Measuring the Psyschological Toll of Racism

by Ashley Payne

Dr. Monnica Williams reports in Psychology Today a change in the diagnostic criteria of PTSD allowing for a more broad application and treatment. Currently, racism (according to the current version, DSM-IV) can only cause PTSD if it is related to a specific inciting incident, i.e. assault. This is quite limiting, as you can imagine.

Racism has evolved from the old school burncrossesonyourlawn overt racism to a form just as insidious, aversive racism. Aversive racism is more subtle and has been captured in such terms as microagressions, a burgeoning field of study in Psychology. The new criteria allow for the recognition that a steady stream of microaggressions over a period of time can cause trauma leading to other mental health challenges like major depressive disorder or generalized anxiety disorder. PTSD is incredibly debilitating and many of us are familiar with its effects on returning soldiers, domestic violence survivors, and even police officers.

This sounds eerily similar to a TEDx talk I heard in June 2011 in Richmond, CA. Jeff Duncan-Andrade contends that urban youth who experience violence are two times more likely than a soldier who returns from battle to experience PTSD. Duncan Andrade’s talk also clarifies the distinction between cumulative experiences of racism and an inciting incident. Urban youth continue to live in these unsafe and hostile spaces experiencing the trauma over and over again whereas soldiers leave the battlefield behind. He calls this Complex Trauma Stress Disorder. Maybe, the ‘C’ should stand for chronic or continuous.

As I learned on Talk of the Nation Science Friday, the DSM guides research in the field. That in and of itself is a huge implication to leaving out racism as a diagnostic criterion. Not only does the DSM guide research and thus, funding, but the other obvious implication is that it informs the patient on how to think about their illness. Obviously, racism causes problems for people psychologically, emotionally, and financially leading to stress or other maladaptive behaviors. With the majority of mental health practitioners being white, the question then arises, “How are white practitioners going to be trained in order to treat an America who is skewing toward a minority-majority every day?” If these experiences have little or no research behind them, how are treatments going to be developed? If there are no treatment plans, then when we seek help, there won’t be any to turn to. How are blacks going to be able to fully self-actualize without a sound psyche backing them up?

This ongoing indifference doesn’t help to correct the stigma of mental illness and medical neglect and abuse within our community. This doesn’t make us inclined to seek out treatment in order to help ourselves become our best selves.

Perhaps what’s most damaging is by choosing to leave racism out of the PTSD diagnostic criteria or develop a new diagnostic variant like Duncan-Andrade’s suggestion, CTSD, is just another instance of invalidating our lived experiences as not important enough to count as a problem, deserving of funding to be researched, as something not worthy of being resolved to truly achieve a post-racial society.

Complicating this neglect on the APA’s part to include racism when diagnosing PTSD, or the more appropriate, CTSD, is that racism isn’t the only form of discrimination leading to bias, microaggressions, oppressive realities, etc. We live intersectional experiences due to our sex, gender, religion, weight, class, etc. and all of these facets of our identity can bring about trauma from the prejudiced.

This refusal to include racism in the DSM is disheartening because the impact on black mental well-being has been well documented in other fields either through the arts, literature, economics, sociology, African-American/Black Studies, and/or women’s and gender’s studies. This decision by the APA in developing the DSM-V means our voices are continuing to be shut out of the mainstream and relegated to what some have called the “academic ghetto.”

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Ashley Payne is an intern with For Harriet living in Harlem. She studied fine art as an undergrad and politics as a graduate student. Her areas of interest include: education, feminism/womanism, literature, art, and politics.