Ethnoautobiography by Christopher Bowers

Do not think about doing her work of seeing and healing before sacrificing your Self to the tree, before talking in útiseta to your ancestors. Do not think you can pass by the guardian Heimdallr by just uttering the name of your ancestors. Yes, that you must do. But it is only the beginning. Until you have not been picked apart in the deep darkness of all the changes, all the history which Urðarbrunnur contains, until you have not shed the tears of memory, until you have not plunged into the shadow of all and everything our ancestors have wrought, until then: Remember the tree! Do not attempt to pass Heimdallr, because you are a lost soul, and lost you will be in the world you are trying to enter (Valgerdur & Kremer, 1999).

Crossing the Threshold

         So this is the task in front of me, to shed the tears of memory, to be picked apart. It is a task I hardly understand. I don’t even know how to get to the gate let alone pass through it. Weeks now I’ve tucked letters to my ancestors under my pillow hoping for some imaginal response to come forth while I am sleeping. Last night I dreamt an imageless dream that none the less contained words simple and clear: “The red sky, the blue sky, and the grey sky are sisters”. I am amused and baffled. It sounds like some mythological cosmology, but I feel I’ve let down whoever the sender may be. I haven’t a clue what this could mean. I’ve gone to the green hills and offered tobacco to the incredible oaks, hoping that they will somehow bridge this gap between me and those whose DNA I transport hundreds of years into their future; bridge the gap between Sweden and the United States, between what is known and was is not, between what is past and what is not. In front of me the oaks seem to stand in defiant silence. And how can I blame them. For behind me are the suburbs that have crept up the mountain a little more every year. I can name the people whose houses were once fields and I can name the games no longer played in those fields. I can name the differences between these fields and those of my ancestors. And with this I can begin to name what was lost:

           

 Bread came from the rye field and meat from the cattle. Clothing and shoes were made in the home by itinerant tailors and cobblers, out of wool from the sheep, flax from the ground, skins from the animals. All necessary things were taken from the earth. The people were at the mercy of the Lord’s weather, which brought fat years and lean years-but they depended on no other power under the sun. The farm was a world of its own, beholden to no one. The cottages nestled low and gray, timbered to last for centuries, and under the same roof of bark and sod the people lived their lives from birth to death. Weddings were held, christening and wake ale was drunk, life was lit and blown out within these same four walls of rough-hewn pine logs. Outside of life’s great events, little happened other than the change of seasons. In the field the shoots were green in spring and the stubble yellow in autumn. Life was lived quietly while the farm’s allotted years rounded their cycle (Mobery, 1949).

Without the Irish Curse

            Mobery’s idyllic description of 19^th century Sweden illuminates a silhouette of grief, giving it form and texture. It is the grief that I felt but didn’t know why. The vague sadness that crept in when I watched “The Lord of the Rings” and wanted to cry at the colorful depictions of the hobbits picturesque homeland, “The Shire”. It is the grief I felt whenever I read one of Kurt Vonnegut’s nostalgic laments about folk society. Maybe he idealized it and maybe I do too. But when I am in angry in traffic, or at home alone remembering that it’s been three months since I saw a friend who lives a mile away, it’s times like that I am certain of nothing but loss. It’s not just loss. It’s hunger, longing. Growing up in the United States, a place so void of folksy cultural markers, so void of communal intimacy, I often feel like a dog gnawing and gnawing on a meatless bone. As any eastern philosophy would say, loss is just the other side of gain, that they are two parts to one phenomenon. So what gain has created this loss?

            When I first learned about white privilege, those unearned benefits, those gains that come with the color of my skin I felt guilty. Not so much for the vague understanding that my ancestors had spilled the blood of the indigenous or for the modern manifestations of white supremacy. The guilt came in that I was, as commie-hobo-poet Utah Phillips (1996) once put it “armed to the teeth with the weapons of privilege”, and despite that, I was so unhappy. Not an uncommon experience among the privileged. Reflective of the American paradox, this question of increased wealth and decreased joy has become central to my life and work. To understand the costs of privilege, a cost that is so obvious in our oblivion but so obscured in our opulence, I must go back. Back beyond my nine month residency in the womb of a middle-class white woman married to a dark-skinned “white” man. Back beyond the civil war where my northern ancestors fought to end slavery while they simultaneously slaughtered the Indigenous.

             My maternal great grandfather Carl T. Roman (once spelled Rohman) took the ten-week oceanic voyage from Sweden to the United States in 1910. He had come from a long-line of farmers but like many early 20^th century Swedes he’d acquired industrial skills as a tool and dye maker. Industrialism and global economics had decimated many farming communities in Sweden. By 1911 more than half the emigrants had industrial skills. A sociopolitical crisis from 1907-1909, brought reduced wages and hours, labor unrest, strikes, and lockouts. The result of this crisis was that 1910 was a big year for emigration (Barton, 1975). Carl followed several siblings who had already successfully established themselves in the United States and one who hadn’t. His brother Lars killed himself after several years of struggling to set up a new life in the United States. Carl set up in Chicago, which had one of the most vibrant Swedish communities in the country. In 1910 one could go to “Swede Town”, as it was known, and one could find Swedish hospitals, newspapers, orphanages, convalescent homes, even a Swedish vaudeville scene (McGill, 1997).

            Carl soon met Tansy Nelson, though her immigrant parents spelled it Nihlsson. Tansy, like Carl, came from a long line of farmers in Sweden. However, homegrown wheat prices plunged when industrialism made it possible for other countries, including the United States to flood Swedish markets at home and abroad. From 1890-1910 agricultural population sank from 72% to 48%.  Also, Sweden abandoned free trade in favor of tariffs. Tariffs protected some farmers and industry elite but raised costs for poorer rural and urban workers. During this time there was also an increase in compulsory military service as well as increased religious conflicts with the Swedish Catholic Church (Barton, 1975).

