The Racist History of Psychology
“The general wards were abysmal, and there were only five doctors, four of them foreigners, who were not licensed to practice in the United States, and did not have credentials as psychiatrists in their home country. The fifth psychiatrist was in charge, and he was clearly unfamiliar with modern psychiatry, and looked like he was running a plantation in some southern state.” This was part of the report written by Inspector Marilyn Rose, when she participated in a 1967 committee to inspect psychiatric hospital facilities, especially in Alabama and Mississippi, where black people with mental health problems, or what would now be known as psychopaths, were cared for.
Yes, they were treated separately, in institutions that did not allow them to mix with the white population, within the context of racial segregation and the persecution of blacks that the United States of America has known since its founding, until recently, and the face of psychiatry was ugly in that matter, and at that time.
In the history of the establishment of psychiatry, many psychological experiments and studies have sought to distort and oppress black people. In fact, many pioneers of psychology who have made significant contributions to the field of psychology have been involved in supporting this racism and strengthening its control over their scientific and research work.
From the facilities of psychiatric hospitals in the states of Alabama and Mississippi, we move to the College of Education at Stanford University, specifically in the early twentieth century, where Lewis Madison Terman, one of the most prominent American psychologists, worked. He later became famous as a pioneer of educational psychology, and among his achievements was the development of a special test to measure a person's intelligence level, called the "Stanford-Binet Intelligence Test".
Terman was one of the prominent scientists who supported the idea of "improving" the race, and he was a member of a well-known organization at that time called "Human Improvement", in addition to holding the position of President of the "American Psychological Association".
In his work on the IQ test, Terman made several statements that were later deemed extremely racist against people of color, including saying that black people were "innately dull" and that "the children of these groups [of color] should be separated into special classes and given concrete and practical instruction...they cannot handle abstract matters." Terman also said that "from the eugenics point of view, 'blacks' pose a serious problem because of their unusually prolific breeding."
Black people, "They're not supposed to get sick"
This racist school of psychology believed that black people were immune to mental illness and would not fall into the clutches of depression or other neurotic symptoms, all because of their special psychological and mental makeup, or in Terman's words because of their "innate dullness," as he claimed.
Dr. Uchenna Umeh, a former doctor in San Antonio, Texas, and a woman of Nigerian origin living in the United States, decided to leave her job in 2018 to focus on public lectures, with the aim of spreading and raising awareness about mental disorders among people of African descent in the United States.
Dr. Oceana explains that for many years, many black people believed that they were supposed to be free from mental health problems, based on the bizarre idea of John Galt, a physician and medical director of the Williamsburg, Virginia, Asylum, published in 1848, that black people had a natural immunity to mental illness.
Galt based his earlier view on the assumption that Africans were enslaved, that slaves owned nothing, had no role in free enterprise, and did not participate in civic affairs or engage in political activities such as voting or holding office. Based on this assumption, the risk of developing mental health problems would be higher among whites who are exposed on a daily basis to the effects of political activities, the competition for ambition and advancement within entrepreneurial and commercial communities, and the resulting stresses that accompany gains or crises that follow losses.
Samuel Cartwright was one of those doctors who argued that slavery was the “natural state” of African Americans, adding that they benefited from hard labor and were unable to care for themselves outside of this system. Cartwright also claimed that people of color displayed a “childish” simplicity of feeling and a lack of complex emotional processes, which he saw as characteristic of their entire race.
Based on Cartwright’s view that slavery was the “natural” state of black people, deviation from this “natural” state was a mental disorder. This is exactly what Cartwright explained in 1851, when he published a report in which he invented two “psychic” disorders, the symptoms of which included the tendency of “slaves” to escape or resist hard labor, and these disorders were classified as “mental diseases,” and he called them “draeptomania” and “dysaesthesia aethiopica.”
Hospital administrators used Cartwright’s ideas to justify their medical opinions that there were no real psychiatric treatments for African American patients, that they did not feel the same way as whites, or that they were not suitable for things like psychoanalysis or group therapy. This is why black patients were segregated into separate, substandard hospital facilities, and were put to work in the hospital laundry, kitchen, and fields.
