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 VOLUME 6, ISSUE 1     PSYCHNEWS INTERNATIONAL        May 2001

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SECTION F: ARTICLE 


        WHY DO AMERICAN MINORITIES -- ESPECIALLY BLACKS --
             DISTRUST AMERICAN PSYCHIATRISTS? (1,2)

                   Maxie C. Maultsby, Jr., M. D.


   One reason American minorities distrust psychiatry is the same 
reason that most Americans distrust psychiatry: To varying degrees, 
most Americans still believe in pre-World War II ideas about sane 
or normal people versus insane or crazy people.

   At that time, the average American believed there were only two 
groups of people: There were sane or normal people and there were 
insane or crazy people. The sane or normal people were the ones 
like you and me, seen walking around in everyday life. The insane 
or crazy people were the ones psychiatrists locked up in stone 
fortresses, usually located in the country and commonly referred 
to as "nut houses", the "crazy houses" or the state hospitals.

   Prior to World War II, the concepts of community mental health, 
community mental health clinics, and outpatient psychiatry were 
largely unknown in America. Understandably, most Americans then 
also believed that normal people were supposed to solve their own 
emotional problems by themselves. If they could not, or did not, 
they went crazy and a psychiatrist would lock them up in the "nut 
house".

   Here's another reason why most Americans distrust psychiatrists:  
To some degree, most Americans believe that psychiatrists can and 
do read people's minds. In addition, most people, at one time or 
another, have unusual, if not weird ideas they are ashamed to let 
others know about. Understandably, most people feel nervous when they 
think about talking to a psychiatrist.  They are afraid the 
psychiatrist will read their minds, discover their weird ideas, decide 
they are crazy, and that they need to be locked up in the "nut house".

   Despite those similarities, American minorities still distrust 
psychiatry much more than non-minority Americans distrust psychiatry. 
That distrust has produced, in my opinion, two undesirable psychiatric 
situations:

(a) American minorities in general (and Black people in particular) 
are less likely than non-minorities to accept psychiatric treatment, 
even when psychiatric treatment is prepaid and readily available;

and 

(b) American minorities in general (and Black people in particular) 
are less likely to comply with their prescribed psychiatric treatments.  
They are more likely to stop their treatments before completing them. 
Therefore, even with the same treatment for the same psychiatric 
disorders, American minorities usually benefit less than non-minorities 
benefit.

   Those facts lead concerned psychiatrists to wonder: Why is it that 
minorities have such a self-defeating distrust for American Psychiatry? 
Here are what I consider two main reasons most psychiatrists know, but 
consistently ignore.

   First, when American minorities seek psychiatric help, they are much 
more likely than non-minorities to be incorrectly diagnosed, as having 
a more serious psychiatric disorder than they really have.  Second, 
American minorities are much more likely than non-minorities to be 
hospitalized and or treated with potentially dangerous, mind-altering 
drugs.

   Patients' rights to the least restrictive and least invasive 
psychiatric treatments make it important for psychiatrists to answer 
this question: Why do American minorities receive such undesirable 
psychiatric care? Probably the main reason is ignorance on the part 
of most American psychiatrists.

   Usually, American psychiatrists have not been trained to recognize 
the unique, culturally-conditioned, normal behaviors of various 
minority groups, behaviors which lead  uninformed psychiatrists 
to misdiagnose them as more psychiatrically disturbed than they 
really are. Fortunately, though, most psychiatric training programs 
now include seminars on cross-cultural psychiatry. The new emphasis 
on cultural correlates of behavior, plus more complete assimilation 
of the well known, basic assumptions of American Psychiatry about 
mental health, should help to solve the problems related to distrust 
of American Psychiatry for all minorities, except American Black people.

   The origin of the distrust that American Black people have for 
American Psychiatry is different from, and is more ominously momentous 
than, the case for other minorities. Consequently, the solution to the 
problem of distrust of American Psychiatry that Black people have is 
more complex than is the case for other American minorities.

   For example, the worst thing Black people could do to themselves is 
to more completely assimilate the well-known basic assumptions that 
have historically directed American Psychiatry's approach to the 
mental health of Black people. That first assumption was and still 
is that Black people are inferior to White people.  The second 
assumption is that psychopathologic behavior for Black people is 
often the opposite of psychopathologic behavior for White people.

   Most modern American mental health professionals don't know 
that fact. In addition, that idea is anathema to modern, 
scientifically-minded American mental health professionals; 
therefore, they initially resist believing it. In a moment, 
therefore, I shall describe the historical facts which show that 
those two basic assumptions are the "guiding lights" for American 
Psychiatry's approach to Black people. These historical facts will 
also show why American Psychiatrists made those odious assumptions 
in the first place. However, first I will point out four important 
facts about American Psychiatry that most people, including 
psychiatrists, either don't know or simply want to ignore.  

   First, the relationship that American Psychiatry has with 
American society is different from the relationship that the other 
medical specialties have with society. Physicians in other medical 
specialties discover and describe the facts about health and illness, 
then they teach those facts to society. In addition, those physicians 
teach society which beliefs and laws are most appropriate for protecting 
and enhancing the health of both sick people and society as a whole.

   In American Psychiatry, however, that historical relationship between 
physicians (that is, psychiatrists) and American society has always been 
somewhat reversed. The most obvious example of this fact is the diagnosis 
of insanity. The recognition and treatment of this condition is the 
backbone of psychiatry. Yet, psychiatrists have never been allowed to 
make that diagnosis. Instead, insanity has always been a legal declaration 
by a judge, whose knowledge of psychiatric illness is almost never any 
greater than that of the person being declared insane.

