Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic

"Crazy for This Democracy": Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic

Catherine A. Stewart

American Quarterly, Volume 65, Number 2, June 2013, pp. 371-395 (Article)

Published by Johns Hopkins University Press DOI: https://doi.org/10.1353/aq.2013.0025

For additional information about this article https://muse.jhu.edu/article/510633

Access provided at 7 Apr 2020 21:44 GMT with no institutional affiliation Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 371

“Crazy for This Democracy”: Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic

Catherine A. Stewart

n 1945 Negro Digest published an essay by the renowned writer Zora Neale Hurston titled “Crazy for This Democracy.” Hurston drew upon the meta- Iphor of disease to critique the United States’ failure to deliver democracy either abroad or at home, as President Franklin D. Roosevelt’s wartime rhetoric had promised. As Hurston wittily suggested, it would be more accurate to refer to the president’s “arsenal of democracy” as the “arse and all of democracy,” as the US military moved to shore up teetering imperial powers against indigenous movements fighting for decolonization.1 For Hurston, Jim Crow laws were symptomatic of the larger disease of racial discrimination, just as the bumps and blisters of smallpox (with which she compared them) were the visible signs of the disease and not the disease itself.2 Smallpox resonated for black writers like Hurston and Ralph Ellison as a particularly apt metaphor for the diseased state of American democracy: African Americans in the South were particularly susceptible, and it manifested itself both in the blood and on the epidermis, critical sites of racial taxonomies—what Frantz Fanon would term the “racial epidermal schema”—thus making visible the internal scarring left by contact with the diseased body politic.3 In Ellison’s Invisible Man, one of the asylum patients in the Golden Day is “a short pock-marked man,” a former doctor and World War II veteran, whose craziness is the result of prolonged exposure to the hypocrisy of fighting for democracy in a Jim Crowed army.4 Smallpox and racism were highly communicable diseases, and Hurston prescribed “a shot of serum that [would] kill the thing in the blood,” specifically, the immediate repeal of Jim Crow.5 Unfortunately, the United States seemed reluctant to take Hurston’s prescription, which she chalked up to a psychological case of mass delusion among white Americans. Using disease as a metaphor, Hurston illuminated how segregation was not just about the control of black bodies—politically, socially, and economi- cally—but about the psychological control of black minds. Jim Crow laws led to the “unnatural exaltation of one ego, and the equally unnatural grinding

©2013 The American Studies Association | 372American| Quarterly down of the other,” as they inculcated among whites a belief in their racial superiority and simultaneously persuaded blacks of their inferiority.6 Thus Hurston used the term crazy to signify two different states of mind: white America’s irrational refusal to acknowledge African Americans’ equality, which resulted in a different form of “crazy” for black folk subjected to Jim Crow. But Hurston’s title referred to a third meaning as well: her own passionate (and sane) desire to actually experience democracy. “I am crazy about the idea of this democracy,” Hurston proclaimed. “I am all for trying it out. I want to see how it feels. Therefore I am all for the repeal of every Jim Crow law in the nation here and now.”7 Hurston’s wordplay with the concepts of crazy and sane is emblematic of African American writers’ growing interest in psychoanalysis.8 Its popularization after World War II provided African American writers with a new paradigm for exploring the effects of white racism on the formation of black identity.9 Hurston’s entwining of black America’s mental state with the diseased state of American democracy was a trope that would also resonate in the writings of her contemporaries, Ellison and Richard Wright, whose growing interest in psychoanalysis manifested itself in their fiction and nonfiction. Both explored how the geography of American racism mapped itself onto black subjects, creating a troubled topography within the black psyche. These writers’ adaptation of psychoanalytic concepts for the project of black liberation and the realization of a democratic society developed concomitantly with the field of social psychiatry, which shifted the emphasis from the individual’s personal trauma and psychopathology to the societal and environmental forces at work on the individual.10 African American writers shared an interest in the social causes of mental health disturbances with experts in this growing field; however, they drew upon the concept of the damaged black psyche as symptomatic of a more systemic problem of the body politic, a body riven with the disease of white racism.11 Thus African American appropriations of psychoanalytic discourse were particularly apropos for their dual project of liberating the individual and curing the social order.12 Black writers, while engaged in unmaking a black “racialized” identity, were also working to redefine white identity by pathologizing whiteness and white norms. Their focus was white unreason as the cause of a diseased democracy and black unreason as a symptom; thus, these writers reconfigured and subverted postwar psychiatry’s emphasis on black pathology by pinpointing its source in the damaged white psyche. Both Ellison and Wright were instrumental in helping the prominent psychiatrist Fredric Wertham establish the Lafargue Clinic, the first community outpatient “mental hygiene” clinic in Harlem and a unique experiment in bringing the therapeutic benefits of psychoanalysis to an underserved minority Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 373 population. The “mental hygiene” movement focused on the application of psychiatric knowledge to social issues in the interest of prevention and public health.13 The Lafargue Clinic’s records, which include staff’s notations of clients’ oral narratives, provide a unique window into patients’ experiences with the clinic’s revolutionary method of empathetic listening and simultaneous transcription; this technique helped preserve more of the clients’ perspective, much of it recorded in their own words, than other case history records.14 As these unique patient narratives attest, the forces of racial discrimination increased some African Americans’ vulnerability to episodes of mental health disturbances.15 Like Hurston’s symptomatology, the diagnostic and therapeutic methods of the Lafargue Clinic worked to shift clinical focus from the medical establishment’s “Negro problem” to the pathology of whiteness and the problems that stemmed from racial discrimination.16 Just as Hurston’s essay plays with three meanings of crazy—whites’ racial prejudice, blacks’ temporary loss of sanity owing to contact with white unreason, and her own unbridled (but rational) enthusiasm for the realization of democracy—crazy similarly emerges in the Lafargue Clinic’s records in three different usages. There, crazy serves as a way to critique a diseased body politic, as a potentially real and tragic consequence of black encounters with discrimination, and as black reason reconfigured ascrazy by whites’ misread- ings of black responses to racial discrimination, responses that were either sincere or strategically performed as a form of resistance against the structures of white oppression. W. E. B. Du Bois was the first to draw upon the discipline of psychology to articulate the state of mind, “double-consciousness,” induced by the failure of American democracy to recognize black Americans as equal citizens.17 The linkages between governmentality, race, and psychological states engendered by encounters with racialized power structures would later be explored by the French Algerian psychiatrist Fanon, who examined how the psychopathology of colonialist regimes often resulted in madness among indigenous popula- tions.18 Black intellectuals demonstrated the highly infectious nature of an irrational and tyrannical system of oppression; it may be white craziness that establishes the system in the first place, but to survive within its confines, blacks must also become inmates in the asylum.19 As Fanon observed, “For a man whose only weapon is reason there is nothing more neurotic than contact with unreason.”20 This formulation appears seven years earlier in Ellison’s notes for Invisible Man and the conundrum faced by his narrator: “He is a man born into a tragic, irrational situation who attempts to respond to it as though it were completely logical.”21 | 374American| Quarterly

Du Bois, Wright, and Ellison are the most oft-cited examples of African American writers’ engagement with psychoanalysis, but Wright’s and Ellison’s investment went beyond the literary realm to the clinical world of social psychiatry. The intellectual collaboration between Wright and Wertham has been well documented by literary scholars such as Claudia Tate and David Marriott. However, their primary interest is Wright’s literary use of psychoanalytic discourse and excludes close consideration of the Lafargue Clinic’s actual methods and operations.22 Badia Ahad astutely positions both Wright’s and Ellison’s investment in Lafargue as a commitment to “the democratization of psychoanalytic psychiatry” necessitated by the racial hierarchy in American society, which prevented the realization of democracy.23 But Ahad comes to the conclusion that Lafargue’s “therapeutic responses to the problem of racial and economic inequities relied upon some disturbing assumptions,” namely “that the promise of legitimate citizenship could only be accessed by submitting to heteronormative cultural and social ideals.”24 In Ahad’s view, the normalizing imperatives of postwar psychoanalysis “all but foreclosed the possibility of ‘turning Freud upside down,’” an assertion that undermines Wertham’s commitment to social psychiatry as a way to bridge the gap between psychoanalysis and progressive political action in order to effectively undermine societal hierarchies.25 Because Ahad does not consult the Lafargue Clinic Records, she ignores the clinic’s actual methods for “turning Freud upside down.” Lafargue worked to position African Americans, as Ahad claims, “as ‘normative’ subjects in the larger public sphere,” but it did so by redefining their maladies as symptomatic of a diseased body politic.26 The historian of medicine Dennis Doyle provides a good institutional history of Lafargue, but he gives short shrift to the clinic’s use of the patient narrative itself as a central method of therapy. Persistent in his use of case files is an assumption that “the clinician, not the patient, remained the chief architect in the construction of the patient’s case.”27 My approach uncovers the clinic’s use of case histories as an essential diagnostic and therapeutic tool that could help African Americans reframe their problems as stemming from societal inequities as opposed to personal failings or racial inferiority. Most scholars do not distinguish, as I do (and as the clinic did), between different valences of “crazy”: clients who sought help were not always presenting serious mental health issues requiring major psychiatric treatment, and far from pathologizing all clients, Wertham directed his staff to distinguish carefully among rational or neurotic responses to environmental stimuli and more serious psychoses. Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 375

