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Influence of Drapetomania and Dysaethesia Aethiopica on Pathologisation of Black Resistance

Info: 2559 words (10 pages) Nursing Essay
Published: 27th Oct 2020

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Rascals and runaways were the words used to describe enslaved black people who fought for freedom in the antebellum South by Dr. Samuel Cartwright. The behaviours of the enslaved as observed by Cartwright led him to hypothesise that the actions were symptoms of illness. Cartwright created two diseases known to affect the “negro” and cause them to flee the plantation or to exhibit “rascality.” Drapetomania and Dysaesthesia Aethiopica were the terms respectively coined to diagnose the enslaved persons and their apparent ill-health. These diseases were published in The New Orleans Medical and Surgical Journal of May 1851.  The discovery of these diseases led to Cartwright becoming the authority on “diseases of the negro.”

This paper seeks to examine how Drapetomania and Dysaethesia Aethiopica, though now retired medical diagnoses, have influenced the modern-day pathologisation of black resistance and their associated movements.

Drapetomania was characterised by the enslaved person “absconding from service.” Cartwright asserted that this condition was a disease of the mind and was very curable by means of the whip at the first sight of the symptoms, such as sulky and dissatisfied demeanor. The masters could also prevent the possibility of Drapetomania by treating the enslaved “kindly” by providing food, clothes and fuel for a small fire and allowing the enslaved to have their own houses for their families (Cartwright, 1851). Cartwright also listed amputation of the toes as a simple cure for Drapetomania (Eze, 2011).

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While Drapetomania was a malady of only the mind, Dysaethesia Aethiopica was an illness of the mind and body. Characterised by “hebetude of the mind and obtuse sensibility of the body” (Cartwright, 1851) which manifested itself in ‘rascality’. Rascality was exhibited in behaviours such as careless movements, intentional mischief, the breaking, wasting and destroying of crops and tools, wandering about at night and raising disturbance with overseers and fellow servants. (Cartwright, 1851) These behaviours were accompanied lesions about the body, which were assumed to be physical symptoms of the condition. Negroes could be treated for Dysaethesia Aethiopica by washing the “afflicted” person with warm water and soap, anointing with oil and then proceeding to slap with a broad leather strap. After this curative treatment, the person should now be put to some hard kind of work (Cartwright, 1851).

Accompanying the pathologisation by Cartwright of what can be seen as resistance to the system of slavery in the South of the United States, there are numerous statements about the nature of the negro in the 1851. Cartwright states that “like children, they require government in everything.” He goes on to say that “every spot of earth they have ever had uncontrolled possession over for any length of time” was likely to become ‘like the ruins and dilapidation of Hayti [sic]” (1851). Cartwright went as far as to state that Dysaethesia Aethiopica was the “natural offspring of negro liberty - the liberty to be idle, to wallow in filth and to indulge in improper food and drinks.”

It can be seen from Cartwright’s narrative, the enslaved were to remain property as they were incapable of self-governance and if they attempted to be free, they would be afflicted with one of two illnesses of his own creation.

The historical thread of resistance as illness is further explored by Johnathan Metzl in his book where he investigates the interplay between race and psychiatric diagnosis. Metzl refers to the diagnosis of “protest psychosis” where black men exhibited hostility and aggression and developed “delusional anti-whiteness,” a projection of paranoia on to Caucasians by the Negro (Bromberg and Simon, 1968). The root of this behaviour was attributed to black men listening to Malcolm X and adopting teachings which advocated for equality and civil rights for black people. Bromberg and Simon, the authors of the original article ‘Protest’ Psychosis: A special type of reactive psychosis stated that this “protest psychosis” required psychiatric treatment as this posed a threat to the social order of white America (1968).

This comes a century after Cartwright’s diagnoses. The struggle of black people had changed; they were no longer fighting for freedom, but for rights. However, the diagnoses by the white clinicians remained the same; black peoples’ desire for freedom amounted to certain madness.

