The protest psychosis How schizophrenia became a Black disease

Jonathan Metzl, 1964-

Book - 2009

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Subjects
Published
Boston, Mass. : Beacon Press c2009.
Language
English
Main Author
Jonathan Metzl, 1964- (-)
Physical Description
xxi, 246 p. : ill. ; 24 cm
Bibliography
Includes bibliographical references and index.
ISBN
9780807085929
  • Preface: The Protest Psychosis
  • Part I. Ionia
  • Chapter 1. Homicidal
  • Chapter 2. Ionia
  • Part II. Alice Wilson
  • Chapter 3. She Tells Very Little about Her Behavior Yet Shows a Lot
  • Chapter 4. Loosening Associations
  • Chapter 5. Like a Family
  • Part III. Octavius Greene
  • Chapter 6. The Other Direction
  • Chapter 7. Categories
  • Chapter 8. Octavius Greene Had No Exit Interview
  • Chapter 9. The Persistence of Memory
  • Part IV. Caeser Williams
  • Chapter 10. Too Close for Comfort
  • Chapter 11. His Actions Are Determined Largely by His Emotions
  • Chapter 12. Revisionist Mystery
  • Chapter 13. A Racialized Disease
  • Chapter 14. A Metaphor for Race
  • Part V. Rasheed Karim
  • Chapter 15. Turned Loose
  • Chapter 16. Deinstitutionalization
  • Chapter 17. Raised in a Slum Ghetto
  • Chapter 18. Power, Knowledge, and Diagnostic Revision
  • Chapter 19. Return of the Repressed
  • Chapter 20. Rashomon
  • Chapter 21. Something Else Instead
  • Part VI. Remnants
  • Chapter 22. Locked Away
  • Chapter 23. Diversity
  • Chapter 24. Inside
  • Chapter 25. Remnants
  • Chapter 26. Controllin' the Planet
  • Chapter 27. Conclusion
  • Acknowledgments
  • Notes
  • Index
Review by Choice Review

Drawing on the archival records of the Ionia Asylum for the Criminally Insane (in Ionia, Michigan) and bolstering his argument with convincing case studies, Metzl (psychiatry and women's studies, Univ. of Michigan) tells a fascinating, disturbing story of the shift in the diagnosis of schizophrenia as a disease of passive, nonthreatening white women (in the 1920s-40s) to a disease of hostile, aggressive black men (in the 1960s-70s). The book's title refers to suggestions by psychiatrists in the 1960s that black men who aligned themselves with civil rights protests, particularly militant protests, were mentally ill. Metzl attributes the diagnostic shift and the lingering--inaccurate--notion that schizophrenia is associated with violence to this historical period of racial unrest and the rhetoric associated with it. He avoids attributing the causes and treatment of schizophrenia to culture alone, but he makes a compelling case for racial undercurrents influencing not only psychiatry's view of this illness but also the views of the wider society. Ambiguity in use of the terms "schizophrenia" and "schizophrenic"--i.e., sometimes references are metaphorical, at other times to the illness itself--is unfortunate but does not undermine the power of this narrative. Summing Up: Highly recommended. All collections. K. S. Milar Earlham College

Copyright American Library Association, used with permission.
Review by Booklist Review

In the 1960s, the psychiatric diagnosis of schizophrenia morphed from a malady suffered by sensitive white intellectuals to one of disaffected, angry black men. Psychiatric professor Metzl explores changes in the profession from the 1920s to today but focuses particularly on the 1960s, which saw violent protests against racial discrimination. Metzl details the social, political, and cultural influences behind debates within the profession about what constituted mental illness. Drawing on case studies from Michigan's now-defunct Asylum for Insane Criminals in Ionia, 130 miles from racially volatile Detroit, Metzl illustrates how schizophrenia became a racialized disease. He analyzes black cultural allusions to double consciousness, from W. E. B. DuBois to modern-day rappers who have adapted notions of schizophrenia in response to American racism or as a social diagnosis of white America itself. Metzl also examines shortcomings in American society and the psychiatric profession in particular, which resisted the notion that violent responses to racism might have been rational. An enlightening look at how those in power define aberrant behavior and evade self-analysis.--Bush, Vanessa Copyright 2010 Booklist

From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review

Metzl, a psychiatrist and Univ. of Michigan professor, uses the largely unknown story of Michigan's Ionia Mental Hospital to track the evolving definition of schizophrenia from the 1920s to the '70s, from an illness of "pastoral, feminine neurosis into one of urban, male psychosis" correlated with aggression. Metzl puts the imperfect science of diagnosis in historical context with admirable lucidity, moving into the present to examine how a tangle of medical errors and systemic racism that labels "threats to authority as mental illness" influences the diagnosis of black men with schizophrenia. He offers a laudably complex look at a complex and still poorly understood condition, expanding his discussion to include the impact of deinstitutionalization and the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) in the 1960s. The result is a sophisticated analysis of the mechanisms of racism in the mental health system and, by extension, the criminal justice system. (Jan.) Copyright 2009 Reed Business Information.


