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Awareness: The Key to Black Mental Health, by Dr. Na´im Akbar

Most of the neuroses as we know them in America are unknown in cultures with limited contact with European values. Disorders such as female frigidity, sexual perversions, and extreme anxiety are essentially unknown in cultures with drastically differ

An increasing amount of rhetoric and discussion accompanied by a decrease in effective programs have come to characterize our orientation and attack on economic, social, political, and psychological problems of African people within the confines of the United States of America. Unfortunately, it has become more fashionable to offer extensive Marxian or other such impressive but distant theoretical descriptions of the problems confronting our people than it has been to provide relief from the economic blight still faced by a growing (yes, growing) number of black people. Drug use, Black—on—Black crime, suicide and other symptoms of social - emotional unrest increase despite the resounding cries of "Beautiful Black," how "together" we are, what the "honky" has done, is doing, or will be doing to us. The essential problem is that we have not followed through logically or practically on the awakening of the sixties during which an awareness began to surface of the dynamics of our condition in this country and in other parts of the world.

Black psychologists and professionals in other mental health fields have decried the application of inappropriate norms to the assessment of our problems. With few dissenting votes, we have condemned things such as IQ tests, personality inventories and other measures of psychological characteristics as inappropriate and destructive to our well—being. We have condemned white researchers and mental health workers as unqualified to define and provide solutions for the morass of problems which confront us. At the same time, we have so far failed to come forth with viable alternative solutions, which take into account our increased awareness of our condition in this country along with our true and historically legitimate characteristics as African people.

Let me assume that all of us have heard the basic arguments that have been put forth against the traditional conception of mental health problems. For those who are not aware let me recommend Black Rage by Grier and Cobb, and Dark Ghetto by Kenneth Clark as early attempts to analyze the mental condition of the black people of this country. The error made by these accomplished black scholars is that they redefine the cause and character of the mental health problems confronting our communities within the traditional context of Western psychology including its emphasis on pathology in their assessments. These social Scientists fail to fully accept a proposition implicit in their works - that most of the basic tenets of psychology have grown out of the attempts that Western men have made to understand the mental problems which occur within and as a consequence of their environment. The two premises that render such notions inappropriate to the problems of Blacks are:

(1) We are Africans (i.e., non-Western) in our basic dispositions; and

(2) the quality of our environment (by the mere factor of oppression) is systematically different from the environment which Western writers use as the point of departure for understanding their condition.

John Orley in Culture and Mental Illness, Freud in Civilization and its Discontents , and many other Western theoreticians have espoused the notion that mental illness is the price paid for "social development" or increased "civilization." The assumption here again is that increasing civilization and meaningful social development are directly proportional to the degree to which a people come to resemble the people of the Western world in their interactions, manners and concerns. In fact, though, these writers unwittingly provide a warning to people of the world that a pervasive backdrop of real pathology lies within the constructs of what is revered as Western culture.  American racism in its most insidious and sundry forms is only one of many symptoms underlying the insanity, which characterizes the Western world. This fact alone represents the certainty of mental disorder for African people who find themselves in a social setting controlled and maintained directly or implicitly by Western people. This style of black disorder is what I have referred to in an earlier paper as "white psychopathy." "White psychopaths" are black persons whose familial and cultural experiences have so duplicated the modal white experience in this country that they have in fact developed a Western consciousness which disposes then to markedly similar disorders as those experienced by Euro-Americans within their cultures. Most of the neuroses as we know them in America are unknown in cultures with limited contact with European values. Disorders such as female frigidity, sexual perversions, and extreme anxiety are essentially unknown in cultures with drastically different value systems and social organizations.

The treatment implication for Blacks with emotional problems of this nature is two-fold. On the one hand such individuals probably represent a sample of people who have systematically denied their disposition as African people. Secondly, these "patients" have overly identified with the wider cultural milieu to the extent that within their minds they have become Euro-Americans. To assist people suffering from such problems, it is necessary that we understand the nature of the Western mind which makes then vulnerable to such disorders and the characteristics which African people have assimilated leading them to the development of similar disorders. I suggest to you that one of these characteristics is the Western notion of individuality, which denies the interdependence of self and others. The idea that each person should "do your own thing" is an attitudinal construct which moves us away from the necessary control of our behavior by our own communities. There is no doubt that much of the distress experienced by black people today has to do with their passionate attempt "to do their own thing" and their discovery (often too late) that they have no "thing" to do. The priority value for any social group is the "thing" which assures the survival of that group first and secondarily the individual as a member of that group. It is no wonder that a growing group of middle-class black women have lost the innate disposition of sexual responsiveness. Many of these women have defined their "own thing" as the degree to which they can look, act, and feel like Elizabeth Taylor, Racquel Welch or other such models of white aesthetics. It is no wonder that we become depressed to the point of suicide if our growing preoccupation is the extent to which we have out performed our neighbor in a competitive situation which was without meaning or substance to begin with. There is growing evidence that the increase of suicide among black people is directly proportional to the extent to which those people have identified with the Euro-American value system which emphasizes the autonomy of the individual while simultaneously attributing all blame to the individual. 

