1 00:00:13,000 --> 00:00:16,439 Speaker 1: Un Little Delicious friends, and welcome to Who Did What Now? 2 00:00:16,840 --> 00:00:20,480 Speaker 1: The history podcast that is not your history class with 3 00:00:20,560 --> 00:00:25,560 Speaker 1: me your host Katie Charlwood, History Harlott and reader of books. 4 00:00:26,239 --> 00:00:28,440 Speaker 1: And I had a funny one this week. You know 5 00:00:28,480 --> 00:00:31,520 Speaker 1: how people like to complain about my content, Well, I 6 00:00:31,560 --> 00:00:34,600 Speaker 1: had someone accuse me of being nasty with my USA 7 00:00:34,720 --> 00:00:38,840 Speaker 1: History Month. This month, if you're unaware, July twenty twenty 8 00:00:38,880 --> 00:00:46,320 Speaker 1: six is the celebration of the agreeing of the Declaration 9 00:00:46,360 --> 00:00:50,240 Speaker 1: of Independence, not the gaining of independence in the US, 10 00:00:50,360 --> 00:00:54,600 Speaker 1: and so everyone's like, it's America's birthday, and so I 11 00:00:54,680 --> 00:00:58,640 Speaker 1: was like, well, let's do American history then causes seemed 12 00:00:58,680 --> 00:01:02,320 Speaker 1: like a very reasonable and large option. So some people 13 00:01:03,240 --> 00:01:07,480 Speaker 1: got a little bit testy about that, and someone accused 14 00:01:07,480 --> 00:01:12,800 Speaker 1: me of being nasty with my USA History Month because 15 00:01:12,800 --> 00:01:15,720 Speaker 1: I'm talking about how the USA became the USA, which 16 00:01:15,800 --> 00:01:20,720 Speaker 1: is which is wild, Like you think actual history is 17 00:01:20,720 --> 00:01:23,880 Speaker 1: made bad mouth in a country like sugar lump. No 18 00:01:24,800 --> 00:01:27,440 Speaker 1: if you think this is nasty, right, And I haven't 19 00:01:27,480 --> 00:01:34,199 Speaker 1: even touched on the British Empire yet, like I'm I'm 20 00:01:34,240 --> 00:01:40,080 Speaker 1: just getting started. But also it's not nasty or cruel 21 00:01:40,360 --> 00:01:44,600 Speaker 1: or horrible to talk about the entire history of somewhere 22 00:01:45,160 --> 00:01:47,600 Speaker 1: Here's like, I'm not even doing the entire history. I've 23 00:01:47,640 --> 00:01:51,600 Speaker 1: got so much out because history is vast and large, 24 00:01:51,640 --> 00:01:54,400 Speaker 1: and I don't know, if you know, this has lasted 25 00:01:54,440 --> 00:01:57,760 Speaker 1: a long time. So it's one of those things, right 26 00:01:57,920 --> 00:02:04,280 Speaker 1: because history, like if you're only focusing on you know, 27 00:02:05,240 --> 00:02:11,639 Speaker 1: the rainbow lollipops and you ignore everything else than that, 28 00:02:11,639 --> 00:02:17,960 Speaker 1: that's not history, you know, that's it's fan fiction. Yeah, 29 00:02:18,200 --> 00:02:21,320 Speaker 1: but anyway back to me, I do have more tu 30 00:02:21,440 --> 00:02:25,079 Speaker 1: dates coming soon. Once I have them locked in, you 31 00:02:25,240 --> 00:02:27,280 Speaker 1: will be the first to know. Well, no, the people 32 00:02:27,400 --> 00:02:30,240 Speaker 1: people who signed up like in the show, voting to 33 00:02:30,400 --> 00:02:33,200 Speaker 1: know first will know first, and then Patreon supporters will 34 00:02:33,200 --> 00:02:35,600 Speaker 1: be in the first to know as well, and then 35 00:02:35,720 --> 00:02:39,880 Speaker 1: and then everyone else who listens here but Belfast is 36 00:02:40,040 --> 00:02:45,960 Speaker 1: it's selling the cockcakes and Los Angeles, come on. It 37 00:02:46,080 --> 00:02:48,280 Speaker 1: is a tragic day in Sunset Boulevard when you don't 38 00:02:48,280 --> 00:02:52,359 Speaker 1: get your tickets. I'm not even on Sunset Boulevard, but 39 00:02:52,520 --> 00:02:55,480 Speaker 1: you know, I'm chronically online, and if you get it, 40 00:02:55,520 --> 00:02:57,760 Speaker 1: you get it. Some people are going to be listening 41 00:02:57,760 --> 00:03:00,960 Speaker 1: to this going what Sunset Belove got to do with this? 42 00:03:02,480 --> 00:03:05,160 Speaker 1: Like just so you know, I'm going to be such 43 00:03:05,280 --> 00:03:11,519 Speaker 1: a broken record about this because like international tour guys. 44 00:03:13,000 --> 00:03:16,520 Speaker 1: Also in today's news, because it is too funny not 45 00:03:16,680 --> 00:03:22,240 Speaker 1: to share, Andrew Tate got arrested in capris and are 46 00:03:22,280 --> 00:03:28,480 Speaker 1: going out top like full mid two thousand style, Like 47 00:03:28,639 --> 00:03:31,480 Speaker 1: I swear that I think my mum had a day 48 00:03:31,520 --> 00:03:35,800 Speaker 1: to night outfit just like this. So for those of 49 00:03:35,800 --> 00:03:38,320 Speaker 1: you who don't know, there was a big thing in 50 00:03:38,400 --> 00:03:43,560 Speaker 1: fashion where people were genuinely concerned about their outfits and 51 00:03:43,600 --> 00:03:47,000 Speaker 1: their makeup being able to go from day to night 52 00:03:47,280 --> 00:03:49,560 Speaker 1: so you could go from the office to the club, 53 00:03:49,680 --> 00:03:55,320 Speaker 1: which is why everyone wore a blazer. But speaking of clubs, 54 00:03:57,240 --> 00:04:00,480 Speaker 1: the Tate brothers, like when they got arrested, So you've 55 00:04:00,520 --> 00:04:05,760 Speaker 1: got Andrew Dayton, he's in his little purple Elizabeth Taylor outfit, 56 00:04:06,480 --> 00:04:10,320 Speaker 1: and then you've caught Scapri's and sensible lovers, and then 57 00:04:10,360 --> 00:04:13,200 Speaker 1: you've got the other brother who's in a full three 58 00:04:13,240 --> 00:04:18,520 Speaker 1: piece suit and fedora like they both somehow look like 59 00:04:18,600 --> 00:04:22,520 Speaker 1: Russian American nightclub owners in a direct to VHS movie 60 00:04:22,560 --> 00:04:26,520 Speaker 1: somewhere between ninety eight and two thousand and I stand 61 00:04:26,720 --> 00:04:33,839 Speaker 1: by that absolutely. Also, oh so more news, the Guild. 62 00:04:33,920 --> 00:04:35,680 Speaker 1: I was a big fan of the Guild. The Guild 63 00:04:35,839 --> 00:04:38,240 Speaker 1: is making a movie which my little nerdy heart is 64 00:04:38,279 --> 00:04:41,200 Speaker 1: so excited for. So there's a lot of good news 65 00:04:41,200 --> 00:04:43,000 Speaker 1: going around here. But I know what you're thinking. You're thinking, 66 00:04:43,080 --> 00:04:47,640 Speaker 1: Katie quite Yo, Jeba Daba, in fact me, in fact you, 67 00:04:47,720 --> 00:04:50,600 Speaker 1: I will. But first we've got to get our source on. 68 00:04:52,440 --> 00:04:57,839 Speaker 1: Our sources are the Protest Psychosis House, Schizophrenia Became a 69 00:04:57,880 --> 00:05:03,960 Speaker 1: Black Disease by Jonathan Metzel, How the Black Man Became 70 00:05:04,040 --> 00:05:10,159 Speaker 1: Schizophrenic by Karen Franklin, The Effects of race and Ethnicity 71 00:05:10,240 --> 00:05:16,600 Speaker 1: on schizophrenia, Individual and neighborhood contexts by Augustine Jake, Pausa, Glente, 72 00:05:16,960 --> 00:05:26,120 Speaker 1: Sonacai and Edward W. Butler. Madness, Race and Insanity in 73 00:05:26,160 --> 00:05:31,719 Speaker 1: The Jim Crow Asylum by Antonia Hilton. And of course 74 00:05:32,080 --> 00:05:36,359 Speaker 1: we have our old favorites biography dot com and History 75 00:05:36,440 --> 00:05:43,600 Speaker 1: dot Com. I also didnk comfortably good. Then let's begin. 76 00:05:45,480 --> 00:05:48,880 Speaker 1: There are a few things history loves more than watching 77 00:05:49,000 --> 00:05:54,000 Speaker 1: powerful instigusians convince themselves that they're being perfectly rational while 78 00:05:54,000 --> 00:05:57,120 Speaker 1: doing something that future generations will collectively look back on 79 00:05:57,200 --> 00:06:01,960 Speaker 1: and say, all right, well, that was the stubborn and 80 00:06:02,000 --> 00:06:06,080 Speaker 1: so this this story today is one of those moments 81 00:06:07,279 --> 00:06:13,919 Speaker 1: like it is about psychiatry, race, politics, and what happens 82 00:06:13,960 --> 00:06:20,160 Speaker 1: when medicine, like history, does not exist in a vacuum. 83 00:06:20,240 --> 00:06:22,520 Speaker 1: So I'm going to talk about today, as I'm sure 84 00:06:22,560 --> 00:06:29,599 Speaker 1: you know from the title of the episode, the protest psychosis. Now, 85 00:06:31,680 --> 00:06:34,640 Speaker 1: I want to clarify before I get into anything else, 86 00:06:34,960 --> 00:06:39,640 Speaker 1: that this episode is not about whether schizophrenia is a 87 00:06:39,680 --> 00:06:44,640 Speaker 1: real illness, because it is, because schizophrenia is a serious 88 00:06:44,720 --> 00:06:50,360 Speaker 1: psychiatric disorder, and it affects millions of people worldwide, and 89 00:06:50,440 --> 00:06:56,560 Speaker 1: because we've researched it for decades. You know, our modern 90 00:06:56,600 --> 00:07:02,960 Speaker 1: research has dramatically improved our understanding of causes, diagnoses, treatment, 91 00:07:04,080 --> 00:07:08,080 Speaker 1: and nothing that we're discussing today should be interpreted as 92 00:07:08,160 --> 00:07:13,200 Speaker 1: dismissing the experiences of people living with schizophrenia or suggesting 93 00:07:13,240 --> 00:07:16,640 Speaker 1: that modern psychiatry view is political activism as evidence of 94 00:07:16,720 --> 00:07:23,400 Speaker 1: mental illness. Only ideas do that. Now, this episode is 95 00:07:23,560 --> 00:07:29,480 Speaker 1: about history, specifically, It's about how psychiatric idea has changed 96 00:07:29,520 --> 00:07:33,640 Speaker 1: over time, how social and political attitudes can shape medical thinking, 97 00:07:34,160 --> 00:07:40,920 Speaker 1: and how one diagnosis, schizophrenia underwent a remarkable transformation during 98 00:07:40,920 --> 00:07:46,120 Speaker 1: one of the most turbulent periods in American history because 99 00:07:46,240 --> 00:07:52,040 Speaker 1: diseases don't exist in isolation. Now, the biology might stay 100 00:07:52,080 --> 00:07:57,280 Speaker 1: the same, but the story societies tell about illness it 101 00:07:58,040 --> 00:08:03,800 Speaker 1: doesn't like things. It's like, okay, sidebar. You know, when 102 00:08:03,800 --> 00:08:07,440 Speaker 1: they talk about leprosy in the Bible, the disease that 103 00:08:07,600 --> 00:08:10,320 Speaker 1: is leprosy, that is known as leprosy is not the 104 00:08:10,360 --> 00:08:15,080 Speaker 1: same leprosy that exists today. It is a very very 105 00:08:15,080 --> 00:08:18,720 Speaker 1: different It's a very very different disease, which I will 106 00:08:18,760 --> 00:08:22,480 Speaker 1: happily talk about one day because I really like historical diseases. 