   Second, harmless human behaviors are sometimes legally labeled as 
"psychiatric diseases" solely because those behaviors conflict with laws 
passed by ignorant legislators, rather than because those behaviors 
conflict with Mother Nature's laws of human health.  Numerous examples 
of that fact now exist as a result of the prohibitive laws relating to 
harmless sexual behaviors between sane, consenting adults in the privacy 
of their homes.

   This brings me to the third, usually ignored, but important fact 
about American Psychiatry. Unlike the other medical specialties, until 
the 1950s American Psychiatry had always been at least as much of a 
subjective social philosophy as it was a medical science. Consequently, 
American Psychiatry has not officially disavowed the plethora of 19th 
and 20th Century racist propaganda about American Blacks that remains 
today in the American, psychiatric, peer-review literature. The two 
most pernicious of those American myths were the two basic assumptions 
in American Psychiatry about Black people just mentioned above, neither 
of which American Psychiatry has officially disavowed. Predictably, 
therefore, American psychiatric research and treatment practices have 
always reflected America's current legally-supported, (and often 
medically-repudiated), wide-spread social prejudices and racial 
bigotries. 

   Now let's consider the fourth and most important, but usually 
unknown or ignored fact about American Psychiatry. Until the civil 
rights era of the 1950's, there had been a de facto, anti-Black mental 
health conspiracy between the American medical (and therefore the 
American psychiatric) profession and the American government. That 
conspiracy tried to prove scientifically that Black people were 
inferior to White people; and in addition, when compared to White 
people, the personality structure of Black people was said to be 
irrevocably and pathologically flawed.

   At first, the reality of that conspiracy may be hard for you to 
believe. If so, your disbelief  could prevent you from fully 
understanding the solutions to the self-defeating distrust Black 
people have for American Psychiatry. To avoid that fate, pay 
particular attention to the definition of de facto conspiracy 
that I am using in this paper. Second, without excuse or 
explanation, let the facts of Black American history speak for 
themselves.

   A de facto conspiracy has these two unique features: First, 
there are two or more subgroups sharing the same negative beliefs 
and behavioral tendencies toward another group, called the victim 
group. Second, without any formal cooperative agreement, the 
independent actions of the former two or more groups consistently 
reinforce, excuse, and otherwise rationalize their shared, but 
objectively-incorrect negative beliefs and therefore, inappropriate, 
unconstitutional behaviors toward the victim group.

   In this article, the victim group is the American Black people. 
The conspiring groups are the American medical (and therefore 
psychiatric) professions and the American government.


A BRIEF LOOK AT AMERICAN BLACK HISTORY

   American Black people never wanted to come to America in the 
first place. To prove that fact they frequently committed suicide 
and infanticide, both on the slave ships and as soon as possible 
after arriving in America. To justify enslaving such unwilling 
victims, the "Christian" slave owners first had to convince 
themselves that Black slaves were an inferior race of people, 
descendants of Ham, and cursed to forever be the servants of 
servants, which, when translated into early American English, 
meant to forever be American slaves.

   To ensure that the clause "All men are created equal" would not 
apply to Black Americans, the writers of the American Constitution 
estimated the humanity of a slave to be only three-fifths that of 
a White person. With that respected governmental sanction, it was 
easy for slave owners to believe that owning Black slaves was 
their Christian duty to help those mere three-fifths human beings 
qualify for "Divine Salvation" after having been worked to death 
as slaves. Accordingly, many of the American colonies passed laws 
that permitted only slaves who had been converted to Christianity 
to be brought into the colony.

   The industrial revolution in the northern American states 
quickly began to make slavery unprofitable there. That fact 
freed northern Christian ministers to rethink and question the 
popular belief that American slavery was really what God had in 
mind for Ham's descendants. As a result, the abolitionist 
movement became progressively stronger.

   To protect and justify their investment in slavery with a 
clear "Christian" conscience, the slave owners switched from their 
then, unreliable, doubting ministers for support of slavery to 
physicians. Now let's consider how that switch to physicians seemed 
to slave owners to be a smart move.   

   As is the case now, physicians in America were better and more 
widely accepted as experts on human nature than were ministers. Also, 
physicians were believed to have had a more scientific basis for 
their claims about Black people than ministers had. Yet, like 
ministers, physicians have always been and still are among the 
strongest believers in and supporters of the current social and 
racial prejudices and bigotries of their societies. In addition, 
psychological research clearly shows that higher education and training 
as health professionals does not free those professionals of their 
life-long, culturally-conditioned racial and other prejudices. 
Predictably, therefore, long before slave owners turned to American 
physicians for scientific support for their justification for slavery, 
nationally-respected White American physicians were already publishing 
in the American medical journals pseudoscientific reports that seemed 
to prove the biological inferiority of Black people.

   One such early-American medical science fiction writer was 
Dr. Samuel Morton, Professor of Anatomy, at the nationally-prestigious 
Pennsylvania Medical College. In the 1840's, Morton published that 
"the brains of people become progressively smaller as one descends 
from the Caucasian to the Ethiopian". Morton based his false claim on 
his own, highly-variable method of measuring the volumes of human skulls 
using buckshot.

   He wrote that "as one descends from the Caucasian to the Ethiopian".  
That clause reveals that Morton believed in the then popular myth of 
racial Darwinism. That myth claimed that within the human race the same 
evolutionary process had occurred that seemed to have occurred 
throughout the animal kingdom. A mythical racial evolution was 
supposed to have resulted in Caucasians achieving the highest level 
of human development. The other races were supposed to have reached 
their highest level of evolutionary progress at lower levels on the 
human evolutionary ladder. Black people and Native American Indians 
were supposed to have stopped developing at the very bottom of the 
human evolutionary ladder.