            Swedes landed in the U.S. with privilege that went beyond race. Prior to the Chinese they were the most recruited nationality to work on the railroads and for many years they were preferred labor because they were white “without the ‘Irish curse’” (Barton, 1975). Some of the privilege that I benefited from began with this wealth.

Pie in the Sky

             I found my identity as a radical post-modernist affirmed in the class readings. Thus, I was particularly excited to learn of one Swedish immigrant by the name of Joel Hägglund. Joel had fled Sweden only eight years before my great-grandfather. Presumably he was fleeing the same class strife Carl faced. Joel was a migrant laborer who joined the International Workers of the World. Like me, he was a radical and a songwriter. He wrote a song that coined the phrase “Pie in the Sky”. Mr. Hägglund became a great labor organizer known to many by the name Joe Hill. The same government my great-grandfather adored murdered Joe Hill.

            Most Swedish immigrants were not radical and in fact were embarrassed by socialist Swedes (Barton 1975). Carl was not a radical. He insisted on assimilation. My grandfather and his two brothers never learned Swedish. In some ways I am baffled by how my great grandfather left his homeland to resist conscription and to find equal opportunity only to go to a world leader in both military strength and class strife. Carl raised his kids to believe in the national myth of democracy and equality despite the fact that many faced similar circumstances that led Carl to leave Sweden. However, here in the United States there was a crucial difference. That difference was white privilege. In fact, Barton (1975) suggests that the Swedes very success in America is what led to the loss of their own culture within America.

            In this moment I have just reconstructed a memory that at the time seemed laughable, but now feels painful. When I was about 25 my grandfather sat drunk at the dinner table. He began to speak about the one time he went to Sweden. He was four years old. He spoke of it as if it were yesterday. He began to cry. At the time I looked at my mother and she rolled her eyes. We all thought the old man was just drunk and overly sentimental. He is dead now and I find myself  wishing that I could talk with him, grieve with him.

            I believe this story is not specific to Swedish immigrants. Never the less, it is the reason why I will never know the intoxicating nuances of brännvin, the taste of knäckebröd, lingonberry preserves or cured lutfisk. I also don’t know anything about the lives of Carl or Tansy’s parents, I know no stories of life on the farm, life before the farm, no stories of a life ruled by a cosmology instead of a constitution.

Revisionist History

            Clearly the case should be made that the beginning of white privilege came from making the choice to emigrate, rather than being stolen from ancestral lands. Here in the United States Carl and his family could raise their socioeconomic standing simply because racial markers had been constructed into an economic and social hierarchy. The class strife Carl faced in northern Europe could be minimized if not erased because here others with darker skin and Irish accents would take his place in the lower classes.

            Like most difficult and problematic privileges, this one too began with the best of intentions: the desire for freedom, survival, adventure, a willingness to live up to that which you believe you are capable. As well, the intention to get back what was already being lost with the forces of industrialization and the global economy. Like the other privileges I enjoy, my great grandfather’s privilege to willfully go to America, or in Swedish “mer-rika” (more rich) has made my life what it is- all the losses and all the gains began with these innocent intentions. And yet, I find myself questioning these intentions. Was it the spirit of adventure or acquiescence to power?

            In my post-modern identity I find something I didn’t expect on this path: resentment towards my ancestors.  Why didn’t they question or struggle against the classism and racism of their time? The common argument is “Those were different times”. Yet, Joe Hill was not unlike my great grandfather in many ways. Perhaps my ancestors would resent this socialist re-contextualization. After all, the implication is that acculturation included the willful loss of class identity within personal identity. I have to ask myself, is this revisionist history a reclaiming of a deeper identity or simply narcissistic wish fulfillment?  Erik Erikson in studying the Sioux was able to connect loss of personal identity to the loss of cultural identity (Frager & Fadiman, 2005). I suspect a similar phenomenon in so called white America.

Whiteness Takes A Detour

            I have chosen to focus on the Swedish strand because so little was known. So little is still known. Without the same level of detail there is one other strand on my father’s side worth mentioning. Growing up my father had a great tan. Twenty-four hours a day, seven days a week, 365 days a year, my father had a great tan. He was just born with good pigment. That was the story but not until I am in my thirties do I realize this is not the whole story. My girlfriend at the time, whom I’d met doing anti-racism work, is looking at one of my photo albums.

            “Your dad is a person of color” she casually remarks. I am stunned into silence. Somewhere in me I knew everything that such a statement implied and it was utterly disorienting. Perhaps most stunning was the realization that if my father was not fully European-American, then neither was I.

            My dad is an ex-marine, a conservative republican and some would say racist. He has consistently made racist jokes, racist statements, and his sense of entitlement and supremacy is not always so obscured. Never the less, save for one incident that I am aware of, my father has enjoyed the privilege of passing as a dark-skinned white man. The incident to which I refer is one I’d been aware of prior to the revelation that my dad is not fully white. When he was applying to colleges and attaching newspaper photos of his record-setting track and field achievements, one college in Texas rejected him on the basis that they did not accept “negros”. Even when hearing this story, it never occurred to me that there was a much bigger story at hand. This story, like so many stories that make up the collective shadow of this country, is filled with omissions, assumptions, half-truths, inconsistencies and again, loss.