107 00:08:23,000 --> 00:08:29,160 Speaker 1: But we will cover this. And that's the thing. Right, So, 108 00:08:30,680 --> 00:08:33,040 Speaker 1: as you guessed, I'm going to be talking about mental 109 00:08:33,080 --> 00:08:36,800 Speaker 1: illness quite a bit in this week's episode, I'm going 110 00:08:36,880 --> 00:08:39,440 Speaker 1: to talk about racism. I'm going to be talking about 111 00:08:39,840 --> 00:08:44,079 Speaker 1: many horrible things consecutively, one after another in a row. 112 00:08:44,640 --> 00:08:46,640 Speaker 1: And if you think that's something that's going to be 113 00:08:46,640 --> 00:08:49,920 Speaker 1: a bit much for you to listen to, feel free 114 00:08:49,960 --> 00:08:56,000 Speaker 1: to exit stage left and we will see you next time. Now, 115 00:08:56,080 --> 00:09:00,520 Speaker 1: the civil rights movement in the US one many great 116 00:09:00,520 --> 00:09:05,520 Speaker 1: things for a nation's minorities, right, but these victories came 117 00:09:05,679 --> 00:09:09,080 Speaker 1: at a cost for the people who won them. Now, 118 00:09:09,080 --> 00:09:12,040 Speaker 1: I know a joke about vivl or revolution quite a bit, 119 00:09:12,360 --> 00:09:15,640 Speaker 1: or not as much recently because it's not as funny 120 00:09:16,200 --> 00:09:20,240 Speaker 1: when the world is burning. But people who look like me, 121 00:09:21,160 --> 00:09:26,040 Speaker 1: whied women, and just white people in general, a lot 122 00:09:26,080 --> 00:09:28,720 Speaker 1: of the time when they talk about revolution and switching 123 00:09:28,760 --> 00:09:32,719 Speaker 1: things up and fighting back and changing the system, they 124 00:09:33,000 --> 00:09:36,200 Speaker 1: very conveniently forget that it's always the most vulnerable members 125 00:09:36,240 --> 00:09:42,040 Speaker 1: of society who will be hurt first. Like you can't 126 00:09:42,120 --> 00:09:46,320 Speaker 1: make a normlet without breaking eggs. And I think that 127 00:09:46,360 --> 00:09:49,640 Speaker 1: people need to be aware of the exactly the consequences 128 00:09:49,640 --> 00:09:54,360 Speaker 1: of their actions and ensure that they are comfortable with 129 00:09:54,600 --> 00:09:58,679 Speaker 1: that of the consequences of that. Are they okay with it? 130 00:09:58,800 --> 00:10:04,280 Speaker 1: Is everything happy? Are they good with that? Can they 131 00:10:04,720 --> 00:10:08,280 Speaker 1: live with the consequences of their actions? So a lot 132 00:10:08,320 --> 00:10:12,960 Speaker 1: of the time they don't consider it, Like when people 133 00:10:13,000 --> 00:10:17,320 Speaker 1: demand change and they and they you know, they forget 134 00:10:17,320 --> 00:10:20,319 Speaker 1: that it's always going to be the marginalized who are 135 00:10:20,400 --> 00:10:28,640 Speaker 1: in you know, the firing line. But the civil rights 136 00:10:28,720 --> 00:10:33,760 Speaker 1: movement is and like a lot of people are aware 137 00:10:34,040 --> 00:10:39,480 Speaker 1: of the civil rights movement, but they manage to ignore 138 00:10:39,920 --> 00:10:46,600 Speaker 1: how black communities suffered through protests, riots, And I'm going 139 00:10:46,679 --> 00:10:53,120 Speaker 1: to call it vigorous police enforcement. Of course, discrimination from 140 00:10:53,160 --> 00:10:57,360 Speaker 1: this time, which almost no one knows about, which is 141 00:10:57,640 --> 00:11:02,800 Speaker 1: one that put a lot of black men into mental hospitals, 142 00:11:03,080 --> 00:11:09,920 Speaker 1: or at least tried to. So. The phrase protest psychosis 143 00:11:10,200 --> 00:11:13,760 Speaker 1: was not an official diagnosis that appeared in psychiatric manuals. 144 00:11:14,000 --> 00:11:16,480 Speaker 1: You couldn't walk into a hospital and be formally diagnosed 145 00:11:16,480 --> 00:11:21,839 Speaker 1: with protest psychosis. Instead, the term refers to a historical 146 00:11:21,880 --> 00:11:27,839 Speaker 1: phenomenon in which psychiatrists, institutions, and the media increasingly associated 147 00:11:27,840 --> 00:11:33,440 Speaker 1: schizophrenia with black political activism, anger, and resistance during the 148 00:11:33,440 --> 00:11:38,400 Speaker 1: Civil Rights era. In the following years, schizophrenia diagnosis in 149 00:11:38,600 --> 00:11:45,600 Speaker 1: angry black men skyrocketed. This is a very specific type 150 00:11:45,600 --> 00:11:53,520 Speaker 1: of schizophrenia. Right suddenly discovered paranoid schizophrenia, sufferers of which 151 00:11:53,559 --> 00:12:01,599 Speaker 1: were typified as having delusional anti whiteness, which is, frankly, considering, 152 00:12:01,760 --> 00:12:05,520 Speaker 1: you know, the lynching and the bombings and the segregation 153 00:12:06,040 --> 00:12:11,520 Speaker 1: and the arson and all of the medical experimentation, like, 154 00:12:13,280 --> 00:12:17,440 Speaker 1: how is that delusional anti whiteness? That is delusional for 155 00:12:17,480 --> 00:12:21,000 Speaker 1: black men not to be anti white after being through that, 156 00:12:22,960 --> 00:12:31,680 Speaker 1: and I know you might be thinking, were these psychiatrists racist? Yes, yes, 157 00:12:31,760 --> 00:12:37,679 Speaker 1: they were right, Like they reflected the social tensions of 158 00:12:37,760 --> 00:12:44,640 Speaker 1: nineteen sixties America, and so this influenced this, this decision, 159 00:12:45,040 --> 00:12:50,320 Speaker 1: It was enhanced by their inherent biases, Like this wasn't 160 00:12:50,360 --> 00:12:56,400 Speaker 1: a cold clinical decision. The new diagnosis procedures were heavily 161 00:12:56,800 --> 00:13:01,199 Speaker 1: intertwined with the cultural values of the day, sorry, the 162 00:13:01,280 --> 00:13:06,480 Speaker 1: cultural values of white doctors, leading them to create what 163 00:13:06,679 --> 00:13:12,680 Speaker 1: was essentially a modern version of drape domania, an illness 164 00:13:12,920 --> 00:13:19,760 Speaker 1: that was concocted to explain and rationalize why the enslaved 165 00:13:19,880 --> 00:13:29,679 Speaker 1: would so often flee their masters. So this diagnosis of schizophrenia, 166 00:13:30,040 --> 00:13:33,600 Speaker 1: it's it's a it's a big flip at this time period, 167 00:13:33,640 --> 00:13:40,280 Speaker 1: because schizophrenia had previously been associated with people, you know, 168 00:13:41,760 --> 00:13:47,360 Speaker 1: quiet withdrawn, often middle class white patients. Right, this somehow 169 00:13:47,480 --> 00:13:54,560 Speaker 1: becomes linked with angry black men protesting racial injustice. Now 170 00:13:56,480 --> 00:14:01,199 Speaker 1: it sounds convenient for those already empowered. Well, that's that's 171 00:14:01,760 --> 00:14:10,840 Speaker 1: one way of putting that. So there are thousands of 172 00:14:11,120 --> 00:14:16,800 Speaker 1: hospital records, psychiatric journals, advertisements for anti psychotic medications. There 173 00:14:16,800 --> 00:14:21,560 Speaker 1: were newspaper articles and institutional documents to trace how ideas 174 00:14:21,600 --> 00:14:29,640 Speaker 1: about schizophrenia evolved alongside changing racial politics in America, So 175 00:14:31,920 --> 00:14:40,120 Speaker 1: medicine strives to be objective humans not so much. Before 176 00:14:40,120 --> 00:14:44,840 Speaker 1: the nineteen sixties, schizophrenia was commonly portrayed in psychiatric literature 177 00:14:44,880 --> 00:14:50,640 Speaker 1: as an illness characterized by withdrawal, emotional flatness, passivity, and 178 00:14:50,800 --> 00:14:57,040 Speaker 1: retreat for reality. Images in medical textbooks often showed anxious 179 00:14:57,040 --> 00:15:02,360 Speaker 1: white housewives or socially isolated white men. Now, the illness 180 00:15:02,400 --> 00:15:07,440 Speaker 1: was frightening, certainly, but it wasn't generally portrayed as violent 181 00:15:07,800 --> 00:15:14,480 Speaker 1: or politically threatening. Then America changed. The civil rights movement 182 00:15:14,560 --> 00:15:18,520 Speaker 1: gathered momentum. You get sit ins, freedom rights, the March 183 00:15:18,600 --> 00:15:23,520 Speaker 1: on Washington, You've got up and uprisings, you've got police 184 00:15:23,640 --> 00:15:29,640 Speaker 1: violence broadcast on national TV, Black Americans demanding rights they'd 185 00:15:29,640 --> 00:15:34,760 Speaker 1: been promise for generations but consistently denied. And suddenly public 186 00:15:34,760 --> 00:15:43,680 Speaker 1: discussions about race became saturated with fear. Right, it's also okay, sidebar. Now, 187 00:15:44,840 --> 00:15:50,600 Speaker 1: if you listened to my history of Coca Cola episode, like, so, 188 00:15:50,640 --> 00:15:53,160 Speaker 1: coca cola used to have cocaine in it, and it 189 00:15:53,320 --> 00:15:58,040 Speaker 1: used to be cheap, right, so cheap that anybody could 190 00:15:58,080 --> 00:16:01,520 Speaker 1: afford it, even black people. And so there was a 191 00:16:01,720 --> 00:16:06,600 Speaker 1: fear that because of the cocaine in coca cola. The 192 00:16:07,040 --> 00:16:10,200 Speaker 1: black men were going to drink it and they were 193 00:16:10,200 --> 00:16:14,040 Speaker 1: going to violently attack white women. Like this was a genuine, 194 00:16:14,560 --> 00:16:17,960 Speaker 1: a genuine concern, and that is why they removed the 195 00:16:18,000 --> 00:16:27,960 Speaker 1: cocaine from Coca Cola. So fear there wasn't fear in 196 00:16:28,280 --> 00:16:33,440 Speaker 1: black communities right like they other was. I mean, they 197 00:16:33,480 --> 00:16:35,440 Speaker 1: had very good reasons to fear violence from the state. 198 00:16:35,640 --> 00:16:39,720 Speaker 1: But there was fear amongst white institutions that believed social 199 00:16:39,880 --> 00:16:45,480 Speaker 1: order itself was under threat. Place would somebody think of 200 00:16:45,560 --> 00:16:53,920 Speaker 1: the children? So this fear spread to politics, policing, journalism, 201 00:16:53,960 --> 00:17:03,400 Speaker 1: and popular culture and psychiatry changes to and increasingly psychiatric 202 00:17:03,560 --> 00:17:09,680 Speaker 1: articles began describing schizophrenia in terms of hostility, aggression, paranoia, 203 00:17:10,200 --> 00:17:15,560 Speaker 1: and violence, and some research chers explicitly linked these symptoms 204 00:17:15,680 --> 00:17:20,600 Speaker 1: to black men. Others suggested that the civil rights activism 205 00:17:20,680 --> 00:17:29,040 Speaker 1: itself reflected paranoid thinking or pathological hostility toward authority, delusional 206 00:17:29,480 --> 00:17:34,480 Speaker 1: anti whiteness. Now, before anyone starts shopping in pitchforks, you 207 00:17:34,520 --> 00:17:39,320 Speaker 1: know this is looking at history, looking at history, not 208 00:17:40,840 --> 00:17:47,760 Speaker 1: psychiatric mental health like as a whole. Now, there were 209 00:17:47,800 --> 00:17:51,720 Speaker 1: psychiatrists who disagreed with these ideas. At the time, and 210 00:17:51,920 --> 00:17:56,639 Speaker 1: others just accepting it without questioning it. There'll always be 211 00:17:56,720 --> 00:18:01,600 Speaker 1: some people who, you know, just take information willy nilly, 212 00:18:02,200 --> 00:18:04,639 Speaker 1: like people who watch Fox News, and there are some 213 00:18:04,720 --> 00:18:10,800 Speaker 1: who actually do a loveber research and pay attention. Now, right, 214 00:18:12,280 --> 00:18:18,840 Speaker 1: American society suddenly began imagining schizophrenia differently, right, and it 215 00:18:18,920 --> 00:18:22,240 Speaker 1: had surprisingly a little to do with neuroscience and quite 216 00:18:22,240 --> 00:18:24,479 Speaker 1: a lot to do with the politics of race, fea 217 00:18:24,480 --> 00:18:32,560 Speaker 1: and pillar in twentieth century America. And to basically understand 218 00:18:32,800 --> 00:18:36,840 Speaker 1: how schizophrenia became