How could Fanon’s psychosocial model on pathology be defended?

The objective of the essay is to investigate the nature of mental illness and abnormality with philosophical findings by studying some phenomena. Upon the topic of nature of mental illness, Fanon’s psychosocial model deems social factors as nature of mental illness. The opposing view to Fanon’s is the biological model of mental illness. Its constructs see the biological basis as the nature of mental illness. Firstly, in this essay, I am going to further introduce the biological model and psychosocial model. Secondly, I will defend psychosocial model with Fanon’s view and argue against biological model, by evaluating both models in order to seek the most plausible account for determining the nature of mental illness among two models. Finally, in this essay, I will conclude that Fanon’s psychosocial model helps explain why social factor plays a vital role in determining the nature of mental illness and helps establish a more plausible picture to determine the nature of mental illness as social factor instead of biological basis.

Definition of psychosocial model

First of all, Fanon’s psychosocial model builds a picture of how social factor plays an important role upon mental diseases and focuses on the process of developing mental illness along with the abnormal social life. In Fanon’s view, “the mad person is one who is ‘foreign’ to society” (Alienation and Freedom, p. 517), which infers that a person who is alienated by society is lack of ability to adapt in social life, hence it has a chance to lead to mental illness. The model suggests that mental diseases are not just like physical diseases and the model determines whether a person is mentally ill based on the criterion of being normal (Romdenh-Romluc, 2019) and one’s adaptation in social life, or whether the person can be received by the society in terms of alienation. Hence, it is difficult to understand and treat mental diseases without realizing the role of social factors (Romdenh-Romluc, 2019). The psychosocial model also allows that genetics and biochemistry might play some role in mental disorder when it tries to explain how mental illness is passed down to next generation.

In Fanon’s research, he investigated and explained blackness’ abnormality in terms of alienation and Fanon uses the idea of alienation to give a notion of what is ‘normal ’ to underpin his psychosocial model of mental disorder (Romdenh-Romluc, 2019). He sees the phenomenon of alienation as a kind of social factors which plays a vital role on the development of blackness’ mental illness which makes them not able to participate in the structure of relations. In this essay, I offer three aspects I think can cover some typical examples to explain Fanon’s views due to limit of word count. They are concluded in Fanon’s view that strongly support the psychosocial model in terms of conditions of alienation : 1)”alienation from social praxis”, 2)“alienation from the self – separation from one’s corporeal and personal identity” and 3) “alienation from the general other – e.g., hostile relations between whites and blacks.” (Bulhan, 2004, p. 188).

Definition of biological model

On the other hand, Biological model focuses on biological malfunction process and how it affects mental health, it infers that mental diseases are like physical diseases (Romdenh-Romluc, 2019) and those symptoms of mental diseases or abnormality are caused by flawed parts of the body especially the brain (Murphy, 2017) or genetical factor. Most of the time, theories of genetics and biochemistry is used to explain the biological basis for determining the nature of mental illness such as dementia, schizophrenia and etc.

For biological model

For biological model, nowadays’ studies of brain science believe that there is complicated reason causing mental illness. Even the clues of the complex structure of the brain have not yet been revealed entirely and mysteries of cognitive study are not clear, biological scientists might still believe someday we can come up with a theory constituted by findings from brain scans (Murphy, 2017), fitting the reality and nature of mental illness in terms of biological basis instead of social factors.

Deep research for the root nature of schizophrenia has been conducted for many years, mental illness like schizophrenia was believed to be biological basis and is reducible to physical issues. According to Edward H. Taylor (1987, p. 115),

“computerized axial tomography (CAT) scans show evidence of structural pathology, positron emission tomography (PET) scans find reduced frontal lobe functioning, brain electrical activity mapping (BEAM) suggests increased delta activity in the frontal cortex, and regional cerebral blood flow (rCBF) techniques reveal reduced frontal lobe activity during problem-solving periods.” (Taylor, 1987, p. 115, found in Cohen, 1989, p. 255)

Hence, Taylor posited that the results, in the future, might lead to categorize schizophrenia into “a group of neurobehavioral diseases” disrupting the “frontal cortex and limbic system” (Taylor, 1987, p. 115).