   That pseudoscientific belief was published in peer-reviewed, 
American medical journals.  It was, therefore, accepted by the most 
influential members of the American medical community. Unfortunately, 
as is still the case, even pseudoscientific myths that get published 
in peer-reviewed medical journals immediately acquire the same 
authoritative influence on the minds of naive, unsuspecting 
scientists that objective facts should have. Those pseudoscientific 
myths can pollute the minds of unsuspecting scientists for decades. 
Next, I present three examples of that fact in American, peer-reviewed, 
health literature. 

   Over fifty years later, Dr. G. Stanley Hall, the first president 
of the American Psychological Association and founder of the 
prestigious American Journal of Psychology, published in that 
peer-reviewed journal this pseudoscientific myth: He claimed to 
have objective data indicating that Black people and Indians are 
members of adolescent races and in a permanent state of arrested 
human development.

   Samuel Morton's pseudoscientific reports about the size of human 
brains and its implications were still polluting the minds of 
unsuspecting anatomists more than 50 years later. For example, 
in 1906, Dr. R. Bean, Professor of Anatomy at the prestigious 
Johns Hopkins University, wrote these pseudoscientific claims 
in the peer-reviewed, American Journal of Anatomy: "The Negro's 
brain is smaller than and has fewer nerve cells and fibers than 
the brains of White people.  Therefore," Bean concluded, "Negroes 
lack judgment and are incapable of devising hypotheses. So, it is 
useless to try to elevate the Negro by education". Unfortunately, 
Bean was not alone in believing such racist nonsense. To the contrary, 
in the first half of the twentieth century pseudoscientific reports 
about Black people were common in peer-reviewed American medical 
literature. Those false reports remain in prestigious American 
medical journals to confuse and mislead unsuspecting future 
American and foreign human behavioral scientists.

   Fortunately, anatomy is such an objective medical science it 
cannot be used for long to support racial myths. For example, in 
the same Journal of Anatomy, Bean's own chairman of his anatomy 
department refuted Bean's pseudoscientific claims. But, as is 
usually the case, it took three years for that refutation to get 
published. Scientific refutations can never prevent all of the 
future harm that the original, peer-reviewed, pseudoscientific 
nonsense causes.

   Also, in America, a sensational, negative, but scientifically 
worthless report gets much more widely published in both the 
professional and lay news media than its later refutation does. 
More important, the refutation does not remove the false report 
from among the earlier, equally-trusted scientific literature. 
Depending on which issue of the same journal scientists read, they 
can be grossly misled by original, false, and later refuted reports 
that have both been published in the same peer review journal.

   This is the important fact I want to emphasize here: Rather 
than accept objective evidence against the myth of Black inferiority, 
and give up that absurd idea, what did the American medical 
professions do? They recommitted themselves to finding genuine 
scientific support for that myth. How? By simply switching from 
physicians who were anatomists to physicians who were and are 
psychiatrists.

   To see how that was a brilliant move, remember this fact:  As 
it largely still is, until the 1950s, American Psychiatry had always 
been more of a subjective social philosophy than an objective natural 
science. Consequently, as is still the case, it accepted, as objective 
facts, the popular myths that American society held about Black people. 
For example, in the mid-nineteenth century, Dr. Sam Cartwright, a 
widely acclaimed White Louisiana psychiatrist, wrote in American medical 
journals the following diagnostic information about the mental health 
of Black people.

   According to Cartwright, there were three groups of Black people. 
The first group, a majority, was theoretically composed of 
psychiatrically-healthy slaves. Their three main distinguishing 
characteristics were: (a) They were faithful to their masters; (b) they 
were hardworking; and (c) they were happy-go-lucky.

   Second, there was the smaller group of psychiatrically-ill Black 
slaves who allegedly had Dysesthesia  Aethiopica. In Cartwright's words, 
this unique slave insanity was "a hebetude of the mind and 
insensibility of the nerves, which caused Black slaves to try 
to avoid work, to try to maim and kill their master's work animals, 
to destroy their master's plows and other valuable property and just 
generally be irritants for their overseers and owners".

   The third group, a small group, was allegedly composed of 
psychiatrically-ill slaves who allegedly had Drapetomania, or 
flight-from-home madness. The sole diagnostic feature of this 
unique, Black psychiatric illness was trying to or actually 
succeeding in running away from slavery.

   To my knowledge, those three groups of diagnostic criteria are 
the only ones ever published in the American medical literature 
that dealt specifically with the mental health of Black people. 
However, the most important fact to remember about those criteria 
for diagnosing psychopathology in Black people is this: Those 
criteria are the opposite of diagnostic criteria for diagnosing 
psychopathology in White people. Can you imagine White people 
being diagnosed as psychiatrically ill merely because they ran 
away from slavery, or because they resisted being slaves? 
Of course not!

   To my knowledge, there has never been another race of people 
that physicians have been willing to label psychiatrically ill 
solely because they ran away from or otherwise resisted being 
slaves. That incredible historical fact of American Psychiatry 
makes perfect sense, in light of the de facto conspiracy I 
mentioned earlier and restate here to refresh your memory.

   Starting with the American Constitution, a de facto 
conspiracy began between the American government and American 
physicians to make American Black people appear both 
biologically inferior and psychologically defective when 
compared to White people.