entangled with the race and protest, we 219 00:18:36,960 --> 00:18:41,560 Speaker 1: have to understand what psychiatrists thought schizophrenia actually was before 220 00:18:42,480 --> 00:18:45,880 Speaker 1: the Civil rights movement. And the story it doesn't even 221 00:18:45,920 --> 00:18:48,760 Speaker 1: begin in America. It starts in Europe or a really 222 00:18:48,800 --> 00:18:53,480 Speaker 1: good past a dish. So at the time of the 223 00:18:53,520 --> 00:18:59,960 Speaker 1: twentieth century, German psychiatrist Emil Krepelen discovered what you called 224 00:19:00,080 --> 00:19:04,840 Speaker 1: the dementia precox basically meaning early dementia. He believed it 225 00:19:04,880 --> 00:19:09,920 Speaker 1: was a disease that emerged in sort of I say, 226 00:19:09,920 --> 00:19:15,439 Speaker 1: youngin's youths, so adolescents or early adulthood, and it would 227 00:19:15,600 --> 00:19:20,280 Speaker 1: just inevitably result in mental decline. And it didn't last 228 00:19:20,320 --> 00:19:25,720 Speaker 1: little because in nineteen eleven, a Swiss psychiatrist, Eugene Brunell 229 00:19:26,440 --> 00:19:31,359 Speaker 1: argued that Creaplin had been too pessimistic, right, Like, patients 230 00:19:31,560 --> 00:19:36,240 Speaker 1: didn't always experience this inevitable deterioration, and their symptoms like 231 00:19:36,400 --> 00:19:44,040 Speaker 1: varied massively. So buler he bueler, bueler, bueler, bluler, listen Swiss, 232 00:19:44,080 --> 00:19:46,800 Speaker 1: it's hard to say it's full of holes. So he 233 00:19:46,880 --> 00:19:50,919 Speaker 1: coined a new term, schizophrenia from the Greek words you know, 234 00:19:51,320 --> 00:19:57,119 Speaker 1: skidzign meaning to split, and friend meaning mind. Contrary to 235 00:19:57,240 --> 00:20:04,119 Speaker 1: popular culture's favorite misunderstanding, he wasn't describing multiple personalities. He 236 00:20:04,280 --> 00:20:11,800 Speaker 1: meant like the breaking up, the fragmentation of mental processes, thoughts, emotions, 237 00:20:11,880 --> 00:20:16,919 Speaker 1: and perceptions. They kind of stopped working together in a 238 00:20:16,960 --> 00:20:21,600 Speaker 1: coherent way. That being said, this misconception somehow managed to 239 00:20:21,600 --> 00:20:24,160 Speaker 1: survive for more than a century, and at this point 240 00:20:24,280 --> 00:20:28,720 Speaker 1: deserves its own frequent fly on miles. So, throughout the 241 00:20:28,800 --> 00:20:34,000 Speaker 1: first half of the twentieth century, psychiatists genuinely characterized schizophrenia 242 00:20:34,160 --> 00:20:39,240 Speaker 1: through what today we'd call negative symptoms. So, like I 243 00:20:39,280 --> 00:20:44,920 Speaker 1: said earlier, patients were described as emotionally withdrawn, socially isolated, passive, apathetic, 244 00:20:45,000 --> 00:20:50,040 Speaker 1: and detached from reality. They might speak very little, show 245 00:20:50,080 --> 00:20:55,560 Speaker 1: little fashion expression, appear emotionally flat, retreat from friends and family, 246 00:20:55,720 --> 00:21:00,520 Speaker 1: spend long periods with their own thoughts. You know, just 247 00:21:00,560 --> 00:21:04,640 Speaker 1: an introvert caxt least alone. So the dominant image, right, 248 00:21:04,680 --> 00:21:08,440 Speaker 1: it wasn't one of violence or aggression. It was absence 249 00:21:08,520 --> 00:21:13,280 Speaker 1: of emotions, social engagement and motivation. Sounds a wee bit 250 00:21:13,680 --> 00:21:18,520 Speaker 1: like certain flavors of autism, doesn't it. I'm not trying 251 00:21:18,520 --> 00:21:26,840 Speaker 1: to diagnose anybody. I'm just saying so, if anything, schizophrenia 252 00:21:26,880 --> 00:21:31,080 Speaker 1: was viewed as an illness of retreat, raveling confrontation. Now 253 00:21:31,080 --> 00:21:37,040 Speaker 1: this distinction will become important later. American psychiatric textbooks through 254 00:21:37,080 --> 00:21:42,440 Speaker 1: the nineteen thirties, the forties, and the fifties repeatedly emphasized 255 00:21:42,480 --> 00:21:49,200 Speaker 1: these characteristics hallucinations and delusions. They did feature in clinical descriptions, 256 00:21:50,000 --> 00:21:53,239 Speaker 1: but they weren't always considered the defining characteristics as they 257 00:21:53,280 --> 00:21:59,840 Speaker 1: are today. Instead, it focused heavily on patience, appearing discan 258 00:22:00,320 --> 00:22:04,679 Speaker 1: from the world around them, and who were these patients? 259 00:22:04,920 --> 00:22:10,119 Speaker 1: According to psychiatric literature and popular media. More often than not, 260 00:22:11,400 --> 00:22:16,280 Speaker 1: they were white, not exclusively of gouse. That basically because 261 00:22:16,320 --> 00:22:21,160 Speaker 1: schizophrenia has never really respected racial boundaries. People of every 262 00:22:21,160 --> 00:22:26,440 Speaker 1: ethnicity and race have experienced this disorder because ethnicity and 263 00:22:26,520 --> 00:22:32,320 Speaker 1: race is different. Just feel like like okay, so it 264 00:22:32,400 --> 00:22:37,480 Speaker 1: is okay, no right, okay, sidebar. It's interesting, right because 265 00:22:38,840 --> 00:22:42,600 Speaker 1: like the amount that we know about the world in general, 266 00:22:42,920 --> 00:22:45,680 Speaker 1: the fact that people are still confusing ethnicity, race and 267 00:22:45,800 --> 00:22:51,040 Speaker 1: nationality like those are different things. And also race is 268 00:22:51,040 --> 00:22:55,040 Speaker 1: a social construct designed to keep the boot on the 269 00:22:55,119 --> 00:23:04,719 Speaker 1: neck of the marginalized, but representation metters. The photographs accompanying 270 00:23:04,800 --> 00:23:13,000 Speaker 1: journal articles, educational materials, and the pharmaceutical advertisements overwhelmingly featured 271 00:23:13,400 --> 00:23:21,720 Speaker 1: white patients, usually white women. Hospital case studies disproportionately centered 272 00:23:21,720 --> 00:23:26,680 Speaker 1: on white Americans, and the illness itself became culturally associated 273 00:23:27,440 --> 00:23:36,359 Speaker 1: with whiteness. Even more specifically, many portrayals focused on middle 274 00:23:36,440 --> 00:23:42,240 Speaker 1: class white women, so psychiatrical lecture of the day frequently 275 00:23:42,320 --> 00:23:47,560 Speaker 1: described housewives who had become emotionally detached, withdrawn from family life, 276 00:23:47,880 --> 00:23:51,359 Speaker 1: or unable to fill domestic roles society expected of them. 277 00:23:52,760 --> 00:23:56,480 Speaker 1: In the words, just take away seconds, you know, to 278 00:23:56,520 --> 00:24:01,119 Speaker 1: appreciate just how enthusiastically mid century America responded to women 279 00:24:01,560 --> 00:24:05,439 Speaker 1: who weren't coping particularly well with the impossible expectations placed 280 00:24:05,520 --> 00:24:10,480 Speaker 1: upon them, feeling overwhelmed by being expected to be the 281 00:24:10,480 --> 00:24:16,080 Speaker 1: perfect wife, the perfect mother, the perfect homemaker, impeccably dressed, permanently, cheerful, 282 00:24:16,240 --> 00:24:22,040 Speaker 1: and somehow fulfilled by waxing the kitchen floor. Well, have 283 00:24:22,160 --> 00:24:28,160 Speaker 1: you dried sedatives? Right? By the fifties and sixties, doctors 284 00:24:28,160 --> 00:24:33,560 Speaker 1: were prescribing tranquilizers to women at astonishing rates, drugs like 285 00:24:33,840 --> 00:24:40,080 Speaker 1: Milltown and Valium. Like these immortalized in the Rolling Stone 286 00:24:40,160 --> 00:24:44,359 Speaker 1: song Mother's that will helper right and like it was 287 00:24:44,440 --> 00:24:47,879 Speaker 1: known as Mother's little helper right, and this became the 288 00:24:47,920 --> 00:24:53,040 Speaker 1: pharmaceutical equivalent of putting a polite smile over systemic problems. 289 00:24:54,040 --> 00:24:58,880 Speaker 1: Because the message wasn't perhaps society she'd reconsider these impossible expectations. 290 00:25:00,200 --> 00:25:02,760 Speaker 1: It was more like, have a tablet and try not 291 00:25:02,880 --> 00:25:07,879 Speaker 1: to make everyone uncomfortable. And if medication didn't seem to 292 00:25:07,880 --> 00:25:14,320 Speaker 1: be helping well, psychiatrist still had other ideas, lobotomies, particularly 293 00:25:14,680 --> 00:25:18,640 Speaker 1: again in the forties and fifties. Of the early fifties, 294 00:25:18,880 --> 00:25:22,879 Speaker 1: these were performed on tens of thousands of Americans. Although 295 00:25:22,880 --> 00:25:25,960 Speaker 1: they were used for a variety of psychiatric conditions, including 296 00:25:26,200 --> 00:25:32,800 Speaker 1: civil depression, anxiety disorders, and schizophrenia. Women were disproportionately subjected 297 00:25:32,880 --> 00:25:38,240 Speaker 1: to the procedure I speak to the fucking brain. Sometimes 298 00:25:38,240 --> 00:25:42,280 Speaker 1: it was because they were genuinely severely ill, Sometimes because 299 00:25:42,320 --> 00:25:46,680 Speaker 1: they were considered emotionally unstable, difficult to manage, or simply 300 00:25:46,960 --> 00:25:51,800 Speaker 1: failed to conform to expectations of femininity. I don't know 301 00:25:51,840 --> 00:25:56,359 Speaker 1: if you know this, guys, but history does have a 302 00:25:56,600 --> 00:26:02,200 Speaker 1: habit of confusing noncomplain alliance with pathology, which we will 303 00:26:02,240 --> 00:26:08,080 Speaker 1: say more later. Now, schizophrenia was one of the conditions 304 00:26:08,080 --> 00:26:13,919 Speaker 1: for which lobotomies were attempted in some physicians genuinely hoped 305 00:26:14,080 --> 00:26:20,119 Speaker 1: the operation might relieve otherwise an untreatable psychosis, long before 306 00:26:20,280 --> 00:26:26,439 Speaker 1: antipsychotic medications existed. Now, by modern standards, the procedure is devastating, 307 00:26:26,520 --> 00:26:31,280 Speaker 1: often leaving patients profoundly disabled, and it has since become 308 00:26:31,320 --> 00:26:37,520 Speaker 1: one of the most infamous chapters in psychiatric history. Now, 309 00:26:37,880 --> 00:26:40,399 Speaker 1: the focus of this isn't that schizophrenia was treating with 310 00:26:40,480 --> 00:26:44,639 Speaker 1: lobotomies or sedatives like we know that. It's that the 311 00:26:44,840 --> 00:26:49,399 Speaker 1: image of schizophrenia, like before the Civil rights era, was 312 00:26:49,560 --> 00:26:54,639 Speaker 1: overwhelmingly domestic. It was the anxious housewife, the withdrawn daughter, 313 00:26:55,040 --> 00:26:58,399 Speaker 1: the emotionally distant women who no longer fit neatly into 314 00:26:58,400 --> 00:27:03,240 Speaker 1: society's expectations. Good thing we've done all that research on 315 00:27:03,320 --> 00:27:07,680 Speaker 1: women's health now, Good thing we know all about postpartum 316 00:27:07,760 --> 00:27:11,080 Speaker 1: depression and menopause and all that research we've done and 317 00:27:11,119 --> 00:27:16,720 Speaker 1: to endometriosis and everything that's been done. Right again, we're 318 00:27:16,720 --> 00:27:23,200 Speaker 1: still focusing on white women women like POC, like they've 319 00:27:23,200 --> 00:27:27,720 Speaker 1: had it much harder, Like it's just worse. An advocacy 320 00:27:27,840 --> 00:27:31,240 Speaker 1: is listen, okay, I'm just I'm getting angry now, So 321 00:27:31,359 --> 00:27:35,640 Speaker 1: let's not effectively the stereotype of the dangerous schizophrenic had 322 00:27:35,840 --> 00:27:38,240 Speaker 1: yet to take central stage, and that would come later. 