Black and Blue: The Origins and Consequences of Medical Racism by Hoberman J

Author:Hoberman, J. [Hoberman, J.]
Language: eng
Format: epub
Tags: Medical, Health Care Delivery, Social Science, Ethnic Studies, American, African American & Black Studies, Anthropology, General, Archaeology, Minority Studies, Sociology, Discrimination, Disease & Health Issues
ISBN: 9780520274013
Google: dakwDwAAQBAJ
Amazon: 0520274016
Publisher: University of California Press
Published: 1978-10-09T00:00:00+00:00

This interpretation of time orientation in the ghetto provoked a forceful and disapproving response from the prominent black psychiatrist Carl C. Bell, who reported being “extremely disturbed” by an interpretation of black behavior that “left a bad taste in my mouth.” The overt disagreement with his white colleagues was that, after ten years treating ghetto patients, he had “a hard time believing that their original lateness stemmed from an orientation toward time that was deeply rooted in their fundamental Hoberman_Ch04.indd 185

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186 / Medical Apartheid, Internal Colonialism value system,” a phrasing that evokes one of the classic objections to the Moynihan Report’s critique of black “culture.” Lateness to appointments, he said, signaled an emotional vulnerability requiring an appropriate therapeutic response that should convey, among other things, an insistence on punctual behavior:

It has been my impression that the ghetto patient who casually fl oats in late to his session is being “cool.” It is extremely important that ghetto patients maintain some sense of power and control; to maintain this

“overcompensatory grandiosity” they may initially attempt to down-play the importance of the therapeutic relationship by casually fl oating in late to their sessions. This behavior will continue unless the therapist makes it clear that it will not be accepted. Allowing this behavior to go unchecked only develops and reinforces a defense that undermines the necessity of being on time for work.136

White therapists may be too intimidated to insist on punctuality from black clients, or they may “simply excuse the patient’s behavior as being culturally appropriate”—a naïve form of unwitting condescension toward the black patient and the “culture of poverty” that has deformed his relationship to time. White therapists can also mishandle the situation by misinterpreting sexual and aggressive behaviors “as being signs of impulsive behavior and therefore superego defi cits. I would hardly expect,” Bell comments, “such therapists to simply state that if the patient is late, he will not be seen.”137 On the contrary, having exaggerated the signifi cance of the sexual and aggressive behaviors in his black clients, the therapist would be inclined to favor the continuation of therapy for the purpose of treating these disorders.

It is important to recognize that black psychiatrists’ response to the perceptions and therapeutic strategies of their white colleagues operates on two levels. In the foreground is an apparently straightforward disagreement about whether most “ghetto” patients are willing to respect the rules of punctuality and show up on time for their appointments. While Bell claims that compliance with this requirement is “fairly high,” the white authors reply that their experience had been that “patients who are told fi rmly that they need to be on time before they have established a relationship tend to drop out in great numbers.” On a less obvious level, it is clear from his commentary that black practitioners regard this interchange as more than a disagreement about facts. The “bad taste” in Dr. Bell’s mouth is related in part to his judgment that references to “black people’s

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