            What I know is not much: My dad’s grandmother Leona is either one-half or one-fourth Native American. She had some illicit affair that alienated her from her children. Whatever knowledge they had of her heritage was taken to their grave along with their resentments. My dad’s father was not dark-skinned but had recognizable indigenous facial features in his jaw and nose. Leona’s birth certificate lists as her parents John Griffith and Sarah Spurgeon. There is nothing particularly ethnic about those names and there are no known photos or records. How can one “talk to your ancestors” when you don’t even know who they are or where they were from? The most I know about my ancestors is what they are not. They are not record keepers, they are not totally white, and they are not speaking to me. Loss.

            Other complicated histories on my father’s side: The first generation is from the Bavarian region of Germany. John Underfanger fought in the Union during the Civil War. While they fought to end slavery, they also slaughtered the indigenous. It is quite possible it was at this crossroads in our nations history that my family’s whiteness took a detour.  Maybe one of my grandfathers met a woman too beautiful to kill. Or maybe he loved her and killed her anyways. In the United States ethnic history is a violent history.

            As I write this I consider more deeply and more directly how my own violence may be something brought to me from the past. Specifically I wonder if the ways that I have hurt others in my life is just an extension of my fathers internalized racism, the internal rage he may have felt at being aware of his difference without understanding its meaning. Is this my rage as well? Is my great, great, great grandfather’s dissociation that made him to fight for one group and kill another similar to that which allowed me to major in feminism in college and then be emotionally abusive in my relationships with women? When blame is removed from the equation the answer becomes more collective and opposing forces feel a little less so. Along with Carl, Tansy, Leona, John and others I now have the names of over 50 other people in five different countries over 300 years whose lives led to mine. Yet, I know almost nothing of a even one of their lives. “Do not think you can pass by the guardian Heimdallr by just uttering the name of your ancestors…” If I consider all those I don’t have the names of and go back even more years I find the loss is multiplied. More and more memory and culture lost to assimilation and survival. The fact is that my ancestors who participated in class warfare, genocide, and hoarding of wealth were merely circles that came before my circular path and they themselves were lost souls. They themselves had lost their way and I cannot separate my loss from theirs.

           

PART II

            Sometimes I wonder what would knowing more do for me anyway? Even if I go to Sweden, connect with my relatives and learn the Swedish ways, how will that really affect my life here? I am not convinced that it will change much at all. Plus, I am not just Swedish. I am many things. Some of them are ethnic and some are not. Some are self-created, some are not. Some are from the past, some are not. It seems to me the task of white people in the United States is to negotiate white identity in a way that recontextualizes it as an identity of reconciliation and integration. Bringing into the now, all that has passed- all the horror, all the loss, and all the pride and from this bring forth some thing new, dynamic and evolving, something not so monolithic in nature. So, I again look to the past to make sense of the now.

Ishi at the World Fair

            This month in 1904 the World’s Fair was in St. Louis. One of the exhibitions was a Native American known as Ishi who had crawled out of the woods near Oroville, California, the lone surviving member of his clan. He was put on display as the “the last wild Indian”. But, the “wild” had been taken out of wilderness.

            The hills are green though the gold is waiting in the wings of spring. I am reminded of Moberg’s writings: In the field the shoots were green in spring and the stubble yellow in autumn. Life was lived quietly while the farm’s allotted years rounded their cycle. I have grown up in these fields. Not Moberg’s Sweden but perhaps not unlike it either. I have traversed these trails since I was a young boy. My ancestors went from being farmers to migrant industrial workers to capitalists. When the industrial revolution came to Sweden people lost their land and with it a sense of ecology. Emigration and assimilation made this loss complete.

             As much of a sentimental connection as I have to this land, I realize I have never taken the time to notice the hills change color. I go to bed one night and the hills are green. I wake up the next day and they are gold. When did I become so alienated from the metamorphoses? Only recently have I noticed how loud the birds sing on spring mornings like this one. My connection to land is largely visual. I first knew this landscape from the window of my kindergarten school bus as it drove the ten miles from my house to school. I would sit in back in silent revelry of the hills around me. As a child I played in these hills, as a teen I hiked in them. The sad irony is that now I enjoy this connection largely via the spoils of industrialism and white flight as I take long, nostalgic drives through the beautiful back roads that scar up the countryside. This land is simultaneously loved and ruined, just like Ishi at the World Fair.

Rain Dogs

             Why don’t I know how to grow a tomato? Why did it take me so many years to notice the cacophonic symphony of the local voleries? This land was once stewarded by native peoples, primarily the Pomo. They probably perceived many shades between green and gold, probably had conversations with the birds it took me thirty-some years to notice.

            The factors that obscure my own indigenous roots are personal and institutional, systematic and mythological, real and imagined, past and present. For this inquiry I began to research different indigenous cultures of Northern Europe, the Sami, the Old Norse. It was an attempt at cosmological healing, to go to the origins of things. It became quickly apparent that this is far more complicated than finding a singular beginning point. As a white person in modern North America there is no one origin to go back to. There are many strands to choose from and almost all of them will lead into darkness and obscurity. Musician Tom Waits named his 1990 album “Rain Dogs” explaining that rain dogs are the canine that wander the street at night because the rain has washed away the scent that would have led them home. As a white person in North America, I feel like a rain dog.

            To get an experiential sense of origin, I can go back to my childhood, to a sense of being in love with the world without any sense of God but instead a mythology of innocence and wonder. When I was a child, more than any other epoch of my life, I lived according to cycles outside of modernist and capitalist digitized time. I lived a little closer to something eternal, an existence in which I did not know that time was portioned into days, weeks and months all of which adulterated by names and deadlines, an existence ignorant to the imprisoning structure of schedules. I awoke with the sun and I knew the day was getting on by how the trees I climbed cast longer shadows at different angles and because the sun had changed the scope of its illumination upon the dirt in which I dug up imaginary but priceless treasures.