Objection to biological model

Despite the scientific fact that we can discover abnormal brain chemistry that mainly puts patients at risk of schizophrenia and signs of omen or impairment at the aspect of neurology (Cohen, 1989, p. 255), that does not successfully establish biological foundation based on neurobiology’s findings (Murphy, 2017), because the biological model only focus on causal relation among the observable data and phenomena from results of all kinds of brain scan and tests, but not on the unobservables. For instance, Gold and Gold (2014, p. 163-166, found in Murphy, 2017) hypothesize that many psychotic syndromes such as some delusions may be the result of “Suspicion System” which allows us to detect the social threats in advance and defense us from the potential threats. There is the hidden system we need to deal with and its existence does not look like something which will manifest itself or be detected by technical equipment. Thus, it does not seem that the traditional sense which is by using the brain scans to discover the physiological change is enough for discovery of something like “Suspicion System” (Murphy, 2017). Gold’s theory stresses social contacts and pays attention to investigations of cognitive science, social anxiety, children’s mental development and etc. (Duncan, 2015, p. 98).

Hence, it does not seem plausible that the biological model can provide strong arguments to determine the nature of mental illness as biological basis. On the contrary, the psychosocial model might offer a new view with arguments to determine the nature of mental illness as social one.

For psychosocial model: Alienation from social praxis

To support the psychosocial model, Fanon’s view with concept of alienation is going to be used to explain the phenomena of abnormal behavior of patients in various cases. Fanon thinks that conditions of alienation are abnormal for everyone. Some people in conditions of alienation develop certain psychological conditions, because in Fanon’s view, the conditions of alienation can ruin harmonious mental state and connectedness from self and society (Romdenh-Romluc, 2019). If those conditions frustrate freedom from within, then the conditions should be classified into mental illness. For example, girls are forbidden from going to school due to social custom. Once this kind of realization of one’s own potential is forbidden, society cannot fulfill their wishes, then people will feel being denied self-determining and getting alienated by society (Bulhan, 2004, p. 118). This is a kind of conditions of alienation from social praxis.

There is a case of hysteria. According to Hunter (1983, p. 470-471, 478), Bertha was a willful, energetic, intuitive, and compassionate person, but she developed hysteria and the illness became severe gradually. One of the root causes is the tradition: many families tended to prioritize the sons’ education and their bright future and sacrifice daughters’ in nineteenth century. It was also a long tradition for young women to nurse their ageing parents. For a moment, Bertha found her lonesome existence was meaningless after her father’s death. Later, she claimed “her lack of formal education as ‘defective spiritual nourishment’,” which the long for education is seen. During the course of her treatment, Bertha always needed her psychiatrist, Josef Breuer , to listen to her creation of story. Hunter mentioned that Breuer became an audience for private theatre. When the time to visit Bertha became more frequent for Breuer, Bertha even wanted to have a love affair with this married man. Being repressed by the past twisted social norm which does not allow her to go to school at her age of sixteen, made Bertha became resentful. By the time she was cured, she started dedicating for social reforms for supporting feminism. “In 1889, she wrote a play entitled Women’s Rights (Hunter, 1983, p. 478)”, emphasized men’s wickedness for exploiting women’s weakness and women’s fragility (Hunter, 1983, p. 470-471, 478).