   Probably the single most obvious example of that conspiracy 
in action was the 1840 U.S. Federal Census. The U.S. Census of 
1840 was the first one in which insane and mentally defective 
people were counted. To get the full significance of that event, 
keep in mind that official government statistics normally have the 
same authoritative influence that scientific facts have on the minds 
of both scientists and lay people.

   Also, remember that in 1840 the U.S. Census program was 
administered by the Office of the Secretary of State. The Secretary 
of State in 1840 was the slave-owning, former South Carolina Senator, 
John C. Calhoun. In the common political practice of that time, many 
if not most of the census takers were temporary, southern White 
political appointees. Even so, hardly anyone was prepared for the 
next shocking surprise.

   The 1840 Census reported that the combined insanity and idiocy 
rates for free Black Americans in the northern free states was 10 times 
higher than that of slaves in the southern states. The precisely stated 
ratio for the free Blacks was one out of every 162.4 free Blacks in 
northern free states was either an idiot or insane. However, out of 
every 1,558 Southern Black slaves only one was either an idiot or 
insane. Maine, then the most racially liberal of the Northern States, 
seemed to be particularly hazardous for the mental health of Black 
people. Census takers reported that one in every 14 free Black people 
in Maine was either an idiot or a lunatic. However, the census takers 
found only one idiot or lunatic in every 4,310 Louisiana Black slaves.

   There was only one problem with those sensational 1840 US Census 
data: Almost all of the data related to Black people was false. The 
census takers often obtained their data by arbitrarily changing the 
racial designation of White insane and mentally defective people to 
Black. That fact is usually as hard for today's well-trained 
American health professionals to believe as it first was for 
Dr. Edward Jarvis to believe. However, his disbelief quickly 
disappeared when he read the Census report that 133 Black patients 
were in the then all-White, Worcester, Massachusetts Insane Asylum.

   Jarvis was a White Massachusetts physician and statistician. He 
knew that all of the patients in the Worcester, Massachusetts Insane 
Asylum were White people. He also knew that Black people were not 
generally admitted to American hospitals at that time. Yet the 1840 
census reported only Black patients in that all-White insane asylum. 
The 133 White patients seemed to have just disappeared, or never 
to have existed. 

   With a quick personal trip to the Worcester Insane Asylum, Jarvis 
reconfirmed the obvious: The census figures were false. He personally 
checked the reported Black idiocy, insanity and mentally defective 
census data for the states of Maine and New Hampshire. There he found 
more instances where insane, blind, deaf and dumb, and idiotic Black 
people were reported in towns that did not have a single Black 
resident. The facts indicated that in many instances the census 
takers fabricated their Black census data. Much more commonly, the 
census takers arbitrarily changed the racial labels of White insane, 
blind, deaf and dumb and idiotic people to Black. Later, Dr. Jarvis 
made a systematic study of the insanity figures in the other northern 
states. He found that changing the racial designation of White insane 
or mentally defective people to Black was a common practice in the 
1840 Census program.

   In an 1844 issue of the American Journal of Medical Science, 
Jarvis published a detailed account of the 1840 U.S. Census fraud. 
Jarvis was not the only physician to discover the 1840 census fraud. 
Among the many others was Dr. James McCure Smithe, the first American 
Black physician.  Smithe even described his proof of the 1840 Census 
fraud in his famous Memorial of 1844 to the United States Senate.

   By 1844, the nationally-embarrassing evidence of the 1840 U.S. 
Census fraud was so obvious that John Quincy Adams, the former 
President of the Unites States and then U. S. Representative from 
Massachusetts, chaired a congressional investigation of the 1840 
Census. During those congressional hearings, Secretary of State 
John C. Calhoun, admitted there were errors in the 1840 Census. 
However, Secretary Calhoun explained, the errors were so numerous 
that they balanced themselves out. Therefore, Calhoun maintained, 
the reported rates of mental defectiveness and insanity of free 
Black people in northern states would have been the same, even 
if no errors had been made.

   Ultimately, Secretary of State Calhoun gave in to congressional 
pressure and appointed William A. Weaver to investigate the claim 
of 1840 Census fraud. Except for one small detail, that appointment 
might have solved the problem. That small detail was that Weaver 
had been the personal supervisor of the whole 1840 Census program. 
So, in effect, Weaver had been asked to investigate himself. 
I don't have to tell you how unlikely it was for that investigation 
to reveal any fraud, and it didn't.

   After Mr. Weaver's careful investigation, he reported that no 
errors at all had been made in the 1840 Census. So, despite much 
widely-published objective proof of obvious census fraud, the 
fraudulent figures remained as the official 1840 U. S. Census. 
Now let's see how those false, but official governmental data 
polluted the minds of unsuspecting future scientists.

   Here is a direct quote from an article that appeared in the 
American Journal of Insanity, 11 years after the fraudulent 
1840 census data were published. "Who would believe it without 
the facts in black and white before him, that every fourteenth 
colored person in the state of Maine is either an idiot, or a lunatic?"  
You are probably as aware as I am of the old joke that says government 
statistics are either lies or damn lies.  As I shall now show you, 
once those damn lies are officially declared to be facts, they are no 
longer jokes:  They are automatically reacted to as if they were 
objective facts. For example, Mr. Calhoun used those fraudulent 1840 
census figures when he tried and failed to persuade the British to return 
escaped American slaves to what Mr. Calhoun claimed had been proven to be 
the more emotionally-healthy climate of slavery. Mr. Calhoun was able to 
stop "the westward spread of Black insanity" by successfully using the 
fraudulent 1840 census figures to help justify admitting Texas into the 
Union as a slave territory and later as a slave state.