            Sadly, this nostalgia is not indigenism but contains some aspect of it: sense of place, ecology, a connection to something bigger than myself. Yet, it is the only experience I have ever known of living without some internalized modernism. This is complicated by the fact that without modernism, my time in the temporal spotlight would have been very short indeed. I was born with only a half of a heart and modern science made it so that that half was sufficient.

            When modernism married Christianity, indigenous knowledge seemed to not stand a chance. And yet there are pockets of the world that have been resilient and I feel that this resiliency has planted seeds in my own heart. I feel that despite all I don’t know, despite all I will never know, there is also wisdom still available to me should I remain engaged in the process.

            In the process of participatory inquiry we are asked to investigate the various aspects of a deep question, to relate them to one another and come to something altogether new. We are asked to create a feedback loop of changing and being changed, of nurturing and be nurtured, the “circular relationship of knowledge” (Valgerdur & Kremer, 1999). So in this way perhaps what I don’t know can commune with what I do know and some empty spaces may be filled. Or, as Tom Waits (1990) puts it “the things you can’t remember tell the things you can’t forget that history puts a saint in every dream”.  In this way, what will seem to be speculation from here on out is in fact something more.

Be the Tree           

            I have chosen the path of a healer in this life. This path has been prescribed to me in very specific terms by modern Western culture, a culture which seems to have divided phenomena into a series of dichotomies only to emphasize the more negative sides. I am told that being a healer means knowing deviance and dysfunction. Yet, deviance and dysfunction can only be defined against a norm. Part of white privilege is that your very existence, your life as it is, is the norm. White people, though diverse in many other ways, largely define the norm simply by being. That norm has been shaped by modernism, capitalism, racism, and all the disparate strands that played out in my life and in the lives of my ancestors. A primary cost of privilege, the loss of ancestral knowledge is really just a smaller part of a feedback loop, for our ancestors lost something too. My Swedish atavists did not know their indigenous roots. The loss of the modern age may very well be the loss of indigenous knowledge, that is to say, the knowledge of wholeness.  

            Western culture has no unified cosmology and appears to depend on dichotomy to maintain its dominance: norm and deviance, objective and subjective, us and them, individual and community, white and non-white. In these dichotomies there is no wholeness because both sides are rarely held simultaneously and only clumsily synthesized. In western culture, one pole subsumes the other. Instead of this and that, it becomes this vs. that, either/or. These dichotomies become internalized and before we know it, we are at war with ourselves, a war impossible to win. In my own life I know that healing has often come in trying to skillfully synthesize or integrate two competing parts of myself: the seeker and the activist, the artist and the intellectual, the anger and the love, etc. I suspect that my generation is being called to this same task on a macro level. In some way this speaks to another fundamental brokenness waiting to be healed and made whole: self and other.

            The larger strands of my ancestry are Scandinavian. I am possibly of the Sami people, but since most of my Swedish heritage is from southern Sweden I may also be Viking. I do not know where to look for the appropriate healing. I am still waiting for the whispers of inspiration in dreams, meditations and in walkabouts. For now I can only make very rough estimations using more intellect than intuition.  In the Old Norse mythology there are two important trees. From one tree come Askr and Embla, the first two humans. I am struck by Engles drawing of these two figures. I was unable to find any reflections by Engles or other art critics on what he may have intended. However, it seems to infer the very conflict of the modern area with the indigenous origin. Who is the sword-wielding man with coattails? Are his arms raised in reverence or in revolt?

            The other tree is a version of the “tree of life”. In the Old Norse mythological story known as Gylfaginning, there is a dialog between a seeker and an elder. In this exchange we learn the significance of this tree:

            The tree is birth and death, becoming and decaying, generation and regeneration.  At its root are the nornir, three of them are well known to us by their name: Urðr, the one who holds the memory from which Verðandi creates what is coming to be present; and then there is

Skuld, she knows what is owed to the ages, what their meaning is. They keep track of the

lunar cycles of time, they score the records as humans have taken the clue from them and

scored the movements of the moon for many thousands of years. (Valgerdur & Kremer, 1999).

           

            Urðr,Verðandi, and Skuld are personified representations of functions and tasks specific to the indigenous wisdom. However, this call to healing cannot be fulfilled without some sacrifice. The seeker is admonished to “be the tree”. In fact, the seeker is told that this is the only way that they can cross the threshold into spiritual communion.

            Thus the tree of life is nourished by the women who live at her roots and ladle the fluids

from Urðarbrunnur and other sources. As the tree receives she gives nourishment to others: At her roots snakes gnaw away, and deer eat her leaves. She gives protection to the eagles and hawks in her top. Squirrels run up and down as messengers between the different parts of the world. She stretches into all nine worlds, into all nine aspects of being, she connects us with them, and she is all these, she is the above, the below, and the middle. We are trees, and to honor our origins and in order to journey across the spirit bridge we can sacrifice our self to spirit on the tree by fasting (Valgerdur & Kremer, 1999).

           

            And here I find some guidance both literal and metaphorical, clear and esoteric: Nourish and be nourished, give for the good of all, stretch myself into different aspects of my being, and at the end a call for sacrifice to the spirit through the practice of fasting.