We can see why the hysteria’s symptoms arose during her young age and how this case infers to a discovery that social factor could be the nature of mental illness. When the society restricts one’s freedom and rights of obtaining the realization of one’s potential – the alienation from social praxis or due to traditional custom, one will feel being alienated. It is hard for one to exist in the society without being abnormal, because one will find his existence meaningless under this condition of alienation. When she was born in an era of sexism, she suffered from the restriction of women’s right. Those suffers from the young age made her stuck in the conditions of alienation. She then later understood the significance of women’s liberation, so did it push her to go on to support reforms for feminism after being cured. Her experience implies the significance of the social factors upon her psychotic condition. Since the social praxis limits one’s realization of one’s potential, for example, being forbidden from going to school, it leads to severe mental illness, which suggests that the nature of mental illness could be social factors.

However, one or two cases cannot infer that the social factor is the nature of mental illness. Using evidence to prove how social factors play a vital role can make psychosocial model more convincing.

For psychosocial model: investigation of migrants in schizophrenia

For psychosocial model, the evidence of immigrants with higher chance of developing schizophrenia or other psychosis in several countries are suggesting an intriguing phenomenon of how environmental factor plays a vital role upon mental health or even is the nature of mental illness.

Researchers in United States (US) conducted the first influential investigation of schizophrenia amongst the immigrants during the first half of the twentieth century. It confirmed that the doubled amount of the Norwegian migrants of schizophrenics to US, compared with those who never immigrated. (Fearon, 2006, p. 405). Within 2 decades after World War Two, enormous inflows of immigrants from commonwealth countries settled in United Kingdom. In the later researches, the studies focus on the population from the Caribbean and the Indian subcontinent such as West Indians. There are at least 18 studies of schizophrenics, demonstrating that rates rose 2 to 18 times in the African Caribbean Indians immigrated to Britain relative to the native white population in Britain (Fearon,2006, p. 405). The fact that the higher incidence of schizophrenia in the new migrant populations of West Indians has been suggested by the researches. The migrant populations even have a higher rate of other psychiatric of morbidity than non-migrants (Hemsi, 1967, p. 98-99).

The intriguing situation is that the occurrence rates among various ethnicity of the immigrants is different. The data of AESOP study was collected from the Nottingham, London and Bristol. The AESOP study shows “a 7-fold increase in mania among African-Caribbeans and black Africans” relative to the whites, and “a 2- to 3-fold increase in mania among other ethnics of migrant groups”, in the same finding, it shows a similar result for schizophrenia (Lloyd, 2005, p. 126-131, found Fearon, 2006, p. 406). It is reasonable to say that “the rates for schizophrenia and mania in Asians are not raised to the same extent as in African-Caribbeans and black Africans”, in the meantime, the rates of schizophrenia in immigration populations is also greater than the rates of schizophrenia in populations of the same ethnicity that haven’t emigrated (Fearon, 2006, p. 406). These statistics demonstrated that social environment plays a role in causing various psychotic disorders and argue against a biological model’s explanation which is purely in terms of genetics and neurology. In addition, the most cases above shown are related to connection between black immigrants and white society. Thus, the phenomena might lead to a cause, racism.

Alienation from self – separation between embodied self and self-identity

In order to explain the discrepancy between African people and native white populations highlighted by the phenomena, I am going to explain how and why abnormality and mental illness happened to immigrants of Antilleans upon the issue of racism. The psychosocial model will be supported with the concept of ‘alienation from self’ (Romdenh-Romluc, 2019).

In the Antillean schoolboy’s society, there are massive ways to shape his view of the world with the help of books and newspapers and schools. Those who learned his ancestors are the “bringer of civilization”, identifies himself as the white man, which means that he adopts a white man’s attitude. Therefore, he considers himself belong to the group of whiteness. The world is white to Antillean, because the black considers themselves as white so as to causing no black voice exists. The Antillean used to live in Antilles, he was unaware of his Negro identity in whiteness’ view when he cannot broaden his horizon beyond his own environment. (Fanon, 2008, p. 111, 118).