   If you recall the de facto conspiracy between the American government 
and American Psychiatry, you will understand this current academic 
deception: When you look under Negro or Black in the index of almost 
any psycho-social textbook, it almost always gives you these directions: 
"See AIDS, see alcoholism, see street crimes, see gang wars, see Black 
on Black murders, see drugs, see juvenile delinquency, see teenage pregnancy, 
see sexually-transmitted diseases, see illegitimacy, see welfare, see 
probation and parole, see prisons, see rape, see female single-parent 
families, see unwed mothers, see suicide" and on and on. You will almost
 never see anything that gives you even a hint that such a thing as a 
mentally healthy, successful Black person exists in America. In fact, 
even today, some of the most influential American psychiatrists loudly 
proclaim that emotionally-healthy and successful Black people either don't 
exist, or, they are so rare that it's a waste of time to try to find and 
study them.

   Two such psychiatrists are Drs. Abram Kardiner and Lionel Ovesey. 
In the training programs for American mental health professionals 
throughout the USA, their book, entitled "The Mark of Oppression", 
even today is often standard and required reading about the mental 
health of Black people. However, the many scientific-minded, American 
psychiatrists I have interviewed about that book say that it is 
probably the most pernicious example of widely-believed 
pseudoscientific trash about Black people since the nonsense 
that Dr. Samuel Cartwright published in the mid-nineteenth century.

   In their book, Drs. Kardiner and Ovesey state that the 
personalities of Black people are caricatures of the personalities 
of White people, that Black people have every reason to hate 
themselves and that they have no basis for healthy self-esteem. 
These psychiatrists admitted that they could not tell from their 
studies what comprises the psycho-social adaptation of the 
successful Negro. That's because, they stated, a composite 
picture of successful, psycho-social Negro adaptation is 
unimportant because psycho-socially healthy Negroes are 
exceptions and not the rule.

   As a well-trained American psychiatrist, I can confidently 
predict this factual future for American Psychiatry. As long as 
academic American psychiatrists, almost all of whom are White, 
maintain their historical mindset about Black people, they will 
continue to train unsuspecting, White and Black psychiatrists to 
incorrectly diagnose Black people as more psychiatrically disturbed 
than they really are. Therefore, Black patients will continue to be 
treated much more than similar White patients with incarceration on 
psychiatric wards. Black patients will also continue to be 
unnecessarily treated with more potentially dangerous mind-altering 
drugs.

   Because peer-review articles and books the like of "The Mark of 
Oppression" are both intellectually and medically dangerous, I shall 
now describe four universally-accepted, scientific reasons why 
Drs. Kardiner's and Ovesey's book would never have been published 
if it had been written about any other group of people than American 
Black people. The first reason is insufficient sample size of the 
group studied. Remember, this book is heralded as a valuable 
scientific, comparative study of the personality structure of 
American Black people, compared to the personality structure of 
middle-class White people. That means the statements these doctors 
made about Black people are supposed to have applied to almost all 
of the more than 20 million of us who were living in 1951. In addition, 
this book's status as a standard reference on Black people's mental 
health implies that that pseudoscientific nonsense is accepted today 
by most mental health training programs as an accurate picture of 
American Black mental health.

   Let's begin by looking at the group of Black people Drs. Kardiner 
and Ovesey believed they needed to study. Of the more than 
20 million Black people living in 1951, how many thousands, 
or even hundreds of Black Americans did those self-styled human 
behavioral scientists study as the basis for making their claims 
about the then more than 20 million Black Americans? Also, from how 
many different states of the United States do you think these 
psychiatrists obtained their Black subjects?

   Would you believe these doctors only interviewed 25 Black people? 
Can you stretch the limits of your intelligence to believe, or even 
imagine, that all of those 25 Black people lived in Harlem, New York? 
That's right, Harlem, New York, a place where over 75% of Black Americans 
most probably had never even visited, much less had the miserable 
disadvantage of living there. However, 25 Black Americans were those 
psychiatrists' sample Black population.

   What does that fact loudly and clearly say to sane, intelligent, 
American Black high school graduates, as well as to drop outs from 
the generally, legally-imposed, White-dominated educational systems 
with its de facto conspiracy between White administrators and their 
White and "Oreo" teachers?  Does this give Black American students 
as inferior an education as possible, despite legal and only 
pseudo-classroom integrated teaching?  It tells Black students 
that White psychiatrists, who are legally and medically expected 
to know better, believe the following old, and still nationally 
popular, idiotic idea about Black people: "If you have talked to 
one or two, who are on welfare, you know all there is to know about 
those primitive-minded, ignorant people and why it's foolish to expect 
them to achieve a White person's standard of living regardless of 
legally-enforced attempts to educate them in White/Black, integrated 
schools".

   Having been raised by one of the millions of successful, 
educated, American Black families Drs. Kardiner and Ovesey ignorantly 
believed were too rare to include in their study, the following was 
easy for me to understand:  Those White psychiatrists received the 
usual unchallenged, lifelong White American family and secondary 
group cultural conditioning to make Black racism as natural as 
expecting Christmas presents under their Christmas trees. With 
that pre-adult firm grounding in Black racism, plus their college 
and professional training in America's finest racist teaching 
universities, I would not have believed it. So, my only surprise 
about Drs. Kardiner and Ovesey's sample size was that they bothered 
to study as many as 25 poor, ignorant American Blacks. My explanation 
about that is this: Their scientific naivete (plus that of their peer 
reviewers) and their pernicious ignorance of American Black people was 
great. They sincerely believed that studying only 25 of 20 plus 
million Black American people reveals all that is worth knowing about 
all of them.

