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���������� Note: At times, it seems that the advocacy needed to fulfill cultural competency in mental health treatment is insurmountable. Lowest common denominator discussions around language access ignore the vast cultural implications that centuries of political, sociological, institutional, educational, vocational, geographical, and systemic oppression have had on the way our system of care recognizes and addresses “abnormal” human behavior. MIA offers a brief synopsis below of a powerful article written by Metzl of how these issues are appropriated and given symbolic ownership by historically (and still) oppressed communities.

Rap Embraces Schizophrenia and Owns It

• Mad in America; 10/8/2014

  Vanderbilt University psychiatrist Jonathan Metzl, author of��The Protest Psychosis, has published a brief history of “schizophrenia” in relation to African American culture in the journal��Transition. The article opens and closes with quotes from modern rap lyrics, showing the ways in which black artists often embrace and even boast about their own schizophrenia, and Metzl explores some of the historical roots of such uses of the term within anti-establishment black culture.

“Rap lyrics are the latest installments in a political debate that has evolved over the past century (at least) regarding the contested relationships between race, madness, violence, and civil rights. This debate put psychiatrists into unknowing conversation with liberation theorists, Black Power activists, and protest musicians,” writes Metzl. “At stake is a series of existential and material questions about the causes, actions, and implications of sanity itself.”

Metzl traces popular ideas about schizophrenia from early medical texts to 1930s notions of dual personality “found in men of luminosity” such as poets and novelists touched by “grandiloquence.”

“However, a radical shift happened in the 1960s,” writes Metzl. “In 1968, in the midst of a political climate marked by profound protest and social unrest, psychiatry published the second edition of the Diagnostic and Statistical Manual. That text recast the paranoid subtype of schizophrenia as a disorder of masculinized belligerence… frequently hostile and aggressive…”

“A number of studies conflated black schizophrenia with Black Power in order to illustrate evolving understandings of the illness as hostile or violent, using long-standing stereotypes of manic, crazy black men to demonstrate ‘new’ forms of schizophrenic illness.” Yet even as this was occurring, writes Metzl, people like Martin Luther King, Jr. “frequently used the examples of ‘schizophrenia’ and ‘madness’ to urge African Americans to psychologically ‘maladjust’ themselves in the name of nonviolent protest… King’s use of the term schizophrenia implied an ethical, spiritual divide that was, at once, universal to mankind and particular to the African American experience.”

So in contemporary rap lyrics, suggests Metzl, we’re seeing a reappropriation of psychiatric authority. “You diagnosed us as aggressive, violent, and schizophrenic, rap lyrics contend, but we claim your racist diagnosis as our own.”

Metzl argues that rap’s schizophrenia “invokes more than mental illness; it also conveys a hidden critique of racist society, and promotes an identity forged through time and experience and then worn as a mark of strength and survival, rather than as a stigma… not a disease, but an identity claimed in response to a system that misperceives survival strategies as insanity.”

Metzl quotes “Natural Born Killaz” by Dr. Dre and Ice Cube: “Journey with me into the mind of a maniac, doomed to be a killer . . . with a heart full of terror… I’m the unforgiving, psycho-driven murderer / It’s authentic, goddamn it, schizophrenic.”

EPMD and LL Cool J, Metzl writes, “boasted that they smoked M.C.s because their rhyme style was ‘deadly psychopath schizophrenic.’” Bizzy Bone’s in “Thugz Cry,” meanwhile, “intoned that ‘we represent the planet, get schizophrenic and panic.’”

��(Metzl, Jonathan. Transition. No. 115, Mad (2014), pp. 23-33.) Abstract.

��������from Vanderbilt University.

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