The black person eventually immigrates to the white community, he becomes abnormally sensitive to foreign environment, because the whiteness oppresses him with the “whole weight of blackness” (Fanon, 2008, p. 116). If his psychological structure is weak, there is higher chance to cause unstable mental state. The black person’s behavior will be weird because the intention of his behavior is to act how white men dress, talk and eat. The disguise like that is to protect their self-esteem and for the black person to assimilate into the white society. Hence, the black persons’ freedom and wishes are continuously confronted with inhibitions, contradictions and anxieties by black’s inferiorness and white society’s tradition and contempt upon blackness (Fanon and Geronimi 1959, p. 717, found in Romdenh-Romluc, 2019). Thus, the black person’s experience leads to “separation from his corporeal and personal identity” and have abnormal behavior. (Fanon, 2008, p. 117-118).

Fanon further elaborates the detail why the black person becomes self-loathing. When he found the black person representing sin at his young age, he hates Negro and became self-loathing by the time he was told that he is a Negro (Fanon, 2008, p. xiv). This contradicting circumstance is harmful to the black person. (Fanon, 1986, p. 197, found in Hook, 2004).

Fanon quoted Sartre’s case happened to Jewish kids in “Black skin and white mask”. There is a strong connection with the black persons in this case:

A young Jewish girl he knew had no knowledge about the word “Yids ” while they got insulted until she was fifteen. During the World War Two, a Jewish doctor lived in Fontainebleau and raised his children without telling them their origin under the German military control. But they eventually knew the truth from the implication of the mocking, the gossip or insult in person. Suddenly they realize what people apply to them is an irritating term. The later the disclosure comes, the more gruesome the shock is (Anti-Semite and Jew, p. 75., found in Fanon, 2008, p. 116).

The case is similar with the black persons’, by the time Antilleans realized white person thinking of them as the black, they had already taken on the subjectivity of whiteness and leads to the condition of alienation from self -- the separation from embodied self and self-identity. Identifying one’s original identity or race is painful because of race, ethnicity or even gender, when you do not have knowledge about the original identity along with one’s growth. It only hurts more when the black person discovers that he is inferior instead of what he is proud of and that leads to growing self-loath because of the discrimination towards lower social class of the blackness from the white, which makes the alienation severer. The races are easily distinguishable, so the black persons with the soul of whiteness will be always reminded of their original race through the social contact and discrimination. The black persons continuously remain in a situation in which two contradictory identity is. Hence, Fanon (1986, p. 192, found in Hook, 2004, p. 128) argued that ‘the Negro lives an ambiguity that is extraordinarily neurotic’ – the condition of ‘alienation from self’, which leads to higher chance of developing mental illness, such as schizophrenia. Since the condition of ‘alienation from self’ began to happen to the Negro when they had contacts with the white society, it is plausible to say that the social factor might be the nature of mental illness.

Alienation from the general other – e.g., hostile relations between whites and blacks.

Furthermore, the hostile relationship between black and white is harmful enough to contribute to the condition of alienation from white society, which can cause the black to develop mental illness. This kind of relationship forms the condition of ‘alienation from the general other’.

People in every civilization, create a way to release their violence after the accumulation of any form of pressure. Any society requires its own form of catharsis such as drama activity and entertaining performance. Patients who need treatment might need some of the forms of group therapy such as psychodramas which work for the sake of catharsis so as to release people’s emotion. There are some examples of stories “serving as a release for collective aggression”, such as “the Tarzan stories, the sagas of twelves-year-old explorers, the adventures of Mickey Mouse and the other comic book stories” (Fanon, 2008, p. 112). The magazines describe the hostile relationship between heroes and the villains which are usually symbolized by the black. Local children read them for entertainment. It is reasonable to think that many colonies have this same situation. In the stories, the bad Negro is always a trouble maker to the white, the adventurer. None of them realizes the consequences of spreading the messages behind these stories. (Fanon, 2008, p. 112).

