The Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition is the manual that mental health providers use in determining mental disorders. The DSM-IV is also utilized by mental health institutions across the country to determine if someone is depressed, anxious, bipolar, schizophrenic or other emotional problem. Therapists are expected to use codes from the DSM-IV in order to receive payment from insurance companies.

The DSM-IV does not accept that the hatred of someone because they are different as a mental disorder. According to a recent ABC News article, “The American Psychiatric Association (APA) does not list racism in its Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatrists worldwide. Most psychiatrists believe that racism is a cultural and social problem, not a matter of individual pathology.

Harvard University psychiatrist Alvin Poussaint thinks that’s a mistake.
‘Extreme racism is treatable, and sometimes even lesser forms of racism are treatable because they have psychodynamics to them,” he told Nightline. “They don’t exist as a social problem, they … exist as psychological problems inside the individual.’

Poussaint, who is black, believes that racism — like other human behaviors — exists on a continuum, and that racism’s extreme forms, in which a person has racist delusions that can lead to violence, should be considered a serious mental illness and be listed in the DSM.

The association’s officials disagree:
‘Brutal, violent hate crimes are usually committed by mean, not sick, individuals and groups. We must not provide the convenient excuse of mental illness for those who are not genuinely ill,’APA President Daniel Borenstein wrote in the association’s newsletter last September.”

Homophobia, sexism and other forms of hatred are also not classified as mental health disorders in the DSM. They probably don’t want to provide a “convenient excuse of mental illness” for these folks either. The APA feels that either hatred of those who are different are not mental illnesses or they can be categorized as other mental illnesses such as depression, anxiety, bipolar disorder or intermittent explosive disorder.

Extreme hatred does cause extreme crime. Recent examples are: Detroit Tigers outfielder Delmon Young was arrested on a hate crime assault for allegedly attacking a group of men and yelling anti-Semetic epithets outside a New York City hotel; Jake England , 19, and Alvin Watts, 32 were arrested recently for shooting three African-American North Tulsa residents to death and injuring two others had a racist posting on his Facebook pages. The apparently random racially motivated shootings terrorized Tulsa’s African-American community; and of course the Trayvon Martin case where a seventeen year old black boy was shot to death by George Zimmerman whose own racist beliefs possibly caused this murder to occur.

Are these men deserving of punishment if they are found guilty? They certainly are and should be incarcerated in order to protect the public from future harm. But, is locking them up going to somehow crush the hatred that engulfs them? The answer to that is no; putting them behind bars is never going to solve this problem for them and others that carry this level of hatred.

If hatred of others was classified as a mental illness, then these alleged perpetrators could receive psychological treatment for this specific issue. As professional psychotherapists, we could attempt to raise the profile of this problem to involve the entire community. We could develop prevention and early intervention strategies. We could attempt to understand what causes such hatred. Is it the fear that others will take something away from them? Does it derive from not really knowing others from different ethnicities or sexual orientations? What role do politicians and the media play in pitting people against each other? What role does economic class play here? Whose interest does this all serve?
One of the goals of treatment would be to help the client understand the reasons and etiology for his hatred. Hopefully this understanding would transform him to a person who is more empathetic and understanding. He could learn to experience and comprehend his pain. His healing could stop the cycle of violence here.

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