Jonathan M. Metzl, MD, PhD, is a psychiatrist who also has a Ph.D. in American Studies. He is Associate Professor of Psychiatry and Women's Studies and Director of Program in Culture, Health, and Medicine at the University of Michigan. In this capacity he works as a Senior Attending Physician in the adult psychiatric clinics and teaches courses in the areas of history of psychiatry, gender, and health at the undergraduate and graduate levels. He is the author of "Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs" (Duke University Press, 2003), and of "The Protest Psychosis: How Schizophrenia Became a Black Disease" (Beacon Press, 2010).
Question: How has the racialization of schizophrenia impacted African-American culture?
Jonathan Metzl: Basically the central argument of the book is that there was a transformation in popular and medical and psychiatric understandings of schizophrenia that happened in the 1960s in relation to certain responses, different kinds of responses to the civil rights era and to the tensions of the civil rights movement at the time, and I show pretty directly how civil rights politics, civil rights anxieties, other kinds of things really shaped our understanding of insanity in this country, and one part of that narrative is that, as I was mentioning before, we developed at that time a belief that schizophrenia was an illness that was increasingly marked by anger, hostility, projection and even though that is not part of the diagnosis anymore you see the origin in the 1960s of a set of stigmatizations of people with schizophrenia in particular as being violent that rose throughout the latter half of the 20th century even after they were associated with race. All of a sudden this… Initially this was a category that was applied to these angry, protesting African-American men, but you see a broadening of this stigma to the point where it came to apply to all persons who suffered from schizophrenia and there are great research studies that actually come from Phelan and Link, two sociologists here at Columbia that show that even though Americans have actually grown more accepting of particular mental illnesses, stigma against depression, obsessive-compulsive disorder, anxiety, have all gone down over the last 50 years. Stigma against schizophrenia, particularly as being violent, has risen over the same time period, and I think this history tells us why. So one aftereffect of this period is stigma against schizophrenia as being violent. A second thing we see in the aftermath of this history is a literature that is called the misdiagnosis or overdiagnosis of schizophrenia in minority populations, particularly black men.
A third area, which I can talk about in a bit if you wish, is the criminalization of mental illness and this assumption that people with schizophrenia are threats to the state in a certain kind of way. But there is a flip side to the story as well, which is that schizophrenia was also a metaphor, a term, a linguistic usage that was taken up within civil rights discourse itself. I have a few chapters where I talk about how schizophrenia became a term that Martin Luther King used in seven or eight of his main sermons and in a bunch of his writings and for King schizophrenia was an illness that… It actually wasn’t an illness. What he said was schizophrenia literally means split mind and he said there is a split in our minds between good and evil, dark and light and what we need to do is choose the path of nonviolent resistance. Schizophrenia was also a term that was taken up by leaders of the Nation of Islam, the Black Power movement, Malcolm X was himself misdiagnosed with schizophrenia in a CIA file. I talk about that in the book. Many of the leaders used schizophrenia, but what they said is it’s not an illness of the black mind. Instead, schizophrenia is a response to the illness of white racism that basically this is a justifiable means of fighting back against white society and it’s interesting for me. What I do is track through that particular usage and show how that didn’t disappear and part of the way I get to that is to look at present day uses of mental illness terms in rap and hip-hop and popular cultural music. I do a kind of mini research project where I look at lyrics databases and first what I do is look for terms like “depression” or “depressed” across all American popular music, and what you find is that terms like depression and depressed show up in the lyrics of people like America, Styx, Celine Dion, Joanie Mitchell, the Eagles, you know, kind of what you might call white crooning in a certain kind of way - I hate to over generalize. But it’s very often assumed to be a particular mood disorder, but if you go into the same databases and you type the word “schizophrenic,” “schizophrenia” or “schizophrenic,” as I talk about in the book, and I list references to over 200 rap or hip-hop artists, the artists are actually calling themselves schizophrenic. Tupac, Isham, other artists, and basically what they say is, “Yeah, I’m schizophrenic and I’m violent and I’m hostile and I’m a threat to you or to other rappers or to the police or to the state and you better get out of my way.” It’s really interesting to say, why would this mental illness term show up in hip-hop, right? And on one hand, which I think would be wrong, is to say well they’re taking psychiatric usage in a way, and saying I’m just crazy or something like that, which is in part true, but for me it’s actually saying this history, this usage, is actually coming from an earlier tradition. It’s coming right out of the usage in Black Power in the 1960s, basically saying hostility is a response to structural violence and I’m going to assume this identity as a way of fighting back and so it’s interesting that it remains a protest identity in this particular form.
Recorded on January 29, 2010
Interviewed by Austin Allen