Hence, the stereotype of the wicked black burnt in each generation’s head via the stories creates hostile relationship between the white and the black. The intense relationship acts as a kind of long-term stressor affecting the Negro and the white’s mental development. Since the ‘alienation from the general other’ causes mental illness, it seems plausible to think that the social factor is the nature of mental illness.

For psychosocial model: transgenerational inheritance via wealth disparity

It is important to investigate how mental illness is passed down to those descendants after the racism is considered as one of those social factors, in order to support the psychosocial model. During the time of racism, radical disparity in the wealth is one way that can lead to transgenerational inheritance.

The wealth gap between the black and the white is mainly caused by the slavery tradition. During the days of slavery in the United States, black slaves were property to the white owners, so neither most of them did not profit from their work nor save any money for their retirement. By the time Reconstruction of US came, they were freed without obtaining what they deserved (Sullivan, 2015, p. 100-101). “In 2010, the median net household worth of white American families was twenty-two times that of black American families: $110,729 compared to $4,955.” (Luhby, 2012, found in Sullivan, 2015, p. 100). Since then, the supremacy of the white stands out through money’s power and the characteristic of the black becomes inferior when the black has a slight contact with the white world. This naturally also led to the gap of social status and the barrier of communication. In the sense of social contact, the mental illness is passed down through the hostile relationship which can be caused by the stereotype of the black from the white’s traditional view. Hence, this explains how the mental illness is passed down to next generation due to social factors and implies that the nature of mental illness is social one.

Objection to the psychosocial model

However, for those Negro who has never had any relations with whites, why would they also have mental illness? If the black offspring did not see his father being treated badly or lynched by a white man, then some might think if there is remote experience been burnt into the unconsciousness which connects with the past. If so, how is the mental illness being passed down to next generation? (Fanon, 2008, p. 112).

Some might strongly argue that the inheritance of mental illness can be due to family history and genetic flaws. If so, then the nature of mental illness might sound more likely to be biological basis.

For psychosocial model: transgenerational inheritance via epigenetics

To defend psychosocial model, the theory of epigenetics is needed. Sullivan’s view offers a strong argument to support the psychosocial model with some phenomena. Next, I am going to draw on the concept of epigenetics in the chapter of “The Epigenome” from “The physiology of sexist and racist oppression”, to demonstrate how social environment affects the compositions of chemicals, hormones, cells and fibers of the human body and how it causes natural-born mental illness (Sullivan, 2015, p. 103).

Firstly, I am going to introduce the term “Epigenetic”. in Sullivan’s view, “Epigenetic” refers to “somatically heritable states of gene expression. . . without alternations in the DNA sequence.” (Sullivan, 2015, p. 110). The term was created because the impact which different social environments can have upon cellular activity was acknowledged. The gene has nothing attached to it under a rare situation, but normally, it is attached by various organic molecules which can administer its function. Methylation is one of the most typical structure for “DNA regulation ”. If a gene attached with chemical compound of methyl group which one carbon and three hydrogen atoms, it is methylated, otherwise, it is unmethylated. The extent to be methylated could be different. We may imagine that the methyl attachment is a “power knob” and it might be turned up or down or even off. “The more methylated a gene is, the more its expression inhibited, and vice versa.” (Sullivan, 2015, p. 110-111).

We now know that the state of the gene expression here is epigenetic. In order to understand what epigenetic is, we can first understand its influence upon animals:

“when the genes in mice contributing to both coat color and various health problems (such as obesity, diabetes, and cancer) are unmethylated—that is, turned up—the mice have yellow coats and significant health problems. When the same genes are highly methylated—that is, turned down/off—the mice have both darker coloration and no health problems associated with obesity, diabetes, or cancer." (Sullivan, 2015, p. 111).

The example shows the connection between the methylation and health conditions of mice.

This methyl attachments and detachments can be the result from any coincidence of environmental factors. For example, “testosterone levels ” increased by competition can change the gene expression, and any mental trauma and constant stress have the similar influence upon gene expression through the exceeding increase in cortisol production. One of the typical environmental factors which can cause stressful situation is racism. It might raise the cortisol level causing Post-traumatic stress disorder (PTSD). (Sullivan, 2015, p. 113).

