Psychiatry Ponders Whether Extreme Bias Can Be an Illness

I’m not sure how I feel about this. For people who are confronted with these issues and honestly want to change, I believe such a movement would be helpful. But I also worry that it becomes a crutch or an excuse for those looking to excuse their racist or prejudiced views, by simply claiming it’s a part of their disorder and they can’t help it. I think more research is needed before a final determination can be made, and such a diagnosis would be at least a decade away from ever becoming “official.” (It’s a slow, political and empirical process that leads to official diagnoses.)

Mental health practitioners say they regularly confront extreme forms of racism, homophobia and other prejudice in the course of therapy, and that some patients are disabled by these beliefs. As doctors increasingly weigh the effects of race and culture on mental illness, some are asking whether pathological bias ought to be an official psychiatric diagnosis.

Advocates have circulated draft guidelines and have begun to conduct systematic studies. While the proposal is gaining traction, it is still in the early stages of being considered by the professionals who decide on new diagnoses.

If it succeeds, it could have huge ramifications on clinical practice, employment disputes and the criminal justice system. Perpetrators of hate crimes could become candidates for treatment, and physicians would become arbiters of how to distinguish “ordinary prejudice” from pathological bias.

Several experts said they are unsure whether bias can be pathological. Solomon, for instance, is uncomfortable with the idea. But they agreed that psychiatry has been inattentive to the effects of prejudice on mental health and illness.

“Has anyone done a word search for ‘racism’ in DSM-IV? It doesn’t exist,” said Carl C. Bell, a Chicago psychiatrist, referring to psychiatry’s manual of mental disorders. “Has anyone asked, ‘If you have paranoia, do you project your hostility toward other groups?’ The answer is ‘Hell, no!’ ”

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 10 Dec 2005
    Published on PsychCentral.com. All rights reserved.