The Azibo Nosology II: Epexegesis and 25Th Anniversary Update: 55 Culture-Focused Mental Disorders Suffered by African Descent People
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The Azibo Nosology II: Epexegesis and 25th Anniversary Update: 55 Culture-focused Mental Disorders Suffered by African Descent People by Daudi Ajani ya Azibo, Ph.D. [email protected] Independent Scholar St. Louis, Missouri United States of America Asante sana (thank you very much) to Maggie Jackson, Tequila Keith, and Colita Nichols Fairfax, Ph.D for various assistance over the years. Dedication This work is dedicated to Mother Jean Wilkens Dember, M.H.S. She is a founder of Afrikans United for Sanity Now!, which under her direction has for the last 24 years organized annual grass roots mental health conferences in Houston and New York City. She also has engaged the Roman Papacy to intervene in police shootings of African-U.S. in New York City by Catholic police officers. A Queen Mother for true. Special Dedication To the memory of Lorraine Marie Allen-Miller, my mother To the memory of Frank K. Miller, my father To Muthy Fatama, my wife of 31 years, how blessed I have been to have had you all in my life 32 The Journal of Pan African Studies, vol.7, no.5, November 2014 Abstract Containing 55 disorders derived from the centered African framework and drawing on the works of 22 mental health scholars spanning over 60 years, the Azibo Nosology II replaces the original Azibo Nosology published in the Journal of Black Psychology 25 years ago as of Spring 1989 with 18 culture-focused disorders. African deep thinking on the nature of the original human being’s nature (African personality construct) is the platform for juxtaposing normalcy or appropriate thinking and behaving with disordered psychological functioning. Mental health is defined Africentrically as that psychological and behavioral functioning that is in accord with the basic nature of the original human nature and its attendant cosmology (cultural deep thought) and survival thrust. Exegetical definitions and discussion as well as considerations for each disorder are provided. Additionally, DSM and ICD nosologies are structurally integrated into the Azibo Nosology II with qualifications. Keywords: African personality construct, Azibo Nosology, DSM, ICD, mentacide, mental disorder, mental health, nosology, and psychological misorientation. [T]he license to name the world, to categorize, classify, or otherwise demarcate the world and behavior on the part of Whites, must be revoked. Afrikans must assert their right and power of self-definition—of categorizing and classifying the world and the nature of their being in it ... in ways which make their minds and bodies humanitarian instruments of Afrikan power and liberation. Amos Wilson (1993, 119, original emphasis) To outline this work, it begins with a proem that covers the approaches to psychological inquiry employed in developing the nosology. The nosology itself is led into with discussion of multicultural competence, the Africentric definition of mental health and its grounding in the African asili or deep structure of culture, and mental health at the level of psycho-behavioral modalities. Real life examples of mentally healthy functioning are provided to vivify the Africentric mental health idea contained in the African personality construct and referred to as correct orientation (Azibo, 1989). A templet for correct orientation/mentally healthy functioning is presented next followed by practical working criteria for primary and secondary mental disorder (defined below). Then, how DSM and ICD conditions are handled by the Azibo Nosology II is explained and contrasted with the asinine position of Kambon (2003) which dismisses out of hand the relevance of Western mental illness concepts. After this the 55 specific disorders are presented followed by concluding remarks and an afterword. 33 The Journal of Pan African Studies, vol.7, no.5, November 2014 Proemial Remarks Wilson’s is a most apropos epigraph to start with as the original Azibo Nosology (Atwell & Azibo, 1991; Azibo, 1989) 25 years ago epitomized kujichagulia (self-determination, self- definition) in conceptualizing mental well-being and disorder in African descent people (ADP). That nosology took its own African-centered culture-focused lead and in doing so it revoked proactively the license of the Eurasian conceptual systems of mental health and personality disorder reflected in the DSM and ICD nosologies to prevail. This legacy is maintained in the Azibo Nosology II. My overall gestalt of the Azibo Nosology II likens it to the spear in the African proverb “If you have enemies then travel with your spear” (Baruti, 2003, 329). It is the spear for the African descent mental health worker and it is the platform from which s/he should enter the discourse on and