The De-Institutionalization of Racism

It is interesting but not surprising that Racism will not be listed as a mental disorder in the soon to be release DSM-V.  Almost invariably prominent psychiatrist and psychologist such as Dr. Carl Bell and Dr. Alvin Poussaint strongly suggest the inclusion of Racism as a mental illness.  Nevertheless, it will not be included.  The arguments against identifying Racism (even in its most extreme forms) as a mental illness state that it is a social problem not a mental disorder or racist beliefs are a part of the norm because so many people are racist.   Arguments are also made that having racism as a mental disorder would make it easier for persons committing racists acts to claim an "insanity" defense.  Well, these arguments and the fact that Racism will not be included in the DSM-V demonstrates the reality that Racism is institutionalized.  It has been and still is the norm in America.  

Adding Racism in to the DSM-V would have been a major step in de-institutionalizing racism.  The reality is that it is only a matter of time before it is de-institutionalized.  America is becoming more and more diverse and the non-white population is reproducing at a faster rate than the white population.  But what is also speeding up the process of de-institutionalization of racism is the fact that more and more of our children are growing up in a world that is less isolated and more appreciative of the richness of cultural diversity.   Our children are exposed to more alternative ways of looking at the world.  They are growing up knowing that the America and world we live in is much more than just Black and White.  However, as this process of the natural de-institutionalization of racism progresses, those that are afflicted must find ways to hide and disguise their affliction.  But it doesn't take much to see through the disguises.  It's like an alcoholic who is in denial or better yet a nicotine addict (by the way both of which are listed as mental disorders in the DSM-IV and will be in the DSM-V) that continues to smoke in spite of the harm that he or she suffers.

The Tea Party has given persons afflicted with racism a place of refuge and enabling of their affliction.  It is crystal clear to me that their cries for a more free America (which on the surface sounds commendable) are actually based in a fear that the America of old is changing.  The America where white Americans have privileges above other groups.  The America where one can pretend that poverty and injustice does not exist (and according to Michele Bachmann was only in the past).  The America that would be fair to everyone if it wasn't for government intervention. 

The first problem is that the image of America by the Tea Party folk is an illusion.  That America does not exist, has never existed, and will never exist.  Yet, based on their illusion they were recently able to hold the Congress hostage and threaten severe financial damage to millions of working Americans (the very same Americans they claim to be representing).  The question is: How did this happen?  Why is it happening?  I think Chris Rock said it best.  He compared the Tea Party and their activities to a toddler or small child just before they fall asleep.  They become very irritable, loud, and unruly and then... silence.

The Tea Party claims to be fighting for freedom just as those who participated in the "Boston Tea Party" did.  But their main actual function is to provide a means for persons afflicted with racism to publicly express their racism without it being called racism.  However, when you look closely at their behavior in relation to our President who is African American, it becomes very clear.  Because Racism is institutionalized and we have a Black President, it becomes acceptable to make statements like "our primary objective is to get rid of Obama at any cost" or "stopping Obama from being successful is job one."  President Obama could have a plan that would create millions of needed jobs, but the Tea Party would find a way to be against it.  For a person afflicted with Racism having an African American President is unacceptable.  For them it is a sign that America is going in the wrong direction.  They feel compelled to reverse the process no matter what; even if it means hurting all Americans along the way.  And being afflicted with Racism they would not hesitate to sacrifice segments of the population that are not a part of their "In Group".  The people outside of their group are not really "true Americans" (such as President Obama).  Their view of America and the world is extremely myopic and isolating.  Fortunately, they will be "sleep" soon.  The reality of the culturally diverse country that America has become will soon overtake their illusion of America that is rooted in the affliction of Racism.

The DSM-V will not include racism as a mental disorder, but I bet the DSM-VI will.

Introduction to Cultural Infusion

About 10 years ago in Chicago, Illinois the concept of Cultural Infusion was born.  It emerged out of a meeting of the Cultural Competency Committee of the South Shore/Chatham MISA Consortium.  The Consortium was made up of mental health and substance abuse treatment providers and consumers.  The main goal of the consortium was to facilitate the development of an effective continuum of care for persons with co-occurring disorders (mental illness and substance abuse).  While the professionals on the committee viewed the idea of cultural competency from a provider perspective the consumer on the committee viewed the issue from a consumer point of view where the consumer contributes (or detracts from cultural competency).  The consumer gave us examples of being in a group when a new member joins that is culturally different than the rest of the group.  He explained that it is very important that all group members respond with open minds to the new group member and not be biased against him or her. 


