Nancy Potter: Applied Philosophy: Race, Gender, and Mental Illness

Applied Philosophy: Race, Gender, and Mental Illness
Phil 523/623
PAS 510/615
WGST 593/692
Tuesdays 7-9.45 p.m.
Hum 106

Required Texts:
Sander Gilman, Difference and Pathology: Stereotypes of Sexuality, Race, and Madness
Paula Caplan and Lisa Cosgrove, ed., Bias in Psychiatric Diagnosis
Readings on e-Reserve: You are expected to print them out, read them, and bring
them to class.

Course Description:
Western science is typically claimed to be objective, basing its theories and practices on empirical findings. But the identification and treatment of the mentally ill raises important questions about the current state of the disciplines of psychiatry and psychology. Just as one example, African-Americans are less likely to seek treatment for mental distress and, when they do, are often misdiagnosed as psychotic or schizophrenic rather than as experiencing anxiety due to stressors such as poverty and racism. There are reasons to believe that some populations are particularly vulnerable to certain forms of mental distress (women getting depressed, African-Americans developing anxiety disorders,) and we will take seriously the existence of mental illness per se. But if these claims are right, are people getting the help they need? How do one’s race, ethnicity, and gender affect one’s vulnerability to mental distress—or to being perceived as being mentally disordered? For example, among the personality disorders, the typical patient diagnosed with Borderline Personality Disorder is a white woman, while the typical patient diagnosed with Antisocial Personality Disorder is a male in a low socioeconomic status. Are these differences based on objective criteria? How are these differences being explained? How do psychiatrists and psychologists respond to socially marked differences in their patients? How do race, ethnicity, and gender influence pharmacological treatment? This course aims to situate mental illness in the broader context of historical, cultural, and sociological factors in order to examine the vulnerabilities of minority groups when it comes to mental health and illness. Readings will be interdisciplinary but we will take a philosophical approach to analyzing the intersection of medical science with social issues. For instance, we will need to analyze the central concepts in play, such as race, ethnicity, gender, mental illness, culture, and difference. This is an exploratory course, and students should expect to be full participants in examining and probing these questions.

Course Requirements:

1. Attendance. Each class meeting is equivalent to one week of the course. Furthermore, we will not meet one Tuesday during the semester because of Fall Break. Therefore, you need to make every effort to be in class every Tuesday that we meet. I will take attendance both at the beginning of class and after the breaks. Anyone who misses more than one night will be exempt from receiving an “A” in the course.
2. Class participation. You are expected to have read the assigned readings and to be prepared to discuss them. This class will be conducted as a seminar, so preparation prior to class meetings is necessary for you and others to get the most out of the course.
3. Protocols. Each Tuesday, two or three class members will present a brief (one to two page) summary and critique of the main points of the previous week’s discussion. A Protocol should include the writers’ reactions, insights, and/or further reflections on points raised during class. Note that you should not merely give an outline of the previous class. For example, if you went home thinking an important question was unexplored, if a term was unclear, or if your views on something have changed as a result of the previous week’s class, you could include that in your Protocol. Protocols are written collaboratively and then they are typed and photocopied for the class and presented orally at the beginning of the class meeting. Note that you are not collaborating when you and your classmates divide up the work and each writes up one section. The duty of writing the Protocol rotates among the members of the class, and a sign-up sheet will be passed around the first night of class.
4. Three papers. For each of these papers, you will be asked to respond to a set of questions relating to the material covered in the course to date. I will hand out paper topics one week before each paper is due (two weeks for the 3rd paper.) For the last paper, you are strongly encouraged to write on a topic of your own choosing, but you must meet with me in person—and with a written outline of your ideas in hand—no later than November 22.
5. Leading class discussion. Students who registered for this course at the 6xx-level will be required to lead one classroom discussion for one hour. You can choose your topic from the syllabus and sign up in advance. I expect you to prepare and hand out a written agenda with discussion questions selected from the readings, to go over central arguments in the readings, and to facilitate class discussion. I am happy to meet with you prior to your teaching time if you wish.

