Jonathan Metzl

Apparently many people need to be persuaded that doing the right thing is in their interest. Being anti-racist needs to be sold to White people as being inherently in *our* best interests as well, because simply benefiting people of color is not enough. While decades of evidence that trickle down policies do not benefit those (of any skin color) at the bottom rungs of capitalism, bottom-up policies seem to defy gravity in their trickle up effects. Unfortunately, many of those (White folks) show more at the bottom rungs cling to trickle down policies so that they can hold on to a few of their greatest privileges: those afforded them due to the color of their white skin, and the fact that they were born in the United States.

At any rate, this book quantifies the effects of austerity, White supremacy, and neo-liberalism and their exceedingly negative effects on White lives. (This is to say nothing of the lives of immigrants, people of color, and others, who have been living in a country both inherently and overtly hostile to their lives.)

Things I liked about this book: just about everything. Except, of course, for the fact that I'm living in this dystopian United States (albeit in a somewhat blue state).

Things I didn't like about this book: the author's claim that individuals in support of White supremacist policies "aren't racist" (not being an overtly racist person doesn't make one not racist, and if you don't believe this, you need to read more Ibram X. Kendi), pretty much all of the graphs and charts in this book (showing a relationship between two data points and calling it a trend... yikes, plus all of the other things that can go wrong with graphs, were done wrong in this book). show less

This is a study of the roots of toxic white masculinity in Missouri, Tennessee, and Kansas. Want to know why these despicables usually vote against their own well-being? The author, in meetings with low income white men (why he ignored women is another question), hears again and again how these men in ill health hated the Affordable Care Act because they didn't want to be lumped in with brown and black people, "Mexicans" and "welfare queens". Were there EVER truer words spoken than these by show more Lyndon Johnson: "If you can convince the lowest white man he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll empty his pockets for you.” It's difficult to gin up any sympathy for these people, or for their so-called leaders Kris Kobach, Matt Bevins, and Sam Brownback.

In Missouri, it's a pervasive identification with gun culture that keeps the suicide rate by gun much higher than neighboring Kentucky, where gun laws are stricter. Tennessee starts out with decent healthcare but then refuses to allow Medicaid expansion and the resulting decrease in life span of white men is glaringly obvious. In "The Kansas Experiment", a vast trashing of schools and infrastructure by raising taxes on poor and middle class people while slashing them for corporate overlords like the Kochs finally results in Republicans turning on themselves to fix it, and the results are so drastic that the state's formerly fine education facilities may never recover.

Quotes: "Politicians benefit by convincing different groups of Americans that they have nothing in common with each other."

"Trevor voiced a literal willingness to die, literally, rather than participate in a system that might put him on the same plane as immigrants or racial minorities. It's a complex dynamic in which poor white populations vote for politicians who enact cuts to government spending out of a combination of anger that the government is wasting money on "people who do not deserve it", alongside guilt that they themselves need help."

"...notions that white Americans should remain atop other racial or ethnic groups in the US social hierarchy, or that white "status" was at risk."

"...ironically harms the aggregate well-being of US whites as a demographic group, thereby making whiteness itself a negative health indicator."

"This logic suggests that men need to be on top because they embody no skills for acting otherwise."

"The intersecting trajectories of guns, whiteness, and privilege...address why people who feel their privilege was bestowed by guns might be so loath to give them up."

"Few people realize that the KKK began as a gun control organization that aimed to confiscate any guns that free blacks might have obtained...and thereby "achieve complete black disarmament."

"Guns became the totems for particular versions of white identity politics that rose with the Tea Party and soon encompassed the entire GOP."

"Not a single high-profile mass shooting in 2018 had been carried out using an illegally obtained weapon." show less

In one sense, you don’t need to read this book; Metzl introduces us to the thesis with one of his interviewees, a man dying of liver failure because of untreated hepatitis and hard living, who would refuse to sign up for Obamacare because he’s damned if Mexicans would take his money. That’s the book, in a nutshell. But if you can stand it, the examination of specific topics (guns and gun suicide in Missouri, health care in Tennessee, and educational funding in Kansas) is, while show more occasionally bogged down with numbers, penetrating and powerful. Metzl, himself white, has a lot of empathy for the whites he interacts with, while never losing sight of the fact that as a group they have made nonwhites suffer even more, for the sake of an evanescent privilege. He did a particularly good job of this with white male gun suicide, noting that most discussions of homicide seem more willing to break out race as a variable while the special vulnerability of white men to gun suicide went unaddressed. And while the epidemic of white male death by gun suicide can be connected to a “crisis of masculinity,” he points out that masculinity has been in crisis for a while; that the rhetoric of crisis can suggest that white men are so fragile that if they’re not in control they destroy things including themselves, while everyone else is supposed to be strong through adversity; and that most white men were never wealthy masters, making the conservative story of white privilege under threat a lie about the past as well as about the present.

