Like the discipline of psychiatry that it legitimizes, the DSM attempts to transcend its history by burying it.

According to the authors of the DSM-IV, the original version of the DSM consisted of a few boxes of the 1840 United States Census.  The 1840 census includes a small section on mental illness, ostensibly intended to collect rudimentary data on the prevalence of mental illness in the United States.   The DSM-IV authors describe this section as comprising a single category for “idiocy/insanity.”  Although their description is technically correct, they omit the fact that “idiocy/insanity” is differentiated into more specific categories.   A close look at the census form reveals that “Idiocy/ insanity” is divided along racial lines into “White” and “Colored”, and then into “at public charge” (i.e. residing in a public facility) and “at private charge.”

John C. Calhoun

John C. Calhoun

Why does the 1840 census categorize mental illness by race?   For one thing, the racial divisions on the census line up with the racial segregations of the mental hospitals of the era.  In the 19th century, hospitals throughout the United States were segregated into white and nonwhite facilities.  It was widely believed in the medical professions that strict segregation of hospitals by race was good management.  Moreover, conveniently for pro-slavery politicians, the 1840 census appeared to find that a majority of nonwhites categorized under “idiocy/insanity” resided in the Northern states. The infamous Southern politician John C. Calhoun used that finding to argue that slavery supposedly enhanced the mental health of African Americans.  Calhoun’s argument was a version of the standard pro-slavery position of the time: that slavery improved the lives of slaves.

Later, the census data were challenged.   Abolitionist critics discovered that the director of the census, the Virginian politician William Augustus Weaver, had designed the 1840 census questionnaire to artificially inflate the numbers of freed slaves who were classified under “idiocy/insanity.”    The census was slanted to give the impression that freeing slaves drove them mad.  For abolitionists, Weaver’s input was naturally suspect, as he was a Southerner.   Despite, or because of, Weaver’s apparent error, he was reappointed as director for another term.   The official responsible for the reappointment was John. C. Calhoun.   As Secretary of State, Calhoun had had been assigned by congress to oversee the census.

In short, the mental health section of the 1840 census, the original ancestor of the DSM, was the brainchild of Southern pro-slavery politicians.  It was never meant to be scientific.  It was propaganda, through and through.

What does it suggest about the DSM that the precursors of its famed diagnostic categories were, quite literally, categories of segregation?  What does it suggest about American psychiatry that its diagnostic bible originated as a pseudoscientific political construct designed to legitimize oppression?  What does it suggest about the political needs of the current DSM system that its authors chose to whitewash these unpleasant facts?

In the recently released DSM-5, the “history” section has shrunk from a page to a brief paragraph.   If this trend continues, the history section of the DSM-6 will be a mere footnote.  In the new “history” paragraph, the ignoble tale of the 1840 census is no longer whitewashed, as it had been in the DSM-IVIt is simply omitted.   The DSM-5 manual bypasses the 1840 census completely, instead locating the origin of the DSM in an 1844 classification system that was produced by the American Psychiatric Association in its inaugural year.   Through an arbitrary adjustment made to its year of conception, the DSM appears to free itself from the racist clutches of John C. Calhoun.

Like the discipline of psychiatry that it legitimizes, the DSM attempts to transcend its history by burying it.

Kyle Arnold

About Kyle Arnold

Kyle Arnold, PhD, is a licensed psychologist who practices in the area of community mental health, and a member of the Society for Humanistic Psychology. He is a Clinical Assistant Professor of Psychiatry at SUNY Downstate Medical Center in Brooklyn, NY. His previous publications include articles on psychotherapeutic listening, the history of psychotherapy, psychobiography, and multiplicity.