            In the very writing of this paper, the very creation of this moment something exciting and sad arises. If it is my true intent to hear the voices of my ancestors, to heal the personal and philosophical dichotomies, to reclaim wisdom thought forever lost, to get beyond the limits of modernism, I doubt very much if I can escape sacrifice. I am suddenly aware of yet another cost, another loss: the aversion to sacrifice that privilege engenders. Privilege rarely necessitates sacrifice. Entitlement, a seeming natural side effect of privilege could be defined as the expectation that one acquires without sacrifice. Sacrifice is a central tenant of communal health in indigenous cultures. Fasting, traveling (leaving behind the familiar), killing, and sublimation of personal needs are all hallmarks of indigenous spiritual practice and nourishment.

            I cannot say that I truly understand this. In my own attempts to forge an identity out of the darkness of being white, I have employed the spiritual practices of a culture that is not my own. Buddhist meditation has given me tools to forgive myself for my own unskillful enactments of privilege and entitlement. It has given me a ritual with which to come home to my own being, to notice the previously unconscious thoughts that ruled the moment and to challenge my assumptions and beliefs. It has not however connected me with my ancestors, my local ecology, my community, or the spirit world.

Conclusion: Sister Sky

            The elder says that if I want to be the tree, I must sacrifice myself to it as well. I do not know about my indigenous roots. However, I do have names of my ancestors and mythological glimpses into their ancestors. The job of a collage artist is to make one picture from parts of many others. So, I have taken to collecting and recollecting. What I have to work with is sorted words and phrases of stories shredded by progress, little movements of mythology, imaginal mementos, and events from my own living experience. I find that there is hope if I can get these estranged refugees to talk to one another, if I can continue this process of participatory inquiry, of nurturing and being nurtured. I also have a deeper understanding of myself in relation to something far bigger than myself and more far-reaching than my own life.

            It is evening. It is spring. The wild oats are taller now and the perennial ryegrass is yielding. I breathe in the nuance of nature’s pheromones, the scents that come in the spring but imply summer’s eminent arrival.  Soon, the hills will change. I spot a red-headed woodpecker and it spots me. His call sounds like an alarm and my anthropomorphizing ears hear him sound a warning, or maybe register a complaint.  I keep walking and soon encounter a bobcat on a rock getting some sun. It tenses but is not willing to give up the sunbath. I walk on. I look back and above the houses I see a family of deer walking away from suburbia. I project a kinship and pretend that the deer, the bobcat and the woodpecker are my community, at least for the duration of the hike. Maybe I am not pretending.

            I have made small attempts at this new endeavor of sacrifice. Today, having eaten nothing I walk into the fields, to my favorite oak and offer puffs of tobacco before closing my eyes into meditation. I try not to expect something miraculous and my expectations are summarily met. Nothing miraculous. No visions, no insights, but instead, a gentle let go, a relaxation. Some time later I open my eyes. The sun has dropped below the horizon and its red glow illuminates the grey clouds passing through the fading blue sky. But this is one solid image, Red Sky, Blue Sky, Grey Sky, three sisters, my dream manifested in the dusk. There is a visceral sense of wholeness, a sense of synecdoche, at peace with the whole, at peace with the parts.

…memories, so long abandoned and put out of mind, nothing now survived, everything was scattered… But when from a long-distant past nothing subsists, after the people are dead, after the things are broken and scattered, taste and smell alone, more fragile but more enduring, more unsubstantial, more persistent, more faithful, remain poised a long time, like souls, remembering, waiting, hoping, amid the ruins of all the rest; and bear unflinchingly, in the tiny and almost impalpable drop of their essence, the vast structure of recollection… (Proust, 1982)

References

Barton, H. A. (1975). Letters from the Promised Land, Swedes in America, 1840-1914. Minneapolis, MN: University of Minnesota Press, Minneapolis.

Frager, R., & Fadiman, J. (2005). Erik Erikson and the life cycle. In

                 Personality and Personal Growth (Sixth ed., pp. 172-199). Upper Saddle

                 River, New Jersey : Pearson Prentice Hall. (Original work published 1974)

McGill, A. (1997). The opportunity of land. In S. Stotsky (Ed.), The Swedish Americans (pp. 31-50). Philadelphia, PA: Chelsea House Publishers.

Moberg, V. (1949). By way of introduction. In The Emigrants (p. xxvii)

      [Introduction]. St. Paul, MN: Borealis/Minnesota Historical Society Press.

Phillips, B. U., & Difranco, A. (1996). Korea. On The past didn't go anywhere

      [CD]. Buffalo, NY: Righteous Babe Records.

Proust, M. (1982). Remembrance of things past. volume 1: swann's way: within a

      budding grove (pp. 48-51). New York: Vintage.

Valgerdur, B. H., & Kremer, J. W. (1999). Prolegomena to a cosmology of healing

                 in Vanir Norse mythology . Yearbook of Cross-Cultural Medicine and

      Psychotherapy, (1998/99), 125-174.

Waits, T. (1990). Time. On Rain dogs [CD]. Los Angeles, CA: Island Records

Image:

Engles R. (1919) http://commons.wikimedia.org/wiki/File:Ask_and_Embla_by_Robert_Engels.jpg

She and I by O. Stevens

She asked, “can’t we just move past all these race issues?”
She said, “all this race talk makes me feel uncomfortable.”

She asked, “really, when was the last time someone was lynched?”
She said, “racism doesn’t even exist anymore.”

She asked, “How can I be racist if I love Beyonce?”
She said, “I don’t see color.”

She asked, “You’re only half Black, right?”
She said, “That doesn’t really apply to you because you’re not even all Black.”

She asked, “Your brother dresses super fly, is he a rapper?”
She said, “I love gangster rap; Kanye West is so cute.”

She asked, “Why can’t I say nigga too?
She said, “My bestfriend in the 2nd grade was half-Black.”

