As ridiculous a concept as anosognosia – a post by Rossa Forbes

Rossa Forbes is the wonderful blogger at the helm of Holistic Recovery from Schizophrenia. She is the mother of a young man who carries the label of schizophrenia. Her blog is a beautiful and unusual testament of insight and courage from the perspective of a parent.

I asked if I could publish her piece from today.

Here it is:

As ridiculous a concept as anosognosia:

In 1851, Dr. Samuel A. Cartwright, a Louisiana surgeon and psychologist, filed a report in the New Orleans Medical and Surgical Journal on diseases prevalent among the South’s black population. Among the various maladies Dr. Cartwright described was ”drapetomania” or ”the disease causing slaves to run away.”

Though a serious mental illness, drapetomania, wrote Dr. Cartwright, was happily quite treatable: ”The cause, in the most of cases, that induces the negro to run away from service, is as much a disease of the mind as any other species of mental alienation, and much more curable. With the advantages of proper medical advice, strictly followed, this troublesome practice that many negroes have of running away can be almost entirely prevented.”

A particularly absurd chapter in the annals of racist 19th-century science? Without question, but for Alvin Poussaint, a clinical professor of psychiatry at Harvard Medical School, Cartwright’s hopelessly unscientific diagnosis is of more than just historical interest. It is a vivid illustration of how definitions of normal and abnormal behavior are shaped by the values of the society that makes them. ”The culture influences what you consider pathology,” says Dr. Poussaint. ”Cartwright saw slavery as normative. So when slaves deviated from the norm, he called them mentally ill. The business of deciding what’s normal and what’s psychopathology gets influenced by culture and politics. It’s not hard science.”

Dr. E. Fuller Torrey has popularized the use of the word “anosognosia” to describe someone who is unable to understand that he is mentally ill. Seriously, please try to pronounce this word while keeping a straight face. Dr. Torrey is also one of the most vocal advocates of outpatient commitment for those judged unlikely to survive safely in the community without supervision, i.e. the mentally ill, although come to think of it, slaves, too, fit this description. While we all dislike seeing visibly disturbed individuals roaming the streets, let’s also keep in mind that society felt the same way about slavery, incarcerating its victims under the guise of helping those who are judged unable to act in their own best interests. Anyone can see there is a problem (either with someone presenting as mentally disturbed or as a runaway slave), but what is at the base of that problem? Do we label everything we can’t or won’t accept as mental illness? Seems like we do. It makes Dr. Thomas Szasz’s belief that mental illness is a social construct very credible.

From the New York Times: Bigotry as Mental Illness or Just Another Norm

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