As we progress into the 21st century, Drapetomania has undergone rebranding. The new diagnosis for the insubordinate black person is Oppositional Defiant Disorder (O.D.D).  The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition states that O.D.D. is characterised by “angry and irritable mood, argumentative and defiant behaviour, and/or vindictiveness” (Grimmett et al, 2016). The behaviour must be disruptive to school, home or work life, exhibited to one individual who is not a sibling and persist for longer than 6 months (Grimmett et al, 2016). Oppositional Defiant Disorder is a childhood disordered characterised by resistance to authority (Graham, 2011). African American males were diagnosed with O.D.D. at a disproportionately higher rate than their White American counterparts (Grimmett et al, 2016). White males who exhibited similar behaviours were likely to be diagnosed with adjustment disorder rather than Oppositional Defiant Disorder (Grimmett et al, 2016). Grimmett (2016) further postulates that the higher rate of diagnoses may be due to low cultural competency of the practitioner, counsellor bias or misinterpretation of symptoms. In addition, the stigma of a diagnosis of Oppositional Defiant Disorder and the subsequent treatment of the diagnosed as problematic and disruptive severely impacts and disadvantages the affected person.

There are many similarities between the diagnoses referred to previously and Oppositonal Defiant Disorder. Lack of deference by members of the black community, adult or child, is chronically pathologized, while such behaviours exhibited by other ethnic groups are unlikely to receive the same diagnosis.

The common thread in the pathologised behaviours exhibited is the drive for freedom and retaliation to a form of authority. The concentration on the black man and the criminalisation and medicalisation of his reaction to trauma and oppression seems to be of particular interest to the field of psychiatry. These diagnoses are used to further justify the subjugation of black people, especially black men, as they pose dangers to society and order.

The final parallel I would like to draw between Cartwright’s diseases and modern-day appraisal of black resistance is a phenomenon known as the “Black Identity Extremist.” A leaked document from the Federal Bureau of Investigation in 2017 states that there has been an increase in violent behaviour by African Americans toward the police in retaliation to “perceptions of police brutality (FBI, 2017).” The document cites “anti-authoritarian, Moorish sovereign citizen ideology, and BIE ideology” as the motivators for this recent spate of attacks. The document also states that violence toward the police by “BIE’s” had not been perpetrated “for nearly two decades;" the peak of “BIE” violence was in the Civil Rights era in response to “changing socioeconomic attitudes and treatment of blacks. (FBI, 2017).” Hence, the acknowledgement that “Black Identity Extremist” activity is most prevalent at times of severe societal injustice against black communities. However, this information is cursorily mentioned, and it has been made to seem that the resistance and retaliation is the result of issues internal to the “extremist’ and external to society.

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This categorisation as Black Identity Extremists draws from narratives of violent extremism and radicalism. Violent extremism is defined as ‘violence committed by an individual and/or group in support of a specific political or religious ideology, and this term is often used interchangeably with terrorism’ (O’Driscoll, 2018). Extremism has been linked to mental illness and trauma (RAN, 2019). The article by the Radicalisation Awareness Network further states that precursors and preconditions or radicalisation include “interplay of diagnoses, psychosocial impairments, trauma, other personal factors, social dynamics and environmental stressors” (RAN, 2019). While this particular article does factor psychosocial and environmental contributors to extremism and radicalisation, this diagnosis is highly racialised like all others previously discussed.

The relationship between psychiatry and black people has been historically terse. As examined in this paper, the dissatisfaction with society and methods of showing such by marginalised people leads to more discrimination, medicalisation and stigmatisation of emotional responses. The scientism employed by psychiatry in an attempt to ground reality in science and solidify itself as a natural science is damaging to those that come into contact with the field. Dr Jose de Leon defines psychiatry as a “hybrid scientific discipline that should combine the methods of the natural sciences… and the social sciences” (Pies, 2016). In the five diagnoses highlighted in this paper, there is an exclusion of social factors from the diagnostic process. While many of the practitioners mentioned the possible social and environmental contributors to the observable behaviours which characterised a particular disease or disorder, this did not prevent the fault being placed on the individual and not on society at large.

Dr Kwame Anthony Appiah refers to the “cognitive incapacity” of the racist, which he describes as an irrationality, the inability and unwillingness to use evidence available to challenge a racist belief.  This cognitive incapacity is very explicit in the diagnoses of Cartwright and Bromberg and Simon. In the midst of social injustice, hostile environments and the withholding of basic rights from black people, their show of angst, frustration and trauma was declared a disease. Their desire for freedom was unfathomable to those who needed to rationalise their subjugation of masses of humans like themselves.