323 00:27:38,640 --> 00:27:45,160 Speaker 1: And it wasn't an accident. See it's not that women 324 00:27:45,200 --> 00:27:49,600 Speaker 1: were actually more likely to develop schizophrenia than men, because 325 00:27:49,880 --> 00:27:54,480 Speaker 1: research suggests condition affects both sexes a broadly similar rate. 326 00:27:54,560 --> 00:28:00,000 Speaker 1: Those symptoms and age of they can differ, right. Rather, 327 00:28:01,480 --> 00:28:07,000 Speaker 1: it reflects who psychiatrists noticed, who sought treatment, who had 328 00:28:07,040 --> 00:28:15,119 Speaker 1: access to hospitals, and whose stories medical institutions chose to document. Medicine. 329 00:28:15,440 --> 00:28:19,560 Speaker 1: Quite like photography always depended on where the cameras pointed, 330 00:28:20,800 --> 00:28:23,800 Speaker 1: and for much of early twentieth century, the camera was 331 00:28:23,840 --> 00:28:27,240 Speaker 1: pointed firmly ad White America. I know you're shocked. Shocked. 332 00:28:30,000 --> 00:28:33,920 Speaker 1: State Psychiatric hospitals in the first half of the twentieth 333 00:28:33,920 --> 00:28:40,000 Speaker 1: century where enormous places. By the forties and fifties, many 334 00:28:40,040 --> 00:28:45,000 Speaker 1: housed thousands of patients, often in overcrounded conditions. They served 335 00:28:45,040 --> 00:28:50,600 Speaker 1: as treatment centers, but they also functioned as long term 336 00:28:50,680 --> 00:28:55,160 Speaker 1: custodial institutions. Like people didn't stay for weeks, they often 337 00:28:55,200 --> 00:29:03,160 Speaker 1: stayed for years, and they suffered because treatments I'm gonna 338 00:29:03,160 --> 00:29:08,640 Speaker 1: say a bit barbaric. They ranged from occupational therapy and 339 00:29:08,680 --> 00:29:14,800 Speaker 1: psychotherapy to insulin comma therapy, electro convulsive therapy, and of 340 00:29:14,840 --> 00:29:20,800 Speaker 1: course lobotomys. Antipsychotic medication wouldn't become widely available until the 341 00:29:20,800 --> 00:29:23,560 Speaker 1: mid nineteen fifties. Now, World War Two had a big 342 00:29:23,560 --> 00:29:29,200 Speaker 1: effect on this as well. So you have this society 343 00:29:29,400 --> 00:29:37,280 Speaker 1: where men of you know, races, religions, you know, society, cultural, 344 00:29:37,960 --> 00:29:42,440 Speaker 1: they're all going to war. There's conscription, there's all of this, 345 00:29:42,800 --> 00:29:48,440 Speaker 1: and televisions and radio communication is is vast, and so 346 00:29:48,520 --> 00:29:52,320 Speaker 1: people are learning things. More communication is shared and people 347 00:29:52,360 --> 00:29:56,120 Speaker 1: are understanding that you can rise up, you can fight, 348 00:29:56,240 --> 00:30:00,080 Speaker 1: you can grow and evolve and get rights, and and 349 00:30:01,000 --> 00:30:04,120 Speaker 1: women took a lot of jobs and helped industry survive 350 00:30:04,280 --> 00:30:09,400 Speaker 1: during the Second World War and the first. But after 351 00:30:09,440 --> 00:30:11,240 Speaker 1: which you know, they're getting all these rights, and they're 352 00:30:11,240 --> 00:30:12,920 Speaker 1: told they can get educated and they can do A, 353 00:30:13,040 --> 00:30:17,400 Speaker 1: B and C, and then they're pushed back into this role. 354 00:30:18,200 --> 00:30:23,320 Speaker 1: And just like Black America, they were expected to fight 355 00:30:23,360 --> 00:30:27,920 Speaker 1: for their country, but weren't expected to have rights in 356 00:30:27,960 --> 00:30:33,400 Speaker 1: that country, which is like you can die for the country, 357 00:30:33,720 --> 00:30:37,840 Speaker 1: or you're not allowed to vote, Like what fucking bullshit 358 00:30:37,960 --> 00:30:48,720 Speaker 1: is this? So much of psychiatric care, right it consisted 359 00:30:48,760 --> 00:30:53,920 Speaker 1: of observation, management, and containment, not really recovery. And these 360 00:30:53,920 --> 00:30:59,560 Speaker 1: hospitals reflected basically the broader inequalities in American society. Segregation 361 00:30:59,760 --> 00:31:06,320 Speaker 1: and side psychiatric institutions, it existed just as it existed 362 00:31:06,400 --> 00:31:10,840 Speaker 1: outside them. Black patients were frequently treated in separate wards, 363 00:31:11,000 --> 00:31:15,840 Speaker 1: admitted to underfunded hospitals, or just denied access to facilities 364 00:31:15,880 --> 00:31:22,360 Speaker 1: available to white patients. Resources were unequal, conditions were unequal. 365 00:31:22,800 --> 00:31:26,200 Speaker 1: Even medical records often differed in the level of detail 366 00:31:26,320 --> 00:31:32,760 Speaker 1: physicians recorded. So while schizophrenia was culturally imagined as a 367 00:31:32,800 --> 00:31:37,200 Speaker 1: disease of white withdrawal. Black Americans with serious mental illnesses 368 00:31:37,640 --> 00:31:41,160 Speaker 1: certainly existed within the psychiatric system, they just went on 369 00:31:41,200 --> 00:31:46,680 Speaker 1: the face of the diagnosis, at least not yet, because 370 00:31:47,880 --> 00:31:50,320 Speaker 1: over the next two decades, as the Civil rights movement 371 00:31:50,360 --> 00:31:55,840 Speaker 1: transformed American society, psychiatry's image of schizophrenia would undergo a 372 00:31:56,000 --> 00:32:02,160 Speaker 1: remarkable and troubling transformation. The biology of the illness hadn't changed, 373 00:32:02,920 --> 00:32:09,200 Speaker 1: the patients hadn't suddenly become different, but the stories America 374 00:32:09,280 --> 00:32:23,880 Speaker 1: told about schizophrenia were about to change dramatically. By the 375 00:32:23,960 --> 00:32:27,479 Speaker 1: late fifties, America was changing. Now you know what, changing 376 00:32:27,560 --> 00:32:30,479 Speaker 1: is a bit too gentle of a word, because it 377 00:32:30,520 --> 00:32:34,200 Speaker 1: was being forced to confront contradictions and had spent generations 378 00:32:34,200 --> 00:32:37,160 Speaker 1: pretending either doesn't exist or weren't quite as bad as 379 00:32:37,200 --> 00:32:40,760 Speaker 1: everyone was making out. It was, after all, the self 380 00:32:40,800 --> 00:32:44,520 Speaker 1: proclaimed leader of the free world, the nation that had 381 00:32:44,560 --> 00:32:50,040 Speaker 1: defeated fascism, the beacon of democracy, the country telling the 382 00:32:50,080 --> 00:32:54,920 Speaker 1: Soviet Union about the importance of liberty, all while millions 383 00:32:54,920 --> 00:32:58,400 Speaker 1: of its own citizens were legally segregated because of the 384 00:32:58,440 --> 00:33:05,160 Speaker 1: color of the skin, and this contradiction was becoming more 385 00:33:05,200 --> 00:33:10,840 Speaker 1: and more difficult to explain away. And like Okay, the 386 00:33:10,880 --> 00:33:15,680 Speaker 1: civil rights movement. It didn't just appear overnight. Black Americans 387 00:33:15,680 --> 00:33:21,880 Speaker 1: had resisted racial oppression for centuries, but during the nineteen 388 00:33:21,880 --> 00:33:26,920 Speaker 1: fifties and nineteen sixties that resistance became impossible for much 389 00:33:27,000 --> 00:33:30,920 Speaker 1: of white America to ignore it. In nineteen fifty four, 390 00:33:31,000 --> 00:33:33,840 Speaker 1: the Supreme Court ruled in Brownbee Board of Education that 391 00:33:34,080 --> 00:33:39,960 Speaker 1: racial segregation in public schools was unconstitutional. A year later 392 00:33:40,280 --> 00:33:44,000 Speaker 1: came the Montgomery bus boycott. And this is all sparked 393 00:33:44,000 --> 00:33:49,640 Speaker 1: by Rosa Park's refusal to suppender her seat. Now, side bark, 394 00:33:49,680 --> 00:33:52,120 Speaker 1: the story about Rosa Parks are like, oh, if you're retired, 395 00:33:52,200 --> 00:33:53,880 Speaker 1: I don't want to sit down. No, she was a 396 00:33:53,880 --> 00:34:00,280 Speaker 1: political activist and she chose to do that, right, she 397 00:34:00,440 --> 00:34:04,920 Speaker 1: was always going to stand up. Now, sit ins followed, 398 00:34:05,400 --> 00:34:10,960 Speaker 1: freedom rides, challenged, segregated into state travel. You had students marches, 399 00:34:11,239 --> 00:34:14,759 Speaker 1: you had churches they were organizing, You had communities that 400 00:34:14,840 --> 00:34:21,319 Speaker 1: were mobilized. And television cameras captured it all. And this 401 00:34:21,480 --> 00:34:25,279 Speaker 1: is the thing. Perhaps for the first time, millions of 402 00:34:25,400 --> 00:34:31,200 Speaker 1: white Americans watched peaceful demonstrators being attacked with police docs, 403 00:34:31,840 --> 00:34:36,080 Speaker 1: blasted with fire hoses, beaten by officers, and arrested for 404 00:34:36,200 --> 00:34:41,320 Speaker 1: simply demanding rights they had supposedly possessed all along. Because 405 00:34:41,680 --> 00:34:44,880 Speaker 1: the civil rights movement was not about creating ajustice, it 406 00:34:45,000 --> 00:34:48,480 Speaker 1: was about exposing it. And that is an important distinction, 407 00:34:50,040 --> 00:34:53,919 Speaker 1: because while many Americans watched these events with sympathy, as 408 00:34:53,960 --> 00:34:58,000 Speaker 1: did the rest of the fucking world, others saw something 409 00:34:58,040 --> 00:35:02,200 Speaker 1: really different. You know, they say that beauty is in 410 00:35:02,239 --> 00:35:06,120 Speaker 1: the eye of beholder. Also is everything, because your perception 411 00:35:06,320 --> 00:35:10,359 Speaker 1: on how you see the world will reflect on how 412 00:35:10,400 --> 00:35:16,200 Speaker 1: you think about it. Because some people didn't see people 413 00:35:16,239 --> 00:35:23,000 Speaker 1: standing up for themselves, those with the boot upon their neck. Instead, 414 00:35:23,040 --> 00:35:28,799 Speaker 1: they saw disorder, disruption, and authority being challenged and for 415 00:35:28,960 --> 00:35:34,880 Speaker 1: institutions built upon maintaining social order. That was unsettling, to 416 00:35:35,000 --> 00:35:39,840 Speaker 1: say the least. Now, after which came the urban uprisings. 417 00:35:41,040 --> 00:35:44,160 Speaker 1: Because starting and around was at the mid nineteen sixties, 418 00:35:44,800 --> 00:35:50,480 Speaker 1: cities across the United States experienced outbreaks of violence following 419 00:35:51,600 --> 00:35:57,560 Speaker 1: decades and I do mean decades of police brutality, discrimination, unemployment, 420 00:35:57,840 --> 00:36:03,560 Speaker 1: per housing, and systemic neglect. Harlem, What's Newark, Detroit like. 421 00:36:04,080 --> 00:36:08,920 Speaker 1: More than one hundred cities experienced significant unrest during what 422 00:36:09,000 --> 00:36:17,319 Speaker 1: newspapers increasingly described as race riots because it wasn't a 423 00:36:17,360 --> 00:36:20,279 Speaker 1: race riot. It's like we still use it today, and 424 00:36:20,320 --> 00:36:23,760 Speaker 1: sometimes I'll use it to name something so that people 425 00:36:23,840 --> 00:36:25,880 Speaker 1: know what I'm talking about, and then I'll go and 426 00:36:25,920 --> 00:36:29,360 Speaker 1: explain it because it's not a race riot. It's a rebellion. 