“My family, my friends, my acquaintances, my patients, their parents, their grandparents, we are all black, so we are supposed to never have to struggle with mental health issues,” says Nigerian-American physician Uchenna Umeh. “Unfortunately, we ourselves have bought into this narrative [of Galt and others like him], that mental health issues do not exist in our race, and we have unconsciously spread this narrative to our detriment.”
During her work, Dr. Uchenna noticed a significant increase in depression and suicidal ideation among her patients. “Suicide rates among African American children ages 5 to 11 have increased steadily since the 1980s and are now twice as high as those of their Caucasian peers,” she says. “Black men accounted for 80 percent of African American suicide attempts in 2015. And those numbers are rising.”
In order to understand the practice of racism and its presence in psychiatry historically and sequentially, let us tell you the roots of the matter from the beginning. Specifically, between 1861 and 1865, the period in which the "Civil War" took place between the northern and southern states of America, and during which the American field of "psychology" was officially institutionalized, where programs, departments, academic degrees, societies and schools specialized in the study of psychology were established and created.
This war is considered one of the worst bloody events that the American Federal Union has been exposed to, and one of its main causes was the "slavery/servitude" system. At a time when the northern states wanted to restrict the scope of slavery and put in place laws that would achieve this, the southern states were expanding slavery, and even relying primarily in their economic system based entirely on agricultural slave labor.
The Civil War freed nearly four million slaves across the South, but this did not lead to more enlightened medical attitudes toward the treatment of African Americans. Quite the opposite, as psychiatry continued its racist sectarianism.
In 1895, Dr. Powell, the superintendent of the Georgia State Asylum, as it was called, noted an alarming increase in mental health problems among blacks in his state. Powell attributed this increase to the three decades of freedom that had preceded the emancipation of slaves, as a large segment of them had not been able to adjust to the openness and consequences of the Civil War. Powell seemed to see slavery and freedom as biologically innate and inevitable.
Powell argued that when former slaves gained their freedom, they were unable to control their desires and emotions, which in turn led to abuses that led to higher rates of mental health diagnoses.
Of course, Powell did not see the truth, which was right in front of him, but his racism prevented him from going to the root of the problem, as the reason for the increase in mental health problems among blacks goes back to a long history of living under extremely poor social and economic conditions, including poverty, racial discrimination, and the specter of violence that may have reached the point of execution, but he chose the easiest way; he said that black people obtaining freedom is the root of their mental and psychological problems.
Colonial Psychology
When the American Psychological Association was founded in 1892, it was headed by Granville Stanley Hall and had 31 white male members elected to its membership. At that time, formal psychology was primarily white-led and heavily relied on the then-popular theory of evolution. The Western psychological field gave its full support to the idea of "white" male superiority, as a result of its findings, and focused its entire attention on demonstrating individual differences among different racial groups.
In 1904, G. Stanley Hall, the founding president of the American Psychological Association, published his theory of "adolescence." In it, he described the First Nations, the indigenous peoples of the Americas before the time of Christopher Columbus, as living in a phase of "human childhood," and that their adults were more like the adolescents of white children or adolescents.
Hall developed colonial "civilization programs" specifically designed to meet what he saw as the needs of the First Nations. These programs provided the moral framework for colonialism, and the result was the cultural genocide of different peoples, with the glamorous goal: we are doing this in order to civilize them and subordinate them to the Western model, under the rule of the white man.
But after World War I, a reverse movement occurred, as some of the sons of poor peoples rushed to the United States and other rich countries of the North, and unprecedented numbers of immigrants arrived, accompanied by a surge in anti-immigration sentiment, and here the theory of "eugenics" emerged, using the principles of genetics. Here, African Americans, who were said to suffer from mental "deficiencies", faced a new and more serious threat to their safety.