Oppositional Defiant Disorder while not as explicitly racialised as the aforementioned diagnoses, has been weaponised against black male children. Higher rates of diagnoses due to misdiagnosis and misrecognition of differences, cultural incompetency and internalised counsellor biases has resulted in African American males being labelled with a form of conduct disorder that severely limits their opportunities inside and outside of institutions. The stigma of a diagnosis of a mental disorder and the interplay with the other forms of societal oppressions, such as racism is especially disadvantageous to black individuals (Grimmett et al, 2016).

The final categorisation, Black Identity Extremism, though not a mental disorder is closely linked with mental disorders and ideological motivation. The document which outlines the behaviour of individuals classified as Black Identity Extremists clearly acknowledges the cause as the “perceived” police brutality, where a number of black persons have lost their lives in what should have been simple interactions with law enforcement. For the retaliation of the affected community to be labelled extremism, linked to radical ideology and to ignore the facts of unprovoked black death, certainly bears similarity to Appiah’s “cognitive incapacity” model.

In sum, the historical medicalisation of black peoples’ struggle for autonomy has been a cornerstone of scientific racism. The realities of oppression are ignored in the diagnostic process, as to acknowledge them would be to acknowledge the illness of society and not the individual. This medicalisation has grave consequences for the diagnosed. Many of these diagnoses, though based in very little reality, can result in real consequences for the individuals such as stigmatisation, incarceration and death. The further reaching effects of misdiagnosis and misrecognising of difference by the practitioner, is the alienation of black people from necessary mental health services. Black people are less likely to access mental health service ( citation), less likely to acknowledge  mental health issues ( cite ) and have poorer treatment outcomes ( cite).

The field of psychiatry should be a site of reparatory efforts for its contribution to scientific racism and the damaging effects to the communities it has targeted. When the internalised racism of the field is eradicated, it is hoped that this form of medicine would be able to serve as a method of human elevation.


  • http://mississippiencyclopedia.org/entries/samuel-adolphus-cartwright/
    Author(s): Emmanuel C. Eze
    Source: Callaloo, Vol. 34, No. 3 (Summer, 2011), pp. 877-898 Published by: The Johns Hopkins University Press
  • The protest psychosis: how schizophrenia became a black disease John Metzl
  • Reviewed Work(s): The Protest Psychosis: How Schizophrenia Became a Black Disease by Jonathan M. Metzl
  • Review by: Frank M. Johnson
    Source: The Journal of African American History , Vol. 97, No. 4 (Fall 2012), pp. 499-501
  • Published by: The University of Chicago Press on behalf of Association for the Study of African American Life and History
  • Myers, D. (2014). "Drapetomania": Rebellion, Defiance and Free Black Insanity in the Antebellum United States. UCLA. ProQuest ID: Myers_ucla_0031D_13159. Merritt ID: ark:/13030/m56d77cv. Retrieved from https://escholarship.org/uc/item/9dc055h5
  • ODD Medical text written June 2011 by Dr A Graham, Child and Adolescent Psychiatrist, Child and Family Consultation Centre, Richmond, London, UK. Accessed via https://contact.org.uk/advice-and-support/medical-information/conditions/c/conduct-disorder-and-oppositional-defiant-disorder/
  • The Process and Implications of Diagnosing
  • Oppositional Defiant Disorder in African
  • American Males
  • Marc A. Grimmett, Adria S. Dunbar, Teshanee Williams, Cory Clark, Brittany Prioleau, Jen S. Miller
  • O’Driscoll, D. (2018). Violent Extremism and Mental Health. K4D Helpdesk Report. Brighton, UK: Institute of Development Studies
  • RAN Policy & Practice 3 JUNE 2019, Paris (FR)
  • A mental health approach to understanding violent extremism
  • Pies, R. (2016). Science, Scientism and Psychiatry. Psych Central. Retrieved on November 5, 2019, from https://pro.psychcentral.com/science-scientism-and-psychiatry
  • Appiah, Kwame Anthony. “Racisms.” Chapter 1 in Anatomy of Racism. Edited by David Theo Goldberg. University of Minnesota Press, 1990. © University of Minnesota Press.
  • Nineteenth Century Review of Mental Health Care for African Americans: A Legacy of Service and Policy Barriers
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