Us professionals on the committee (myself and Rafael Rivera) were focused on what the group leader should do as the person responsible for the group.  It hadn't occurred to us that the consumers in the group would have some responsibilities that would have a direct bearing on the usefulness and cultural competency of the group.  This revelation sent our discussion in a new direction as we discussed the importance of creating an atmosphere where people are free to be themselves and not feel pressure to conform to expectations coming from the group leader, the organization, or other group members.  Thus, the idea of creating an approach that establishes an atmosphere of openness and acceptance was born.  We decided to name the concept Cultural Infusion. 


Cultural Infusion is defined as:


The incorporation of culture and cultural identity into every aspect of treatment and organizational functioning.


Before I go any further lets define some of the terms commonly used in discussions of culture.  A very basic definition of culture is the collection of beliefs and practices that distinguishes one group from another.  Of course in reality it is much more complicated because there is so much overlap, interchange, and interaction among groups that it would be extremely difficult to find an individual that practices only one culture or belongs to only one culture.  We are all multicultural in one way or another in our daily behavior.  It has become necessary to be so.  Nevertheless, we tend to have a primary cultural identity.  Some of us identify with our primary culture very strongly while others are more fluid in our identification with a particular culture.  Also, different circumstances demand different cultural responses.  When we are around family we may behave and speak very differently than when we are at the doctor's office or at work.


Yet, we can define two major types of culture within this context.


1.  Popular Culture*
The unconscious fluid reaction to everyday life and environment.

2.  National Culture*

•Self-conscious collective thought and practice thru which a people creates itself, celebrates itself and introduces itself to history and humanity.

Examples of Popular Culture include:  

Hip-Hop

Country Western Music

High-heeled shoes

Shirts & Ties

Slang expressions

Local Vernacular

TV Shows

Hair Styles

& on & on
  

Examples of National Culture include:

Specific Language

Stars and Stripes

Red, Black, and Green Flag

National Anthems

Traditional Rituals and Celebrations

•Kwanzaa

•Cinco de Mayo

Cultural Songs and Stories
 

To conclude this introduction lets make some distinctions between Cultural Sensitivity, Cultural Competence, and Cultural Infusion. 

In Cultural Sensitivity the emphasis is on openness.  Each individual encountered is received and approached with an attitude of openness and non-judgment.  The provider attempts to be open to the culture of the individual they are encountering.  However, they may know very little about the culture and ignorant to biases they may possess towards the persons culture.  When European Missionaries went to Africa and other places with very different cultures they went with an attitude of openness.  Nevertheless, they came with many biases and assumptions and were most often very paternalistic. 

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In Cultural Competence the emphasis is on knowledge and understanding.  An effort is made to understand the culture and sometimes the language of the culture encountered.  Cultural nuances are discerned and understood.  The person becomes an "expert" on a particular culture or cultures.  While learning about a culture often assist with eliminating bias it is not guaranteed.  Even a person with the best intentions could maintain certain previously held biases unconsciously that would interfere with establishing healthy and therapeutic relationships.



In Cultural Infusion the emphasis is on acceptance.  The individual learns to accept people just as they are and accept the fact that they may have hidden biases that must be discovered.  Cultural Infusion goes both ways.  The person must be aware and comfortable with their own culture and cultural dynamics in order to accept the culture and cultural dynamics of another individual.  In Cultural Infusion biases are actively searched out and identified so that they can be released.  The person must be willing and able to accept another's culture on an equal footing with their own.  Sometimes this means elevating ones own sense of culturally identity at other times it means elevating the perception of the other persons culture.  Finally, Cultural Infusion is strength based.  An active process of identifying the strength of your own culture as well as the other person's is critical.
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In future blogs we will get into more detail on the various issues identified above and utilize many examples.  Bias, prejudice and racism are impediments to the building of healthy and therapeutic relationships and can be very harmful and destructive.  We will discuss these issues and go into great detail on how to deal with such problems whether you are the one who is biased or the object of the bias.
 

We will also discuss in detail the application and usefulness of the concept Cultural Infusion.

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*From Kawaida Theory by Maulana Karenga