RIchard Wright– Psychiatry Comes ToHarlem

8/12/2019 RIchard Wright Psychiatry Comes ToHarlem

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PHYCHIATRY COMES TOHARLEMb y R I C H A R D W R I G H T

We hear much of minorities minority rights. And we think of the Italian minorityin Y ugoslavia, or the Muslim minority in India. But we need not go so farafieldHere is a case study of merely one of the problems of one of the minorities in our owndemocracy, in our own New York City.

would be far easier to confiscate privateproper ty than to violate, under howeverlaudable a pretext , the contemporary metaphysical canons of organized medicine in America. Even if the pretext be that of chronichuman need, glar ing and scandalous, thesteady, unblinking eyes of American medicinewould look past that need and say in a toneless, neutral voice (as one doctor actually saidto me) : "We mus t wai t . These th ings mus tbe done in a s low, sound, t radit ional manner ."And the need would remain, fester , spread,while the canons of organized medicine wouldcon t inue to loom pure and u nadu l te ra ted .

Thurman Arno ld , in h i s Folklore of Capi-talism, says in effect that the more idealisticmen wax in defending an inst i tut ion, the moreone should suspect that that inst i tut ion hasbecome separated from the needs of realityand is serving narrow, anti-social ends; andthe more our inst i tut ions are divorced f rom theneeds of real i ty , the more urgently wil l men,responding to the desire to meet the needs ofreality, devise sub rasa, almost lawless or criminal methods to service the community, to healthe sick, to aid sufferers, to defend the victimsof injustice.PSYCHOLOGICALLY repressed need goesunderground , g ropes fo r an unguarded ou t le tin the dark and, once finding it, sneaks out,exper imental ly tast ing the new freedom, thenat last gushing for th in a wild torrent , f ranticlest a new taboo deprive it of the right to exist.As with the hu ma n personali ty , so with hu m aninst i tut ions which seek to administer to humanneeds. Social needs, too, go un derg rou nd whe nthey have been emotionally or morally rejected,only to reappear later in s trange channels and

in guises as fantastic as the images of a nightmare .This mechanism, of course, is an old story.We are famil iar with the technique by whichour Consti tut ion becomes more sacredly idealized in direct rat io to the means adopted to cir cumvent i ts essential spir i t and meaning.Indeed, one could state without a t inge ofcynicism, that the more idealistic the haze surrounding a public quest ion, the more l ikelyone is to find at its core corruption, ignorance,moral timidity, profit-seeking, and even justplain s teal ing.

O N E of the least thou ght of and most obviousexamples of "idealism protect ing corruption"is that of the total lackuntil very recentlyofany real, sustained psychiatric aid for the 400,-000 hapless black men, women, and childrenwho inhab i t a ghet to popu lar ly known asHa rlem . For more tha n 10 years a dem andin gyell has gone up from social reformers, doctors,and the clergy that a mental hygiene cl inic wasneeded to serve the artificially-made psychological problems of Har lem; that Har lem's 400,000black people produced 53% of al l the juveniledel iquen ts o f Manhat tan , which has a whi tepopulation of 1,600,000; that, while in theoryNegroe s have access to psyc hiatric aid (just asthe Negroes of Mississippi, in theory, haveaccess to the vo te ) , such aid really does n otexist owing to the subtle but effective racialdiscr imination that obtains against Negroes inalmost all New York City hospitals and clinics;that it is all but impossilale for Negro internesto gain admission to hospitals to receive theirpsychiatr ic t raining; and that the powerfulpersonality conflicts engendered in Negroes bythe consistent sabotage of their democrat ic

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aspirat ions in housing, jobs , educat ion, andsocial mobil i ty creates an environment ofanxiety and tens ion which eas i ly t ips the normal emotional scales toward neurosis .H OW did th i s s i tua t ion come about? W hatexcuses are offered to keep it in being? H owdoes organized med icine explain i t? T he following summarized l is t of medical object ionsto es tabl ishing a mental hygiene cl inic inHarlem might wel l seem sadis t ic , but i t shouldbe remembered that these object ions are uttered not only with s t raight medical faces ,but , i ndeed , wi th mora l so lemni ty .

Firs t , i t i s argued that the es tabl ishment of amenta l hygiene c l in ic in Har lem mus t wa i tupon the t ra ining of Negro psychiatr is ts to mansuch a clinic. Yet it is doubtful if there are eightpract ic ing Negro psychiatr is ts in the ent i re nat ion; race hate and the quota sys tem of ourmedical schools have made i t wel l -nigh imposs ible for a Negro to receive such t raining.