Students registered for undergraduate 5xx:
Paper lengths between 5-7 pages
One protocol
Grading:
Protocols = 5 points
1st paper = 25 %
2nd paper = 30 %
3rd paper = 40 %

Students registered for graduate 5xx:
Paper lengths between 7-8 pages
Two protocols
Grading:
Protocols = 10 points (5 pts each)
1st paper = 25 %
2nd paper = 30 %
3rd paper = 35 %

Students registered for 6xx:
Paper lengths between 8-10 pages and last one 10-12 pages
Two protocols
Lead one one-hour class discussion
Grading:
Protocols = 10 points (5 pts each)
1st paper = 25 %
2nd paper = 30 %
3rd paper = 35 %
Leading discussion = pass/fail

Notes:

Late assignments. I do not routinely accept late work. Assignments are due at the beginning of the class period. This means that any papers or essays turned in later than the due date will be graded down.

Attendance. Class begins at the beginning of the class and runs through the entire scheduled period. I expect students to make every effort to get to class on time and remain until class is over unless an exceptional circumstance prevents it. Consistent tardiness or early departure puts you at a disadvantage and is disrespectful to other class members.

Incompletes. I follow University policy regarding incompletes. The grade of I (Incomplete) will be assigned only when the following three conditions have been met: when circumstances beyond your control prevent you from completing the required work, when the majority of the coursework has been completed, and when requested in writing before the due date of the final paper. Furthermore, in order for me to consider giving you an “I”, you must make specific arrangements with me before grades are due as to exactly how and when you plan to complete the course.

Academic honesty: Students are expected to adhere to our university's academic standards for honesty and integrity. These standards are stated at the beginning of the Undergraduate Catalog under "Code of Student Rights and Responsibilities. It makes clear that “academic dishonesty is prohibited at the University of Louisville. It is a serious offense because it diminishes the quality of scholarship, makes accurate evaluation of student progress impossible, and defrauds those in society who must ultimately depend upon the knowledge and integrity of the institution and its students and faculty.” You should pay special attention to Sections Five and Six where it defines terms and explains just what sorts of things count as academic dishonesty. It is your responsibility to know this code and comply with its requirements. Penalties for academic dishonesty include suspension and expulsion from the University. You can be sure that if I suspect any violations of this Code, I will take serious action. If you have any questions about what constitutes academic dishonesty, you are expected to ask me before any assignments, tests, or other course work are due.


Schedule of Readings
Note: this schedule is subject to change and it is your responsibility to remain informed of any changes in the syllabus. Check Blackboard regularly.

DP = Difference and Pathology, Gilman
BD = Bias in Psychiatric Diagnosis, ed. Caplan and Cosgrove
e = e-Reserve

Week One: Introduction: Facts, Science, and the Production of Mental Illness
August 23

Week Two: Psychiatry and Differences
August 30
Assigned readings:
· Sander Gilman, “Introduction: What are stereotypes and why use texts to study them?” (DP)
· Marilyn Nissim-Sabat, “Race and Culture” (e)
· John Sadler, “Sex and Gender” (e)
· “Poverty and women’s mental health” (e)
· “Racism and mental health” (e)

Recommended:
· Daniel Blackburn, “Why Race is Not a Biological Concept” (e)

Week Three: Bias in Psychiatric Diagnosis and Treatment
Sept 6
Assigned readings:
· Jeffrey Poland and Paula Caplan, “The Deep Structure of Bias in Psychiatric Diagnosis” (BD)
· Gilman, “On the Nexus of Blackness and Madness” (DP)
· Gilman, “The Madness of the Jews” (DP)

Week Four: Intersections and Bias
Sept 13
Assigned readings:
· Alisha Ali, “The Intersection of Racism and Sexism in Psychiatric Diagnosis” (BD)
· Nayyar Javed, “Clinical cases and the Intersection of Sexism and Racism” (BD)
· Wesley A. Profit, “Should Racism Be Classified as a Mental Illness?” (BD)