   Now, I ask you to honestly consider the following scenario.  With 
the exception of a sick book of Black racist jokes, can you imagine 
a reputable American White publisher, assumed to be non-racist, 
(such as the original New York, W. W. Norton publisher claims to be) 
would publish and distribute such a book as this one? I can't.  No 
reputable publisher that wants to protect itself from being legitimately 
classified as doing the infamous American-type publishing done in the 
1880s called "Yellow Dog Publishing" would have published Drs. Kardiner 
and Ovesey's book, "The Mark Of Oppression, A psychosocial study of 
the American Negro."  

   Early in their book, Drs. Kardiner and Ovesey asked themselves 
this question: "How do we know that our sample of 25 Black people 
is a correct and good representation of American Blacks?" Then they 
honestly admitted that they didn't know whether their small sample was 
a correct and good representation of Black people. However, they 
defended their sample size with the following logic:  They  said, 
"Our control is the American White man. Both White and Black people 
live under similar cultural conditions, with the exception of a few 
easily identifiable variables, which exist only for Black people. 
It was logical therefore, to expect to find in Black people a White 
middle class, White people's type of American personality".

   Now let's look objectively at what that expectation says and 
at what it does not say:  It does NOT say that White people who 
are not members of the White middle class have something wrong 
with their personality. That expectation does say that if Black 
people fail to qualify for membership in the White American 
middle class, that proves something is innately wrong with 
them that cannot yet be corrected.  Most Black high school 
science students, even with their often inferior, integrated 
education, can see the absurdity of such reasoning. Such pseudo-logic 
alone should have disqualified this book for publication and could 
easily be added to the second reason, described above, or to the 
third reason, that now follows below. 

   That third reason is this: To have a valid comparative study of 
two subgroups of the same group of people, you must specify exactly 
all the known relevant factors that are objectively the same for 
the two subgroups that make it logical to study the two groups. To 
accurately study different groups of people or any non-human 
things, you must specify some characteristics that are known to 
be present in both groups. As most junior high school students know, 
you cannot logically equate oranges with watermelons just because 
they grow on the same farm. 

   In my opinion, the following facts made it less logical for 
Drs. Kardiner and Ovesey to have tried to compare their 25 Black 
subjects to the typical, successful White middle class family, just 
because they live in the same American country. I assume that you 
have a valid mental picture of the typical successful White middle 
class family. So, as you read on, I ask you to honestly ask yourself 
if their Black sample was a valid basis for seriously making "The 
psychosocial study of the American Negro" that the cover of 
"The Mark of Oppression" proclaims it to be.  


DRS. KARDINER  AND OVESEY'S STUDY SAMPLE

   These psychiatrists interviewed 25 Black people.  In their words 
they were "of different, sex, age, and status, sufficiently varied 
to cover as many aspects of Negro adaptation as possible.  All 
subjects were seen once, twice or three times a week for a 
minimum of twenty to a maximum of more than a hundred visits. 
The average subject was observed during a period of four to six 
months, except for one who was seen only ten times in six seeks. 
Fourteen (56% of the subjects) were unpaid, but were psychiatric 
patients of Dr. Ovesey's throughout the study.  Eleven subjects 
were paid $1.50 per interview immediately at the end of the 
interview and each received a $20.00 bonus at the end of the 
twentieth session. There were 10 male adults, ages 26 -35 and 
two 15-year-old males. There were 2 female teenagers, 16 and 
18-years-old, and 12 adult females, ages 21 to 35-years-old. 
There were four college graduates, two teachers and two 
un-described government clerks. The remaining adults were 
either domestic servants, unskilled laborers or unemployed, 
living either in the streets or with relatives, receiving public 
assistance, if eligible". 

   Now let's look at how these doctors justified comparing 
56% of known neurotically-ill Black patients in a sample of 
25 American Blacks and (a) claiming that they are a typical 
cross section of the other twenty-plus millions American Blacks;  
and (b) then comparing those 25 Blacks to the typical, 
ideally-healthy, middle-class White person and his or her 
personality structure. In my opinion the logic and knowledge 
of basic human nature that produced that research design is a 
joke at best and at worse, an obscene insult to the intelligence 
of genuine human behavioral scientists. Drs. Kardiner's and 
Ovesey's mindset below was so childish that if I was not quoting 
them, I would not have the courage to put it in print.  
They said: "For the purposes of this study, neurotics are people. 
Except for localized disorders like anxiety and impotence, the 
personality of neurotics functions normally. But," they emphasized, 
"since that is not true of insane people, we did not include any 
psychotic people in our study".

   The failure to compare psychotic Blacks to normal middle-class 
White people is about as surprising as refusing to include women 
in any comparative study of men. So don't let that mealy-mouthed 
disclosure distract you from this fact:  Those White 
psychiatrists were trying to get their readers to believe 
this blatant bit of pseudo-scientific nonsense, namely, that 
whether or not Black people are neurotic, if they are not psychotic, 
it's logical to expect them to be, and if they do not measure up to 
Drs. Kardiner and Ovesey's ideas of the then healthy White, 
middle-class American, then those Black people, and all American 
Black people, have pathologically-flawed personality structures.

   Here's the fourth reason. The Mark of Oppression should never 
have been published:  These psychiatrists said that their standard 
social unit of comparison for their Black subjects was the intact, 
stable, monogamous White family, with the father as the titular 
head and income producer. Yet, these doctors did not describe any 
personal efforts to interview comparable Black families or any 
intact Black families at all. Nor did they describe any contacts 
with any Black churches or Black schools or Black social 
organizations. Understandably, therefore, only half of their 
Black subjects were living in intact families. None of those 
subjects even came close to measuring up, financially or otherwise, 
to the authors' ideal White middle-class family.