Blues Narratives

I argue that the Lafargue Clinic’s adaptations of psychoanalytic methods can best be understood as what Clyde Woods calls “the blues epistemology” or “the blues tradition of investigation and interpretation”—a form of socially ethical praxis and not just an aesthetic tradition—by improvising on and often strategically revising and inverting the traditional tropes of psychoanalysis.28 In the clinic’s blues epistemology, the origin of neurosis is not Freud’s individual but society; the patients are sane and the doctors are crazy; whiteness, not blackness, is pathologized; and when blacks exhibit symptoms of mental disturbance, it is often an ir/rational response to white insanity. Lastly, subversion of the structures of oppression, and not subservience or accommodation to them, is the prescription for the recovery of the black psyche. These narratives’ impro- visations on psychoanalytic states of being make them blues texts, insofar as having a case of the blues is a state of mind engendered by black encounters with oppression, and as their structure and content frequently embody what Houston Baker Jr. has identified as the “blues matrix” of black cultural expres- siveness, a vernacular form deriving from the tradition of blues and jazz.29 Blues is the musical form of self-narrative, in particular of strife and tragedy, but also of resistance and protest.30 Ellison, one of the first writers to theorize about this African American tradition, notes that “the Blues is an autobiographi- cal chronicle of personal catastrophe expressed lyrically.”31 From its beginnings, blues music abounded with song titles and lyrics referring to disturbed states of mind such as Mamie Smith’s “Crazy Blues” (1920) and the “Blow-Top Blues” (1945), which names New York City’s premier psychiatric hospital: “I woke up in Bellevue, but I left my mind behind! I’m a gal who blew a fuse, I’ve got those blow-top blues.”32 These lyrics play on the double meaning of getting mad and going mad. Crazy in this context refers to those who refuse to succumb to the rules of Jim Crow.33 As Ellison observed, African American music and idiom in the 1940s were becoming saturated with “expressions like frantic, buggy, and mad”—a phenomenon he interpreted as an attempt to evoke a type of “word-magic against the states they name.”34 Blues texts, like their eponymous musical form, contain elements of cre- ativity, improvisation, personal pain, and social critique transmuted through lyricism. As Baker explains, these black narratives discursively riff on master discourses of Western civilization, a process of resistance he calls “the defor- mation of mastery.”35 The Lafargue Clinic’s patient narratives and therapeutic methods embody both forms of blues traditions—blues as personal narrative and as an epistemological method—which play with and often upend master | 376American| Quarterly discourses as a strategy of critique, resistance, and societal transformation.36 Like the blues, psychoanalysis and medical symptomatology are part of the same disciplinary method that, in Carlo Ginzburg’s words, “permits diagnosis, though the disease cannot be directly observed, on the basis of superficial symptoms or signs, often irrelevant to the eye of the layman.”37 However, these blues interventions are also about restoring the health of the body politic and not just finding a cure for the individual. The diagnostic elements of Lafargue’s patient narratives regarding an ailing democracy become evident only when we look at them as blues texts. Scholars have acknowledged Wertham’s interest in literature as another means for exploring the interactions between social issues and the individual psyche, but they tend to assume that conversations with Wright and Ellison led primarily to Wertham’s psychiatric expertise informing black modernist literary texts. I would like to suggest that the influence also went the other direction; the clinic’s approach and methods exhibit the same blues epistemology that others have identified in the writings of Wright and Ellison.38 They testified to the potentially healing power of narrative as a therapeutic act while they worked to destabilize traditional (white) definitions ofsanity and insanity to expose and critique racial hierarchy. I begin by briefly exploring African Americans’ encounters with psychiatry during World War II, then return to examine the Lafargue Clinic’s interventions in psychoanalytic discourse and the use of client narratives as a central form of therapeutic treatment.

World War II and the Rise of Psychoanalysis

World War II was a turning point that helped radicalize black political consciousness regarding the limits of American democracy. As Hurston pointed out, Roosevelt’s rhetoric about a “war for democracy” threw into sharp relief the hypocrisy of having African American servicemen fight white supremacy abroad while being subjected to it at home.39 The military itself practiced Jim Crow, as enlisted African Americans served in segregated units commanded by white officers.40 Thus World War II elicited conflicting responses among African Americans, which Ellison addressed in a 1943 editorial in Negro Quarterly. Describing black ambivalence toward the war, Ellison drew upon the language of psychoanalysis to criticize those who unquestioningly called for wartime unity, as well as those who unequivocally dismissed it as a “‘white man’s’ war.”41 The former showed a “disintegration of the group personality” stemming from “a fear and uncertainty that is almost psychopathic,” while the latter’s cynicism and passivity amounted to “a political form of self-pity.”42 Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 377

Ellison characterized both as unhealthy responses to Jim Crow. “The problem,” he concluded, “is psychological” and could be solved only by a black leadership that would transform “Negro resentment, self-pity, and indignation . . . into positive action.”43 Ellison’s diagnosis of African American responses to World War II reflects the popularization of psychoanalysis; print media and other cultural mediums such as blues recordings had made the American public, by 1940, “familiar with a number of psychoanalytic conceptions defined in widely varied ways: the unconscious, the importance of early childhood and of sexuality, repression, psychological conflict, a continuum between normal and abnormal, dreams as expressions of repressed emotions.”44 The growth of psychoanalysis in the United States was also a result of the military’s development and application of psychiatric testing during World War II.45 Unfortunately, the military’s use of such tools often resulted in misdiagnoses based on assumptions of black racial inferiority.46 As the historian Ellen Dwyer has documented, a disproportionate number of those rejected by the Selective Service for psychiatric reasons were African American.47 For psychiatrists on the examining boards, Dwyer notes, there was “a high level of diagnostic uncertainty . . . especially in cases involving African-American inductees. As one doctor admitted: ‘The colored men offered me the greatest difficulty in diagnosis. Poor cultural, occupation and educational backgrounds often made it difficult to decide whether they were defective, preschizoid, or just colored.’”48 Clearly, military personnel charged with determining suitability for combat drew upon the new tools provided by psychiatry in a discriminating fashion and wielded a great deal of power in making their designations. However, black draftees could potentially exploit racial assumptions by providing answers they knew might raise concern among army psychiatrists. Ellison himself sought to avoid serving in the Jim Crow army through a psychiatric deferral, enlist- ing the help of his friend Wright and presenting a letter from Wertham.49 As the historian Robin Kelley has argued, the number of African American men who resisted the draft during World War II is probably larger than statistics suggest; some managed to avoid imprisonment by strategically failing their examinations. While a number faked physical ailments, for example, by mix- ing Benzedrine nasal spray with cocaine to mimic a heart defect, others, most famously Malcolm X and the jazz trumpeter Dizzy Gillespie, acted “crazy” to obtain 4-F classification, which meant unfit to serve.50 In his autobiography, Malcolm X reveals his enactment of insanity as a consciously crafted strategy. For his meeting with the army psychiatrist, he “costumed like an actor. With my wild zoot suit I wore the yellow knob-toe | 378American| Quarterly shoes, and I frizzled my hair up into a reddish bush of conk. I went in skipping and tipping—‘Crazy-o, Daddy-o, get me moving. I can’t wait to get in that brown [uniform].’ . . . Then I bent and whispered fast in his ear: ‘Daddy-o, don’t you tell nobody. . . . I want to get sent down South. Organize them Ne- gro soldiers, you dig? Steal us some guns and kill some crackers!’”51 Similarly, Gillespie told his recruitment officer that if he was instructed to shoot at the enemy, he was likely to target white Americans instead of Germans. “Well look, at this time, in this stage of my life here in the United States whose foot has been in my ass? The white man’s foot has been in my ass hole buried up to his knee in my ass hole! . . . You’re telling me the German is the enemy. At this point, I can never even remember having met a German. So if you put me out there with a gun in my hand and tell me to shoot at the enemy, I’m liable to create a case of ‘mistaken identity,’ in terms of who I might shoot.”52 Both men received their 4-F cards. But what seemed like craziness to the draft board was actually a sign of black sanity. These performances served as a critique of American democracy and a complete rejection of its social norms. They also suggest the slippage that existed for African Americans between definitions of sane and insane; “mad” could signify black rage and reason, as opposed to black pathology and unreason.53 Cultural perceptions about black identity based on prevailing racial ideolo- gies affected African Americans’ encounters with psychiatry in complex ways. During the first half of the twentieth century, assumptions about the biological nature of African Americans among white psychiatrists and psychologists led many to assert that black Americans were not as susceptible to certain mental health problems; owing to their more “primitive” state and a less well-developed and hence delicate central nervous system, they were supposedly less likely to manifest symptoms of nervous disorders, such as neurasthenia, dementia prae- cox, psychoneurosis, or suicidal ideation.54 As the Fisk University sociologist Horace Mann Bond observed in an essay critiquing these assumptions, “The belief that Negroes . . . are almost immune to insanity is based also on the belief that Negroes have very little material for an unbalanced mental constitution. If you begin with the fixed idea that Negroes have less ‘mind’ than white people, it is straight-line reasoning to believe that they will have less insanity . . . [and] if you believe that the Negro has a characteristic ‘temperament,’ a racial ‘genius’ for laughter and song and merriment, you can easily explain why this care-free creature should become insane less frequently than the serious-minded white man, whose mentality is so superior that it drives him ‘crazy’ where the Negro would remain jovial.”55 But, as Bond noted, a belief in racial differences and behavioral characteristics could also, paradoxically, lead to an overdiagnosis Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 379 of insanity.56 Thus black patients were much more likely to be diagnosed as schizophrenic, based on the “symptoms” they displayed of anger, aggression, and self-assertiveness.57 All too often African Americans suffered rather than benefited from misdiagnoses made by a white medical establishment predisposed to view black identity and behavior in pseudoscientific “racial” terms—as too primitive and simplistic to suffer from the more complex mental illnesses reserved for whites, or conversely too prone to serious mental health disturbances. An emerging counterpoint came from anthropologists such as Franz Boas and Otto Klineberg, who emphasized the role of society and culture in determining manifestations of mental illness. Likewise, social psychiatrists identified segregation and other forms of racial discrimination as factors in the etiology of mental health disturbances among African Americans.58 World War II led American psychiatrists to embrace psychoanalysis, and along with it, an emphasis on environmental pressures that went beyond the stresses of war to those of civilian life. As Gerald Grob observes, in the postwar era “the community, not the mental hospital, would become the focal point of psychiatric practice, and practitioners would become active in promoting the appropriate social and environmental changes” that would decrease mental illness among the general population. Activists of the 1940s and 1950s hoped to expand psychiatric services beyond institutional settings to help create “a more just social order.”59