Week Five: Patient Populations
Sept 20
Assigned readings:
· Phyllis Chesler, “The Female Career as a Psychiatric Patient” (e)
· Chesler, “Psychiatrically Institutionalized Women” (e)
· Heather E. Bullock, “Diagnosis of Low-Income Women” (BD)
· Nikki Gerrard, “Mislabeling Anxiety and Depression in Rural Women” (BD)

Due in class: Paper #1

Week Six: Psychopathologies and the Female Life Cycle
Sept 27
Assigned readings:
· Joan Christler and Ingrid Johnston-Robledo, “Raging Hormones? Feminist Perspectives on Premenstrual Syndrome and Postpartum Depression” (e)
· Nancy Theriot, “Diagnosing Unnatural Motherhood: Nineteenth-century Physicians and ‘Puerperal Insanity’” (e)
· Lisa Cosgrove and Paula Caplan, “Medicalizing Menstrual Distress” (BD)

Week Seven: Eating Disorders and Body Image Problems
Oct 4
Assigned readings:
· Shaun Gallagher and Mette Vaever, “Body: Disorders of Embodiment” (e)
· Judith Rabinor, “The ‘Eating-Disordered’ Patient”
· Emily Cohen, “The Fine Line between Clinical and Subclinical Anorexia”
· Vander Wal and Thomas, “Predictors of body image dissatisfaction and disturbed eating attitudes and behaviors in African American and Hispanic girls” (e)

In-class film
Week Eight: Personality Disorders
Oct 18
Assigned readings:
· Nancy Potter, “Why BPD Patients Evoke Negative Reactions and What’s At Stake” (e)
· Skeem, Edens, Camp, and Colwell, “Are there differences in levels of psychopathy? A meta-analysis” (e)
· Blair, et. al., “Deafness to fear among boys with psychopathic tendencies” (e)

In-class film

Week Nine: Sexuality Part 1
Oct 25
Assigned readings:

· Jean Walton, “Masquerade and Reparation: (White) Womanliness in Riviere and Klein” (e)
· Gilman, “The Hottentot and the Prostitute: Toward an Iconography of Female Sexuality” (DP)
· Gilman, “Black Sexuality and Modern Consciousness” (DP)

Week Ten: Sexuality Part II
Nov 1
Assigned readings:
· Gilman, “Sexology, Psychoanalysis, and Degeneration” (DP)
· Alan Soble, “Desire: Paraphilia and Distress in DSM-IV (e)
· William Metcalfe and Paula Caplan, “Seeking ‘Normal’ Sexuality on a Complex Matrix” (BD)
· The Working Group, “A New View of Women’s Sexual Problems” (BD)
· “Serial Sexual Killers: Your Life for Their Orgasm" (e)


Week Eleven: Post-Traumatic Stress Disorder
Nov 8
Assigned readings:
·
· Meadow Linder, “Creating Post-traumatic Stress Disorder: A Case study of the History, Sociology, and Politics of Psychiatric Classification” (BD)
· Dana Becker, “Post-traumatic Stress Disorder” (BD)
· Vincent Fish, “Some Gender Biases in Diagnosing Traumatized Women” (BD)

Due in class: Paper #2

Week Twelve: Depression
Nov 15
Assigned readings:
· Sarah McSweeney, “Depression in Women” (BD)
· Jennifer Hansen, “Affectivity: Depression and Mania” (e)

Week Thirteen: Schizophrenia
Nov 22
Assigned readings:
· Elizabeth Sparks, “Depression and Schizophrenia in Women: The Intersection of Gender, Race/Ethnicity, and Class”
· Jeffrey Poland, “Bias and Schizophrenia”
· Bae, Brekke, and Bola, “Ethnicity and treatment outcome variation in schizophrenia: a longitudinal study of community-based psychosocial rehabilitation interventions” (e)

Week Fourteen: Cross-Cultural Differences
Nov 29
Assigned readings:
· Lewis-Fernandez and Kleinman, “Cultural Psychiatry: Theoretical, clinical, and research issues” (e)
· Yen and Wilbraham, “Discourses of culture and illness in South African mental health and indigenous healing, Parts I and II (e)

Due in my box no later than noon Dec. 9: Paper #3