Is Racism an Illness?

Some psychiatrists believe that racism is a mental disorder, but medicalizing social ills gets us no closer to a solution

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Members of the Ku Klux Klan burn a cross at a night rally in 1946.

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.

(MORE: Inside the Racist Mind)

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?

(MORE: The Problem with the ‘Some of My Best Friends Are Black’ Defense)

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.

(MORE: The Myth of Desegregation)

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.

MORE: The New Black Irony

6 comments
OhJeeze!!!
OhJeeze!!!

I believe that racism is a spiritual illness that stems from the inability to acknowledge one's own nobility, resulting in denying others theirs.  Low self esteem has murdered many people.

SteveMcCrea
SteveMcCrea

"Medicalizing a social problem?" Isn't that what the DSM is all about? Kids who can't tolerate a standard classroom "have ADHD." Mothers who are depressed in the wake of intense social and emotional changes (including an intense lack of support in many case) are diagnosed with "Postpartum Depression." Men who abuse their partners are diagnosed with "Intermittent Explosive Disorder." Someone (like me historically) who is shy and dislikes big social scenes has "Social Anxiety Disorder." Psychiatry today is almost exclusively about medicalizing social problems. Even Schizophrenia is heavily influenced by urbanization, trauma, race, and immigrant status. Why shouldn't they add racism to their pile of social constructs? Or better yet, why not stop diagnosing people and actually deal with them as human beings?


---- Steve

mark.helsinki
mark.helsinki

I would say that any discussion of the psychopathology of racism has to look at harms, both to the individual, to close others, and to society. That is the normal criteria for deciding when aspects of human personality become distorted to the point of becoming disabling and pathological. Fear of others is understandable in some situations, but when it becomes harmful, socially disabling or even becomes a social phobia against a specific group, then clearly it has become a disorder that needs to be categorised.

Racism is a psychosocial phenomenon with a very strong mental health component. It could probably never be 'reduced' to a mental illness, but it breeds psychological harms that can lead to phobia, addictive behaviour, adjustment disorders etc. Indeed, psychological bias is probably the most sensible grounds on which to 'medicalise' racism, with other features becoming typical secondary diagnosis.

Ironic isn't it that the medical profession are quite happy to medicalise things like ageing, menapause, and sexual function and yet are reluctant to medicalise a very real social ill like racism, which finds violent and abusive expression. Yes, not all racists are violent, but then not all drug addicts are obviously harming others either, but they are certainly harming themselves. Yes, racism is a social phenomenon. But so is substance-abuse. Alcoholics often indulge their addictive behaviour in a drinking community. Does that make it any less pathological? Of course not. Saying racism is a 'social' problem is merely another way of saying it has a social dimension that can act to reinforce the pathalogical behaviour. The pathology doesn't disappear by recognising its social elements.

I fail to see how a 'desire for freedom' can be irrational or even what are the harms that come from this desire. I say that because this idea of political activism as being mental illness is very easily challenged and should not leave us reluctant to challenge the psychopathology of some 'political ideas'. 

Indeed, when people kill others and claim God inspired them to do so, we do not handcuff ourselves by saying that this cannot be seen as psychopathology because of the 'freedom of religion' principle. Indeed, genocide is often psychotic killing, but we do not excuse it on the basis that it has a 'political' or 'ethnic' justification. The psychopathology is not found or sought in the political or spiritual justifications, but in the actual harms to the individual, to those around them, or to those indirectly affected. There are sufficient harms arising out of racism to seek to categorise the desire to inflict that kind of harm as pathological. 

GuyHolder
GuyHolder

Stop making excuses for yourselves - pick yourselves up and offer better guidance to your young. Any illness is within your own community. Until you can accept responsibility and take steps to change what appears to be a black culture in decline - all our legislative efforts and focus on political correctness won't make a difference.I'm old enough to see how useless these efforts have been and old enough to see a marked decline in blacks attitudes towards whites, a decline in blacks attitude toward society and a decline in blacks attitude towards inproving themselves.On an individual level we see many blacks become leaders in all fields. Those that have drive and seperate themselves from the pack do well. Stop carrying a chip and make the changes you have to.I wasn't brought up to be racist - but what I have observed over 50 years leaves me wary and without much hope when I see articles like these.Born in 62, I interacted very normally with blacks throughout my formative years. The soulful and thoughtful black man of the seventies is a far cry from the crude rapper / gangster wanna be so many young blacks emulate today.Just stop it - stop blaming us and look inward towards your own community and fix what is wrong.

mark.helsinki
mark.helsinki

@OhJeeze!!! People have murdered many people - it's silly to find a 'condition' and then phrase it in such a way that it is the 'condition' that commits the crimes. The only way out of the cage of 'low self-esteem' is to realise that we do have some control over it, or even, that we can and must exercise some control - then, we are truly actors in our own lives and not merely 'reacting'.