The Lafargue Clinic

The first psychiatric clinic in New York City that would try to address the problems among African Americans emanating from racial discrimination was the Lafargue Clinic, established in March 1946 in the Parish House basement of St. Philip’s Episcopal Church in Harlem by the German-born psychiatrist Fredric Wertham.60 Wertham’s interest in psychoanalysis led him to correspond with Freud. In 1921 he came to the United States at the invitation of Adolf Meyer, who greatly influenced the development of psychoanalysis in the United States. Both became increasingly disenchanted with the Freudian fixation on sexuality and early childhood development, preferring instead to examine the patient’s life history and wider social environment.61 For most of his career, Wertham sought to expand psychiatry’s focus from Freud’s emphasis on the individual to an awareness of how society shapes the individual: “One can nei- ther understand nor treat a man alone; one can only study man-in-society.”62 Psychiatric treatment, as Wertham explained in an interview, must include “a patient’s personal and biological history to get at the micro-dynamic factors | 380American| Quarterly in his case, and his economic position and group culture to grasp the macro- dynamic factors.”63 In her recounting of Lafargue’s origins and methods, the physician-in-charge, Dr. Hilde Mosse, explained that while “a knowledge of what Freud discovered is indispensable to any form of psychotherapy . . . this does not mean that we recommend or apply the psychoanalytic method as prescribed by Freud except in selected, rare cases.” Lafargue’s “new approach to psychotherapy demands not only that we scrutinize the inner and outer life history of the patient, but also his social, economic and historical situation. This type of analysis guards against the error of trying to explain social facts on the basis of individual psychopathology alone.”64 Wright called Wertham’s implementation of social psychiatry in Harlem “the turning of Freud upside down.”65 While serving as chief resident psychiatrist at Johns Hopkins, Wertham met Clarence Darrow, who began sending African American clients to him.66 As director of the mental hygiene clinic at Queens General Hospital (after six years at Bellevue) and senior psychiatrist of the New York City Department of Hospitals, Wertham had long been aware of the lack of psychiatric services available to the city’s black community.67 “Negroes are not allowed the luxury of neuroses,” Wertham wryly noted.68 Former staff member Dr. Elizabeth Bishop recalled the prevailing belief among New York City’s health officials “based on fantasies, fables, and prejudices” that “Negroes were not in need of psychiatric services.”69 A front-page article in the New York Amsterdam News in 1946 with the headline “Mental Hospitals Bar Negroes—Psychiatrists Aver: ‘They’re Crazy Anyway’” reported that the Psychiatric Institute, at 168th and Broadway, had a color ban in place despite the fact that it received state fund- ing: “One prominent Negro physician stated: ‘They seem to think all Negroes are crazy anyway. The case of a Negro seldom receives the same attention that a similar mental ailment in a white receives. The services offered the Negro citizen are atrocious.’”70 Wright, one of Lafargue’s founders, alleged that Af- rican Americans had just as much access to psychiatric aid as “the Negroes of Mississippi, in theory, have access to the vote!”71 The clinic, named for the Cuban-born physician and social reformer Paul Lafargue, aimed to provide low-cost mental health services, since few medical facilities in New York offered treatment to African Americans,72 and those that did had a bad reputation for their misdiagnoses of black patients along with their policies of mandatory referrals and involuntary commitment.73 The columnist Ralph Martin observed that “overcrowded, understaffed Bellevue has an unenviable reputation in Harlem. Negroes have to be carried in there; few walk in. The few who do are told . . . ‘There’s nothing wrong with you. You’re Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 381 a Negro. You think too much, that’s all.’”74 Ellison had a similar experience in 1945 when he sought psychiatric help for depression and was told that he was “thinking too much and too hard.” As his friend Wright recorded the incident in his journal: “Of course, this was because he was a Negro. Ralph said that he wanted to hit the doctor.”75 Exacerbating this situation, Wertham noted, was the fact that African Americans were often in greater need of these services as a result of encounters with racial discrimination. “I chose Harlem,” Wertham explained, “not as an interracial experiment, but because conditions here have created one of the world’s greatest psychological problems. Harlem’s social conflicts have caused a vast number of personality breakdowns.”76 As Wright clarified, “The consistent sabotage of their democratic aspirations in housing, jobs, education, and social mobility creates an environment of anxiety and tension which easily tips the normal emotional scales toward neurosis.”77 In a 1948 essay Ellison, who do- nated the clinic’s first table, applauded the clinic for recognizing “the sickness of the social order” that “barred [African Americans] from participating in the main institutional life of society . . . leav[ing] the most balanced Negro open to anxiety.”78 Harlem was the perfect location, according to Ellison, because it was “the scene and symbol of the Negro’s perpetual alienation in the land of his birth.”79 According to Wertham, “Perhaps a third of our patients would not need treatment at all if they were white, but ordinarily mild neuroses arising from other causes are stimulated beyond the bounds of safety by the pressures of the community.”80

Blues Geography

One central problem the clinic sought to address was its African American clients’ social invisibility. As both Ellison and Wright identified in their publicity for the clinic, it was intimately connected to their economic and political marginalization manifested in the concrete relegation of black people to Harlem. A 1939 study in Chicago postulated that the attendant hardships of living as an urban minority contributed to higher rates of psychosis among black residents.81 In northern cities like Chicago and New York, where African Americans had migrated but not been integrated, they experienced a type of social exile that stemmed from a hypervisibility which, as Ellison explained, “actually rendered one un-visible,” that is, visible to whites only as a projected and feared image.82 Perceived invisibility was a recognized symptom of the psychotic state of depersonalization. The noted British psychoanalyst R. D. Laing described this | 382American| Quarterly phenomenon as a state of “apprehensive awareness of oneself as potentially exposed to danger by the simple fact of being visible to others. The obvious defence against such a danger is to make oneself invisible in one way or another.”83 Ellison’s Invisible Man is the literary embodiment of the depersonalization African Americans experienced as a result of their constant awareness of the reality of their endangerment. Wertham declared that those who sought treatment at Lafargue were suffering primarily not from “intrapsychic conflict” but from depersonalization. “These people are not neurotics,” he stated in the New York Post. “They’re mental DPs and we’re here to take care of them.”84 It seems clear that Ellison’s involvement with the founding of the Lafargue Clinic, which occurred around the time he started writing Invisible Man (summer 1945), had a deep impact on the novel, a connection surprisingly overlooked by scholars.85 In his blueprint for the novel, Ellison explained that invisibility “springs from two basic facts of American life. From the racial con- ditioning which often makes the white American interpret cultural, physical, or psychological differences as signs of racial inferiority” and from the exclusion of African Americans from “the institutions and patterns of life which mold white Americans’ personality. . . . Negro life is a world psychologically apart.”86 As both Wright and Ellison would point out, the resulting social exile for African Americans led to internal states of exile, as one’s mind was colonized by the white majority’s value system. As Ellison warned, the self-abnegation necessitated by African Americans’ conformity to Jim Crow went hand in hand with a type of self-abdication. Physical migration, displacement, and marginalization induces a type of mental migration, as the geography of American race relations is mapped onto the black psyche, a type of blues geography.87 Even the phrase “to take leave of one’s senses” suggests that insanity involves a self-imposed exile from one’s own sovereignty governed by reason. In his essay about Lafargue from 1948, “Harlem Is Nowhere,” Ellison observed that “significantly, in Harlem the reply to the greeting ‘How are you?’ is very often ‘Oh, man, I’m nowhere.’”88 To survive the daily indignities of Jim Crow, African Americans were forced to repress the many negative emotions racism engendered by driving them underground into the unconscious. As Ellison wrote to Wright in 1941, “I have learned to keep the bitterness submerged so that my vision might be kept clear; so that those passions which could so easily be criminal might be socially useful. I know those emotions which tear the insides to be free and memories which must be kept underground, caged by rigid discipline lest they destroy, but which yet are precious to me because they are mine.”89 Perhaps Wright remembered this exchange when he wrote in his article on Lafargue: Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 383