I also liked the point that, although it’s simple to call white rejection of health care self-defeating/deluded, it has connections to other forms of protest through bodily suffering that liberal readers often treat with more sympathy (although he rarely fails to mention that the suffering chosen by white conservatives is also inflicted on many other people who didn’t choose it). On education, he argues that the long-term damage of major cuts is not just in educational and related health outcomes, but in expectations about what public education can be like, which affects views of what it should be like—which is, of course, part of the point of those who would destroy it. Things we did very recently—like funding higher education—slip from memory and become socialist pipe dreams. And they do so not naturally but because to forget them serves a set of wealthy people’s interests. show less

In The Protest Psychosis: How Schizophrenia Became A Black Disease, Jonathan M. Metzl writes, “Psychiatric definitions of insanity continue to police racial hierarchies, tensions, and unspoken codes in addition to separating normal from abnormal behavior” (pg. ix). He argues, “From a historical perspective, race impacts medical communication because racial tensions are structured into clinical interactions long before doctors or patients enter examination rooms. To a remarkable extent, show more anxieties about racial difference shape diagnostic criteria, health-care policies, medical and popular attitudes about mentally ill persons, the structures of treatment facilities, and, ultimately, the conversations that take place there within” (pg. xi). He draws upon “American medical journals, newspapers, popular magazines, pharmaceutical advertisements, historically black newspapers, studies of popular opinion, music lyrics, films, and civil rights memoirs” (pg. xii). Metzl concludes from the sources “that, far from being a timeless phenomenon, institutional racism waxes and wanes, becoming more powerful in the context of specific moments when racial tensions rise to the fore of American consciousness” (pg. xii). Metzl contributes to the historiography, by introducing a counternarrative in which “new notions of schizophrenia also provided powerful language for civil rights leaders, who argued that insanity and rage arose not because of defects in black bodies, but because of violent racist ideals that emanated from the white society in which these bodies lived and worked” (pg. xvi). Metzl draws extensively on the work of Michel Foucault, David Rothman, Nancy Tomes, and Angela Davis for historical and theoretical context, while a Foucauldian discourse runs through his work.

Metzl writes of the “process of racialization in which schizophrenia morphed from an illness of pastoral, feminine neurosis into one of urban, male psychosis, not just within American society, but within the asylum’s increasingly sturdy walls” (pg. 14). He continues, “The DSM-II criteria for schizophrenia, paranoid type, foregrounded masculinized hostility, violence, and aggression as key components of the illness” (pg. 97). Further, “The DSM-II functioned as an implicitly racist text because it mirrored the social context of its origins in ways that enabled users to knowingly or unknowingly pathologize protest as mental illness. This was because the 1960s was an era when the notion that large groups of people acted in hostile ways while rationalizing their aggression as a justifiable response to the attitudes of others was a tremendously powerful social message. But that group was not people with schizophrenia; it was people who were black” (pg. 98). Metzl details the work of Walter Bromber and Franck Simon, who described protest psychosis, a disease of their own invention that they used to pathologize all African American resistance to white society in the civil rights era (pg. 100). Metzl continues, “Whether intended or not, psychiatric discourse co-opted the protesting voices of social others, and then encoded the protest rhetoric into new definitions of schizophrenia. In a host of explicit and subtle ways, psychiatry thereby positioned itself as an authority that made sense of the crisis posed by angry, protesting black men during the civil rights era. And the moment of crisis bolstered psychiatry as an authority that treated cultural ‘pathologies’ in addition to individual illnesses for decades to come” (pg. 108, italics in the original). Analyzing the media, Metzl writes, “These articles deployed schizophrenia as a metaphor for fissured notions of American unity. Perhaps that unity was an illusion before civil rights, the logic implied, when two races lived next to each other much like two hemispheres of the brain” (pg. 114).

Discussing psychology in the legal arena, Metzl writes, “The work of the psychiatrist Frederic Wertham and the psychologists Kenneth and Mamie Clark, among others, gained prominence during the Brown v. the Board of Education of Topeka ruling in 1954. The Clarks provided expert testimony about the results of their infamous doll studies in Briggs v. Elliot, one of the cases later combined into Brown v. Board, in which children’s preference for playing with dolls of lighter skin color provided evidence of internalized psychological racism. Wertham similarly called on clinical research to testify that segregation caused ‘unsolvable emotional conflicts’ in the minds of segregated children” (pgs. 116-117).

Metzl concludes of his work’s significance, “Historical reflection helps us develop the competency and the humility to grapple with this, our cultural past. History thus lets us begin to understand why, in the present day, schizophrenia remains at once pathologized and pathologizing, and signifies both the need to maintain order and a political imperative to disrupt it” (pg. 212). show less