Katie Rose Guest Pryal

Novelist and Essayist at Chronicle Vitae

Shattering the Madness Monolith: On the Intersections of Race, Gender, and Psychiatric Disability

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Working as an academic is hard enough without adding psychiatric disability to the mix. Academics worry about whether they should disclose their disabilities to colleagues. And they also must deal with the all-too-common ableist insults that some of these same colleagues toss around without a thought.

When we talk about psychiatric disability in the academy, we cannot ignore how race, gender, socioeconomic, and other kinds of privilege affect how people with disabilities live and work. It’s a lot easier to deal with the stigma of mental illness if your colleagues aren’t already questioning your competency on the job—overtly or not—because of which boxes you check on census forms.

Most of all, we must recognize that people with psychiatric disabilities do not experience their disabilities in a monolithic fashion. On the contrary, our diverse identities ensure that our experiences of disability are also diverse. (For example, the National Alliance on Mental Illness has designated July as Minority Mental Health Month to draw attention to the dramatic differences in how mental health is addressed across various racial and ethnic communities in the U.S.)

Race and other types of privilege can affect how we experience psychiatric disability in the academy. Dominic (a pseudonym) is a white, straight, male, tenure-track faculty member at a public regional university. He has an anxiety disorder. He reports that he doesn’t hear many ableist insults, even though, he tells me, “Academics can be such terrible human beings. It really is astounding.” He believes that his colleagues avoid using hurtful language around him because he is “out” with his disability in his department and because of his “enormous privileges.” He describes how his social position plays an important role in how he is treated: “I have a pretty good presence, am white, male, tenure-track, extremely verbal, and I disclose my anxiety and panic disorders without a trace of apology (because I've been doing so for some time). In these circumstances, even crappy people typically don’t feel comfortable saying much of anything in my presence.”

Dominic recognizes that, while all who are psychiatrically disabled are subject to stigma, privilege can make stigma easier to bear. Because of his race, gender, sexuality, and job status, his colleagues afford him a presumption of competence. The presumption affects how his colleagues treat him, and how he expects to be treated.

All people with psychiatric disabilities are familiar with the presumption of incompetence attached to having what others perceive to be a broken brain. Add to this presumption the myriad others—for example, that women are bad at math, that black women scientists can be abused with impunity, that female academics who are mothers aren’t worthy of the tenure track (not that there’s much of a tenure track left)—and often you end up with the makings of an academic trainwreck.

But not always. Here are three stories of academic women of color with psychiatric disabilities. These stories show, in three unique ways, how the presumption of incompetence can lead scholars down unexpected paths. But each woman has found her successes, too.

Cara: “My Life Is Run By My Conditions”

Cara (a pseudonym) is a female, queer, African-American doctoral student in pharmacology. She has a physical disability (lupus) and a psychiatric disability (bipolar disorder). She is currently in the final months of her Ph.D. program. She told me, “I don’t think the intersectionality of my mental illness and personal identity have affected my work in an identifiable way.” However: “Having a mental illness and physical illness while trying to complete a challenging course of study like pharmacology is an awesome feat that is extremely isolating sometimes.”

This February, Cara’s lupus caused her to have a stroke, which took three weeks to recover from. “Often I feel as if my life is run by my conditions,” she tells me. “I'm always running from one appointment to the next.” Her disability sometimes keeps her from participating in departmental life: “I often give in to my social anxiety and avoid events because I feel so out of place—not because of my gender, race, or sexuality, but because of my disability.”

Cara was also forced to change her course of study due to her disability. First, she had to switch from medical school to her doctoral program. Then, rather than accommodate her and let her keep her research plan, the university pushed her into changing paths: “In part because of my recurrent depression and physical limitations, I had to change labs, from bench work with cells to translational-clinical work with humans.” She’s still unhappy about this “soft forced choice”: “There are low points and high points like any research project, but they are tinged by a sense of resentment.”

But Cara will graduate soon—an “awesome feat” indeed.