“Repressed need goes underground, gropes for an unguarded outlet in the dark and, once finding it, sneaks out, experimentally tasting the new freedom, then at last gushing forth in a wild torrent, frantic lest a new taboo deprive it of the right to exist.”90 But underground for Ellison also existed as a safe space for the expression of the repressed, through the figurative trapdoor of fiction, and likewise in the underground rooms that housed the Lafargue Clinic. It was off the map of American racial geography and unmarked by the color line, as both white and black clients were treated by an interracial staff: “Not only is it the sole mental clinic in [Harlem],” wrote Ellison, “it is the only center in the city wherein both Negroes and whites may receive extended psychiatric care. Thus its importance transcends even its great value as a center for psychotherapy: it represents an underground extension of democracy.”91

Therapeutic Acts

The social psychiatry practiced at the clinic worked to address the impact of racial discrimination in the form of poor housing, poverty, and unemploy- ment, using a modified form of psychotherapy, “since there is no need for long delving into the subconscious if the cause of the trouble is in the physical environment.”92 Wertham intentionally hired staff members who were knowl- edgeable about the community and culture in Harlem. In the Herald Tribune, he described his criteria. Of two candidates, both well qualified in terms of their training, Wertham only accepted “the one who had good experience as well. . . . It’s of utmost importance,” he stated, “that the people who work here should be completely acquainted with life in Harlem. Some of our staff know it intimately, having lived here a long time.”93 Staff were well aware of the medical establishment’s tendency to misdiagnose aspects of black culture as symptoms of pathology. One young boy, who had been initially taken to Bellevue for treatment, was diagnosed as a sexual sociopath because he kept singing a popular blues song that began, “Don’t you feel my leg, because when you feel my leg, you’re gonna feel my thigh.” When the patient was referred to Lafargue, the social worker assigned to his case immediately recognized the Bellevue psychiatrist’s mistaken diagnosis: “God Almighty . . . everybody in Harlem knows that song. It’s a popular recording. That psychiatrist just didn’t know Harlem, that’s all. Before he could diagnose that kid, he should know the cultural pattern of the community, what the kid lived through and how it affected him. That, again, is social psychiatry.”94 Far from following the tendency of postwar psychiatry to demarcate normal from deviant behavior, often along the lines of race and sexuality, Lafargue | 384American| Quarterly worked to correct assumptions of black pathology. For example, schizophrenia was a frequent diagnosis for African Americans by the white medical establishment throughout the twentieth century, revealing more about the racial biases of psychiatrists than the actual symptoms of those under diagnosis, as Wertham observed well in advance of more recent studies.95 Mosse, a child psychiatrist, drew attention to the overdiagnosis of schizophrenia among children. In the American Journal of Psychiatry, Mosse claimed that the majority of the cases she had seen at the clinic and in private practice had been misdiagnosed with schizophrenia when they displayed “behavioral problems or suffered from common juvenile fantasies.”96 These clinical attitudes were identified by Wertham as part of the racial discrimination African Americans faced. White psychiatrists, he suggested, tended to fall into one of three categories when it came to dealing with African American patients: those who overtly discriminated on “racial” grounds; those “humanitarians” who “are worse than the first kind because they are smug . . . and humiliate the patient”; and those who hide prejudicial attitudes behind “the pretense of objective neutrality.”97 To ensure that staff members were the right fit for Lafargue, criteria for dismissal included attitudes of racial prejudice: “If the staff members think that all colored people are given the breaks now, they are disqualified from working in the clinic.”98 Although all staff positions were unpaid, performance was carefully reviewed and discussed at regular committee meetings. One new member was criticized for a poor work ethic, but more importantly for the attitude he displayed toward clients: “He has a lofty manner with patients as if this is slum activity.” Equally troubling was his inability to take a proper case history “in spite [of] having been at clinic twice a week since fall.”99 The egalitarian spirit of the Lafargue Clinic was intended to shift the bal- ance of power between patient and doctor, but it was also an intrinsic feature of the administration of the clinic owing to practical and ideological necessity. A conflict emerged when some staff members wanted to hire only those with psychiatric training. A clinic memo explained, “It is politically and socially wrong to make the standards the same as the others do. We are in opposition to the ones in power. Naturally people who will be drawn to us are not the ones on top.”100 Wertham objected to the conservative tendency of postwar psychiatrists, as members of an elite class, to inculcate their values in patients, encouraging social conformity while denying the very material class divisions within society. Wertham’s brand of social psychiatry was intended to critique society’s racial and socioeconomic hierarchies, not uphold them.101 Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 385

