a secondary use for Propranolol, a commonly prescribed medication for high blood pressure. They claim it could cure implicit bias, or the form of racism that can even occur in people “with a sincere belief in equality.” Scientists believe the discovery can be explained by the fact that implicit racism is fundamentally founded on fear, and the drug acts both on nerve circuits that govern automatic functions, such as heart rate, and the part of the brain involved in emotional responses.
Thinking of any form of racism as an illness is very troubling. Historically, psychiatrists, psychologists, the medical establishment and lay people have all agreed that the roots of racism are cultural or societal — a set of beliefs and behaviors that are learned and, as a result, can be unlearned. If it were to ever be declared an illness that can be treated, racists would no longer be legally or ethically responsible for their actions. Just imagine it: a medical justification for discriminating against, or even killing, those of another race.
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Dr. Carl C. Bell, the coauthor of the Oxford University Press chapter and a member of the APA is, nonetheless, convinced that some forms of racism are a mental illness. He notes that many of his colleagues are “concerned about having the conversation about racism and mental illness because, for them, it is akin to medicalizing a social problem.” He thinks there is some validity to those concerns but believes that while “95–98% of racist behavior is socially, culturally or politically determined, there is still a sliver of racist behavior that may be based on psychopathology.”
He might be right, but how would we differentiate between socially learned and the pathological forms of racism? Do they really present themselves in the world looking that different, one from the other? In addition to providing justification for behaviors currently deemed immoral, or even illegal, medicalizing racism also reduces the pressure to eliminate racist behavior by social and political means, a task at which we are not now excelling. For example, as sociologist Devah Pager’s work has made clear, in contemporary America, black men with no criminal records, solid work histories, and college degrees, fare no better on the job market than do white men with less education who have been newly released from prison. Does declaring racism an illness in any way remedy, address, or lead us toward a solution for this inequity?
Though it has been asked to consider the issue several times, the American Psychiatric Association has never recognized racism as a mental health problem. The issue was first raised in the mid 1960s by a group of black psychiatrists led by the Harvard professor Dr. Alvin Poussaint. After several race-based murders in Mississippi during the civil rights era, the group asked the APA to have racism entered into the Diagnostic and Statistical Manual of Mental Disorders (DSM-II.) The association rejected the recommendation, arguing that because so many Americans are racist, even extreme racism in this country is the norm — a problem for culture to solve, not medicine. In 2004, the organization again rejected a proposal to include extreme forms of pathological bias, such as racism, in the new edition of the DSM-5, due for publication next summer.
And of course, there are reasons to be suspicious of the racial and political consequences of medical and psychiatric diagnosis. In the 19th century, enslaved black people who escaped from their owners were diagnosed as having drapetomania, a disorder characterized by an irrational desire for freedom. The treatment involved beating the afflicted into submission. According to a 2010 book by psychiatrist Jonathan Metzel, The Protest Psychosis: How Schizophrenia Became a Black Disease, doctors began to diagnose black people involved in the civil rights movement as having a form of schizophrenia characterized by a desire to agitate for their rights. Those receiving this diagnosis were institutionalized.
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Race in and of itself does not dictate, or even explain behavior like running away from an owner, or protesting for civil rights. Humanity explains those behaviors. The same questionable thinking that led to the stigmatization of black people who desired freedom is at the heart of the decision to medicalize racism. It is clear that we as a society have a lot of work to do to end racism, and almost none of it will start in the lab.
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