praxis regarding (multi)cultural competence and diversity in mental health instead of perennial, encapsulated debate and adjustment regarding the latest DSMs and ICDs. I assert the fundamental place in the world of the Azibo Nosology II is its destined counterpoise to Eurasian domination in defining mental health in general and for ADP in particular. A Brief Word on the Role of Construction, Reconstruction, and Deconstruction The original 1989 Azibo Nosology was grounded in the long view of centered African psychology meaning the psychology originating among ADP of the ancient nilotic civilization located in today’s Arab-centered Egypt, but called Kemet by the African indigenes (Azibo, 1996a) before Eurasian conquering. Thus, its articulation of concepts and perspective was derived using African utamawazo which means culturally structured thought (Ani, 1994). This unfolding of African-centered psychological knowledge is properly called the construction approach to psychological inquiry as psychological knowledge is created and articulated— literally constructed—using the irrefragable African-centered framework outlined in Azibo (1992). The construction approach, interestingly enough, is the original way psychological knowledge was brought into the world. Using the construction approach in developing the Azibo Nosology II represents my serious endeavor to (re)articulate as accurately as possible the mental health platform of indigenous, culturally matured, classical African civilization. Therefore, constructing knowledge about mental health and mental dysfunction with the Azibo Nosology II is manifest Sankofa as against mouthing Sankofa. The 1989 Azibo Nosology was also open to the reconstruction and deconstruction approaches which were reactions to manifest Eurasian domination. The former means recasting Eurasian psychological concepts or ideas in African-centered premises. As Eurasian formulations of mental functioning frequently are not companion to centered African ones and often are laden with anti-Africanism, deconstruction or dismantling completely the Eurasian idea along with data advanced to support it has been warranted frequently in modern-day mental health. 34 The Journal of Pan African Studies, vol.7, no.5, November 2014 Centered African psychology benefits when deconstruction and reconstruction bridge to construction, a task attempted throughout this article. All three approaches are discussed in Azibo (1996a) and have been used in developing the Azibo Nosology II. They are springboards to appreciating the necessity for multicultural competence in mental health work. The Azibo Nosology II Multicultural Competence Calls from within Western-dominated psychology for multicultural competence (American Psychological, 2011; Schultz, 2003), celebrating the non-Caucasian other (Sampson, 1993), the advancement of culturally sensitive techniques (e.g., Arnault & Shimabukuro, 2012) as well as admonishments that anti-racism efforts in mental health could be better (e.g., Corneau & Stergiopoulos, 2012), critiques of the handling of culture-bound syndromes (Bhugra, & Munro, 1997; Hughes, 1998) and the presentation of disorders related to culture (Kleinman, 1997; Tseng, 2006) have arisen. Dana (1998, 13) succinctly nails the point central to multicultural competence in mental health services that “each multicultural group must provide the idiosyncratic perspective and cultural/racial idiom in which all providers become fluent.” Toldson and Toldson (2001, 417) impressively make the point too: “Psychological health care must begin to .... mak[e] accommodations for the expression of belief patterns, thoughts, and sociocultural customs indicative of the presence of an African identity in the behavior of African people.” The Azibo Nosology II answers these calls for ADP. In 1989, the original Azibo Nosology contained 18 culture-focused disorders. Scholarship responding to it without my involvement (Anderson & Stewart, 2007; Belgrave & Allison, 2006; Harrell, 1999) and with me involved in some way (Anderson, 2003; Atwell & Azibo, 1991; Azibo, 2013c; Azibo Nosology, 1998; Schultz, 2003) has been mostly favorable. As far as I know, Eurasian writers except for Schultz did not acknowledge its existence. As the nosologist of record—creator, definer, and nomenclator of the original—it is my honor to advance the Azibo Nosology II containing 55 disorders drawing on the works of 22 scholars and mental health workers spanning over 60 years. Most of the work is not inchoate, but established. This advancing is an act of freedom or interpreting the world in ways contiguous with that of authentic African ancestral worldview and literacy or applying said freedom in the here and now of ADP’s lives (definitions paraphrased from Harris, 1992). All mental health workers of African descent are invited to participate. The invitation,