Like Fanon, Wertham was interested in examining how racial oppression manifested itself in clients’ dis-ease, often in signs and symptoms that reflected the contours of the color line, such as a schizophrenic who regularly halluci- nated that “whenever the moon is full her skin turns a shade whiter and her hair straightens out.”102 One boy’s file notes that the “Mother states the child showed early preference for light skin, preferring white playmates. That he resents his father’s dark color as well as his own. He now lives in community that is predominantly white, having moved from predominantly colored. He remarked that some of his white playmates expressed a fear that if they touched him they would turn colored.”103 Wertham interpreted such manifestations as a reflection of the pressures of living in a racialized democracy, but also as a result of the larger societal dysfunc- tion.104 Extensive media coverage of the clinic conveyed Wertham’s message and drew examples from actual case studies: “The happy, normal 14-year-old kid who became suddenly obsessed with the fact of being a Negro and tried to kill two children so they wouldn’t have to grow up into a world of prejudice; . . . the woman who wanted to commit suicide because she was fired from too many jobs by bosses who saw her as a color instead of a human being. What about them? Where did they go for help, for advice, for treatment?”105 The clinic aimed to address the symptoms of each client without the means to address the underlying cause.106 Black clients’ problems, Wertham averred, would require a more comprehensive solution to eradicate the inher- ent contradictions of American democracy. Examining segregation’s impact on school children, Wertham compared race prejudice in American society to tuberculosis; as such, it constituted a public health problem, not because every child would be affected the same way but because, as with the bacilli that caused tuberculosis, there was the potential for harm for all children, regardless of race.107 Wertham’s disease metaphor, like Hurston’s, was apt and illuminating: tuberculosis ranked among the top three causes of death for African Americans in urban areas, proliferating as a result of poor nutrition, overwork, and poor housing; the most efficacious treatment for the disease, prior to the development of pharmaceutical interventions, was to remedy these environmental conditions inculcated by segregation.108 In Wertham’s view, racial discrimination was a public health hazard that, like tuberculosis, was most likely to affect African Americans but that also presented white Americans with the possibility of infection. To treat conditions arising from these environmental stresses, the clinic’s staff included psychiatrists, social workers, psychologists, general health practi- | 386American| Quarterly tioners, and remedial reading specialists.109 Although Lafargue’s publicity flyer proclaimed its mission “to provide expert psychotherapy for those who need it and cannot get it,” Wertham ensured that the provision of social services was an integral component of the clinic.110 Staff members routinely helped clients find employment or pursue vocational training, and often acted as advocates for clients with school officials, the Department of Welfare, the Immigration and Naturalization Service, prisons, and the courts.111 Still, as clinic records on organization and training show, all staff members were expected to receive instruction in psychotherapy, regardless of their specialization.112 But the most revolutionary aspect of Lafargue’s methods of treatment was the clinic’s use of patient narratives as a tool for empowering their clients. Intake interviews were essential to the clinic’s methodology, and every worker was instructed on the manner in which Wertham required them to be taken.113 Face-to-face dialogue between clients and staff, as case files make clear, was viewed not just as a diagnostic tool but as a therapeutic method. In one of his frequent lectures, Wertham elaborated on the critical process of examination: “The person who sees the patient first is in a very important position: 1) he sets the emotional setting for many things, 2) he has the best chance to get the story. There is . . . in New York a psychiatric clinic—one where they do diagnosis, one where they do treatment— nonsense, the beginning of an examination is already therapy.”114 The client’s testimony was valued for the cathartic benefits of telling one’s story to an empathetic listener. As the clinic’s protocol sheet clearly stated, the case history “is part of therapy.”115 Wertham’s interest in the intersections between literature and psychiatry clearly carried over into his thinking about clinical case histories, which he described in terms of narrative forms: “Why patient comes to you is like an anecdote. Present illness is like a short story. Life story is like a novel.”116 As Thomas Couser notes, the treatment of illness “necessarily involves a sort of narrative collaboration between doctor and patient,” but in the act of creating the medical history, patients may lose control of their life narratives as they yield them up to objective medical authority, which retains the power to interrogate and interpret patients’ testimony.117 The relatively new field of “narrative medicine” calls attention to the importance of stories in the experience of illness and the work of healing.118 It challenges medical practitioners to pay more attention to construction of the patient’s narrative and emphasizes the importance of valorizing the patient’s perspective.119 The Lafargue Clinic’s method was a forerunner of this approach; staff members were instructed to follow these guiding principles for the first session: “Establish a good working relationship with patient. This can be achieved by showing him both Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 387 your sympathy and your respect for him as a human being. Listen carefully to what he says and how he says it. Take notes while patient is talking, not in retrospect. . . . Refrain from asking too many questions—listen to what the patient has to say; give reassurance whenever necessary; in doing so, use your tact and sensitivity; don’t overdo things, be sincere.”120 Although staff were expected to guide the interview, they were also to give clients agency in constructing their own narratives of dis-ease; instructions for taking down clients’ information caution staff members against privileging their own diagnoses over the client’s perception of his or her own situation: “[The patient’s] own formulations rather than yours can be very enlightening.”121 The respect for patients’ perspective is reflected in handwritten transcriptions of clients’ oral narratives that fluidly shift between first and third person but steadfastly provide the patient’s interpretation without comment or question. Lafargue’s method of empathetic listening—a type of witnessing—was also an attempt to address the social invisibility and marginalization its clients experienced. Talcott Parsons described illness in The Social System as a state of absence, and by extension one of social invisibility. According to Arthur Frank, “Parsons means literal absence from work and other responsibilities, but illness is a more general absence from the social presence that health takes for granted, and this absence is the reflexive ground of the illness narrative. The text is an attempt to fill in absence.”122 All too often black patients in particular found their personal narratives of illness rejected and dismissed during treatment, but the Lafargue Clinic not only enabled African Americans living in Harlem to articulate their encounters with discrimination but validated and honored these experiences. Clients’ narratives relating to racial prejudice reveal that patients and their families were attuned to environmental sources of emotional disturbances. The father of a ten-year-old boy who, according to his fifth-grade teacher, had been repeatedly disruptive in class, explained to clinic staff that he felt the problem lay with the teacher’s discriminatory attitude. “Last year he had a wonderful teacher, he got along splendidly, with this new teacher—a relapse . . . the record card is marked on ‘getting along with others’ she claims he talks out of turn. Does not like teacher.”123 Two weeks later, in a return visit, the father reported further evidence of the teacher’s antagonism toward his son: “Robert out of class to bathroom. When he returned and asked for page on what class was reading—raised his hand, she told him ‘Have had enough of you Robert. It’s about time the Doctors took over.’”124 She also threatened on every report to hold him back a grade. Although Robert’s father acknowledged that his son was “strong willed,” he and his wife felt Robert’s behavior was problematic owing to the teacher’s negative response to him.125 | 388American| Quarterly

A teenager referred by the Department of Welfare revealed the tensions within her interracial family: “‘My mother is prejudiced. She would call my aunt a white this and white that and my aunt would call my mo. a black this and black that.’ Father was a Caucasian-Irish. ‘I don’t think my sister and brother are my father’s children.’”126 She returned to this theme in another interview several months later, as the caseworker reported: “Father was a white man and mother’s family did not like him. Felt there was no love between parents.”127 These narratives challenged the prevailing discourse, which identified Har- lem’s “high rates of delinquency and nervous break-down” as representative of blacks’ racial inferiority, and rescripted black pathology as encounters with white pathology.128 The Lafargue Clinic was a radical and innovative experiment in more ways than one. It sought to redress the asymmetrical power relationship of physician and patient at a time when racial and class hierarchies within the medical profession were particularly stark. “The spirit of the place,” said founding member and Life magazine writer Earl Brown jokingly, “is to be subservient to any bum who may walk in off the street.”129 Patients, on the other hand, were often advised by Wertham “as a matter of psychiatric advice . . . that it is far better to be subversive than subservient.”130 Treatment at Lafargue often involved working to correct the imbalance of what Hurston called the unnatural grinding down of African American ego. Wertham identified black servility as symptomatic of the infectious nature of white racism.131 This was echoed by the psychologist Kenneth Clark, who argued that effective treatment for children suffering from emotional disturbances would “strengthen their personalities” instead of encouraging submission to “prevailing racial injustices.”132 Similarly, Wertham was quoted as saying that the “chief aim of Lafargue is to instill in its patients ‘the will to survive in a hostile world.’”133 While there might be no cure for clients whose illnesses were symptomatic of a larger societal dysfunc- tion not of their own making, there could be some form of healing if clients’ psychological immune systems could be strengthened to better equip them for a life of continued exposure to American pathologies of race. Thus treatment for the psychological injuries inflicted by such encounters involved getting individuals to see their problems as part of, in Wertham’s terminology, the “macro-dynamic” factors, which included group identities and group relationships to society; individual encounters with discrimination were not personal but political.134 Working with their clients, clinicians at Lafargue encouraged the reframing of personal narratives to include the wider framework of American race relations. When staff encountered problems of “free-floating hostility,” causing clients to victimize others, they encouraged Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 389 patients to redirect it into more “constructive channels,” a euphemistic way of referring to political activism targeting inequity. “It is not constructive in Harlem,” Wertham obliquely observed, “to be conservative.”135 Thus the cure for black clients’ disturbances as a result of Jim Crow involved turning incho- ate reactions to inequality into intentional responses. The clinic’s approach resonated with Ellison’s call for black leadership to help transform “Negro resentment, self-pity, and indignation . . . into positive action”—responsive as opposed to reactive resistance.136 The mental hygiene movement as it emerged during World War II was concerned with sanitizing those members of the body politic engaged in im- moral behavior “to ensure that the individual performs in accordance with the governing laws of his or her social environment.”137 But the clinic, under Wertham’s guidance, was redefining the mental health problems of its Harlem clientele as symptomatic of the environmental conditions associated with insti- tutionalized forms of racial discrimination. Treatment, therefore, necessitated raising black clients’ awareness of their oppression rather than repressing it so that it came out in harmful ways. As Wertham declared in an interview with the People’s Voice, “The Lafargue Clinic is not trying to help adjust people to a vicious environment. We give them the best in psychiatric care to help build strong citizens, fighters against this debilitating ghetto! We want our patients to function in a changing world, and work with others to do it!”138 Wertham’s alteration of the mental hygiene movement, far from seeking clients’ assimila- tion into the societal norms that caused their maladies, operated according to the blues ethos of insight and wisdom born of oppression; rather than teach resignation, the clinic, in Wertham’s words, pragmatically aimed “to transform despair not into hope, but into determination.”139 The Lafargue Clinic hoped to reframe African Americans’ experiences with white racism by helping their clients to see it as systemic and not personal; its prescription for an ailing democracy recalled Hurston’s antidote—the immediate repeal of Jim Crow. Sadly, the clinic closed on November 1, 1958, never to reopen, despite Wertham’s and Mosse’s hopes that it might someday resume operations.140 However, the blues epistemology enabled clients and staff of the Lafargue Clinic, along with black modernist writers in the postwar era, to theorize and talk about race and racism in American society in a new way; improvising on the discourse of psychoanalysis, they were able to recon- ceptualize exclusionary practices and behaviors as indicative of white sickness, unreason, and madness, and reject explanations of black racial inferiority and “natural” inequalities. The Lafargue Clinic’s blues epistemology helped serve as an important reminder that symptoms of illness can often be a diagnostic tool not just for the individual but for the health or sickness of the body politic. | 390American| Quarterly