She asked, “How do you starve if you’re on welfare?”
She said, “My check was only $925—I’m going to need Section 8 soon.”

She asked, “What is wrong with you people?”
She said, “Nigger.”

and I just laugh.

The Effects of Racial Bias on Diagnoses of Psychological Disorders by Christopher Bowers

The focus of my paper is racial bias in the diagnosis of psychological disorders. In the United States the majority of clinical psychologists are of European/Caucasian decent. This paper considers the possible consequence of Eurocentric clinica practices. Racial bias in this context can be seen specifically as an increased or decreased likelihood of a particular diagnosis based on the biological markers associated with the concept of race. The marker of skin color is of primary focus. For hundreds of years people have associated meaning and value with skin color.  This paper is an investigation of how clinicians in the field of psychology might misdiagnose a client based on the associations they have to the skin color of their client and/or their misunderstandings of cultural language and behavior.

The majority of the source material for this paper were studies that specifically addressed racial bias in the diagnoses of specific pathologies. In researching this phenomena it became evident that racial bias is most commonly present in the diagnosis of Axis I disorders such as schizophrenia, bipolar disorder and depressive disorders.  One study also looked at diagnostic racial bias in developmental disorders such as Oppositional Defiant Disorder and Attention-Deficit Hyperactive Disorder.  While the studies focus on Axis I disorders, we will see that racial bias may also affect Axis IV and V diagnosis.  Of the studies reviewed they were almost exclusively contrasting the diagnoses of European Americans and African-Americans.

These studies had as few as a hundred participants and as many as over 1500. The studies were conducted in several areas of the United States and most often included more than one county. The studies were set in state-supported mental health triage centers, other inpatient locations, as well as in outpatient programs. The evaluative tools most often employed were the DSM-IV itself or specific scales or tools from the DSM-IV. One study did use definitions from the International Classification of Disorders (Simpson et al., 2007).

The clinicians that made the actual diagnoses were most frequently psychiatrists or psychiatric nurses though one study used counseling professionals with either a Masters or Doctoral level of education. Only one study discussed the race of the clinicians and they were almost exclusively white, other than one clinician of mixed race (Schwartz, 2009).

This paper will also demonstrate that the abnormal psychology of an individual is affected by the social and institutional manifestations of racism. It is important to understand both how racial bias affects diagnosis as well as how racism affects the potential for various pathologies.

There are four themes that all the reviewed studies overtly or inadvertently address. These four themes will be the lens through which we view the effects of racial bias on diagnosing psychological disorders. The first theme is that of how normalcy is constructed and how that conversely defines social deviance. This will allow us to examine how culture can be mistaken as pathology. Second is the issue of cultural competency, the lack of which many believe to be the primary agent of racial bias in clinical settings. The third theme is that of language, significant in client’s description of symptoms. Lastly, we will look at the interplay of institutional racism within psychiatry and the institutional racism of the society in which psychiatry is practiced.

Definitions of Normalcy

If disorders are understood, in part, as a deviance of social norms, it is important to consider that these norms were likely defined and reinforced by the dominant group. There is historic evidence of treating cultural difference as a disorder, intentionally or otherwise (Ali, 2004). This is presumably what led to the development of culturally-bound symptoms in the more recent versions of the Diagnostic Statistical Manual (DSM). However, do these culturally-bound symptoms sufficiently mitigate racial bias? Attention-Deficit Hyperactive Disorder (ADHD) and Oppositional Defiant Disorder (ODD) provide examples of how definitions of normalcy could possibly result in pathologizing cultural norms. These disorders are not culturally bound and yet one study found that African American youth are more likely to be diagnosed with disorders such as ADHD and ODD (Schwartz & Feisthamel, 2009). The authors noted that these were disorders of deviance and the authors were concerned that certain cultural behaviors such as communication style were being seen as deviant by teachers and clinicians from the dominant group. The behavior of these youth might have also felt distressful or dangerous to members of the dominant group, even if no harm was intended.

These so-called “disorders of deviance” also serve as an example of how racial bias in diagnosing Axis I disorders may also affect Axis IV and V diagnosis. If a youth is punished for this deviance by being asked to leave the classroom or by being unnecessarily medicated this could lead to other life stressors or decreased academic and social functioning. This is speculative on my part and no studies suggested this to be the case. Never the less, these implications are troubling.

Another article discussed the intersection of gender and racial bias in the diagnostic process (Ali, 2004). For example, this author found evidence of sexist descriptors of women of color in the DSM casebook. If white women’s sexuality is viewed as the norm and other sexual values that are culturally specific are seen as a form of dysfunction, this would suggest that implicit in the field of psychology we find that different standards of normalcy are dependent on race.

It may be also that the sexualized descriptors are left over cultural assumptions from racist constructions of ethnic identity designed to marginalize and objectify women of color in colonial times. Colonialism offers us another perspective on racial bias in psychology. In considering the question of normalcy we can also look at the origins of psychiatry. Post-modern authors put psychiatric racial bias in the context of capitalism, empiricism, patriarchy, and other modernist ideologies (Fabrega, 2008). One of the blind spots of many modernist thinkers is their ignorance or negation of an implied colonial narrative. That is to say that in their observation, be it anthropological, pedagogical, or psychological, there is a sense of supremacy and domination in their evaluations and methods. Post-modernists suggest that western psychology is inherently racist since it is based on the same colonial narratives of other modernist assumptions and practices. As well, they would admonish us against culturally bias definitions of “mental illness” and even “empiricism” (Fabrega, 2008). A post-modern critique of western psychology will note that it is a field founded, developed and dominated by mostly white men. What has been considered normal in this field may only be normal for the people who dominate the field.