Treatment for disorders such as these must rely on expanding the individualistic consciousness. The concept of consciousness is derived from the Latin phrase con scio, which means "with  knowledge." The helping person must concentrate on expanding the personal awareness and knowledge of the individual to better appreciate the aspects of the self, which are being denied in their attempt to follow faulty models. Those who are familiar with traditional methods of counseling and psychotherapy will recognize the proposition presented here as similar to the goal of most traditional counseling. This recognition is accurate. Implicit in the notions thus far presented is the idea that to the extent to which we have identified with Western people, we have also come to share much of their condition. Some of the methods, which have proved "effective" in the alleviation of that condition for them may, with appropriate modifications, be used in the alleviation of problems which we have developed because of our assimilationist attempts. An example of this proposition lies in the analogous introduction of venereal disease on the African continent by Europeans. Antibiotics are the treatment of choice for such a condition despite the fact that the origin of these diseases is based on the cohabitation of Africans and Europeans. We might extend the analogy by suggesting that although antibiotics may be effective in alleviating this unfortunate physical malady, Africans might have been protected from this disease had they the knowledge and been able or willing to protect themselves from the kind of contacts which led to the initial development of such conditions. 

In other words, I am suggesting that the traditional methods of increasing self-awareness by psychotherapy and counseling must be supplemented by systematic and structural instruction about the nature and acceptance of self. The parroting of European values and behaviors must be replaced by what a close friend and eminent colleague, Dr. Phillip McGee of Stanford University, has called the " restoration of African consciousness." The limitations of this discussion will not permit a full elaboration of this concept but it essentially challenges us to better understand and adopt those communal values and dispositions which underlie the survival of our people who, by all Western notions of physical and mental strength and endurance, should not have survived - but did!

Oppression Disorder

A second general classification of mental health problems of African people includes those disorders that are direct products of a colonialist system of oppression. I recommend the major works of Frantz Fanon (1963, 1967) for an exhaustive description of the dynamics of these ailments. Briefly, these are disorders which represent the self-defeating but adaptive attempts to survive in a society that maintains a system which renders your physical survival (when it occurs in conjunction with your basic African disposition) almost impossible. The pimp who maintains the African disposition of masculine assertiveness and flamboyance may become a sadistic brute and colonialist-like exploiter of his community. He is struggling to actualize these characteristics in a society that has defined the concept of masculinity as inconsistent with blackness and self-confidence as "nigger" arrogance. The junkie searches for an escape from a system that begins with a definition of him or herself as zero and systematically subtracting from them all factors that might increase their self worth. The junkie then attempts to sustain this form of escape through devices of theft, murder and indiscriminate destructiveness. The system then responds by perpetuating, (free of charge) the absence of consciousness called addiction while curtailing the detrimental by—products. Consequently, although the junkie’s awareness of self may be their most valuable asset in group and personal liberation, they are fed a solution like methadone which makes them safe, though asleep. 

There is much to be learned by a critical analysis of the work of one of the most effective social change and therapeutic agencies for Blacks in this country , i.e., the Leadership and Organization of the Honorable Elijah Muhammad. Regardless of the philosophical or ideological differences one might have with the Nation of Islam, we must recognize that Elijah Muhammad has accomplished with his followers what the "sophistication" of all Western technology, psychology and theology has failed to accomplish. The most superficial components of Elijah Muhammad’s teachings for the resolution of mental health problems within this category have to do with knowledge of self and self-help. The Muslim woman who recognizes and receives respect commensurate with the worth of a glorious black woman is incapable of becoming a prostitute. A junkie who has committed himself to the building of a nation based on equality, freedom and justice for himself and his kind (even by such a simple act as selling newspapers on a street corner) has no place for the "sleep" afforded by drug addiction. The alcoholic is unable to flood his body with poison when he or she believes in the essential beauty and worth of that body. 