Notes I would like to thank Sarah Banet-Weiser and the rest of the editorial board of American Quarterly for their generous and insightful comments, as well as the anonymous external reader. Thanks to Diana Lachatanere, curator of the Manuscripts and Rare Books Division at the Schomburg Center for Research in Black Culture, and her staff for granting me permission to use restricted and highly sensitive patient case records. A grant from Cornell College’s Dimensions’ Center for the Science and Culture of Healthcare funded my research. Earlier versions of this work received encouragement from attendees at the 2009 meetings of the American Association for the History of Medicine and the Northeast Modern Language Association. My colleague Phil Lucas helped provide the time needed for revision. This essay benefited greatly from the invaluable comments and suggestions provided by Lynne Ikach, Jill Jack, Michelle Mouton, and David Strass. 1. Zora Neale Hurston, “Crazy for This Democracy,” in Folklore, Memoirs, and Other Writings, ed. Cheryl A. Wall (New York: Library of America, 1995), 946. 2. Hurston may have been thinking of the Yoruba’s association of madness with smallpox. For more on mental illness among the Yoruba, see Jonathan Sadowsky, Imperial Bedlam: Institutions of Madness in Colonial Southwest Nigeria (Berkeley: University of California Press, 1999). 3. Frantz Fanon, Black Skin, White Masks (1952; repr. New York: Grove, 1967), 112. For a fascinating history of smallpox epidemics in the United States and the troubled history of vaccination, see Michael Willrich, Pox: An American History (New York: Penguin, 2011). 4. Ralph Ellison, Invisible Man (1952; repr. New York: Vintage Books/Random House, 1995), 79. 5. Hurston may be referring, tongue in cheek, to medical research on depigmentation techniques, or what Fanon referred to as a “serum for ‘denegrification’” Black( Skin, White Masks, 111). For another critique of this solution, see George Schuyler’s satire Black No More (New York: Macaulay, [1931]). Eric Porter notes that NAACP president Walter White believed hydroquinone might be a remedy for racial discrimination (“‘Black No More’? Walter White, Hydroquinone, and the ‘Negro Problem,’” American Studies 47.1 [2006]: 5–30). 6. Hurston, “Crazy for This Democracy,” 948. 7. Ibid., 947. 8. As Nathan Hale’s thorough history points out, the growth of psychoanalysis in the United States was embraced in a wide variety of therapeutic settings and professions, including psychoanalytic psychiatry, psychology, the mental hygiene movement, and social work, and gave rise to many adaptations including psychoanalytic psychiatrists who became outspoken critics of “orthodox” or “Freudian” psychoanalysis, such as Wertham and Henry Stack Sullivan (Hale, The Rise and Crisis of Psychoanalysis in the United States: Freud and the Americans, 1917–1985 [New York: Oxford University Press, 1995], 136–37). 9. White writers also adopted this discourse to critique white supremacy. See, for example, John Dollard, Caste and Class in a Southern Town (New Haven, CT: Yale University Press, 1937); and Lillian Smith, Killers of the Dream (New York: Norton, 1949). 10. Alexander H. Leighton, John A. Clausen, and Robert N. Wilson, eds., Explorations in Social Psychiatry (New York: Basic Books, 1957). 11. For a critique of postwar social scientists’ problematic portrayal of African Americans as psychologically damaged by racism, see Daryl Michael Scott, Contempt and Pity: Social Policy and the Image of the Damaged Black Psyche, 1880–1996 (Chapel Hill: University of North Carolina Press, 1997). 12. Hurston anticipated Brown v. Board of Education’s emphasis on the psychological consequences of segregation, although she became an outspoken critic of desegregation and the underlying assumption that white space is always preferable to black. The psychologist Kenneth Clark, whose work informed the Supreme Court’s decision, would also refer to prejudice as a “social disease” that “damaged” white children as well as black (Prejudice and Your Child [1955; repr. Boston: Beacon, 1963], 66–81). 13. Bart Beaty, Fredric Wertham and the Critique of Mass Culture (Jackson: University Press of Mississippi, 2005), 16, 19. See also F. I. Wertham, “Discharges against Advice from a Psychiatric Hospital with Only Voluntary Admissions: A Study in Social Psychiatry,” Mental Hygiene 13 (1929): 564–90. 14. As others have noted, it is difficult to find evidence that effectively articulates the patient’s perspective. See Ellen Dwyer, Homes for the Mad: Life inside Two Nineteenth-Century Asylums (New Brunswick, NJ: Rutgers University Press, 1987). 15. Only twenty-nine extant patient case records are available in the Lafargue Clinic Records, Manuscripts, Archives and Rare Books Division, Schomburg Center for Research in Black Culture, New York Public Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 391

Library (hereafter cited as LCR-SCRBC). Given that the clinic saw 288 new clients and recorded a total of 1,483 visits for 1947 alone, the number of case files currently available to researchers is sadly limited (State of New York, Department of Social Welfare, Annual Report of Dispensary Services, 1947, box 52, Fredric Wertham Papers, Manuscript Division, Library of Congress, Washington, DC; hereafter cited as Wertham Papers–LC). The Wertham Papers contain additional patient case files, but they are currently closed owing to Library Services Directive No. 03-01, which limits access to patient medical records for seventy-five years or later from the creation of the documents (Louis Wyman, reference librarian, Manuscript Division, Library of Congress, pers. comm., November 14, 2012). 16. A number of postwar social scientists identified racial prejudice as pathological. See, for example, Oliver Cox, Caste, Class, and Race: A Study in Social Dynamics (New York: Doubleday, 1948), 433–36; and Clark, Prejudice and Your Child. 17. W. E. B. Du Bois, The Souls of Black Folk (Chicago: McClurg, 1903). For more on his adaptation of the concept of double-consciousness, see Cynthia D. Schrager, “Both Sides of the Veil: Race, Science, and Mysticism in W. E. B. Du Bois,” American Quarterly 48.4 (1996): 569; Arnold Rampersad, The Art and Imagination of W. E. B. Du Bois (Cambridge, MA: Harvard University Press, 1976); Dickson D. Bruce Jr., “W. E. B. Du Bois and the Idea of Double-Consciousness,” American Literature 64.2 (1992): 299–309. 18. Frantz Fanon, “Letter to the Resident Minister” (1956), in Toward the African Revolution (Political Essays), trans. Haakon Chevalier (New York: Monthly Review Press, 1967), 53. 19. Du Bois’s “On Being Crazy” (1907) points out the irrational response of whites to civil rights in an Orwellian turn on competing definitions of “social equality” (in American Negro Short Stories, ed. John Henrik Clarke [New York: Hill and Wang, 1966], 9–10). 20. Fanon revises orthodox psychoanalytic thought that asserts that childhood trauma results from encounters with the rational (Black Skin, White Masks, 118). 21. Ralph Ellison, “Working Notes for Invisible Man,” in Ralph Ellison’s Invisible Man: A Casebook, ed. John F. Callahan (New York: Oxford University Press, 2004), 25. 22. Tate’s use of psychoanalytic theories to interpret Wright and other black writers suggests new theo- retical possibilities for further critical exploration of black literary discourse. See Tate, Psychoanalysis and Black Novels: Desire and the Protocols of Race (New York: Oxford University Press, 1998); David Marriott, Haunted Life: Visual Culture and Black Modernity (New Brunswick, NJ: Rutgers University Press, 2007). For another take on Wright’s staging of the oedipal conflict, see Abdul R. JanMohamed, “Savage Holiday: Matricide and Infanticide,” in The Death-Bound Subject: Richard Wright’s Archaeology of Death (Durham, NC: Duke University Press, 2005), 210–32. 23. Badia Sahar Ahad, Freud Upside Down (Urbana: University of Illinois Press, 2010), 94–95. 24. Ibid., 6. There was one area in which the Lafargue Clinic did not break with the psychoanalytic assumptions of the postwar era; in the few extant files of clients who discussed their same-sex prefer- ences, staff members, while sympathetic, still regarded homosexuality as a behavior that needed to be “cured.” However, Wertham cautioned staff members against misdiagnosing clients as homosexuals (“Examination of Patients, Lecture Lafargue Conference 4-1-52,” box 51, Wertham Papers–LC). Dennis Doyle identifies only three case records that deal with homosexuality in the Lafargue Clinic Records (“‘Where the Need Is Greatest’: Social Psychiatry and Race-Blind Universalism in Harlem’s Lafargue Clinic, 1946–1958,” Bulletin of the History of Medicine 83.4 [2009]: 750, 767–70). 25. “Turning Freud upside down” is Wright’s description of Wertham’s methods (Wright, “Psychiatry Comes to Harlem,” Free World, September 1946, 49, box 1, folder 8, Ida Guggenheim Papers, Manuscripts, Archives and Rare Books Division, Schomburg Center for Research in Black Culture; Ahad, Freud Upside Down, 109). 26. Ahad, Freud Upside Down, 85. 27. Doyle, “‘Where the Need Is Greatest,’” 767. 28. Clyde Woods, “‘Sittin’ on Top of the World’: The Challenges of Blues and Hip Hop Geography,” in Black Geographies and the Politics of Place, ed. Katherine McKittrick and Clyde Woods (Cambridge, MA: South End, 2007), 51, 54. 29. Houston A. Baker Jr., Blues, Ideology, and Afro-American Literature: A Vernacular Theory (Chicago: University of Chicago Press, 1984). 30. Angela Davis, Blues Legacies and Black Feminism: Gertrude “Ma” Rainey, Bessie Smith, and Billie Holiday (New York: Pantheon Books, 1998). | 392American| Quarterly

