LectureHop: The “Black Disease”

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On Wednesday afternoon, Jonathan Metzl MD, PhD, an associate professor of Psychiatry and Women’s Studies at the University of Michigan, delivered the inaugural speech for the Institute for the Research on Women and Gender’s Embodiments of Science Lecture Series. The series hopes to explore new socially informed approaches to embodiment in the psychiatric and psychoanalytic sciences. Bwog’s Contessa Gayles reports on Metzl’s cultural and clinical narrative of how schizophrenia became a racially coded diagnosis.

Metzl gave an informative and provocative overview of his new book, The Protest Psychosis: How Schizophrenia Became a Black Disease. Through a combination of clinical data from the Ionia State Hospital of the Criminally Insane in Michigan and pop culture references to anything from 1940’s film to the lyrics of Tupac Shakur, Metzl focused on the societal factors that informed the dramatic shift of the 1960’s and 70’s in determining who was diagnosed with schizophrenia and how the disease was characterized in the US.

Schizophrenia – literally meaning “split mind” – is a mental illness caused by social developmental factors and biological underpinnings, and until the 60’s it was largely represented as a Caucasian disease.  However, by the 1970’s a black male was up to seven times more likely to be diagnosed with schizophrenia than his white counterpart even though according to genetic science, there is no racial basis for this disease which affects 1 in every 100 Americans, regardless of race. The perception of schizophrenic personalities also changed during this time, from the introverted “white male genius” to the “unduly hostile and violent” black male. Metzl pointed out that schizophrenia actually decreases the likelihood of violent behavior in its victims. So what’s with the dramatic and biologically unsupported shift?

Jonathan M. Metzl MD, PhD

Metzl offered a cultural narrative to contextualize the clinical data. Pre 1960’s famous Caucasians such as writer T.E. Lawrence and first lady Mary Todd Lincoln were glorified as historic schizophrenics. Schizophrenia was a popular trope used in women’s magazines to decry the pressures of being perfect housewives as a source of white, middle class woes. Caucasian models posed in pristine white hospitals for anti-psychotic medication advertisements in medical journals.

During the civil rights movement of the 1960’s, the representations of schizophrenia in pop culture mass media changed entirely, claiming the crazed black man as its new poster child. With the desegregation of hospital wards, clinical studies could be performed on black patients for the first time, and these could be compared to studies of white patients. The anti-psychotic ads featured deranged black men with threatening, clenched fists in prison cells and used tag-lines such as, “Assaultive and Belligerent?” Schizophrenia – the disease of the “split mind” – became a metaphor for race in both mass media and in the speeches of Dr. Martin Luther King Jr. to represent a country split along racial lines. It also acquired a protest identity; it was the disease of black American’s “psychotic repudiation of white society.”

Metzl stressed that he was not suggesting that psychiatric diagnostic manuals suddenly adopted a language of violence to characterize the symptoms of schizophrenics in order to target and over-diagnose black men during the civil rights era. However he did conclude with a statistic demonstrating the criminalization of the mental illness: a schizophrenic today has a 5 to 1 chance of ending up in a prison rather than in a hospital. Metzl concluded by stressing the need for “cultural humility training” to dismantle the racial and behavioral stigmas that schizophrenia continues to carry today.

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  1. Very interesting  

    And way over my head...

  2. excellent  

    i really wanted to go to this! thanks bwog!!

  3. Anonymous

    contessa gayles you are one smart lady...i enjoyed reading your post my darling friend! xoxo abs

  4. Jonathan Metzl

    Thank you so much! This is a really great write up!!!!!

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