When does white racism against blacks in the United States become psychopathology? This question was hotly debated at the workshop "Racism and Psychopathology," held at APA’s 2000 annual meeting in Chicago in May.

The workshop was sponsored by APA’s Committee of Black Psychiatrists. Although the session was open to all psychiatrists, it was mostly attended by psychiatrists who were African American. One exception was a white psychiatrist from the Czech Republic.

In the opinion of Carl Bell, M.D., a professor of psychiatry and public health at the University of Illinois in Chicago, there are three groups of white racists in the United States. The first are basically decent people who can see beyond the propaganda of their childhood against blacks and who have some empathy for them. The second are people who have experienced trauma at the hands of a black person and who, as a result, have trouble feeling empathy for African Americans. The third are individuals who are extremely narcissistic and who have no empathy for African Americans whatsoever.

So should racism be classified as a psychiatric disorder? "Sometimes and sometimes not," Bell said. "For the most part, I think it is a social issue."

Los Angeles psychiatrist George Mallory, M.D., agreed with Bell that white racism against blacks exists in varying forms. And when that racism is extreme, say, when whites kill African Americans, Mallory considers it mental illness, but not insanity, which is a legal concept. Claire Cohen, M.D., a Pittsburgh child psychiatrist, concurred with Mallory: Extreme racism is a psychiatric disorder. Such persons need psychiatric treatment, she believes.

Yet when it comes to racism, and especially extreme racism, white Americans certainly don’t have a monopoly on it, the panelists reminded participants. Certain blacks in Africa are racist against other blacks, a psychiatrist in the audience pointed out. Some blacks in the United States are racist regarding whites, a Duke University psychiatrist asserted. And there are other kinds of hatred that has nothing to do with blacks and whites at all—for example, those of certain ethnic groups in Eastern Europe, said the psychiatrist from the Czech Republic. Such racism is on the rise, he added. Thus, if anything is to be placed in DSM-V about racism being a psychiatric disorder, it needs to be broadened beyond simply a white-black problem, he said.

So obviously the microinsults and more egregious abuse that certain white Americans inflict upon African Americans are a complicated issue. Still, African Americans would like to see a halt to such behaviors because, as Bell pointed out, even when such behaviors are nonverbal, which is usually the case, they make "you feel pretty low."

When asked if there were one thing that could be done to improve black-white relations in the United States, Cohen replied: Come to workshops like this one on racism and psychopathology—not to preach, but to listen, because at such workshops African Americans usually end up talking to themselves.