The 48-year-old man turned down a job because he feared that a co-worker would be gay. He was upset that gay culture was becoming mainstream and blamed most of his personal, professional and emotional problems on the gay and lesbian movement.
These fixations preoccupied him every day. Articles in magazines about gays made him agitated. He confessed that his fears had left him socially isolated and unemployed for years: A recovering alcoholic, the man even avoided 12-step meetings out of fear he might encounter a gay person.
"He had a fixed delusion about the world," said Sondra E. Solomon, a psychologist at the University of Vermont who treated the man for two years. "He felt under attack, he felt threatened."
This isn't bigotry--it's a phobia, a rigidly held false fear. The case cited here is an example of an irrational fear that intrudes into the individual's life in unwanted ways. This man is not a homophobe.
I feel I need to make clear, based on what I am about to say, that I abhor hatred in all its forms--race, gender, religion, body size, or sexual status. It is never, under any circumstances, acceptable to treat anyone as a lesser person based on some form of hatred or bigotry.
That said, I think it's a mistake to pathologize hatred. To do so is to set up situations where KKK members will get therapy instead of prison for violence against groups they don't like. To declare racism a disorder is to absolve the individual of responsibility for his/her actions. The skinhead will be able to stand in the courtroom and say to the judge, in all seriousness, "I'm sick, judge, it's an illness. Please--I need help."
I hope I never see that day.
As human beings develop, one of the stages everyone must pass through has "fear of the other" as one of its components. If adults also hold this viewpoint, then the "other," in all its forms, is to be shunned, feared, hated, or killed. This is the foundation for tribal warfare, nation-states, gangs, racial identity groups, and all other forms of us-versus-them thinking. Most nations on the planet are still largely homogeneous, so nationality can still be a form of ethnic identity.
In the United States, however, we don't have that homogeneity. Further, we don't recognize ethnic separation as a tolerable stance any longer--even though it still exists in some areas of the country. This poses problems for people who live their adult lives within that ethnocentric developmental level, which for them is a worldview.
Some therapists aren't looking at the bigger picture and argue against a new DSM classification on anti-PC grounds.
Darrel A. Regier, director of research at the psychiatric association, said he supports research into whether pathological bias is a disorder. But he said the jury is out on whether a diagnostic classification would add anything useful, given that clinicians already know about disorders in which people rigidly hold onto false beliefs.I agree with both these doctors. Yet I think they are missing the point I was trying to make above. We cannot pathologize an entire developmental stage or its corresponding worldview.
"If you are going to put racism into the next edition of DSM, you would have enormous criticism," Regier said. Critics would ask, " 'Are you pathologizing all of life?' You better be prepared to defend that classification."
"I think it's absurd," said Sally Satel, a psychiatrist and the author of "PC, M.D.: How Political Correctness Is Corrupting Medicine." Satel said the diagnosis would allow hate-crime perpetrators to evade responsibility by claiming they suffered from a mental illness. "You could use it as a defense."
Most adults pass through this stage in childhood, but not everyone does or we wouldn't have racists, homophobes, sexists, and so on. These various -isms of hate are extreme forms of "fear of the other," but they should not be seen as pathological in a clinical sense. They do not require medication to cure. They develop as a result of isolationist thinking, which results in segregation and apartheid. They can be cured with information, reframing, and experience.
Racists in their twenties or thirties tend to outgrow that worldview by their fifties and sixties. Here is one view that explains this process in more detail.
[I]dentity development is influenced by personal experiences during the lifespan. For example, encounters in childhood may influence the kind of views that are construed about one's ethnic identity at an early stage. However, as the person develops through the lifespan and is exposed to numerous other encounters, these views may change as the person adapts his/her values, beliefs and attitudes. The qualitative differences generated through these encounters reshape the cognitive, emotional and attitudinal aspects of identity formation. Some aspects of early identity perception may be reinforced and become an integral part of the person's ethnic/cultural identity, whilst other aspects may be given to changes over time and through acculturation.This quote allows, as I maintain, that people can outgrow hatred. The authors also suggest, however, that ethnocentric beliefs can be reinforced and become permanent. While this may be true if left unconfronted--and assuming the individual(s) remain isolated from experiences that may trigger change--it is not reasonable or responsible to pathologize a behavior that can be reformed. However, the behavior should not be accepted or encouraged any more than one accepts a child throwing a tantrum whenever s/he wants attention.
Rather than pathologizing bigots, they should be given the opportunity to grow beyond their limited worldview--providing they have not committed any hate crimes. By providing an opportunity to gain new experiences and new understandings, many people who hold hateful views can learn to reject such narrow perceptions of the world.
Adding racism to the DSM is not going to do much for changing things. We need to think much earlier in the developmental process. Children are not naturally hateful. Adults turn a natural fear of "the other" into hatred by teaching hatred. If we want to eliminate bigotry, we need to start with children.