31. Ralph Ellison, “Richard Wright’s Blues” (1945), in Shadow and Act (New York: Signet, 1964), 90. 32. Marybeth Hamilton, In Search of the Blues (New York: Basic Books, 2008); Leonard Feather, “Blow- Top Blues,” Dinah Washington with Lionel Hampton and His Septet, Decca 23792-A, 1945. 33. For another analysis of blues songs as social critique, see Adam Gusso, “‘Shoot Myself a Cop’: Mamie Smith’s ‘Crazy Blues’ as Social Text,” Callaloo 25.1 (2002): 8–44. 34. Ralph Ellison, “Harlem Is Nowhere,” in Cultural Contexts for Ralph Ellison’s Invisible Man, ed. Eric J. Sundquist (New York: Bedford/St. Martin’s, 1995), 244. 35. Houston A. Baker Jr., Modernism and the Harlem Renaissance (Chicago: University of Chicago Press, 1987), 49–52. 36. As Amiri Baraka points out, the blues is fundamentally a politicized aesthetic engaged in the process of dissent (“The ‘Blues Aesthetic’ and the ‘Black Aesthetic’; Aesthetics as the Continuing Political History of a Culture,” Black Music Research Journal 11.2 [1991]: 108). 37. Carlo Ginzburg, “Morelli, Freud, and Sherlock Holmes: Clues and Scientific Method,”History Workshop Journal 9.1 (1980): 12. 38. This approach begins to address what Mikko Tuhkanen identifies as a reductive and hierarchical application of psychoanalysis to the reading and interpretation of African American writing (The American Optic: Psychoanalysis, Critical Race Theory, and Richard Wright [Albany: State University of New York Press, 2009], xxi). 39. This gave rise to the “Double V” campaign waged in the black press for a military victory over fascism abroad and a social victory over racism at home (Nikhil Pal Singh, “Culture/Wars: Recoding Empire in an Age of Democracy,” American Quarterly 50.3 [1998]: 471–522). 40. See C. L. R. James et al., Fighting Racism in World War II (New York: Monad, 1980). See also Horace Cayton’s recollection, “A Double Victory for Democracy at Home and Abroad,” in Long Old Road (New York: Trident, 1965), 250–53. 41. Ralph Ellison, “The Negro and the Second World War,” in Cultural Contexts for Ralph Ellison’s Invisible Man, 234–36. 42. Ibid. 43. Ibid., 239–40. 44. Hale, Rise and Crisis of Psychoanalysis, 76–77. 45. Hale attributes popularization of Freudian principles largely to American psychiatrists’ attempts to treat shell-shocked veterans of World War I (Rise and Crisis of Psychoanalysis, 157). 46. Ellen Dwyer, “Psychiatry and the Black Soldier during World War II,” in The Problem of Evil: Slavery, Freedom, and the Ambiguities of American Reform, ed. Steven Mintz and John Stauffer (Amherst: University of Massachusetts Press, 2007), 366–81. 47. Ibid. 48. Ibid., 370. 49. His efforts were unsuccessful (Carol Polsgrove, Divided Minds: Intellectuals and the Civil Rights Move- ment [New York: Norton, 2001], 67). 50. Robin D. G. Kelley, “The Riddle of the Zoot: Malcolm Little and Black Cultural Politics during World War II,” in Race Rebels: Culture, Politics, and the Black Working Class (New York: Free Press, 1996), 161–81. 51. Malcolm X, with Alex Haley, The Autobiography of Malcolm X (1964; repr. New York: Ballantine, 1992), 122. 52. Dizzy Gillespie, with Al Fraser, To BE, or not . . . to BOP: Memoirs (Garden City, NY: Doubleday, 1979), 120. 53. For an earlier example of the performance of illness as a strategy for African Americans, see Dea Boster, “An ‘Epeleptick’ Bondswoman: Fits, Slavery, and Power in the Antebellum South,” Bulletin of the History of Medicine 83.2 (2009): 271–301. 54. Michael Gambino, “‘These Strangers within Our Gates’: Race, Psychiatry, and Mental Illness among Black Americans at St. Elizabeths Hospital in Washington, DC, 1900–40,” History of Psychiatry 19.4 (2008): 392. 55. Horace Mann Bond, “Insanity among Negroes: A Symptom of Social Disorganization,” Opportunity 10 (October 1932): 304. 56. Ibid. 57. Current research into the disproportionate rates of hospitalization between blacks and whites attributes this to racial bias among mental health professionals (Arthur L. Whaley, “Ethnicity/Race, Paranoia, Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 393

and Hospitalization for Mental Health Problems among Men,” American Journal of Public Health 94.1 [2004]: 78–81). 58. See Dwyer, “Psychiatry and the Black Soldier,” 367. 59. Gerald N. Grob, “Psychiatry and Social Activism: The Politics of a Specialty in Postwar America,” Bulletin of the History of Medicine 60.4 (1986): 477–501. 60. St. Philip’s central location in Harlem at 214 West 134th Street (near Seventh Avenue) made it the ideal, rent-free choice for the unfunded clinic. The street address for Lafargue was 215 West 133rd Street (“Rector of Harlem Church Is Honored on Anniversary,” New York Times, November 7, 1948, box 3, folder 6, LCR-SCRBC). 61. John Hohenberg, “Harlem: Do Something about It,” New York Post, November 1, 1946, Daily Magazine and Comic Section, 1, box 53, Wertham Papers–LC. For more on Meyer’s influence on psychoanalytic psychiatry, see Hale, Rise and Crisis of Psychoanalysis, 167–73. 62. Frederic Wertham, “Psychiatry and the Prevention of Sex Crimes,” Journal of Criminal Law and Criminology 28 (1938): 847–53; quoted in Beaty, Fredric Wertham and the Critique of Mass Culture, 32. 63. Robert Bendiner, “Psychiatry for the Needy,” Tomorrow, April 1948, 23, box 3, folder 1 “Publicity,” LCR-SCRBC. 64. Hilde Mosse, “Child Psychiatry and Social Action: An Integral Part of the History of American Child Psychiatry,” 22-23, box 4, folder 11, LCR-SCRBC. 65. Wright, “Psychiatry Comes to Harlem,” 51. 66. Ibid. 67. Beaty, Fredric Wertham and the Critique of Mass Culture, 21. 68. Bendiner, “Psychiatry for the Needy,” 24. 69. Elizabeth Bishop Davis was the daughter of Reverend Shelton Hale Bishop of St. Philip’s, who generously provided the site for the clinic (interview by Jean Blackwell Hutson, October 19, 1983, videorecording, Moving Image and Recorded Sound Division, Schomburg Center). Hutson recalled, “We were told Negroes never commit suicide.” 70. “Publicity, News Clippings re Lafargue Clinic, 1946–47”: New York Amsterdam News, City Edition, April 27, 1946, 1, 25, box 3, folder 4, LCR-SCRBC. 71. Wright, “Psychiatry Comes to Harlem,” 49. 72. A voluntary fee of twenty-five cents remained in effect from 1946 to the clinic’s closing in 1958; clients who could not afford the fee were not expected to pay, but staff found that most took it as a point of honor to pay whatever they could, often leaving a nickel or a dime on the table (Lafargue Clinic Notes, December 31, 1947, box 1, folder 9, LCR-SCRBC). Wertham planned to title his memoir “Dr. Quarter” (box 52, Wertham Papers–LC). 73. Wertham’s departure from his position as director of Bellevue’s Mental Hygiene Clinic was likely the result of having received an adverse civil service rating for allegedly identifying Bellevue as an example of “the miscarriages of justice through psychiatry” (Frederic Wertham to the Hon. Paul Kern, March 30, 1939, box 52, Wertham Papers–LC). Wertham changed his name from Friedrich Wertheimer to Frederic Wertham upon immigrating to the United States and eventually dropped the second “e.” 74. Ralph G. Martin, “Doctor’s Dream in Harlem,” New Republic, June 3, 1946, 798. 75. Richard Wright, Journal, January 10 and 22, 1945, Wright Papers, James Weldon Johnson Collection, Beinecke Rare Book and Manuscript Library, Yale University, reprinted in Polsgrove, Divided Minds, 67. 76. Norman M. Lobsenz, “Human Salvage in Harlem,” Coronet, March 1948, 134, box 3, folder 6, LCR- SCRBC. 77. Wright, “Psychiatry Comes to Harlem,” 49–50. 78. Ellison, “Harlem Is Nowhere,” 245–47. 79. Ibid., 243. 80. Bendiner, “Psychiatry for the Needy,” 24. 81. Robert E. L. Faris and H. Warren Dunham, Mental Disorders in Urban Areas (Chicago: University of Chicago Press, 1939), referred to in G. Eric Jarvis, “The Social Causes of Psychosis in North Ameri- can Psychiatry: A Review of a Disappearing Literature,” Canadian Journal of Psychiatry 52.5 (2007): 287–94. 82. Ellison, Invisible Man, xv. I have been helped in my thinking about visibility and blackness by Mar- riott’s lyrical meditations on the experience of displacement by an imaginary double (created by the white gaze) in Haunted Life, 207–24. | 394American| Quarterly

