Cultural Paranoia

The concept of “cultural paranoia” was first introduced by William H. Grier and Price M. Cobbs in their 1968 book Black Rage. These two Black psychiatrists explained that this condition is not a form of psychopathology, but instead is a healthy and adaptive response by African Americans to their historical and contemporary experiences of racial oppression and discrimination in the United States. Charles R. Ridley, an African American psychologist, reintroduced the concept of cultural paranoia more than a decade later to explain why Black clients do not disclose to White psychotherapists. Ridley stated that because the encounter in counseling and psychotherapy is a microcosm of the larger American society, Black clients may not disclose personal information to White therapists for fear that they may be vulnerable to racial discrimination. Thus Black mental health professionals make a distinction between cultural paranoia, a form of adaptive coping, and clinical paranoia, a symptom of mental illness.

There have been some psychologists who questioned the use of the term paranoia to describe a situation that does not involve psychopathology or mental illness. Homer Ashby and Phyllis Bronstein criticized Ridley for using the term cultural paranoia during an exchange in the February 1986 issue of the American Psychologist. Arthur Whaley tried to resolve the debate by arguing that paranoia is not a simple “present-absent” symptom, falling along a continuum from mild to moderate to severe. According to Whaley, cultural aspects of paranoia in terms of lack of trust, especially among African Americans, fall on the mild, nonclinical end of the paranoia continuum. Whaley also pointed out that the term cultural mistrust, for which there is consensus among those on both sides of the debate, is one that is appropriate to describe African Americans’ ways of coping with racism and oppression.

The Cultural Mistrust Inventory (CMI) was developed by Francis and Sandra Terrell to assess this response style in African Americans. Using the CMI, Whaley demonstrated that what was originally labeled “healthy cultural paranoia” is indeed not a form of psychopathology. In addition, Ekta Ahluwalia used the CMI in her doctoral dissertation to study African Americans, Native Americans, Latinos/as, and Asian Americans. Ahluwalia found that Native Americans and African Americans had the highest CMI scores among the ethnic groups. Because both Native Americans and African Americans had unique histories with regard to racism and oppression in the United States, her findings provide support for the notion that the CMI is tapping these cultural experiences.

Whaley conducted qualitative and quantitative reviews of the literature on the CMI and found it to correlate positively and negatively with different measures of psychosocial functioning. The positive associations tend to involve indicators of emotional functioning, whereas the negative correlates include measures of social behavior in interracial situations. This pattern of findings may reflect the fact that the protective qualities for ethnic/racial minority mental health emanate from lack of investment in tasks that increase the risk of exposure to racial prejudice and discrimination. A major element in addressing cultural paranoia or cultural mistrust in counseling and psychotherapy is to acknowledge racism as a reality for people of color and explore the reasons for mistrust. It is also important to recognize that the behavioral manifestations of cultural mistrust are not indicative of psychopathology. Recently, Dennis Combs and his colleagues showed the CMI to be positively associated with a measure of perceived racism and unrelated to measures of depression and clinical paranoia in African Americans. This empirical research is a direct test of the assumption, and supports it, that cultural paranoia is a healthy coping behavior in response to racial oppression and discrimination.

References:

  1. Ahluwalia, E. (1991). Parental cultural mistrust, background variables, and attitudes toward seeking mental health services for children (Doctoral dissertation, University of North Texas, 1990). Dissertation Abstracts International, 51(9-B), 4271.
  2. Ashby, H. U. (1986). Mislabeling the Black client: A reply to Ridley. American Psychologist, 41, 224-225.
  3. Bronstein, P. (1986). Self-disclosure, paranoia, and unaware racism: Another look at the Black client and the White therapist. American Psychologist, 41, 225-226.
  4. Combs, D. R., Penn, D. L., Cassisi, J., Michael, C., Wood, T., Wanner, J., et al. (2006). Perceived racism as a predictor of paranoia in African Americans. Journal of Black Psychology, 32, 87-104.
  5. Grier, W. H., & Cobbs, P. M. (1968). Black rage. New York: Basic Books.
  6. Ridley, C. R. (1984). Clinical treatment of the nondisclosing Black client: A therapeutic paradox. American Psychologist, 39, 1234-1244.
  7. Ridley, C. R. (1986). Optimum service delivery to the Black client. American Psychologist, 41, 226.
  8. Terrell, F., & Terrell, S. L. (1981). An inventory to measure cultural mistrust among Blacks. Western Journal of Black Studies, 5, 180-184.
  9. Whaley, A. L. (2001). Cultural mistrust: An important psychological construct for diagnosis and treatment of African Americans. Professional Psychology: Research and Practice, 32, 555-562.
  10. Whaley, A. L. (2001). Cultural mistrust and mental health services for African Americans: A review and meta-analysis. Counseling Psychologist, 29, 513-531.

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