   As Drs. Kardiner and Ovesey presented their findings, they 
can and often do easily lead unsuspecting readers, especially 
unsuspecting White readers, to conclude that there are no Black 
families who measure up to the White American standards for 
healthy stable families. Yet, genuinely scientific studies of 
Black families done during that same era, revealed this objective 
fact: According to White American standards, over 75% of Black 
families qualified as being both healthy and stable. In addition, 
if only Black families with incomes above the poverty line were 
considered, the percentage of healthy, stable Black families 
jumped to 98%. Thus, both useful and scientifically-sound research 
by American Black human behavioral scientists is only rarely 
available in the libraries of America's White institutions of 
higher learning and it rarely becomes required reading.  

   For reporting a purported scientific study, not mentioning 
even one of those studies is unthinkable for genuine human 
behavioral scientists. However, it is not surprising that 
the equally racist peer reviewers of this book did not insist 
that at least one of those contrary studies be a cited 
reference in that book. For the following reason, that 
omission is all the greater intellectual shortcoming, 
assuming that such a thoroughly academic worthless book 
with great potential for intellectually harming unsuspecting 
graduate health students can have a legitimate shortcoming:  
In the short 11 years after the original publication of The 
Mark of Oppression, the second edition of it was reprinted as 
one of the prestigious Meridian Books by the World Publishing 
Company. That fact guarantees that this intellectually 
obscene book is now a permanent fixture on the encouraged, 
if not required reading list of most major White 
institutions of higher psychosocial learning.  
In my opinion, worst of all is this fact:  In the 
preface of that second edition, Drs. Kardiner and 
Ovesey proudly wrote:  "Nothing has been changed in the 
text except the subtitle.", i.e.,  "A psychosocial study of 
the American Negro".

   I think the fact that such an obvious falsehood is 
printed in the preface of such a prestigious but objectively 
worthless academic book can only be objectively understood 
based on this fact:  There has always been and now still is 
a powerful American, de facto, anti-Black mental health 
conspiracy in the psychiatric sciences and many of the 
other psychosocial sciences. In addition, as long as it 
consciously or purposely persists, American Blacks shall 
continue to have an excellent mental and emotional self-defense 
reason to distrust American Psychiatry.


THE CURRENT AMERICAN PSYCHIATRIC SCENE 

   Too many improvements to count in American Psychiatry today 
have occurred to the great benefit of all psychiatric patients. 
However, that fact does not begin to excuse or make up for the 
following unchanged conditions that need quick, permanent change. 
Though American Psychiatry no longer relies much on religious 
leaders and anatomists as a source of expert knowledge about 
American Black patients and people in general, almost 
exclusively, psychiatry now relies on its own profession 
for that knowledge. But, unfortunately, the basic psychiatric 
goal with reference to American Black patients and people in 
general still remains basically its historical self, namely, 
to find a scientific biological basis for clinging to probably 
the strongest White American myth about Black people-That they 
are by nature, nurture, or both, hopelessly inferior to 
White people.


AMERICAN BLACKS AND AMERICAN PSYCHIATRY?

   The facts presented in this talk seem to support the 
following three conclusions:   First, even the most educated 
Black Americans distrust American Psychiatry much more than 
White Americans do.  Second, Black distrust of psychiatry is 
mainly justified, a healthy self-defense of their sanity, which 
White psychiatrists teach to their unquestioning, racially-naive 
White and Oreo, Black psychiatric residents.  Blacks are still 
compromised with the excessive use of potentially dangerous 
neuro-psychotropic drugs and inappropriate incarceration in 
prison-like psychiatric institutions. Before the era of the 
tranquilization of America, American Blacks had to avoid, as 
best they could, the frank physical abuse that was rationalized 
as being psychiatric treatment. Third, in light of that history, 
to protect their sanity as best they could, American Black people, 
along with most poor people, were forced to develop their current, 
strong, culturally-conditioned preference for solving their own 
mental problems, for themselves, by themselves.

   Since that is the case, you may wonder, why not solve the 
problems of Black distrust of psychiatry by just letting Black 
people solve their own emotional problems? Unfortunately, as a 
group, Black people don't have any more basic knowledge about 
scientifically valid concepts and techniques of safe, therapeutic 
emotional self-help than White people have. However, that 
situation is not hopeless. Here are three practical, as well 
as readily available research-supported solutions:  First, 
American Psychiatry needs to give up its historical preoccupation 
with trying to prove that Black people are inferior to White 
people. There is no credible evidence to support that idea. 

   Second, American Psychiatry needs to commit its research on 
Black people to finding objectively healthy ways to help 
Black people safely help themselves, psycho-emotionally, 
socially, and economically. That focus would lead directly 
to the third practical solution to the distrust Black people 
have for American Psychiatry. 

   That solution is to require that training in 
cognitive-behavior therapy and counseling be included 
in the training programs for psychiatrists and for all 
other mental health professionals. Why? Because methods 
and techniques of cognitive-behavioral psychotherapy and 
counseling teach patients medically-reliable yet practical 
concepts and techniques of emotional and general behavioral 
self-help. In addition, these methods and techniques are 
largely culture-free. Therefore, therapists and patients of 
different races and ethnic groups who have that training are 
most likely to automatically leave at the consultation room 
door, unsuspected, but anti-therapeutic "baggage" related to 
those differences. Then they are ideally suited for efficient 
and effective work with all patients, regardless of differences 
in demography. 