427 00:36:29,440 --> 00:36:34,799 Speaker 1: It's an urban uprising. Because these events didn't just pop 428 00:36:34,840 --> 00:36:37,920 Speaker 1: it in a well. There weren't random explosions of chaos. 429 00:36:38,680 --> 00:36:44,799 Speaker 1: There were responses to inequalities and repeated confrontation with polace 430 00:36:44,840 --> 00:36:47,640 Speaker 1: and local authorities. Now that doesn't mean that every act 431 00:36:47,640 --> 00:36:51,960 Speaker 1: of violence is justified, right, we know that, Okay, don't 432 00:36:52,040 --> 00:36:57,800 Speaker 1: place hilly buggers with us. People died, homes and businesses 433 00:36:57,800 --> 00:37:03,359 Speaker 1: were destroyed, in an entire neighborhood suffered. There was room 434 00:37:03,440 --> 00:37:06,640 Speaker 1: to acknowledge both the structural injustices that fueled these uprising 435 00:37:06,719 --> 00:37:11,200 Speaker 1: and the very real human they imposed. You can't make 436 00:37:11,239 --> 00:37:17,319 Speaker 1: an omelet without breaking X. Understanding why something happened is 437 00:37:17,360 --> 00:37:21,560 Speaker 1: not the same as excusing like everything. So as the 438 00:37:21,640 --> 00:37:28,440 Speaker 1: decades were on, the atmosphere became more volatile. In sixty three, 439 00:37:28,840 --> 00:37:33,359 Speaker 1: John F. Kennedy was assassinated. In sixty five, Malcolm X 440 00:37:33,440 --> 00:37:39,800 Speaker 1: was murdered. In sixty eight, Martin Luther King Junior was 441 00:37:39,840 --> 00:37:45,400 Speaker 1: assassinated in Just two months later, Robert F. Kennedy was 442 00:37:45,440 --> 00:37:51,560 Speaker 1: shot while campaigning for the presidency. Now against this backdrop, 443 00:37:51,760 --> 00:37:55,800 Speaker 1: a new generation of activists began questioning whether nonviolent protest 444 00:37:55,880 --> 00:38:01,160 Speaker 1: alone could achieve lasting change. The Black movement emerged as 445 00:38:01,200 --> 00:38:07,360 Speaker 1: a broad political and cultural movement, emphasizing self determination, economic empowerment, 446 00:38:07,480 --> 00:38:14,120 Speaker 1: and community control. Like people are so focused on, oh, 447 00:38:14,160 --> 00:38:19,960 Speaker 1: it was a militia that they completely ignore. The Black 448 00:38:20,040 --> 00:38:25,239 Speaker 1: Panther Party established free breakfast programs, health clinics, educational initiatives, 449 00:38:25,560 --> 00:38:31,080 Speaker 1: ah while openly advocating armed self defense against police violence. 450 00:38:31,880 --> 00:38:34,320 Speaker 1: Pretty sure that's in the first is at the second Amendment? 451 00:38:34,800 --> 00:38:38,239 Speaker 1: The second Amendment, I'm sorry, you have a right to 452 00:38:38,280 --> 00:38:41,800 Speaker 1: a will armed militia. Well, there you fucking go, lads. 453 00:38:43,520 --> 00:38:50,560 Speaker 1: Supporters saw dignity, empowerment, and protection, and critics often saw militancy. 454 00:38:51,520 --> 00:38:55,439 Speaker 1: The media, unsurprisingly tended to find the photographs of young 455 00:38:55,480 --> 00:38:58,920 Speaker 1: black men carrying rifles considerably a bit more eye catching 456 00:38:59,480 --> 00:39:03,800 Speaker 1: than the pictures of children eating free breakfasts. Because conflict sells, 457 00:39:06,120 --> 00:39:10,799 Speaker 1: new ones always struggle to compete. But for many white Americans, 458 00:39:10,840 --> 00:39:15,320 Speaker 1: these overlapping crises created an overwhelming self that the country 459 00:39:15,400 --> 00:39:17,759 Speaker 1: was losing control. Oh, we want to get back to 460 00:39:17,800 --> 00:39:22,560 Speaker 1: the good old days. Public opinion poems throughout the late 461 00:39:22,640 --> 00:39:27,680 Speaker 1: sixties showed rising concern about crime, protest, and civil disorder. 462 00:39:28,600 --> 00:39:32,560 Speaker 1: Politicians increasingly campaigned with the promises of restoring law and order. 463 00:39:33,239 --> 00:39:36,600 Speaker 1: Newspapers filled their front pages with images of burning buildings, 464 00:39:36,719 --> 00:39:42,600 Speaker 1: armed protesters, and confrontations between demonstrators and police. Fear became 465 00:39:42,719 --> 00:39:49,600 Speaker 1: part of everyday political conversation, and fear has a remarkable 466 00:39:49,640 --> 00:39:54,920 Speaker 1: ability to shape the way societies interpret what they see. 467 00:39:55,120 --> 00:39:59,520 Speaker 1: An angry black activist demanding equal rights, a young man 468 00:39:59,680 --> 00:40:07,200 Speaker 1: con fronting police officers, someone expressing distrust of government institutions. 469 00:40:07,880 --> 00:40:13,839 Speaker 1: Right all, Oh this right today, we'd ask you know 470 00:40:13,920 --> 00:40:17,560 Speaker 1: what led them to those beliefs. But back in the 471 00:40:17,680 --> 00:40:21,320 Speaker 1: very tense political climate of the nineteen sixties, some people, 472 00:40:21,960 --> 00:40:27,200 Speaker 1: including psychiatrists, began asking a very different question. What if 473 00:40:27,239 --> 00:40:32,719 Speaker 1: this wasn't simply political anger? What if it was a symptom? Right? 474 00:40:32,880 --> 00:40:38,440 Speaker 1: And this would profoundly reshape the way schizophrenia was described, diagnosed, 475 00:40:38,440 --> 00:40:41,840 Speaker 1: and understood in America, not because the illness itself had changed, 476 00:40:41,880 --> 00:40:46,839 Speaker 1: but because America had now If the story ended with 477 00:40:46,880 --> 00:40:50,760 Speaker 1: growing social anxiety. It would already be an uncomfortable chapter 478 00:40:50,920 --> 00:40:54,120 Speaker 1: in American history. But it didn't end there because those 479 00:40:54,160 --> 00:40:59,799 Speaker 1: anxieties seeped into medicine, and not through one single conspiracy, 480 00:41:00,400 --> 00:41:05,319 Speaker 1: not because psychiatrists gabled and you know, smoke filled Room's 481 00:41:05,320 --> 00:41:11,480 Speaker 1: plot and to redefine it. It happened gradually, one journal article, 482 00:41:12,160 --> 00:41:18,040 Speaker 1: one revised diagnostic description, a hospital case, report of pharmaceutical advertisements, 483 00:41:18,880 --> 00:41:25,560 Speaker 1: right one by one, and over the course of the sixties, 484 00:41:26,040 --> 00:41:32,440 Speaker 1: the public image of schizophrenia had changed almost beyond recognition. Now, 485 00:41:33,360 --> 00:41:36,040 Speaker 1: if the idea of protest being treated as a symptom 486 00:41:36,400 --> 00:41:41,160 Speaker 1: sounds unbelievable, allow me to introduce one of medicine's all 487 00:41:41,400 --> 00:41:47,400 Speaker 1: time worst takes. In eighteen fifty one, American physician doctor 488 00:41:47,480 --> 00:41:52,440 Speaker 1: Samuel A. Cartwright coined the term drape to mania, in 489 00:41:52,480 --> 00:41:57,680 Speaker 1: which he claimed it was a mental illness causing enslaved 490 00:41:57,719 --> 00:42:02,920 Speaker 1: people to run away from their enslavers. Yes, you had 491 00:42:02,920 --> 00:42:09,239 Speaker 1: that correctly. Instead of maybe considering that people fled slavery 492 00:42:09,280 --> 00:42:14,760 Speaker 1: because it was slavery, Cortwright suggested the desire for freedom 493 00:42:14,880 --> 00:42:25,520 Speaker 1: itself was pathological. Sometimes gentle listeners history well hand as 494 00:42:25,560 --> 00:42:34,520 Speaker 1: an example of something so absurd that satire really becomes unnecessary. Now, 495 00:42:34,760 --> 00:42:39,320 Speaker 1: uptomania was never accepted as a legitimate scientific diagnosis outside 496 00:42:39,360 --> 00:42:44,160 Speaker 1: of a outside a small circle of pro slavery physicians, 497 00:42:44,160 --> 00:42:47,759 Speaker 1: and today it is universally acknowledged as pseudoscience rated in 498 00:42:47,840 --> 00:42:50,960 Speaker 1: racism rather than medicine, or as I like to call it, 499 00:42:51,360 --> 00:42:56,440 Speaker 1: absolute bollocks. But it is an important reminder that medicine 500 00:42:56,480 --> 00:42:59,440 Speaker 1: has at times been used to defend existing power structures 501 00:42:59,800 --> 00:43:05,480 Speaker 1: and instead of questioning them. Because when oppression is treated 502 00:43:05,520 --> 00:43:12,120 Speaker 1: as normal, resistance can begin to look like illness. It's 503 00:43:12,200 --> 00:43:14,719 Speaker 1: kind of like, how I'm going to talk about it? 504 00:43:14,760 --> 00:43:17,879 Speaker 1: You Now, Everyone's like, movies are so sidebar, movies are 505 00:43:17,920 --> 00:43:20,200 Speaker 1: so woke. Now, oh my god, I can't believe they 506 00:43:20,239 --> 00:43:23,000 Speaker 1: have an Asian man in the Odyssey. And it's like 507 00:43:24,560 --> 00:43:29,920 Speaker 1: that the ancient people who were known to travel and trade, 508 00:43:30,400 --> 00:43:39,240 Speaker 1: and you're surprised that one Asian person appeared in Greece. Really, 509 00:43:40,960 --> 00:43:47,759 Speaker 1: we know people traveled, okay, we know. It's like, oh, yes, 510 00:43:47,960 --> 00:43:52,160 Speaker 1: everyone just stuck within their own ethnically homogeneous groups, like 511 00:43:52,520 --> 00:43:56,320 Speaker 1: no one ever went anywhere before fourteen ninety two. Get 512 00:43:56,400 --> 00:44:02,839 Speaker 1: ta fuck pow, Like like this is such a wild thing. 513 00:44:02,920 --> 00:44:09,239 Speaker 1: It's it's like white people because they've we've been part 514 00:44:09,280 --> 00:44:12,520 Speaker 1: of the narrative for so long, and white men especially 515 00:44:12,560 --> 00:44:16,320 Speaker 1: have controlled the narrative that they see themselves as the default. 