83. R. D. Laing, The Divided Self: An Existential Study in Sanity and Madness (London: Penguin, 1990), 109. 84. Hohenberg, “Harlem,” 1. 85. Ahad persuasively suggests that Ellison was influenced by Dr. Harry Stack Sullivan, Ellison’s first em- ployer in New York and a renowned psychoanalyst who worked with the sociologists Charles Johnson and E. Franklin Frazier (Freud Upside Down, 101–2). 86. Ellison, “Working Notes for Invisible Man,” 24. 87. Ahad also identifies this connection for llisonE between “psychical well-being and space” (Freud Upside Down, 96–97). 88. Ellison, “Harlem Is Nowhere,” 244. 89. I am indebted to Dr. Lena Hill for bringing this letter to my attention and allowing me to use her transcription (Ralph Ellison to Richard Wright, Richard Wright Papers, James Weldon Johnson Col- lection, box 97, folder 1314, Beinecke Rare Book and Manuscript Library, Yale University; italics mine). 90. Wright, “Psychiatry Comes to Harlem,” 49. 91. Ellison, “Harlem Is Nowhere,” 242; italics mine. 92. White clients were also seen at the clinic; records of clients’ racial designation were not kept after 1949 and were for Wertham’s use only (“Statistics Lafargue Clinic: 1947/1956,” March 6, 1956, box 1, folder 9, LCR-SCRBC). 93. Helen Strauss, “Lafarge [sic] Clinic Gives Harlem Free Expert Psychiatric Advice,” Herald Tribune, August 11, 1946, box 53, Wertham Papers–LC. 94. Martin, “Doctor’s Dream in Harlem,” 800. 95. Jonathan M. Metzl discusses how schizophrenia became the popular diagnosis in the 1960s for African American men who participated in the black power movement (The Protest Psychosis: How Schizophrenia Became a Black Disease [Boston: Beacon, 2009]). 96. “Medicine: Not Father to the Man,” Time, March 24, 1958, box 3, folder 5, LCR-SCRBC. For statistics on childhood schizophrenia from Lafargue, see “Statistics Lafargue Clinic 1947/1956.” 97. Bendiner, “Psychiatry for the Needy,” 23. 98. “Lafargue Clinic Organization,” September 1, 1952, box 1, folder 11, LCR-SCRBC. 99. “Routine Committee Meeting 3-23-52,” box 1, folder 11, LCR-SCRBC. 100. “Lafargue Clinic Organization.” Lafargue helped diversify the field of mental health care by hiring individuals who, owing to discrimination, could not gain the necessary experience in other clinical settings (“Lafargue Clinic 1946/1956: Staff, 1-2, box 1, folder 9, LCR-SCRBC). 101. Beaty, Fredric Wertham and the Critique of Mass Culture, 43–45. 102. Bendiner, “Psychiatry for the Needy,” 24. 103. “Patient Records,” box 3, folder 16, LCR-SCRBC. 104. See Richard Keller’s discussion of the historiography on psychiatry and colonialism in “Madness and Colonization: Psychiatry in the British and French Empires, 1800–1962,” Journal of Social History 35.2 (2001): 295–326. 105. Martin, “Doctor’s Dream in Harlem,” 798. An astonishing amount of publicity circulated about Lafargue; a television show, Wide Wide World, included a visit to the clinic in a program titled “The House I Enter,” October 27, 1957 (“TV GUIDE,” October 27, 1957, 472, box 3, folder 6, LCR- SCRBC). 106. NBC script for “The House I Enter: A Portrait of the American Doctor,” Wide Wide World, October 27, 1957, 42, box 4, folder 17, LCR-SCRBC. 107. Fredric Wertham, “Psychiatric Observations on Abolition of School Segregation,” Journal of Educational Sociology 26.7 (1953): 333–36. His findings for the Delaware case of 1951 appeared in “Psychological Effects of School Segregation,” American Journal of Psychotherapy 6.1 (1952): 94–103. 108. Samuel Kelton Roberts Jr., Infectious Fear: Politics, Disease, and the Health Effects of Segregation (Chapel Hill: University of North Carolina Press, 2009), 4. 109. “Findings of Recent Survey of Clinic Reported by the Department of Social Welfare,” letter to Wer- tham, September 21, 1949, box 1, folder 1 “Administrative Papers, 1947–56,” LCR-SCRBC. 110. Publicity flyer, box 1, folder 15 “Clinic Forms, Greeting Cards, and Printed Material, 1954–57,” LCR-SCRBC. 111. “Statistics Lafargue Clinic 1947/1956,” 3. Postwar Psychoanalysis, African American Blues Narratives, and the Lafargue Clinic | 395

112. “Lafargue Clinic Organization.” 113. Case histories began with the client’s chief complaints and medical history, then moved to family history, marital history, children, economic security, education, employment, and the “basic mood of patient” (“Case History,” box 1, folder 14, LCR-SCRBC). 114. “Examination of Patients, Lecture Lafargue Conference 4-1-52.” 115. “Case History,” box 1, folder 14, LCR-SCRBC. 116. “Memorandum Lafargue Re Examination and Lectures—January 11, 1949,” January 13, 1952, box 51, Wertham Papers–LC. 117. G. Thomas Couser, Recovering Bodies: Illness, Disability, and Life Writing (Madison: University of Wisconsin Press, 1997), 10. 118. Murray Lamond, “Physician, Heal Thyself,” The Brook: News about Stony Brook University 5.2 (2004): 15. 119. See, for example, William J. Donnelly, “Righting the Medical Record: Transforming Chronicle into Story,” Soundings 72.1 (1989): 127–36; Howard Brody, “‘My Story Is Broken; Can You Help Me Fix It?’: Medical Ethics and the Joint Construction of Narrative,” Literature and Medicine 13.1 (1994): 79–92; Rita Charon, “Doctor-Patient/Reader-Writer: Learning to Find the Text,” Soundings 72.1 (1989): 136–52; Anne Hudson Jones, “Reading Patients—Cautions and Concerns,” Literature and Medicine 13.2 (1994): 190–200; Larry R. Churchill and Sandra W. Churchill, “Storytelling in Medi- cal Arenas: The Art of Self-Determination,” in Literature and Medicine 1 (1982): 74–81; and Cheryl Mattingly, “The Concept of Therapeutic ‘Emplotment,’” Social Science and Medicine 38.6 (1994): 811–22. 120. “Mrs. Zucker’s suggestions for first examination,” n.d., box 1, folder 12, LCR-SCRBC. 121. Ibid. 122. Arthur W. Frank, “Reclaiming an Orphan Genre: The First-Person Narrative of Illness,” Literature and Medicine 13.1 (1994): 13. 123. “Patient Records,” box 3, folder 13, LCR-SCRBC. Client names have been changed to protect their privacy. 124. Ibid. 125. Ibid. 126. Report of C. Karros from case history, 1955, “Patient Records,” box 3, folder 11, LCR-SCRBC. 127. Report of Kolodny from case history, 1956, 13 (back), “Patient Records,” box 3, folder 11. LCR- SCRBC. 128. Wright, “Psychiatry Comes to Harlem,” 51. 129. Bendiner, “Psychiatry for the Needy,” 23. 130. Ibid., 24. 131. This idea would later be expanded on by the discourse of black power that encouraged revolutionary violence, as self-defense, as the best way to restore the black psyche. See, for example, Huey P. Newton, Revolutionary Suicide (New York: Penguin Group, 2009). 132. Clark, Prejudice and Your Child, 103. 133. Lobsenz, “Human Salvage in Harlem,” 136. 134. Bendiner, “Psychiatry for the Needy,” 23. 135. Ibid., 24. 136. Ellison, “Negro and the Second World War,” 239–40. 137. Ahad, Freud Upside Down, 85. 138. Kenneth Spencer, “Sans Funds, LaFarge [sic] Clinic,” People’s Voice, July 13, 1946, box 53, Wertham Papers–LC. 139. Handwritten note for “Dr. Quarter,” labeled “Examination,” box 52, Wertham Papers–LC. Larry Neal’s description of the blues ethos is helpful here: “The essential move behind the best blues song is the acquisition of insight, wisdom”; quoted in Clyde Woods, Development Arrested: The Blues and Plantation Power in the Mississippi Delta (London: Verso, 1998), 19–20. 140. “Letter from Fredric Wertham to the New York State Department of Mental Hygiene, 12/14/58, and 4/6/59,” box 51, Wertham Papers–LC.