In other words, I am suggesting that the key to treatment of this wide range of disorders (which represent attempts to escape self) lies in the basic acceptance of self and vehicles for the maintenance of self. Giving methadone to an addict with no job or job skills to provide for himself and those he loves is like putting out a fire with gasoline. Let’s be very clear that I am not referring to token programs that seek to rehabilitate by teaching basket-weaving when everyone uses plastic bowls. We are suggesting here that clear-cut procedure for the development of self-reliance must be provided. It is important to recognize the service needs of the communities where we live (and let us keep in mind that there is no end to the flight of whites from sharing of environments with Blacks) and prepare people to fulfill these needs. There are basic necessities from the provision of food and shelter to the manufacture and maintenance of technology that we must learn to depend upon ourselves to obtain. From entertainment to the reeducation of our children, after they have been subjected to a day’s worth of programming from the public schools, can be provided by the systematic training of many people who we have given up on because of their attempted escape by the use of drugs, prostitution, alcohol or other methods of self-destruction. The key here is that people who know themselves will love themselves and, if permitted, take excellent care of themselves.

Organic Disorders

I shall not spend extensive time on these conditions of universal occurrence. These disorders are primarily caused by physiological disorders within the occasional biochemical mutations of nature. We must, however, be ever cognizant of the interaction of the physiological with the psychological and of the psychological with the social. High blood pressure has been shown to have a markedly low rate of occurrence among people who have control over their basic life processes and who effectively manage their diets. As the pressures of urban living increase and the vehicles for alleviation of these pressures (such as the availability of jobs) decrease, the hypertension and many similar disorders show a marked increase. Many of the psychoses and especially "true" schizophrenia are increasingly being demonstrated to have biochemical bases. (I make a distinction here between what is in fact a basic disturbance in organizational and perceptual processes based on a biochemical imbalance and the unique behavioral patterns - such as paranoid adaptation, which I have discussed elsewhere - based on attempts to cope with an untenable and hostile environment). In such instances let us be made aware that most of the chemicals for the alteration of consciousness came out of African Science and spiritual practices, and the use of herbs and other forms of plant life to correct chemical imbalances. The difference between African administration of these drugs and the indiscriminate use of drugs by the Western medicine man is the Western emphasis on behavioral modifications rather than alterations of consciousness. The witch doctor applied his chemicals along with systematic re-education and community involvement as the treatment of choice for disorders of this nature. Family therapy is a recent arrival in the Western package of treatment for mental illnesses. Traditional African healers always engaged the entire milieu of the identified "patient" in the treatment process. Consequently, even in instances where the disorder can be identified within the somatic make-up  of the individual, the person’s re-involvement with their social group involves not only their individual treatment but a cooperative re-socialization within the known and identified social group. 

One additional example may further substantiate the point being made here. Senile psychosis and depression are described as natural deterioration of the nervous system -a function of the aging process. It is interesting to note that these disorders in Blacks have increased in incidence as our treatment of our aged has come to parallel the Western man’s treatment of his aged. As we remove our old people from the on-going living process by depositing them in tombs for the living (called "old folks homes"), we also initiate the deterioration processes which take on physiological characteristics. With the loss of meaning and activity of the mind, the body succumbs to death. 

Even in situations where the available knowledge suggests that the disorder is one of physiological origin, we must be in tune-with the critical variables that bridge that artificial Cartesian dichotomy of mind and body. We must be ready to cross that connecting bridge without an overemphasis on either mind or body. 

An underlying dictum throughout this discussion is the importance of sensitive diagnostic differentiation. Essential to understanding and treating mental disorders of African people (and all other people for that matter) is a sensitive ability to differentiate what is a condition of the environment; what is a condition of the individual; and what is the nature of the interaction between the two. This is the first step toward the classification and consequent application of treatment procedures to a particular disorder. The implication here is that the mental health worker must begin with sensitive self-knowledge that frees him from the biases of imposing an irrelevant theoretical conception on a reality that he does not understand.


This discussion formed on three basic assumptions about the mental problems of African people within the U.S.A.:

(1) the basic dispositions of African people differ from the basic dispositions and values of Europeans;

(2) the condition of oppression accounts for a wide range of mental disorders among African people; and

(3) deliberate attempts hamper knowledge of self (i.e., of group and environment) are the dynamic basis of mental problems among African people. Based on these assumptions, from a sensitive understanding and diagnosis of mental disorders, the treatment of choice becomes an initial effort to increase the individual’s knowledge of himself and his kind. An understanding of the system of oppression (awareness) is the hallmark of making systematic attempts to alleviate the condition of oppression and in turn, the behavioral consequences thereof. 

The most insidious device working against effective correction of mental disorders is the naivete of the mental health practitioner. Again let me refer to traditional African society where the healers were widely informed members of the tribe, not only in terms of the secrets of healing but in self- understanding and knowledge of the philosophical underpinnings of the tribal organization. This is a training that was passed down from father-to-son or mother-to-daughter, implying a need for lifelong skill and personal development. The ineptness of most contemporary mental health workers is a greater cause of ineffective treatment than any other single force.

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