Second, despite the endless flow of blackmental pat ients to our s ta te and ci ty hospi tals ,doubt is expressed that need for a c l inic inHarlem is acute , for i t i s t radi t ional ly assumedthat Negroes would natural ly account for alarge pro po rt ion of the me ntal ly i l l . After a l l ,aren' t Negroes "pleasure-loving," " lazy," "shif t less," natural ly incl ined toward crime, s low ofcomprehension, and i rresponsible? (I take theseadjectives from official psychiatric court reports.)Third, i t i s i ronical ly charged that the es tabl i shment of a menta l hygiene c l in ic in Har lemwould be t an tamount to ex tending the a l readywell-set pat tern of racial segregat ion, and aren' twe all toda y op pos ed to segregation? (It isneat ly overlooked that Harlem i tself is an art i f ic ial ly m ade com mu nity )Four th , i t i s contended tha t the now-exis t ing ins t i tut ions serving the mental ly i l lmust be made to give up their racial prejudicesagains t Negroes . Th is conten t ion is no t onlyblatant ly i ronic , but playful ly sadis t ic , for nolawand there are ant i -discriminatory lawsprohibi t ing such pract icescan poss ibly cope

with the manifold dodges used by ins t i tut ionsto deprive Negroes of t reatme nt . I t is a mat te rof record tha t many ins t i tu t ions have doseddown de l ibe ra te ly ra the r than extend equa lt rea tment to Negroes .** Doro t hy N orma n , N . Y. Post c o l umni s t , wr i t i ng i n t heJun e 26, 1944 issue, c i ted the fol lowing: "I n Octob er, 1942, aRace Discriminat ion Amendment went into effect , denying c i tyfunds t o p r i va t e c h i l d -c a re a ge nc i e s whi c h r e fuse d t o t a ke Ne grochi ldren on the same basis as others . Seven priv ate agencieshave refused to accept c i ty funds ra ther than obey this law."

Fifth, many psychiatr is ts become dangerouslydefensive when pressed about their racialprejudices in relat ion to Harlem. They assertthat the psychiatr ic needs of Harlem, despi tefigures to the contrary, are no t more acute thanthose of any other sect ion, and that anyone whosays the opposite is merely trying to singleHarlem out for special a id, which indicates ,they claim, over-sensitivity.

Sixth, i t i s s ta ted tha t there are man y p rivatewhite psychiatr is ts avai lable to serve the peopleof Harlem, and i f the fees charged by thesepsychiatr is ts are rather high for poverty-s t r ickenNegroes , then i t should be remembered tha tpayment of psychiatr ic fees is considered anindispen sable ' pa rt of the psych otherap eut icprocess . And on and on . . .W E know now some of the " idea l s " tha t a rebe ing pro tec ted , but wha t k ind of cor rupt ionis bred when " ideal ism" blocks the extensionof services to a need y area? W it h the city ofNew York wal led racial ly agains t them, Harl em' s emot iona l ly d i s turbed mus t turn b l indlyto what is neares t a t hand for help; to thehordes of pet ty pol i t ic ians and racketeers ; tofantas t ic forms of violen t self-help (cri me );to the embracing of ever wilder out lets of racialemot iona l i sm which dr ives the bewi lde red menand women to demagogues; to the creat ion ofjuveni le gangs which are schools of crime; totrivial bribery; to the "pay-ofE" system; tothievery; to " log-rol l ing"; to cynicism; to theformation of ever more infant i le brands ofrel igion (Father Divine) and pol i tics (variet ies of na t ion al is m ); and, in the end (as canbe seen in the volat i le conduct of Harlemdur ing the war) , t o rac ia l outburs t s which canbe described as bru tal ins tances of spon taneou ssocial therapeut ics .

Thi s pa radox of " idea l i sm protec t ing cor rupt ion" he ld fas t for Har lem unt i l t he reoccurred to the one psychiatr is t who is s t r iving to bui ld a "social psychiatry," a bold, subrosa idea as to how to break the deadlock andsubvert the defensive " ideal ism" of psychiatryin New York C i ty . Dr . F reder i c Wer tham, oneof the nat ion's leading psychiatr is ts , devised as t ratagem that was extraordinary in i ts directness, s implici ty, honesty, and pass ion to serve.Wertham's a t t i tude is that psychiatry is foreverybody or none at a l l . He came to the conclus ion that "reform is poss ible only i f onekeeps away from the reform ers ." After 10years of fut i le pleading for the extension ofpsychia t ry to Har lem, Wer tham asked h imse l fand a dozen or more of his fr iends and aides .