            Another study discusses the potential consequence of psychiatry being dominated by a ruling class. In addition to finding that youth of color were disproportionately diagnosed with ADHD and ODD, Schwartz & Feisthamel (2009) found that African Americans were more likely to be diagnosed with schizophrenia or other psychotic conditions than their white counterparts. Twenty-seven percent of the African Americans in the study were diagnosed with schizophrenia as compared with seventeen percent of the European Americans. Meanwhile, European Americans were more likely to be diagnosed with non-psychotic mood disorders. This suggests the potential that behavior that might be cultural and quite normal in a given culture, may be seen as threatening and diagnosable in the dominant culture. Put another way, when cultural behaviors deviate from a social norm create by the dominate culture, these behaviors are more likely to be seen as pathological.

            The authors maintain that these findings are consistent with prior research. They also suggest that part of the issue may be access. They suggest that suspicion of a mental health system dominated by the ruling class combined with a cultural stigma of mental illness may cause African Americans to be assessed at a later stage of the disorder, therefore having a higher rate of a positive diagnosis. Neighbors, Trierweiler, Ford, and Muroff (2003) further suggest that if this suspicion on the part of the African American client manifests as despondence it could be mistaken for a flat affect thus increasing the potential for a diagnosis of schizophrenia.

            There is specific evidence that the DSM-IV’s culturally-bound symptoms do not sufficiently mitigate racial bias. In a study of racial differences in DSM diagnosis using a semi-structured instrument, Neighbors, Trierweiler, Ford and Muroff (2003) found that African Americans were disproportionately over-diagnosed with more severe disorders, usually schizophrenia, and conversely, African Americans were disproportionately under-diagnosed with bi-polar disorder. If white people are more likely to get less psychotic diagnoses or black people more likely to get more psychotic diagnoses than this suggests a tendency towards “othering” people of color and reinforcing the normalcy of white people’s mental health. Furthermore, if the culturally-bound categories were designed to account for cultural differences between races, then how could this discrepancy occur? The authors found that separating subjective symptoms from cultural norms could be problematic:

            “Distinguishing hallucinations that indicate poor reality testing from culturally governed interpretations of subjective experience may be difficult” (Neighbors, Trierweiler, Ford and Muroff, 2003). This study came to the conclusion that using semi-structured instruments does not eliminate racial bias in part because while the DSM is ostensibly and objective tool, clinicians themselves are required to make subjective judgments about how to apply these objective criterion and this allows a loophole for unconscious predictive bias on the part of the clinician. One study exemplified this idea by suggesting that how clinicians connect their observations of symptoms to diagnostic constructs differed depending on if the client was African American or European American (Neighbors, Trierweiler, Ford, & Muroff, 2003).

Cultural Competency

 The post-modernist critique maintains that the same cultural insensitivity found in other modern, post-colonial disciplines such as anthropology and economics is also found in western psychological research and clinical application (Fabrega, 2008). Most studies suggest that cultural competency is the culprit of a biased or adulterated diagnosis. Issues of cultural competency suggest that the clinical interaction takes place in a historical and social context and that the interaction between clinician and client is not without the same prejudices that affect society at large. This is evident in the analysis of normalcy. While it is suggested that racial bias is a systematic and institutional problem, these biases are played out between individual clients and individual therapists. Therefore, the cultural competency of individual clinicians is a significant factor.

While the study of racial bias in the use of semi-structured instruments suggested that such instruments do not sufficiently mitigate bias the authors suggest also that clinicians competency in using such instruments is also important. If clinicians are trained on how to use sociocultural demographic information appropriately ethnocentric bias may be diminished (Neighbors, Trierweiler, Ford, & Muroff, 2003). The authors put particular emphasis on training clinicians to raise cultural alternatives to perceived symptoms. The authors of this study also suggest that symptoms of paranoia may actually be a learned response to racism, that clients may be suspicious of a clinician or institution based on past experience with racism. Part of cultural competency is to understand that social context in which clinical interactions take place.

Cultural competency also refers to the clinicians understanding of how symptoms may present themselves differently in various cultures. We will investigate this idea more in depth as we look at language. Schwartz & Feisthamel (2009) point out that symptoms of schizophrenia manifest differently for African Americans than European Americans. If a clinician doesn’t understand this, a misdiagnosis seems likely.  

            Several studies suggest the need for better cultural competency training and research. Schwartz & Feisthamel state that there is a perception in the psychiatric community that African Americans are more likely to have schizophrenia. Regardless of if this is accurate, the authors suggest that the very notion could predispose clinicians to demonstrating bias during diagnosis.

Language

            A very important aspect to cultural competency is language. Language is the key to understanding how a client interprets their own condition. Particularly problematic is how to interpret self-reported information. This is important to the examination of racial bias due to the fact that how a client describes a symptom may be bound by local dialect or cultural stigmas and the meaning of either could be lost on an unskilled clinician.

Sometimes there may simply be a language barrier. Other times it may be a cultural barrier that manifests linguistically. Sometimes clinicians misinterpret culturally specific language as a pathological symptom. For example, studies on symptoms that had previously been described as a cultural syndrome called ataque de nervios (attack of the nerves) in mainly Latinas, was found to not be a “clinical entity” but instead a problem of functioning in relations to certain social circumstances (Halgin & Whitbourne, 2010). Similarly, Alisha Ali (2004) explains that women of color may be more likely to describe psychological ailments in physical terms, in part due to the potential of being stigmatized within their ethnic culture for having psychological problems.  For example, I have learned in my own work in the field of HIV that in some Latino families psychological manifestations of HIV are attributed to “el cancer” (the cancer) due to the stigma associated with HIV and it’s association with homosexuality in this culture.