The science of "eugenics" was based on two parallel principles: encouraging births among people with a "good" genetic stock, and sterilizing those who were not fit to reproduce, including individuals suffering from mental illness, as well as the poor and those accused of sexual abuse. The focus was on sterilizing African Americans. In California alone in the 1930s, African Americans, who represented 1% of the population, accounted for 4% of the victims of legal sterilization.
Many pioneers in psychology advocated a social agenda that sought to limit the number of children born to people classified as “less fit,” and people of color classified as “less fit” were considered inferior in Western society in terms of knowledge and common law.
Sir Francis Galton, one of the early leaders of psychology, was the first to coin the term "eugenics". Galton is considered one of the icons of "race science", a branch of science that studies the origins and characteristics of different peoples. The "eugenics theory" played a major role in supporting the idea of racial distinctions in their personal and psychological abilities.
His book "Hereditary Genius", published in 1869, was considered the first scientific attempt to study "genius and greatness", and was seen as one of the early literature that contributed to the study of individual differences and psychological measurements in European and American psychology. He concluded that the average intellectual level of the "Negro race" is two degrees lower than that of the white man.
Francis’s book was a major reference and was widely used by the first generation of psychologists who founded the American Psychological Association, the first recognized psychology journals, and the most influential research programs. Many prominent academics were implicated in popularizing notions of white superiority not only in intelligence, but also in moral, cultural, and psychological terms.
In the journal Psychological Review, just one year after the first issue of the American Psychological Review, a study was published showing that samples of so-called First Nations and blacks sometimes had “faster” reaction times than whites, which they interpreted as indicating a greater degree of haste and impulsiveness in their responses, due to their propensity for violence. The study’s authors argued that the quick response was due to “primitiveness,” and that the more developed intelligence of the white participants led to deeper thinking and slower responses.
Many psychologists continued to support the idea of white superiority in both public and academic outlets. For example, in 1922, psychologist James Rowland Angell, president of Yale University, gave a series of lectures describing the hierarchy of races, espousing white supremacy, and discussing the low intelligence of blacks.
In 1922, the Journal of Comparative Psychology published a study linking the degree of “white blood” in First Nations peoples to higher IQ scores. In 1933, more studies were published arguing that First Nations children were more dishonest than white children.
Perhaps the logical question here is: Was the research or results conducted at the time falsified in order to prove that whites were superior to their colored counterparts? The answer: Perhaps not, but the study itself and the results drawn from it were conducted through a mindset dominated by the idea of white evolution and superiority, so that even if the research and studies came back with the opposite results that people of color were superior in some aspect, this result would be viewed and formulated within an interpretive framework from the position and reference of white superiority.
This is what happened in 1897, when a study conducted on black and white children concluded that colored children had stronger memories, and that they generally outperformed white children on a memory task.
Here, although the results of the study were positive for black people, they were formulated in a completely negative way, as the author attributed the strength of black children’s memories to the ability of their “primitive brains” to remember more than others, and described black children as deficient in thinking.
Racism controls psychiatric diagnosis
Psychiatrists’ preconceived biases against people of color have led to unscientific diagnoses that do not adhere to professional standards. A 2023 study found a significant disparity in the prevalence of schizophrenia spectrum disorders (seeing imaginary figures and hearing voices) between people of color in the United States and Canada and whites in those same countries. Black people are diagnosed with these disorders at higher rates than other groups.
The consequences of this scientifically inaccurate diagnosis are exacerbated by punitive societal effects throughout life, including increased stigma, reduced opportunities, poorer care, and increased likelihood of criminalization and arrest. Stereotypes associated with psychotic symptoms may put these patients at risk for police violence and premature death.
The unfortunate side of this is that, as new data show, the differences in diagnosis rates are unlikely to be genetic, but rather societal in origin. Overdiagnosis of schizophrenia spectrum disorders is largely due to racial biases among clinicians.
The study showed how misunderstandings of race confound attempts to diagnose and treat schizophrenia spectrum disorders in black individuals, in addition to implicit biases preventing black patients from receiving appropriate treatment from primarily white mental health providers, which the study described as a “lack of empathy” among doctors for their patients.