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"if money is really necessary to start a mentalhygiene cl inic?" He suggested, "Why not beginwith out m oney? Let those of us who feel theneed contribute our services and see i f psychia t ry cannot be g iven to the poor . Le t ussee i f we cannot shorten the long, drawn-outmethods of psychotherapeut i cs . There mus t besome way to bring psychiatry to the penni lessurban masses . . ."When one reca l l s tha t modern psychia t ry goton i ts feet through the lush fees demanded ofr i ch pa t i en t s who sought i t s a id , Wer tham'sidea is indeed radical and the react ions to hisdaring proposal range al l the way from adenu nc ia t ion of i t a s imposs ib le to a b rand ingof i t as romantic .

We r t h a m o r g a n i z e d astaff whi te and Negro ,that would serve free, a staff composed of thebest technical ta lent in the ci ty, medical people and social workers of so high a s tandingin their respect ive f ie lds that no one woulddare quest ion their qual i f icat ions .The next s tep was the securing of space inan areaHarlemwhere space is t ruly at apremium; a t one t ime i t s eemed tha t theproject would fail for lack of space. At lastone of Har lem' s prominent Negro c le rgymen.Father Shel ton Hale, Bishop of St . Phi l ip 'sEpi scopa l Church , made ava i l ab le two roomsin the basement of his Parish House for theCl in ic . T hese rooms were cons ide red adequ a tefor a beginning , and the Lafa rgue C l in icquiet ly opened i ts doors on March 8, 1946, andis a t present operat ing two ful l evenings aweek. An d before any publ i c i ty had be en sentout , news of the exis tence of the Cl inic hadspread by word of mouth in Har lem and pat ients began to f low through i ts rooms. Withina month , appoin tment s had p i l ed up weeks inadvance .

JL HE sub rosa. me thod s of es tabl ishing theLafa rgue C l in ic amount in the main to a complete reversal of a l l current rules holding inauthori ta t ive psychiatr ic c i rcles . No referralsare needed to gain admiss ion to the Cl inic;anyone may l i teral ly walk in off the s t reets andtell his troubles. A fee of 25 cents per visitis charged, and 50 cents is charged for a courtappearance; but i f a pat ient lacks this , i t i swaived.

Though the Lafargue Clinic does exis t , therei s a wide ly preva lent fee l ing among many people that i t does not exist; i t i s apparent lyalmost psychological ly impossible for manyl i terate people to bel ieve that a c l inic could be

bui l t wi thout be ing backed by renowned commit tees and f inanced by wel l-known m ill iona i res . Thi s does not mean tha t the Lafargue Clinic does not need money; but i t doesmean tha t money of t imes monopol i zes the a t tent ion of those who seek to bui ld ins t i tut ionsto the extent of paralyzing their minds .T o d ate , most of the cases ha nd led by the

Clinic have been those of Negroes temporari lyswamped by the J im Crow condi t ions of Har l em, who would no doubt have been commi t t edfor indefini te periods of s ta te ins t i tut ions hadno t the Lafa rgue C l in ic in te rvened. On emonth ' s in t ens ive opera t ion has proved tha tHar lem' s h igh ra t es of de l iquency and nervousbreak-down s tem not from biological predi lect ions toward crime exis t ing in Negroes , butfrom an almost total lack of communityservices to cope with the problems of Harlem'sindiv idua l s .Thi s ex tens ion of psychia t ry to Har lem

mus t not be confused wi th phi l an thropy, char i ty, or miss ionary wo rk; i t i s the exten sion of thevery concept of psychiatry into a new realm,the appl icat ion of psychiatry to the masses , theturn ing of F reud ups ide down. The C l in ic hasfound tha t the mos t cons i s t en t the rapeut i c a idthat i t can render Harlem's mental ly i l l i sins t i l l ing in them wha t Wer tham ca l l s " thewil l to survive in a host i le world"; that themany Negroes s ink under their loads becauseof hopelessness, social fear, worry, frustration,and jus t p la in hunger .Organized medic ine has not ye t publ i c lyacknowledged the exis tence of the Lafargue