516 00:44:16,719 --> 00:44:18,919 Speaker 1: So whenever our character was not a straight white man, 517 00:44:19,600 --> 00:44:24,279 Speaker 1: it's often like seen as woke or odd or peculiar 518 00:44:24,360 --> 00:44:28,359 Speaker 1: or just some nonsense. And anything other than straight white 519 00:44:28,400 --> 00:44:34,719 Speaker 1: man is odd, unusual, different, it's not the standard, you know, 520 00:44:34,840 --> 00:44:38,359 Speaker 1: and it's so wild, like they just see themselves as 521 00:44:38,400 --> 00:44:46,120 Speaker 1: the default setting and not like okay, another sidebar. So 522 00:44:47,239 --> 00:44:50,880 Speaker 1: when I was studying history and so sociology, like I 523 00:44:50,960 --> 00:44:53,000 Speaker 1: studied a lot of it in the UK, and in 524 00:44:53,040 --> 00:44:56,240 Speaker 1: the UK right, we were told don't use POC people 525 00:44:56,239 --> 00:45:00,640 Speaker 1: of color, you use bab b ame, which is Black, 526 00:45:00,760 --> 00:45:05,200 Speaker 1: Asian and other minority ethnicities. Now that term is now 527 00:45:05,560 --> 00:45:09,640 Speaker 1: I'm gonna say, gone out of fashion because it's yeah. 528 00:45:10,160 --> 00:45:16,880 Speaker 1: So the other option is the global ethnic majority, because 529 00:45:16,920 --> 00:45:22,080 Speaker 1: white people are not the global ethnic majority, You're not. 530 00:45:22,760 --> 00:45:25,080 Speaker 1: So the fact that white people see themselves as the 531 00:45:25,200 --> 00:45:32,439 Speaker 1: default is very very funny, especially from a nation who 532 00:45:32,480 --> 00:45:37,879 Speaker 1: lives on stolen land, you know. So while protest psychosis 533 00:45:37,880 --> 00:45:40,520 Speaker 1: and dreup to mania emerged in very different centuries and 534 00:45:40,560 --> 00:45:45,520 Speaker 1: not of very different circumstances. They share an uncomfortable family resemblance, 535 00:45:46,320 --> 00:45:49,719 Speaker 1: and both asked the wrong question because they didn't ask 536 00:45:49,880 --> 00:45:54,080 Speaker 1: why are these people resisting? Instead they asked what must 537 00:45:54,160 --> 00:45:58,640 Speaker 1: be wrong with them? Because to understand their shift, we 538 00:45:58,680 --> 00:46:01,480 Speaker 1: need to talk about the Dieg Gnostic and Statistical Manual 539 00:46:01,520 --> 00:46:05,360 Speaker 1: of Mental Disorders otherwise known as the DSM just basically 540 00:46:05,800 --> 00:46:11,320 Speaker 1: psychiatry's real book, which, for the record, thid bar Stockholm 541 00:46:11,360 --> 00:46:15,000 Speaker 1: syndrome isn't in their Stockholm syndrome isn't real. You're confusing 542 00:46:15,040 --> 00:46:18,000 Speaker 1: that with several other different things that have been shoved 543 00:46:18,080 --> 00:46:21,320 Speaker 1: under the one umbrella instead of I'm not gonna say okay, 544 00:46:21,520 --> 00:46:24,040 Speaker 1: no no. Listen to the Stockholm syndrome episode if you 545 00:46:24,040 --> 00:46:28,520 Speaker 1: want to hear me rant about that. But the DSM 546 00:46:29,000 --> 00:46:33,720 Speaker 1: doesn't define diseases in the biological sense, right. It provides 547 00:46:33,760 --> 00:46:39,160 Speaker 1: clinicians with agreed descriptions of symptoms, helping doctors diagnose patients consistently. 548 00:46:40,080 --> 00:46:42,880 Speaker 1: The first edition the DSM one was published in nineteen 549 00:46:42,960 --> 00:46:46,760 Speaker 1: fifty two, and now by modern standards it is brief. 550 00:46:48,040 --> 00:46:51,400 Speaker 1: It reflected the influence of psychoanalytic thinking, and it's often 551 00:46:51,480 --> 00:46:57,360 Speaker 1: described mental illnesses and broad rather subjective language, and schizophrenia 552 00:46:57,480 --> 00:47:01,719 Speaker 1: was largely characterized by disturbances and things thinking, emotional withdrawal, 553 00:47:01,920 --> 00:47:07,320 Speaker 1: disordered relationships with reality, and what psychiatrists called autistic thinking, 554 00:47:08,360 --> 00:47:13,080 Speaker 1: a historical psychiatric term referring to withdrawal into one's inner world, 555 00:47:13,760 --> 00:47:17,720 Speaker 1: which is not autism spectrum disorder as we understand it today. 556 00:47:18,239 --> 00:47:22,680 Speaker 1: The emphasis remained largely on withdrawal, detachment, emotional distance, and 557 00:47:22,800 --> 00:47:27,360 Speaker 1: patients turning inward, But by nineteen sixty eight the DSM 558 00:47:27,480 --> 00:47:31,640 Speaker 1: two arrived. The manual still wasn't a checklist in the 559 00:47:31,680 --> 00:47:36,600 Speaker 1: way later editions would become, but the language surrounding schizophrenia 560 00:47:36,680 --> 00:47:44,240 Speaker 1: had noticeably shift. Descriptions increasingly highlighted hostility, aggression, suspiciousness, belligerence, 561 00:47:44,280 --> 00:47:49,279 Speaker 1: paranoid thinking. Patients were more frequently described as argumentative, combative, 562 00:47:49,480 --> 00:47:55,239 Speaker 1: and hostile towards authority figure. Now to be absolutely fair, 563 00:47:56,400 --> 00:48:03,000 Speaker 1: many people experiencing paranoid schizophrenia can develop persecutory delusions involving governments, 564 00:48:03,200 --> 00:48:09,560 Speaker 1: police neighbors, or authority figures. Modern psychiatry does recognize this 565 00:48:09,719 --> 00:48:16,360 Speaker 1: as one possible manifestation of psychosis. The issue was that 566 00:48:16,440 --> 00:48:24,640 Speaker 1: psychiatrists won't describing paranoia, The issue was whose paranoia they 567 00:48:24,680 --> 00:48:30,160 Speaker 1: were increasingly choosing to describe, because by the late sixties, 568 00:48:30,640 --> 00:48:35,719 Speaker 1: examples of suspiciousness toward authority were appearing in and in America, 569 00:48:36,320 --> 00:48:41,640 Speaker 1: where black citizens had a very good reason to distrust authority. 570 00:48:42,040 --> 00:48:49,040 Speaker 1: The FBI was monitoring civil rights organizations, police brutality was widespread, 571 00:48:49,880 --> 00:48:56,040 Speaker 1: and government agencies were infiltrating activist groups. In reality had 572 00:48:56,040 --> 00:49:02,719 Speaker 1: become rather inconvenient for symplastic psychiatric assumptions. So like in 573 00:49:03,040 --> 00:49:08,200 Speaker 1: psychiatric journals, right articles published during the late sixties began 574 00:49:08,239 --> 00:49:12,440 Speaker 1: presenting patients who claimed to be members of militant organizations, 575 00:49:12,920 --> 00:49:17,800 Speaker 1: believed they possessed revolutionary missions, or expressed intense hostility towards 576 00:49:17,800 --> 00:49:23,839 Speaker 1: white authority figures. Some papers explicitly linked schizophrenia with what 577 00:49:23,880 --> 00:49:29,960 Speaker 1: psychiatrists described as anti white hostility, militant political beliefs, or 578 00:49:30,320 --> 00:49:38,520 Speaker 1: delusional anti whiteness. Now, psychotic delusions frequently incorporate contemporary events. Right, 579 00:49:39,200 --> 00:49:42,760 Speaker 1: someone experienced psychosis today might believe they are being monitored 580 00:49:42,760 --> 00:49:47,520 Speaker 1: through social media or artificial intelligence because those are familiar 581 00:49:47,640 --> 00:49:53,080 Speaker 1: cultural reference points. A century ago, those same delusions might 582 00:49:53,120 --> 00:49:57,680 Speaker 1: have involved radio waves or secret societies, So the appearance 583 00:49:57,680 --> 00:50:03,440 Speaker 1: of civil rights themes in psycho wasn't that surprising. The 584 00:50:03,520 --> 00:50:08,319 Speaker 1: troubling is is why psychiatric literature increasingly appeared to treat 585 00:50:08,400 --> 00:50:13,239 Speaker 1: black political anger itself as evidence of illness, rather than 586 00:50:13,320 --> 00:50:18,839 Speaker 1: distinguishing between legitimate political grievances and genuine psychotic symptoms. Those 587 00:50:18,840 --> 00:50:23,400 Speaker 1: are two very different things, and medicine blurred that distinction 588 00:50:23,560 --> 00:50:28,520 Speaker 1: even more than we'd like to admit. Perhaps the most 589 00:50:28,760 --> 00:50:33,000 Speaker 1: visually striking evidence comes not from medical journals, but from advertising. 590 00:50:34,000 --> 00:50:38,560 Speaker 1: Throughout the nineteen fifties, advertisements for psychiatric medications generally depicted 591 00:50:38,960 --> 00:50:45,800 Speaker 1: quiet patient withdrawn women, despondent families, individuals isolated by sadness 592 00:50:45,920 --> 00:50:51,960 Speaker 1: or emotional detachment. And then came this sixties. Advertisements produced 593 00:50:51,960 --> 00:50:58,080 Speaker 1: by pharmaceutical companies published in respected medical journals aimed at 594 00:50:58,160 --> 00:51:08,000 Speaker 1: psychiatrists looking dramatically different. Gone all the housewives instead, Doctors 595 00:51:08,000 --> 00:51:12,520 Speaker 1: were shown illustrations and photographs of angry black men with 596 00:51:12,800 --> 00:51:17,440 Speaker 1: confrontational body language, clenched jaws and raised fitss, and sometimes 597 00:51:18,560 --> 00:51:23,440 Speaker 1: they explicitly connected schizophrenia with violence, riots, or social unrest. 598 00:51:25,480 --> 00:51:32,360 Speaker 1: Others used imagery, you know, weirdly reminiscent of the racial tensions, 599 00:51:32,400 --> 00:51:37,960 Speaker 1: dominating American headlines. Several featured black men whose expressions and 600 00:51:38,120 --> 00:51:43,760 Speaker 1: poses widely circulated news photographs of protests and urban uprisings. 601 00:51:44,800 --> 00:51:47,120 Speaker 1: And remember these adverts, they're not aimed at the public, 602 00:51:47,960 --> 00:51:52,800 Speaker 1: but aimed at the doctors. Because this is where it changes, 603 00:51:52,800 --> 00:51:58,879 Speaker 1: because schizophrenia is no longer passive, it's dangerous, and increasingly 604 00:51:59,520 --> 00:52:07,680 Speaker 1: schizophrenia looked black now. Pharmaceutical advertisements are marketing materials, not 605 00:52:07,760 --> 00:52:11,640 Speaker 1: scientific documents. They don't tell us how every psychiatrist thought. 606 00:52:12,280 --> 00:52:15,080 Speaker 1: Not do they prove that every doctor accepted these stereotypes. 607 00:52:15,120 --> 00:52:19,520 Speaker 1: But what they do reveal is advertising works by appealing 608 00:52:19,560 --> 00:52:25,440 Speaker 1: to assumptions its audience already recognizes because marketers don't invent 609 00:52:25,480 --> 00:52:29,200 Speaker 1: anxieties at ethanel, that's what Fox News does. Fuck, I 610 00:52:29,239 --> 00:52:32,040 Speaker 1: don't mean to Fox News twice. Can't do it a 611 00:52:32,040 --> 00:52:37,280 Speaker 1: third time. We'll find out if pharmaceutical companies believed images 612 00:52:37,280 --> 00:52:39,920 Speaker 1: of angry black men would resonate with psychiatrists in the 613 00:52:39,960 --> 00:52:43,640 Speaker 1: late nineteen sixties. That tells us something uncomfortable about the 614 00:52:43,640 --> 00:52:48,640 Speaker 1: cultural landscape in which medicine was operating. They reflected racial 615 00:52:48,640 --> 00:52:53,279 Speaker 1: stereotypes that were already circulating through American society and reinforce them, 616 00:52:54,560 --> 00:52:58,360 Speaker 1: and by the end of the decade, the transformation was remarkable. 617 00:53:00,000 --> 00:53:07,120 Speaker 1: Diagnosis associated with quiet withdrawal had become associated with confrontation, 618 00:53:08,640 --> 00:53:13,160 Speaker 1: one represented by white, middle class women, was increasingly represented 619 00:53:13,200 --> 00:53:17,800 Speaker 1: by black men. Biology hadn't changed, the brain hadn't changed, 620 00:53:18,840 --> 00:53:25,120 Speaker 1: but America m its imagination had. And when cultural imagination 621 00:53:25,239 --> 00:53:34,480 Speaker 1: begins influencing medical judgment, consequences don't exactly remain confined textbooks, 622 00:53:34,480 --> 00:53:38,840 Speaker 1: because these ideas weren't just appearing in journals and advertisements. 