Should Racial Trauma be in the DSM?

A thread.

#RacialTrauma #RacialTraumaisReal #psychology #Academic #BlackMentalHealth

1/16

Preface: This is my educated opinion. There are valid arguments on both sides of this issue.

2/16

The DSM (Diagnostic and Statistical Manual) is used to diagnose *mental disorders* in the U.S. It is not used as much internationally (ICD is). The DSM also has a big impact on research.

3/16

DSM-5: "A mental disorder is a syndrome characterized by clinically significant disturbance in...cognition, emotion regulation, or behavior that reflects a dysfunction in the...processes underlying mental functioning...usually associated with significant distress..."

4/16

"An expectable or culturally approved response to a common stressor...is not a mental disorder...conflicts that are primarily between the individual and society are not mental disorders unless the...conflict results from a dysfunction in the individual."

5/16

OK, definitions out of the way. (Also keep in mind the definition of mental disorder is debatable). Racial trauma partially fits the definition.

6/16

Racial trauma symptoms occur when the stress caused by chronic racism leads to emotional/psychological injury that exceeds one's ability to cope, resulting in traumatic stress symptoms (ie. distress).

7/16

However, these reactions can be seen as "expectable or culturally approved." I think even beyond this, many of these symptoms, like avoidance, negative (realistic) beliefs about the world, hypervigilance (vigilance?), are ADAPTIVE and can serve to aid survival.

8/16

Racism is ongoing, systemic and chronic. So changing reactions to racism (often change = MH treatment) may invalidate the individual's experience and can threaten the integrity of adaptive and helpful responses to racism. This can lead to shame, doubt and stigma.

9/16

Reasons to include it: Racial trauma sx *are* distressing and cause suffering. DSM is useful for coding treatment targets for insurance reimbursement. Could also be validating for people - to know that what they are experiencing is seen as real and they can be helped.

10/16

Are these benefits are worth the risks? Including racial trauma in the DSM could signal that traumatic stress in response to racism is maladaptive and results from a dysfunction within the individual. It can pathologize these reactions and those experiencing them.

11/16

One of the oppressor's tools is to take a source of power and to distort it. Pathologizing responses to racism that we have developed to survive - which have allowed us to survive when we were not meant to - is a form of oppression.

12/16

We don't want to make our ability to listen to our bodies, to stay alert, to avoid unsafe places, go away. What we want to do is harness the power of these abilities to help us survive and thrive.

13/16

The suggestion that responses to racism and systematic oppression are pathological, IMO, takes a major source of power from BIPOC, and suggests that it is abnormal. We need our ability to see through the layers of false politeness and gaslighting.

14/16

So I say: Do not be convinced that our special powers - the powers of discernment & awareness - are problems to be cured. Be very, very skeptical of this position. Does our suffering needs to be legitimized by mainstream, medicalized Clinical Psych?

15/16

Racial trauma symptoms are valid reactions to ongoing oppression.

When racism ends, we can put racial trauma in the DSM.

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