In the same context, Dr. Uchenna Umeh, in her article published on the “blackpast” website, questioned the validity of the diagnosis of children detained in psychiatric hospitals and mental health disorders, as she explained that asylum authorities often praised the abilities and skills of these children, which raises many questions about the validity of their mental illness diagnosis in the first place.
Here Uchenna says: “If these black people were truly ‘lost their minds’, how were they able to perform continuous, hard work that required special skills, while white patients were often too ‘weak’ mentally to work?!”
The National Alliance on Mental Illness (NAMI) explains that there is a long history of discrimination and racism in mental health care. People with mental illness have always been discriminated against, denied full participation in society, labeled dangerous and criminal, and many were held in institutions that were more like prisons designed to punish than hospitals designed to treat.
This discrimination was bad for anyone with a mental illness or disorder, but it was especially bad for the most marginalized, including African American men, women, and children. Some centers in states like Alabama and Mississippi segregated patients on racial grounds, and even claimed that it was “medically” necessary to separate patients on racial grounds.
In the 1960s, a series of federal legislation and lawsuits attempted to end this discrimination. The Community Mental Health Centers Act (CMHA) was passed to improve the provision of treatment and care for people with mental illness, or what is now known as mental disorders. In 1964, the Civil Rights Act was passed, which included a provision that made it illegal for any facility or service receiving federal funds to discriminate on the basis of race.
At the time, some states still had segregated treatment policies, which put them at risk of losing funding and receiving no financial support to provide medical care. Instead of accepting these provisions and finding ways to end segregation, states including Alabama and Mississippi chose to fight the federal government in court. They claimed that they had the right to administer state services without federal interference, and that it was “medically” necessary to separate patients on the basis of race.
As with research, experiments, and statistics, doctors based their view of the need for “segregated” treatment on a long history of racist ideas in psychiatry. And Dr. John Galt, who made the preposterous claim that black people shouldn’t have mental health problems, was not the only one whose medical opinion was driven by racism. Since the early 19th century, some psychiatrists have argued that African Americans were biologically “inferior” to other people and races.
Here, Dr. Ochena explains the conditions of treatment for black people with mental health problems: “Most pre-Civil War mental health facilities in the South typically denied treatment to enslaved people.”
It seems clear that mental health experts believed that housing blacks and whites in the same facilities would negatively impact the recovery of whites. Housing conditions in Southern asylums for the few who accepted enslaved people were disastrous compared to white patients. Blacks were often housed outdoors near these institutions or in local jails. There were accounts of some black children being housed in asylum grounds.
"Apology"
Finally, after all this long history of injustice and oppression in mental health and psychiatric institutions for black people, the American Psychiatric Association in 2021 acknowledged and apologized for all of the above. In January, the 176-year-old association issued its first-ever apology for its racist past. It acknowledged what it called the profession's "horrific" past actions, committed its board of directors to identifying, understanding, and correcting past injustices against black people, and pledged to adopt new anti-racist practices aimed at ending this long history of discrimination.
However, some critics saw this apology as insufficient, and doubted that any real positive step would take place, noting that the American Medical Association issued a similar apology in 2008 for its "racist" history of more than 100 years of promoting or accepting racial inequality negatively, and excluding African American doctors, without offering anything actual or realistic after this apology.
Critics inside and outside the APA have made clear that the association needs to overcome significant obstacles to fix its problems and address its racial equity issues in a meaningful way, including the association’s diagnostic biases, the persistent shortage of black psychiatrists, and a physical structure that tends to exclude people who cannot pay for services out of pocket. This may make the crisis of racism in psychiatry too deep and entrenched to be resolved with an “apology” and a “promise” of reform. This was confirmed in the summer of 2020, when Dr. Ruth Shim, director of cultural psychiatry and professor of clinical psychiatry at the University of California, Davis, left the APA, explaining her departure in a tone that expressed her frustration and frustration and in the important statement that “institutional racism is an existential crisis in psychiatry.”
- Arwa Nagib
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