In Bram Stoker’s Dracula the forlorn and despair of padded and straightjackets were recreated. The House on Haunted Hill is a horror movie rooted in the ghost story of a closed American asylum. And again debuts a film called A Cure for Wellness that revisits the horrors of cold water therapies, isolation chambers and other depravities of yesteryear.
It’s hard not to ask why American culture is so obsessed with the horrors of antiquated medical approaches. Why does our psyche revive these images of mad doctors and sadistic physicians every decade in our popular media? Why do we find ourselves so terrified of visiting a doctor? Maybe because the monsters we revile from on the big screen actually did exist. And perhaps where law’s hand cannot reach far enough in the field of medicine and psychiatrics, these witch doctors live among us.
Mad in America shines a light in the crawling darkness of medical history and uncovers a winding, blood curdling cobblestone road into the horrors of the haunted woods of psychiatric medicine and raises invaluable questions. The tortuous “therapies” for wellness, then, have become international human rights violations, now. How do we distinguish cold water baths from Guantanamo Bay waterboarding, from archaic witch trials in colonial Salem, MA? How much does the question “have you taken your meds?”–no matter how warmly asked—gaslight a person into anxious disorder when a psychiatrist used to use neuroleptics to lobotomize instead of crude metal and force? How reasonable is it to expect African-American populations to have faith in the white education with all the evidence of Ivy League efforts for eugenicist genetic extermination?
The delusion of normalcy seems to be an elusive ill in medicine despite the reasonably helpful Quaker rehabilitation approaches in moral therapy. I feel that thanks to codes of ethics like the CRCC and others, the field of rehabilitation can advance with less of the human suffering that existed not long ago. Integrated employment, Person-Centered Planning, etc. all focus on playing to the strengths of a person with a psychiatric disability—or any barrier in general—and establish a more universal and Constitutional health and human services approach. However the historic emphasis placed on racial purity, fidelity to WASP origination, etc. consequently reinforced a eugenicist, genetic determinist and bigotry-fueled establishment of medicine (Whitaker 45).
While in films and media, the discussion of medical ills focused on primarily European characters, the truth virtually always is that the brutality has been perfected on unsuspecting, culturally alien non-Europeans. Chapter 7 in Mad in America does a great job of exploring and acknowledging this reality. What we really see in much of the history are instances of racial medical horror. And for non-Europeans, this reality is documented very well outside of the book (Whitaker 171).
As far back as Sarah Baartman, France’s “Hottentot Venus” who gained fame at side show parlors, and then tragically again as a dissected subject in medical museums due to her “abnormal” African body. Then there was the Belgian sub-Saharan colonial holocausts that preceded Hitler’s gas chambers. Then the immortal Henrietta Lacks whose cells were forever replicated, stored and distributed to save lives—even of people who believed her genetic material was “inferior”. Then of course there were the Tuskegee experiments which exploited African-American men in the name of research.
Much cultural scholarship exists on the psychiatric issues of the African American community and how they are rooted in the intergenerational traumas. However the rehabilitation community tends to be unaware and unprepared. Schizophrenia, mania, bipolarism, and other illnesses are often ignored or used to villainize. So as a result African-American populations in minority situations find themselves the victims of bigotry, scapegoating, police brutality, imprisonment, homeless, marginalized and lacking resources for improvement—especially from our own resource-impoverished family networks.
One film that helps general audiences to empathize with the frightening trauma that especially African Americans have had with Western medicine is a race-horror film Get Out. The film is based on the premise of psychotherapy being used to manipulate an African-American male. Although the idea is fantastical, it is also frighteningly realistic, especially when reading chapter four of Mad in America.
Having a clear understanding on how race and psychiatrics have interacted as a tool to neutralize, sterilize and euthanize especially non-European populations, can help bridge the gap in understanding the hostility and distrust people may feel. Often times a knee-jerk reaction isolates African-American “misbehavior” as an anomaly that exists outside of a historical continuum. And even the field of rehabilitation has suffered from the lack of understanding of African-American perspectives (Leung, et al, 3). The ability of an individual to find proper healthcare when the healthcare system feels to be against them–especially when there are processes of psychosis present–has to be a terrifying and disempowering process. Even for me, to find a feminist African-American male physician or therapist isn’t an easy task. Although I am well adjusted to interact with others unlike myself, this is not always the case for all people seeking help. But even for myself, similarity would be more helpful.
Although intergenerational trauma is a new and substantiated topic in modern psychology, its only slowly gaining traction for African-American patients with psychiatric disabilities and their compound stresses with people of high professional classes like counselors, educators and health professionals.
In order to break the stigmas of African-Americans with psychiatric disabilities that gaslight them into the horrors of constantly aggravated psychosis, we must acknowledge their hardships even if counselors don’t understand it or cannot perceive it. As Rehabilitation Counselors, Health & Human Services Workers, we must always be aware that we benefit from the privilege of education and power and that we aso inherit an institution that was once used to terrorize demographics of non-WASP peoples.
Whitaker, R. (2002). Mad in America. New York: Basic Books.
Leung, P., Flowers, C. R., Talley, W. B., & Sanderson, R. R. (2007). Multicultural issues in rehabilitation and allied health. Linn Creek, MO: Aspen Professional Services.