623 00:53:38,880 --> 00:53:43,799 Speaker 1: They were shaping real diagnoses affecting real patients admitted to 624 00:53:43,880 --> 00:53:50,000 Speaker 1: real psychiatric hospitals. Now it's tempting to just file this 625 00:53:50,120 --> 00:53:55,040 Speaker 1: neatly under wit. Thank goodness, we've moved up, because history 626 00:53:55,160 --> 00:53:57,000 Speaker 1: was probably a bit more comfortable if that was true. 627 00:53:57,040 --> 00:54:04,120 Speaker 1: But history does have that annoying habit of lingering, not 628 00:54:04,960 --> 00:54:11,600 Speaker 1: in obvious ways, sometimes in institutions, sometimes in statistics, sometimes 629 00:54:12,080 --> 00:54:15,760 Speaker 1: in memories passed quietly from one generation to the next. 630 00:54:16,800 --> 00:54:20,160 Speaker 1: And nowhere is that perhaps more evident than in the 631 00:54:20,200 --> 00:54:25,600 Speaker 1: relationship between black communities and the American healthcare system, because 632 00:54:25,640 --> 00:54:28,520 Speaker 1: one of the last in consequences of this is distrust. 633 00:54:29,680 --> 00:54:32,480 Speaker 1: Now you often hear people talk about distrust of medicine 634 00:54:32,480 --> 00:54:35,359 Speaker 1: and Black communities as though it appealed it in no well, 635 00:54:35,960 --> 00:54:39,040 Speaker 1: as though someone woke up one morning and just decided 636 00:54:39,480 --> 00:54:42,880 Speaker 1: doc just can't be trusted, because that's not how this works, 637 00:54:43,280 --> 00:54:49,040 Speaker 1: because trust is built on experience and mistrust is built 638 00:54:49,080 --> 00:54:53,360 Speaker 1: the same way. And for many Black Americans, medicine isn't 639 00:54:53,400 --> 00:54:59,920 Speaker 1: just associated with healing, it's associated with segregation. The Tuskegees 640 00:55:00,320 --> 00:55:06,359 Speaker 1: the study for sterilization, medical experimentation without consent, And as 641 00:55:06,400 --> 00:55:11,160 Speaker 1: we've explored throughout, I mean, if you go listen to 642 00:55:11,200 --> 00:55:16,520 Speaker 1: the Black History Month series, periods when psychiatry interpreted, you know, 643 00:55:16,640 --> 00:55:22,120 Speaker 1: responses to racism through the language of pathology doesn't mean 644 00:55:22,160 --> 00:55:26,040 Speaker 1: that every doctor was racist. It doesn't mean that psychiatry 645 00:55:26,200 --> 00:55:30,200 Speaker 1: is like uniquely flawed. It means that institutions are shaped 646 00:55:30,480 --> 00:55:33,480 Speaker 1: by the societies in which they exist, because if a 647 00:55:33,520 --> 00:55:37,239 Speaker 1: society carries prejudice, that's going to bleed into the institutions too. 648 00:55:39,080 --> 00:55:45,280 Speaker 1: And the protest psychosis isn't just like one outdated psychiatric theory. 649 00:55:45,440 --> 00:55:48,759 Speaker 1: It opened the door to decades of research examining how 650 00:55:48,840 --> 00:55:54,720 Speaker 1: unconscious bias can influence diagnoses. Black patients are more likely 651 00:55:54,800 --> 00:55:58,680 Speaker 1: than white patients presenting with similar symptoms to receive diagnoses 652 00:55:58,719 --> 00:56:02,879 Speaker 1: of schizophrenia or psychotic disorders, while white patients are more 653 00:56:02,960 --> 00:56:08,600 Speaker 1: likely to receive diagnoses such as mood disorders, including major 654 00:56:08,600 --> 00:56:13,960 Speaker 1: depression or bipolar disorder when psychotic symptoms are present. Doesn't 655 00:56:13,960 --> 00:56:17,719 Speaker 1: mean that every diagnosis incorrect or that you know it's 656 00:56:17,840 --> 00:56:22,680 Speaker 1: over diagnosed in every black patient, because mental illness is complex, 657 00:56:24,000 --> 00:56:31,239 Speaker 1: and it does suggest, though, that cultural assumptions influence this. 658 00:56:34,200 --> 00:56:38,160 Speaker 1: So imagine two patients. They're basically saying the same thing. 659 00:56:38,719 --> 00:56:43,200 Speaker 1: People in authority are watching me, right, and for one 660 00:56:43,440 --> 00:56:46,480 Speaker 1: they might hear like the doctor might hear paranoia, and 661 00:56:46,520 --> 00:56:51,720 Speaker 1: for another they might hear anxiety. Right now, you'd hope 662 00:56:51,800 --> 00:56:55,040 Speaker 1: that the doctor would do, you know, ask a couple 663 00:56:55,200 --> 00:56:59,680 Speaker 1: questions about previous experiences with authority, like placing your discrimination 664 00:56:59,760 --> 00:57:05,560 Speaker 1: before or like making conclusions, But sometimes they don't. So 665 00:57:06,400 --> 00:57:11,120 Speaker 1: removing contexts can basically change the meaning of what someone says. 666 00:57:13,280 --> 00:57:20,480 Speaker 1: So modern psychiatry it emphasizes cultural competence. Right, you're supposed 667 00:57:20,520 --> 00:57:25,480 Speaker 1: to have culturally informed or culture responsive care because basically 668 00:57:26,000 --> 00:57:31,760 Speaker 1: sidebar deciding whether a belief is evidence of psychosis, doctors 669 00:57:31,760 --> 00:57:36,120 Speaker 1: should ask whether that belief makes sense within the person's cultural, historical, 670 00:57:36,240 --> 00:57:39,720 Speaker 1: or lived experience, because if someone comes from a community 671 00:57:39,760 --> 00:57:44,160 Speaker 1: with a long history of discrimination, mistrust of institutions, right, 672 00:57:44,560 --> 00:57:50,400 Speaker 1: isn't irrational. If someone has experienced racial profiling, concerns about 673 00:57:50,480 --> 00:57:57,040 Speaker 1: future encounters with police also not irrational. It's not automatically paranoia. 674 00:57:58,680 --> 00:58:04,800 Speaker 1: So context is is relevant and understanding context doesn't prevent 675 00:58:04,880 --> 00:58:08,800 Speaker 1: doctors from diagnosing when it's genuinely present, right, It just 676 00:58:08,840 --> 00:58:16,200 Speaker 1: helps them distinguish between illness and experience. Now, if you 677 00:58:16,240 --> 00:58:19,360 Speaker 1: are listening during b IPOC, I can't want to call 678 00:58:19,360 --> 00:58:21,280 Speaker 1: it bipop is that I don't know if that's right, wrong, 679 00:58:21,760 --> 00:58:26,040 Speaker 1: It's it's a mental health awareness one month, BIPOC mentally 680 00:58:26,040 --> 00:58:29,640 Speaker 1: health awareness a month. And so this history is really important, 681 00:58:29,680 --> 00:58:32,520 Speaker 1: which is why this is a bit different to a 682 00:58:32,640 --> 00:58:36,040 Speaker 1: few other things that I've done. This is very a 683 00:58:36,160 --> 00:58:41,520 Speaker 1: very psychiatry leaden episode. I don't talk about it a lot, 684 00:58:41,560 --> 00:58:44,960 Speaker 1: but so when I was in college. But my main 685 00:58:45,040 --> 00:58:48,840 Speaker 1: areas of focus are history and sociology. But I do 686 00:58:48,880 --> 00:58:53,320 Speaker 1: have a supplemental background in psychology and social geography because 687 00:58:53,600 --> 00:58:59,800 Speaker 1: it's all interlinked. And so this is why this is 688 00:58:59,840 --> 00:59:02,640 Speaker 1: some thing I really I wanted to talk about because 689 00:59:02,640 --> 00:59:05,200 Speaker 1: this is the perfect time to do it. And I 690 00:59:05,280 --> 00:59:11,280 Speaker 1: understand that this is Oh god, it's a very dense 691 00:59:11,760 --> 00:59:15,040 Speaker 1: episode as opposed to this happened and then that happened, 692 00:59:15,040 --> 00:59:18,200 Speaker 1: and then the other happened. But it's important and I 693 00:59:18,280 --> 00:59:26,439 Speaker 1: was making this episode, so yeah. This month, BIPOC Mental 694 00:59:26,480 --> 00:59:30,360 Speaker 1: Health Awareness Month was established in the US to highlight 695 00:59:30,400 --> 00:59:34,320 Speaker 1: the mental health experiences of Black, Indigenous, and other peoples 696 00:59:34,320 --> 00:59:39,480 Speaker 1: of color. It's not just about increasing access to therapy 697 00:59:39,600 --> 00:59:42,560 Speaker 1: or encourage conversations about well being. It's part of it, 698 00:59:42,800 --> 00:59:47,760 Speaker 1: but it's about acknowledging history because people don't seek treatment 699 00:59:47,800 --> 00:59:52,720 Speaker 1: in a historical vacuum, and understanding why some communities distrust 700 00:59:52,760 --> 00:59:57,000 Speaker 1: mental health institutions. Isn't about assigning blame to today's doctors, 701 00:59:58,280 --> 01:00:03,840 Speaker 1: most psychiatrists, psychology some mental health professionals like most are 702 01:00:03,880 --> 01:00:08,400 Speaker 1: committed to providing ethical, evidence based care, but they have 703 01:00:08,480 --> 01:00:15,240 Speaker 1: to know that that trust has to be earned. Now. 704 01:00:17,560 --> 01:00:20,840 Speaker 1: Doctors don't stop being members of society when they put 705 01:00:20,840 --> 01:00:25,600 Speaker 1: on a white coat. Scientific progress doesn't happen in isolation 706 01:00:25,680 --> 01:00:29,960 Speaker 1: from politics, culture, or prejudice, and researchers don't lay the 707 01:00:30,000 --> 01:00:37,600 Speaker 1: assumptions at the lab door right, and diagnostic manuals right, 708 01:00:37,640 --> 01:00:40,680 Speaker 1: they're not. They're not gifts from fucking God. Right. They're 709 01:00:40,680 --> 01:00:46,920 Speaker 1: not like chiseled in stone tablets provided by the heavens. 710 01:00:47,480 --> 01:00:50,560 Speaker 1: They're written by people, which means they can improve, they 711 01:00:50,600 --> 01:00:56,919 Speaker 1: can be corrected, and they can also be wrong. Right now, 712 01:00:58,200 --> 01:01:03,280 Speaker 1: today's psychiatry very little resemblance to the field that I've 713 01:01:03,280 --> 01:01:09,760 Speaker 1: been describing of this episode. Diagnostic criteria has evolved, right, 714 01:01:09,920 --> 01:01:17,240 Speaker 1: it's gotten better, But clinicians are also really aware of 715 01:01:17,280 --> 01:01:23,080 Speaker 1: the ways bias can influence medical decision making. And I'm gonna, Okay, 716 01:01:23,160 --> 01:01:28,040 Speaker 1: I'm gonna throw some stats at you now because it's important. 717 01:01:28,960 --> 01:01:32,480 Speaker 1: Black patients are more likely to report not being believed, 718 01:01:32,640 --> 01:01:36,120 Speaker 1: and we see cases like this all the time. Twenty 719 01:01:36,160 --> 01:01:38,840 Speaker 1: two percent of black adults report that a healthcare provider 720 01:01:38,880 --> 01:01:41,800 Speaker 1: did not believe they were telling the truth. Nineteen percent 721 01:01:41,880 --> 01:01:45,640 Speaker 1: say provider refused to test or treatment that they believe 722 01:01:45,680 --> 01:01:52,240 Speaker 1: they needed, eighteen percent report being refused pain medication, and overall, 723 01:01:52,400 --> 01:01:54,680 Speaker 1: thirty six percent of black adults say that there was 724 01:01:54,720 --> 01:01:57,400 Speaker 1: a time they believed they would have received better medical 725 01:01:57,440 --> 01:02:02,680 Speaker 1: care if they were a different race. One in four 726 01:02:02,720 --> 01:02:07,320 Speaker 1: black adults report race related discrimination while receiving health care. 727 01:02:08,880 --> 01:02:13,920 Speaker 1: Negative health care experiences made patients delay seeking care, switch providers, 728 01:02:14,000 --> 01:02:20,400 Speaker 1: or avoid healthcare altogether. And perhaps what was probably the 729 01:02:20,400 --> 01:02:23,280 Speaker 1: clearest example of what happens when patients are not listened 730 01:02:23,280 --> 01:02:27,280 Speaker 1: to is maternal health care. Black women in the United 731 01:02:27,320 --> 01:02:29,840 Speaker 1: States were three and a half times more likely to 732 01:02:29,920 --> 01:02:33,800 Speaker 1: die from pregnancy related causes than white women. They had 733 01:02:34,200 --> 01:02:39,320 Speaker 1: around five times the mortality rate from preeclamsia. They had 734 01:02:39,440 --> 01:02:44,360 Speaker 1: six times the risk of dying from postpartum cardiomyopathy. This 735 01:02:44,440 --> 01:02:50,960 Speaker 1: is still happening. This is still happening today. Research consistently 736 01:02:51,040 --> 01:02:54,040 Speaker 1: finds that Black Americans are more likely to receive a 737 01:02:54,080 --> 01:02:58,240 Speaker 1: diagnosis of schizophrenia, while white patients presenting with similar effective 738 01:02:58,280 --> 01:03:02,080 Speaker 1: symptoms are more likely to receive the diagnosis of the 739 01:03:02,200 --> 01:03:08,600 Speaker 1: mood disorders. Now, this disparity has been documented across decades 740 01:03:08,880 --> 01:03:12,280 Speaker 1: of psychiatric research and continues to be an area of 741 01:03:12,320 --> 01:03:18,800 Speaker 1: active investigation. Now, that's a peculiar tradition in American history. 