Clinic, but the ofiiciai attitude can be discerned by the refusal of New York City 'sDep ar tm ent of Wel fa re , so fa r , to ac t up on theClinic 's app l icat ion for a l icense. T h e W elfareoffic ials were so as tounded when they learnedof the Cl inic 's operat ion that they have not yetissued a l icense on the grounds t l ra t they arenot sat is f ied with the "f inancial background"of the new ins t i tu t ion . The C l in ic cont inues ,however, for its doctors are all duly licensedto prac t i ce medic ine , and they a re prac t i c ingi t in their new and unheard-of way, donat ingtheir services freely.Maybe one day somebody wi th mi l l ions ofdol l a rs , prompted by a benign vani ty whichthe Lafargue Clinic would surely diagnose asut terly normal , wi l l come forward and f inancial ly underwri te this new idea, thereby helpingto expand this social experiment in psychiatryand t ea r " idea l i sm" away f rom cor rupt ion andweld i t to human need, which is the way ofpass ion even in science.

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D I V I D E a n d C O N Q U E RGERMAN STYLE

b y W I L L I A M H A R L A N H A L E

WH A T i s de fea ted Germ any wor th? Judg ing from his recent den unc iat ion of theFrench plan for separat ing the Ruhr, Forei ignMini s t e r Molotov th inks tha t Germany i sworth more than France. Secretary of StateByrnes , meanwhile , is bidding for only half ofGermany; he regards the merging of the economies of the American and Bri t ish zones as soimportant as to be worth the r isk of endangering any ul t imate set t lement with the SovietUnion on Germany ' s over -a l l economic fu ture .Any way you look at i t , the bidding is pret tysteep.

There is this difference between the contes t an t s , t hough: whi l e Molotov ' s b idding maybe done in the name of expansion, Byrnes ' i sbe ing done in the name of economy. Whatworries the Americans in Germany is the prospect of having to manage, pol ice and feed15,000,000 Germans indefinitelya job whichseems not only unrewarding but i s ac tua l lycost ly to the American taxpayer. These Germans a re not turn ing out anyth ing l ike enoughindustr ia l goods to pay even for their own upkeep , let alone the costs of occupation.

The Russians obviously want to at t ract theGermans. The Americans act as i f they s implywant the Germans to pay the i r own way. Whi lethe Russians have decided to overlook the dissat is fact ion of the French Communis tstheirmost powerful s ingle fol lowing abroadin exchange for the support of the German populat ion nearer home, the Americans appear tothink of the balance of power in terms of balanc ing the budge t .

So the conflict is not only between wills butbetween values . I t i s qui te c lear whose valuesare on the defensive. The Russians , placing ahigh bid each t ime, have made off with thesepsychological prizes:

Firs t , by appearing as the champions of German terr i toria l integri ty (after having loppedoff their own share ) they step forth as thefriends and protectors of western Germany,right under the noses of the western al l ies ;Second, by calling for a strongly-knit, nat ional German government , they top the western al l ies ' bid for a loose-kni t , federal adminis t rat ion, and set themselves up as championsof unif icat ion. Meanwhile , in fact , they havebeen blocking al l moves in the direct ion ofunificat ion;Third, by boldly walking out on the al l iedpol icy of industr ia l removals and declaring theywil l now take a large port ion of their reparat ions out of current German product ion, theyemerge as the champions of the survival ofGerman indus t ryand make the undec ided

western powers look l ike vengeful Morgenthaumen by compar i son .In making these high bids , the Soviets know,exactly what they are after: the allegiance ofthe German masses . The di lemma of the western occupying powers arises from the fact thattheir s takes are lower and that each power hasits own special stake which sets it apart fromthe res t . The four contenders seem to ta l ly upl ike this :S O V I E T U N I O N . Aim: T o t ransform al lGermany into an al ly by means of a nat ionaladmini s t ra t ion domina ted by a Communis t - l edun i ted front ( the Socialis t Un i ty Part y) , and

control led from Berl in. Appeal: Directed no tonly to left -wingers , but to al l nat ional-mii jdedGermans, irrespective of class. Method: Expropr i a t ion of l anded and bus ines s proper ty andi ts redis t r ibut ion to peasants , smal l businessmen, e t c . , t hus forming new proper ty-hold ingclasses that owe their fortune to the Soviets.Special appeals to bureaucrats and former army52 F R E E W O R L D

RIchard Wright– Psychiatry Comes ToHarlem

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