Drapetomania

Drapetomania, from the Greek drapetes (runaway slave) and mania (mad or crazy), literally means “the disease causing slaves to run away.” Dr. Samuel A. Cartwright, an eminent surgeon in the antebellum American South, coined the term to express the idea that runaway slaves exhibited symptoms of mental disorder. Cartwright's position–that sanity meant accepting the condition of enslavement, whereas fleeing slavery was insane–illustrates the role of prevailing sociocultural norms in the construction of psychiatric diagnoses.

Thomas S. Szasz, author of The Myth of Mental Illness, referenced drapetomania in describing the political function of psychiatry in his 1971 essay “The Sane Slave.” Szasz asserted that psychiatric diagnoses emerge from normative standards of a given historical era as mechanisms of social control. The pathologizing of deviations from social norms continues today, Szasz argued, particularly for minorities and other oppressed groups (e.g., battered women's self-defense may be pathologized as battered women's syndrome). Thus, the prevalent diagnoses of a historical era reveal more about social pathology than about individual mental illness.

Cartwright's treatise on drapetomania was written in 1851, a time when abolitionist criticism of slavery threatened to undermine Southern economic and social stability. Cartwright attempted to counter abolitionists by claiming that enslavement engendered psychological health in African Americans, who required paternalistic care, whereas freedom engendered pathology. Cartwright opined that following proper medical advice prevented drapetomania and its symptom (running away): The recommended cure was to keep slaves in their “natural” position of submission while providing for their needs, along with whipping at the onset of the disorder.

The idea that freedom was pathological for African Americans was also presented in Cartwright's report on another diagnosis, dysaesthesia aethiopis, a disorder characterized by intellectual stupor, somatic lesions, “breaking, wasting and destroying” property, wandering at night, avoiding work, and general trouble making (“rascality”). Cartwright thought the disorder prevalent among “free negroes” who were not under supervision, of whom Cartwright stated that nearly all were afflicted. Dysaesthesia aethiopis and drapetomania [Page 159]medically justified the institution of slavery for the “good” of the enslaved while answering abolitionists' charges that slavery debased both the enslaved and the enslaver.

The term “drapetomania” first appeared in Cartwright's 1851 “Report on the Diseases and Physical Peculiarities of the Negro Race,” published in the New Orleans Medical and Surgical Journal (since reprinted several times). The term appears periodically in medical and psychological literature as a critique of the politicization of psychiatry. Noted African American psychiatrist Alvin F. Poussaint, who has argued that racism, rather than reactions to it, should be pathologized, observed that the criteria for abnormality are continually shaped by societal values. Cultural psychologists have argued that these diagnoses represent ethical violations that still resonate in clinical practice. It was not unusual in the antebellum South for a European American doctor to describe disease in people of African descent; ample evidence of slaves put to medical use, including medical experimentation, exists. Psychologist Arthur L. Whaley proposed that the historical trauma incurred by abusive diagnoses such as drapetomania contributes to present-day cultural mistrust of European American mental health providers.

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