742 01:03:18,840 --> 01:03:23,320 Speaker 1: Where large numbers of people begin asking convenient questions, someone 743 01:03:23,440 --> 01:03:29,600 Speaker 1: eventually suggests they're not merely wrong, but mentally ill, and 744 01:03:29,720 --> 01:03:38,160 Speaker 1: so the protest psychosis enter droup dumania. Now Protest psychosis 745 01:03:38,240 --> 01:03:43,120 Speaker 1: was never a legitimate psychiatric diagnosis. It was, however, a 746 01:03:43,280 --> 01:03:49,360 Speaker 1: disturbingly influential idea that emerged in the late twentieth centuries. Psychiatrists, 747 01:03:49,800 --> 01:03:57,720 Speaker 1: law enforcement, and broader social anxieties overlapped, and during the 748 01:03:57,720 --> 01:04:00,760 Speaker 1: Civil Rights movement, research has proposed that black men involved 749 01:04:00,800 --> 01:04:06,360 Speaker 1: in protests and activism were more likely to develop paranoid schizophrenia. 750 01:04:07,040 --> 01:04:16,000 Speaker 1: Now this logic is circular, right, It is wow, Like, 751 01:04:17,000 --> 01:04:22,280 Speaker 1: if you believed the state were surveying, targeting, or oppressing 752 01:04:22,320 --> 01:04:29,280 Speaker 1: Black Americans, perhaps you were the one suffering from delusions. History, 753 01:04:29,320 --> 01:04:35,920 Speaker 1: of course, delivered one of its favorites plot twists. The 754 01:04:36,040 --> 01:04:43,560 Speaker 1: FBI really was surveying civil rights leaders. Quental pro really 755 01:04:43,600 --> 01:04:48,640 Speaker 1: did exist, Martin Luther King Junior really was? Why are tapped? 756 01:04:49,720 --> 01:04:54,720 Speaker 1: Turns out, accurately identifying institutional racism is not, in fact 757 01:04:54,800 --> 01:05:02,600 Speaker 1: a symptom of psychosis. How embarrassing for the diagnostic and 758 01:05:02,680 --> 01:05:07,160 Speaker 1: this idea of protest psychosis reflected something far more revealing 759 01:05:07,440 --> 01:05:12,320 Speaker 1: than any patient's mental state. It shows a society uncomfortable 760 01:05:12,360 --> 01:05:17,040 Speaker 1: with protests and is willing to medicalize political dissent rather 761 01:05:17,040 --> 01:05:21,400 Speaker 1: than confront the injustice is inspiring. It if someone is 762 01:05:21,520 --> 01:05:25,080 Speaker 1: angry because they're denied equal rights, perhaps the problem isn't 763 01:05:25,120 --> 01:05:31,720 Speaker 1: the anger. Perhaps possibly it is the denial of rights. 764 01:05:33,040 --> 01:05:36,280 Speaker 1: Now again to confirm, to clarify, this is not to 765 01:05:36,280 --> 01:05:41,200 Speaker 1: dismiss schizophrenia and other severe mental illnesses. They are serious 766 01:05:41,360 --> 01:05:46,440 Speaker 1: medical conditions affecting millions of people, and they deserve evidence 767 01:05:46,640 --> 01:05:52,160 Speaker 1: based treatment, free from political interference in social stigma. The 768 01:05:52,240 --> 01:05:56,080 Speaker 1: tragedy is that psychiatric language, which is intended to help patients, 769 01:05:56,720 --> 01:06:01,080 Speaker 1: is instead weaponized to undermine activists and re force existing 770 01:06:01,120 --> 01:06:07,560 Speaker 1: power struggles. Good thing they don't have that today. Medicine 771 01:06:07,760 --> 01:06:12,520 Speaker 1: is not immune to prejudice. Psychiatry, like every scientific discipline, 772 01:06:12,960 --> 01:06:18,520 Speaker 1: exists within society that produces it, and diagnoses have historically 773 01:06:18,560 --> 01:06:25,520 Speaker 1: reflected cultural assumptions, is much as clinical observation. We like, jeez, 774 01:06:27,480 --> 01:06:34,000 Speaker 1: homosexuality remained classified as a mental disorder in the DSM. 775 01:06:34,320 --> 01:06:38,720 Speaker 1: That's right, the Diagnostic and Statistical Manual of Mental Disorders 776 01:06:38,880 --> 01:06:47,440 Speaker 1: until nineteen seventy three. Right, Like how easy social discomfort 777 01:06:47,560 --> 01:06:54,160 Speaker 1: masquerades as medical certainty. Now, the lesson here isn't psychiatry 778 01:06:54,240 --> 01:07:00,080 Speaker 1: is inherently suspect. Science works best when it questions it 779 01:07:00,120 --> 01:07:05,000 Speaker 1: self as rigorously as it questions its subjects, because like 780 01:07:05,000 --> 01:07:07,600 Speaker 1: if a diagnostic manual start sounding, you know, like an 781 01:07:07,720 --> 01:07:11,120 Speaker 1: editorial in favor of the status quo, might be time 782 01:07:11,200 --> 01:07:19,440 Speaker 1: to review the methodology. That's a thing like protesting injustice 783 01:07:19,600 --> 01:07:26,120 Speaker 1: is not evidence of mental illness, it's not. It's making 784 01:07:26,160 --> 01:07:30,640 Speaker 1: demands for equality as symptoms of disease. Like that's that's 785 01:07:30,640 --> 01:07:37,760 Speaker 1: a pathology history has diagnosed quite harshly, and like and 786 01:07:37,800 --> 01:07:42,680 Speaker 1: when we talk about mental illness, when we talk about 787 01:07:42,720 --> 01:07:50,800 Speaker 1: it properly, you know, it's still seen with disdain. There's 788 01:07:51,280 --> 01:07:54,400 Speaker 1: there's a stigma still with it, so not only within 789 01:07:54,680 --> 01:07:59,680 Speaker 1: society as a whole, but especially within marginalized communities, because 790 01:08:01,080 --> 01:08:06,760 Speaker 1: black communities are always treated harsher than a white community. Right, 791 01:08:06,920 --> 01:08:12,200 Speaker 1: it's consistent. And I'm a white person, I'm privileged. Right, 792 01:08:12,240 --> 01:08:15,360 Speaker 1: i might be a woman, but I'm still a Mao sapien, 793 01:08:16,160 --> 01:08:17,880 Speaker 1: which puts me in a praise of privilege. And I 794 01:08:17,920 --> 01:08:21,120 Speaker 1: think people like me especially need to check our privilege 795 01:08:21,120 --> 01:08:25,200 Speaker 1: at the fucking door, you know, and actually look at 796 01:08:25,200 --> 01:08:30,240 Speaker 1: what's happening around us and need to learn to be uncomfortable. 797 01:08:30,800 --> 01:08:32,880 Speaker 1: I need to learn to do without in order to 798 01:08:32,920 --> 01:08:36,439 Speaker 1: help others and I think that's a big thing. Again, 799 01:08:36,800 --> 01:08:38,960 Speaker 1: this has been a very different episode to what I 800 01:08:39,000 --> 01:08:43,960 Speaker 1: normally do. But that is that is a story of 801 01:08:45,120 --> 01:08:53,799 Speaker 1: the protest psychosis and yeah, that's that's that. So who again, 802 01:08:54,120 --> 01:08:59,400 Speaker 1: very very dense episode, very laden with yeah. So with that, 803 01:08:59,479 --> 01:09:02,559 Speaker 1: I'm gonna be adi. I'm not gonna buy you ad 804 01:09:02,560 --> 01:09:05,639 Speaker 1: you though, I'm not because it's a recommendation time cyber. 805 01:09:05,680 --> 01:09:08,759 Speaker 1: Actually one more sidebar, one more sidebar. So basically, people 806 01:09:08,800 --> 01:09:12,479 Speaker 1: of color have always been judged more harshly than white 807 01:09:12,520 --> 01:09:17,080 Speaker 1: people and when it comes to being respected in spaces 808 01:09:17,120 --> 01:09:22,000 Speaker 1: as well, right, black people have to be more they 809 01:09:22,040 --> 01:09:29,599 Speaker 1: have had to be more serious. Like I remember when 810 01:09:29,640 --> 01:09:32,000 Speaker 1: the Chubby Bunny challenge was like a big thing like 811 01:09:32,160 --> 01:09:35,439 Speaker 1: this very many years ago. I'm I think I'm going 812 01:09:35,439 --> 01:09:38,559 Speaker 1: back nearly a decade for this, and it was basically 813 01:09:38,640 --> 01:09:41,040 Speaker 1: how many marshmallows can you put in your mouth and 814 01:09:41,080 --> 01:09:47,160 Speaker 1: then speak? And overwhelmingly white. You know, a lot of 815 01:09:47,200 --> 01:09:50,719 Speaker 1: black creaders weren't doing things like the Chubby Bunny challenge 816 01:09:50,760 --> 01:09:57,000 Speaker 1: because those silly challenges would be used to discredit them, 817 01:09:57,080 --> 01:10:00,439 Speaker 1: especially online educators and things like that. So you know, 818 01:10:00,600 --> 01:10:03,599 Speaker 1: you had to be very strict now, luckily things are 819 01:10:03,680 --> 01:10:06,799 Speaker 1: changing slightly, like we're kind of moving in the right direction. 820 01:10:07,600 --> 01:10:12,520 Speaker 1: But it means people like me, like people who have privilege, 821 01:10:13,080 --> 01:10:15,880 Speaker 1: you know, to show up, to stand up and support 822 01:10:15,960 --> 01:10:19,200 Speaker 1: and sometimes to shut our fucking mouths and listen to 823 01:10:19,200 --> 01:10:24,559 Speaker 1: what people are saying, because I understand the irony that 824 01:10:24,680 --> 01:10:28,000 Speaker 1: it's someone who talks about many things that are not 825 01:10:28,120 --> 01:10:36,919 Speaker 1: my race, religion, nation, that I'm always concerned about overstepping 826 01:10:36,960 --> 01:10:40,080 Speaker 1: the mark, and I do try and be respectful. But 827 01:10:40,280 --> 01:10:42,719 Speaker 1: the good thing is people are not shy about telling 828 01:10:42,760 --> 01:10:46,519 Speaker 1: me when I've buggled up, so that's really nice. But yes, 829 01:10:47,360 --> 01:10:51,360 Speaker 1: it's it's recommendation time. Let's let's wrap this up. So 830 01:10:51,400 --> 01:10:55,479 Speaker 1: it is recommendation time. Recommendation time for reading Blanche on 831 01:10:55,520 --> 01:11:00,439 Speaker 1: the Lamb by Barbara Neele what I like him Astray, 832 01:11:01,080 --> 01:11:04,720 Speaker 1: so for watching Write or Die It is my new 833 01:11:04,760 --> 01:11:08,879 Speaker 1: favorite thing. I love it so much. And for listening 834 01:11:09,760 --> 01:11:13,880 Speaker 1: listen to the Wine and Crime podcast. Just like those 835 01:11:13,880 --> 01:11:18,120 Speaker 1: are my girls. I love them so much. So with 836 01:11:18,200 --> 01:11:22,400 Speaker 1: that I shall bid you adieu adios au revoir if 837 01:11:22,439 --> 01:11:24,280 Speaker 1: we as them my friends. Bye bye,