-Caveat Lector- http://abcnews.go.com/sections/living/InYourHead/allinyourhead.html Are Racists Ill or Evil? Psychiatrist Says Hatred Obscures Mental Health Problem Some mental health professionals think that extreme racists have psychological disorders. Some, for instance, might have delusions that all members of a particular racial group are out to get them. (A.Shepherd/ ABCNEWS.com) By Claudine Chamberlain ABCNEWS.com During the civil rights era of the 1960s, a group of black psychiatrists was so disturbed by racially motivated killings and other acts of violence that they sought to have extreme racism classified as a diagnosable mental illness. The American Psychiatric Association turned them down. But now one of those psychiatrists, Harvard’s Dr. Alvin Poussaint, says it’s time to reconsider that decision. “We’ve had a series of racially motivated killings now — Buford Furrow in Los Angeles, Benjamin Nathaniel Smith in the Midwest, the dragging death in Texas,” Poussaint says. “All of these men were suffering from severe delusions about minorities.” But because those delusions were racist delusions, he argues, the men didn’t get the psychiatric help they needed, even though delusional disorder is a clearly identifiable mental illness. Instead of being seen as ill, the attackers were seen as evil — and untreatable. Diagnosis, Treatment, Prevention “That’s my peeve,” Poussaint says. “If we want to do any kind of prevention, psychiatrists have to know and believe themselves that this is a serious mental disorder.” To that end, he says, extreme racism should be listed as an official type of delusional disorder in the Diagnostic and Statistical Manual of Mental Disorders, the index that mental health professionals use in diagnosing patients. Poussaint set forth his argument in a recent editorial in The New York Times. Treatment would likely be the same as other types of delusional disorders — intensive talk therapy to help the patient understand that all African Americans (or Jews or Hispanics) aren’t out to get them, and possibly anti-psychotic medication if the delusions are quite severe. No one argues with the goal of preventing racism. Whether to approach it as a mental health problem, well, that’s a bit more controversial. Two Conditions or One? While it’s certainly possible for someone to be alarmingly racist and mentally ill, the racism alone doesn’t make a person mentally ill, says Dr. Daniel Borenstein, president-elect of the American Psychiatric Association and a professor at the University of California Los Angeles. “Racism per se is, I think, an extreme of a very common thing in humans, and that is prejudice,” Borenstein says. “Some of the ways in which it manifests itself can be disturbing, but prejudice is a normal human tendency.” If someone has a delusional disorder that makes it more likely that they’ll act out on those racist feelings in a violent way, he says, that disorder should be easy enough to diagnose as a separate problem. “It would be wonderful if we could somehow decrease racism by making it a diagnosis,” Borenstein says. “But the diagnostic nomenclature isn’t set up to cure social problems; it’s set up to diagnose and treat mental illness.” Poussaint says he understands the argument that prejudice is a common human condition. He’s not recommending a trip to the shrink’s office for anyone who’s ever told an off-color joke, or any white woman who’s ever held her purse a little closer when a black man walked by. But he is saying that mental health professionals should be on the lookout for patients whose racist thoughts include threats of violence or fantasies of vast conspiracies. Racists Are Bad Characters “People argue that it’s just hatred, but the hatred is part of a delusion,” he says. “It’s a circular argument.” Julia Ramos Grenier, a Connecticut psychologist who helps police departments evaluate mentally unstable suspects, says it’s important to distinguish a character flaw from a mental illness. She thinks racism is a character flaw. “A lot of people in this world go around having negative thoughts about other people,” she says. “But they don’t necessarily break the law because of it.” An important part of her work is determining how dangerous someone is, and for that she considers not so much the ideologies they spout, but other factors, such as whether they have anti-social tendencies, whether they feel rules and laws apply to them, whether they’ve been violent in the past and whether they have access to guns. While those things are important, Poussaint says it’s also crucial to recognize delusional racism early on. If you do, and you can help the person overcome it, you may just prevent the next day-care shooting or deadly rampage. “A lot of people in this world go around having negative thoughts about other people. But they don’t necessarily break the law because of it.” Psychologist Julia Ramos Grenier Copyright ©1999 ABC News Internet Ventures. 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