One literature review on studies that compared rates of depression across different ethnicities found that family physicians and interns are less likely to recognize indicators of major depression in Latinos/Latinas and African Americans when using brief depression symptom questionnaires, and thus less likely to diagnose this population with depression (Simpson, Krishnan, Kunik and Ruiz, 2007). While there may be several reasons for this, the way that symptoms were described on the questionnaire may not have been culturally relevant and/or the clinicians did not recognize the answers given by these ethnicities as indicating depressive symptomology. How a question is worded, be it written or spoken, may affect the validity of the answer. If the question does not employ (or the clinician does not understand) the local “idioms of distress” the answer will be less likely to represent a valid response (Neighbors, Trierweiler, Ford, & Muroff, 2003).

One important aspect of cross-cultural language competency is that it applies not just to ethnic cultures but youth cultures, queer cultures, and class cultures. The more a clinician understands the slang of the cultures with which they work, the more effective and accurate a diagnosis can be made.

Psychiatric Implications of Institutional Racism

            Lastly,  it is important to consider the interplay of institutional racism within psychiatry with the institutional racism of the society in which psychiatry is practiced. Already apparent are several examples of racism within the practice of psychiatry: disproportionately higher diagnosis of more serious diagnosis in people of color, disproportionately higher diagnosis of less severe disorders in white clients, insufficient mitigation of bias in the DSM-IV’s culturally-bound categories, a field dominated by white practitioners, lack of cultural competency by white clinicians, and misunderstanding cultural descriptors of symptomology.

            The various explanations and suggestions offered make an attempt to explain the discrepancies as evidence of racial bias in diagnosis. However, there is one explanation which highly undermines this hypothesis and in doing so sets forth a startling hypothesis of its own. Looking at the possibility that higher rates of schizophrenia in African-Americans may not be attributed to a predictive bias, the authors consider the idea that perhaps the diagnosis rates are actually correct (Schwartz & Feisthamel, 2009). We are then left to consider if there is something about being African-American in the United States that contributes to higher rates of schizophrenia among that population. In other words, can racism be the cause of pathology? By in large the authors suggest that this is unlikely and that clinical bias is a more likely suspect of the discrepant prevalence. None the less, these alternative explanations are important to consider.             Some authors maintain that studies have shown that living in lower socioeconomic levels can cause or exacerbate schizophrenia and that the life stressors that poverty entails can contribute to triggering schizophrenia (Haglin &Whitebourne, 2010). In the United States, African Americans are more likely to be poor and to experience barriers to housing, employment, and health care.

What this would effectively mean is that due to institutional racism, simply being black acts as a genetic factor in a diathesis-stress model of dysfunction. This does not suggest that the genetics that make up racial markers carry within them a predisposition to mental illness, but that the environmental factors predispose individuals with certain genetic racial markers to schizophrenia. One author goes so far as to say that these diagnoses are a pathologizing of the traumatic response of people of color to oppression. Furthermore, in a society where people’s worth is associated with their ability to function in the dominant construction of normality, this phenomena is akin to blaming the victim (Ali, 2004).

            Other important issues that relate to psychiatry and institutional racism is the fact that African Americans are less likely to access preventative care, to receive psychiatric care prior to hospitalization, less likely to leave a hospitalization with a specific diagnosis, less likely to have health insurance, and less more likely to experience the stressors of poverty (Sohler & Bromet, 2003).

             Conclusion

Working from the assumption that a diagnosis is the first step of a treatment plan we find that an exaggerated, diminished or otherwise mistaken diagnosis can lead to inappropriate treatment and poor management of mental illnesses. If race is a component of such a misdiagnosis, this raises serious issues of social justice and accountability within the psychiatric community.

Situations in which people of color are being misdiagnosed with psychotic disorders can have serious and even irreversible affects on their lives. These patients are likely to go onto intensive treatment in the form of hospitalization, strong medication with strong side effects, or even Electroconvulsive Therapy. If they do not in fact have schizophrenia or psychotic symptoms such so-called treatment would be unethical.

The other manifestations of institutional discrimination mentioned also affect treatment. While not having health care can inhibit early diagnosis, it can severely impact treatment. The Surgeon General has reported that African Americans receive inferior and inadequate treatment for mental illness compared to the population at large (Schwartz, 2009).

One study on diagnosis and treatment of depression in the Latino/Latina community found that issues of language and cultural competence were mitigated in the treatment of depression in states where patients were more likely to be seen by physicians of their own ethnic groups. Furthermore,  successful treatment rates would be higher if education and intervention materials were presented in ways that were culturally appropriate (Simpson, Krishnan, Kunik, Ruiz, 2007). The authors of another study made a similar assertion suggesting that “race matching” between client and clinician should be further explored (Neighbors, Trierweiler, Ford and Muroff, 2003). However, it is not likely that this would be viable in many communities given the disproportionate number of white clinicians.

These studies offer empirical evidence of how clinical psychology has done a disservice to people of color. Conversely, they offer guidance on how the field of psychology and psychiatry can become more culturally competent and maintain its empirical and altruistic integrity. Addressing these issues will lead to better treatment for people of color and a strengthened sense of validity in the field of psychology and psychiatry overall.

 

References

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Haglin, R. P., & Whitbourne, S. K. (2010). Chapter 2: Classification and treatment plans, Chapter 9: Schizophrenia and related disorders. In Abnormal psychology: clinical perspectives on psychological disorders (Sixth ed., pp. 276-305). Boston, MA: McGraw Hill. (Original work    published 1993)

 

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