Chapter 1: Homicidal   Cecil Peterson had no history with the police. Even on the day the white stranger insulted his mother, Peterson simply wanted to eat lunch. He sat in his usual seat at the counter of the diner on Woodward Street and ordered his usual BLT and coffee. Somehow he caught the stranger's eye in the squinted way that begets immediate conflict between men. The stranger glared. Peterson was not one to walk away from confrontation, but he knew the implications of glaring back. One should not glare back at a white man. So he looked down. But the two men crossed paths again after Peterson paid his tab and walked outside. And then came the remark. And then came the fight.   Two white Detroit police officers happened to be passing by the diner that September day in 1966. They ran to the altercation and tried to separate the combatants. At that point, according to their formal report, Peterson turned on the officers and struck them "without provocation." According to the report, Peterson knocked one officer down and "kicked him in the side." A second police team arrived and assisted in apprehending the "agitated" Mr. Peterson. Medics took the first officers on the scene to the Wayne County Hospital emergency room. The ER physician's report noted that both officers had "bruises," though neither required treatment. The white stranger was not charged.   Peterson was twenty-nine, African American, and an unmarried father of four who worked the line at Cadillac Motor Company. He had not previously come to the attention of the state. He had not been diagnosed or treated for any physical or mental illness. Nor had he been held for crimes or misdemeanors. He had limited interactions with white people and preferred to stay close to home. But on that September day in 1966 his life changed along with his identity. He became a prisoner. And then he became a patient.   The Wayne County court convicted Mr. Peterson of two counts of "assault on a police officer causing injury requiring medical attention" and sent him to the Wayne County jail on a two- to ten-year sentence. After several weeks of incarceration, prison notes described Mr. Peterson as "extremely paranoid and potentially explosive," screaming that "the white stranger" had "insulted my mother" and that his "civil rights" were being violated. The prison psychiatrist provided a diagnosis of "sociopathic personality disturbance with antisocial reaction," and recommended seclusion, restraint, and continuous doses of Thorazine at 200 milligrams. Within six months, Mr. Peterson's unprovoked outbursts became so severe that he earned the distinction of being a "problem inmate" who was "dangerous on the basis of his presenting a threat to the guards." Soon thereafter, he began to ramble incoherently. One guard's note explained that Mr. Peterson "occasionally grimaces, remains silent for long minutes, then looks up toward the ceiling with his eyes rolling in all directions." A year into his incarceration, Mr. Peterson loudly accused the prison staff of "depriving him of women." They observed him to be "hostile, suspicious, and increasingly annoyed" without any apparent provocation. He soon escalated, and the prison psychiatrist was called again. This time the psychiatrist recommended transferring Mr. Peterson to the notorious Ionia State Hospital for the Criminally Insane. The transfer sheet described Mr. Peterson as "HOMICIDAL."   The drive to Ionia took four hours, much of which Mr. Peterson slept off in the back of the police car. But he stiffened when the vehicle pulled into the winding drive that led up to Ionia Hospital; and his attention reached the level of panic when the car doors opened onto the expansive, forty-onebuilding campus of bricks and chimneys and yards and fences and crazy people as far as the eye could see.   Dragged inside one of the largest of these buildings, Mr. Peterson shouted and struggled to get away. He said he was an "African warrior" and spoke gibberish, which he claimed to be his native African language. Then, in English, he loudly accused the guards of detaining him against his will. He claimed to be under attack by all white men.   Sylvan Cabrioto was not fazed. He had been the on-call physician at the Ionia receiving hospital since 1958, fully ten years before Cecil Peterson appeared in his examination room. A first-generation psychiatrist and secondgeneration American, Cabrioto was an authoritative, robust man of fifty-three who had a different bow tie for each day of the week. Treating the steady flow of burglars, peeping toms, pedophiles, and murderers who came through the Ionia doors gave Cabrioto a detached air of competence that undoubtedly resulted from having seen it all before. So he was not intimidated, at least not overtly, when Peterson appeared in the receiving hospital, or when the two prison guards drove off, or even when, after his handcuffs were taken off, Mr. Peterson "doubled up his fists" and gestured in a manner that was "irritable, disturbed, and sarcastic."   It was, after all, a stance Cabrioto had seen in nearly every one of the growing number of "Negro" patients brought to the Ionia State Hospital for the Criminally Insane in the 1960s. One man heard the voice of Jesus telling him to come home. Another was certain that loved ones were trying to poison him. Another performed "mystic voodoo movements" while claiming an "eternal struggle against the white man."   Like Peterson, most of the men came from "deteriorated neighborhoods" of Detroit. Most nonetheless held gainful employment. Like Peterson, each was convicted of a crime against person or property, ranging from larceny to murder to various forms of civil unrest. Few of the men had seen psychiatrists prior to their convictions, though this was not surprising since few psychiatrists resided in the urban sections of Detroit in the 1960s and 1970s. The men passed through various courts, prisons, and other state institutions. By the time they arrived at Ionia, they were nothing if not psychotic. Like Peterson, they hallucinated and ideated, or acted withdrawn, suspicious, paranoid, or combative. They argued, and fought, and resisted, and projected. And, according to Cabrioto and his colleagues, these actions were easily explained with a single diagnosis. Excerpted from The Protest Psychosis: How Schizophrenia Became a Black Disease by Jonathan M. Metzl All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.