Annie: “Maybe They Just Really Love T’ai Chi”

Annie (a pseudonym) is a Chinese-American, straight, female university professor. While she was in graduate school, she found it difficult to receive medical treatment due to the perceived psychiatric condition of simply being Asian and female: “I went to a doctor at the university because I had recurring abdominal pain. The doctor listened to my description, but rather than doing a physical exam, he explained to me that it was normal for Asian women to be anxious and stressed out, and anxiety was probably causing my abdominal pain.” But surprisingly, the doctor didn’t treat the anxiety either. He just said there was nothing he could do.

Annie was persistent, though, and another doctor diagnosed her with a medical problem unrelated to anxiety and treated her successfully. Annie remains struck, however, by the first doctor’s reaction to her race and gender: “Having a doctor declare a mental issue to be ‘normal’ because of my race has stuck with me through the years.”

Annie’s terrible experience with the university doctor is doubly complicated. First, he failed to diagnose a real gastrointestinal illness because of a psychiatric illness he’d imagined solely because of Annie’s race. Second, he refused to treat the imaginary psychiatric illness, declaring it a facet of being an Asian woman—and therefore untreatable. Annie’s doctor diagnosed her with a psychiatric illness and then deliberately did not treat the illness because of her race.

The problem, according to Annie (and to the American Psychological Association), is that Asian-American women are at high risk of suicide—higher than Asian-American men. Furthermore, Asian Americans often don’t seek mental-health care for cultural reasons, such as fear of shaming their families or lack of trust in traditional (white) mental-health-care systems. Comedian Kristina Wong describes how she had trouble identifying with “psychology brochures featuring stock images of white women looking forlorn against rain-specked windows.” Wong writes, with fake incredulity: “Chinese people didn’t see therapists. Spend $100 to tell a stranger your problems?” Annie’s experience only reinforced the idea that Asian Americans shouldn’t trust white doctors.

At the end of our interview, Annie asked me a question that seemed out of the blue: “Do doctors ever tell you that you should try T’ai Chi?”

I am a white, straight woman. “No,” I laughed. “Never.”

Annie told me, “I have had no fewer than five non-Asian doctors—psychiatrists and medical doctors—tell me that I should try T’ai Chi as a treatment for my illnesses. Maybe it’s because of my race.” She paused. “Or maybe they just really love T’ai Chi.”

Ruth: “The Expectation Is That I Grin and Bear It”

Ruth C. White, a decorated professor of social work at the University of Southern California, is an immigrant black woman who identifies with the queer community. Despite her many professional successes, she points to various facets of her identity, including being an African-American woman, that have put her credentials as an academic into question: “Being a mother, I have found that my ‘competence’ is an issue that hangs in the air but remains unspoken. As a black woman, the expectation is that I grin and bear it.”

Back when she was on her job search, she did not want anyone to know about her psychiatric disability, bipolar disorder: “I have had concerns when job hunting, that it’s bad enough being a black woman, but being a ‘crazy’ one may be a deal-breaker.” Ruth shared her disability with her colleagues and more publicly around the time she published her first book, Bipolar 101. Since then she has published widely on the intersection of mental illness and race.

Ruth worried not only about how her colleagues would view her disability, but also about how her students would view it: “I used to be concerned about how students would view me and my ‘competence’ if they knew I was mentally ill.” But, she explains, since her students have learned of her disability, her experience “has only been very positive.” Indeed, she has become a beacon for her students: “Students with mental illness (and without) see me as a role model and feel safe to come to me when they are having a hard time or seeking guidance and support.”

Now that she’s a professor in a major school of social work, Ruth feels a sense of responsibility toward her profession: “Being in a position to shape professional minds regarding the topic and experience of mental illness, I feel obligated to give them insight beyond ‘abnormal psychology.’ I know that not all mentally ill people can be university professors, but I also want them to know what it’s like to live with a chronic, severe mental illness and thrive.”

Ruth lives a successful professional life. She wants the experts in her field to know that others with mental illness can do the same.

Monoliths Shattered

The stories of Dominic, Cara, Annie, and Ruth reveal the diverse ways that people live with psychiatric disability in the academic workplace. With the presumption of incompetence following you around, every academic with a psychiatric disability knows what it is like to have to work extra hard to prove that you can do your job.

But our experiences of disability are not monolithic across race, gender, and sexuality, as these stories show. Don’t presume that everyone’s story is the same as yours. Take time to listen.

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