   The technique of cognitive-behavior therapy that I have 
personally researched throughout my professional career and 
which I teach and strongly recommend is the one that I 
formulated. It is called Rational Behavior Therapy, or RBT 
for short.

   In addition to being culture-free, it is a comprehensive 
approach to short-term psychotherapy and counseling that 
produces long-term results. That's because adequately treated 
patients also learn skills in using the therapeutic, self-help 
method called, Rational Self-Counseling, which is based on the 
therapeutic concepts and maneuvers in professionally-delivered 
Rational Behavior Therapy. As an additional therapeutic plus, 
adequately treated patients leave RBT treatment better able to 
cope with their past and future life problems than ever before. 
That's what makes RBT short-term psychotherapy that produces 
long-term therapeutic results. 


NOTES

1.  This paper was presented as the keynote speech of the Minority 
Issues Conference, "Unfinished Business: The Challenge of Meeting the 
Needs of Seriously Mentally Ill Minorities in the 90's," National Institute 
of Mental Health, Tuskegee University, Tuskegee, Alabama, August 15-17, 1990.  
This article was largely based on a chapter, titled "Why American 
Blacks Distrust Psychiatrists," published in 1982 in Behavior 
Modification in Black Populations: Empirical findings and Psychological Issues, 
Turner, S.M. and Jones, R.T. eds, New York, Plenum Press. 

I mention this because many of the facts presented here are at first hard 
for even a few naive American Blacks and most naive White readers to believe. 
However, in my chapter in the book Behavior Modification in Black 
Populations, you will find a plethora of scientific reference for the 
sometimes hard to believe facts present in this lecture. Both the Black 
and White peer reviewers of submitted, possible publications by Black authors 
insist on such verification and scientific support.  

2.  Copyright, Maxie C. Maultsby, Jr., M.D., 1990, reprinted in Psychnews 
International by permission of the author.


SELECTED REFERENCES

Bean, R.B.  (1906).  Some racial peculiarities of the Negro brain.  
American Journal of Anatomy, 5, 353-415.

Bevis, W.M. (1921).  Psychological traits of the southern Negro 
with observations as to some of his psychoses.  American Journal 
of Psychiatry, 1, 59-78.

Boyd, N.  (1979).  Black families in therapy.  Psychiatric 
Spectator, (by Sandoz), 11, 212-215.

Dorfman, D.T.  (1978).  The Cyril Burt question:  New finds.  
Science, 201, #4562, 1177-1186.

Fanon, F.B.  (1967).  Black sin white mask.  New York:  Grove Press.

Hall, G.S.  (1904).  Adolescence.  New York:  Appleton, Vol. 2.

Hollinghead, A.B. and Redlich, F.C.  (1958).  Social class and 
mental illness.  New York:  Wiley.

Jarvis, E.  (1844).  Insanity among the coloured population of 
the free states.  American Journal of Medical Sciences, 8, 71-83.

Jones, F.  (1972).  The black psychologist as consultant and 
therapist.  In Black Psychology.  Reginald L. Jones (Ed.).  
New York:  Harper and Row.

Kardiner, A. and Ovesey, L.  (1962).  The mark of oppression.  
New York The World Publishing Company.

Katz, J.H.  (1978).  White awareness.  Norman:  University of 
Oklahoma Press.

Mall, F.P.  (1909).  On several anatomical characters of the 
human brain, said to vary according to race and sex.  
American Journal of Anatomy, 9, 1-32.

Maultsby, M.C.  (1984).  Rational behavior therapy.  
Englewood Cliffs, New Jersey:  Prentice-Hall Publishing Co. 
(To obtain a copy send a check (only) for $22.95 
USD, payable to "Training Center," and addressed to RBT, 
P.O. Box 9610, Alexandria, Virginia, 22304, USA).

Maultsby, M.C.  (1979).  Rational Behavior Therapy in 
behavior modification.  In Black populations:  Psychosocial 
issues and empirical findings.  S.M. Turner and R.T. 
Jones (Eds.).  New York:  Plenum.

Morais, H.M.  (1967).  The history of the Negro in medicine.  
New York:  Publishers Company, Inc.

O'Malley, M.  (1914).  Psychosis in the colored race.  
Journal of Insanity, 71, 309-336.

Prudhomme, C. and Musto, D.F.  (1973).  Historical 
perspectives on mental health and racism in the United States.  
In Racism and mental health.  Willie, C.V. et al. (Ed.), 
Pittsburgh:  University of Pittsburgh Press, pp. 25-57.  

Stanton, W.  (1960).  The leopard's spots:  Scientific 
attitudes toward race in America, 1815-1859.  Chicago:  
University of Chicago Press.

Thomas, A. and Sillen, S.  (1972).  Racism and psychiatry.  
New York:  Brunner/Mazel.

Turner, S.M. and Jones, R.T.  (Eds.)  (1979).  Behavior 
modification in black populations:  Psychosocial issues and 
empirical findings.  New York:  Plenum Press.

Weatherby, D.G.  (1910).  Race and marriage.  American 
Journal of Sociology, 15, 433-454.

White, W.A.  (1903).  Geographic distribution of insanity.  
Journal of Nervous and Mental Disease, 30, 258-279.

Willie, C.V., Kramer, M.B. and Brown, B.S.  (1973). Racism 
and mental health.  Pittsburgh:  University of Pittsburgh Press.

- - -


Maxie C. Maultsby, Jr., M.D., former Chairman of the Department 
of Psychiatry at Howard University Medical School, is Professor 
of Psychiatry at Howard University Medical School in Washington, 
DC., and the author of many books and articles on Rational 
Behavior Therapy.  
His e-mail address is:  maxiejr@maultsby.net