Secondly, after the introduction of how epigenetics works upon epigenetic inheritance, it is important to see that racism as one of the social factors has its durable effects upon the physiological constitution of human body and the descendants via the mechanism of epigenetics. The mechanism of epigenetics will not only cause mental illness for a specific person, but its effects will also extend to the descendants especially the black under racial discrimination. The health disparity related to race. Racism has already happened since before 1980s, black people have to deal with all kinds of stress (Sullivan, 2015, p. 100-106). Normally, even if black women who have high socioeconomic status live in white society such as United States, white people still create environmental stressor to black person and adversely affects black pregnant women and their offspring (Sullivan, 2015, p. 104-105).

For example, uterine environment is one of the types for epigenetic inheritance. While a pregnant female gets stressed, more cortisol gets triggered more than normal level. During the process of formation of fetus, mother’s exceeding cortisol hormones will be absorbed via the placenta and alter form of epigenetics. Fetus’s stress axis, also known as the HPA axis is reconstructed and lead to the excessive activation. “The ‘axis’ between these three endocrine glands is the set of influences and interrelations between them: neurons in the hypothalamus produce a particular hormone (corticotropin-releasing hormone, or CRH) that leads the pituitary gland to produce another hormone (corticotropin, or CT), which in turn stimulates the adrenal gland to release stress hormones such as cortisol” (Sullivan, 2015 p. 113). The alteration of the physiological constitution upon epigenetics can result in struggle of mental illness. One typical mental disorder is fetal post-traumatic stress disorder (PTSD) which is a kind of anxiety disorder. It will make the fetus hyperresponsive to stressful events, even in their adult lives. (Sullivan, 2015 p. 113).

There are two samples, which the source is from Holocaust happened in Germany and the tragic event of 911 World Trade Center attack, capable of proving the significant effect of social environment. When the females were pregnant during the Holocaust and the females were pregnant during the 911 event, they were tremendously stressful and upset about the situation at the moment. After giving birth, those German children and the American children tend to be overreactive to the external environment and have depression than those children whose mother did not suffer from extraordinarily life-threatening period, although the children themselves had no direct experience of tragic events. Hence, there is possibility for children to be born with physical diseases and mental illness due to the parents’ experience and mental health. (Sullivan, 2015, p. 113-114).

“Material and social environments can play as significant a role in cellular activities determining a human organism's health, weight, appearance, and so on, as her DNA does.” (Sullivan, 2015, p. 112). The connection between the one’s past ancestors, the present and the future is highlighted by epigenetics. It explains how they connect via the epigenetic inheritance. Mental illness can be seen as a kind of social illness that is physiologically inside the patients but not entirely their own (Sullivan, 2015, p. 121). Since the argument of connection between ancestors and descendants is offered to verify the possibility that the root cause of mental illness is the social one even though the mental illness is passed down via biochemical reactions, it supports Fanon’s psychosocial model with the theory of epigenetics. Hence, it is plausible to think that the nature of mental illness is social one instead of biological basis.

Conclusion

In conclusion, psychosocial model is more convincing compared to biological model. Firstly, biological model offers argument to support the idea that the nature of mental illness can be determined to be biological basis as long as biologists reveal the whole truth of brain in neurological aspect. Besides, the biologists are on the quest for the evidence of physiological and chemical alteration in brain’s constitution which causes mental illness, but this does not sufficiently offer strong argument enough to determine the nature of mental illness, because the discernible changes in the brain only prove that the mental illness and the brain’s structure have mutual influences.

On the contrary, psychosocial model has a more plausible theory. According to Fanon’s view, “the forms mental illness takes are determined by the structure of relations in which the individual is able or unable to participate and therefore by ‘external’ institutional and social forces” (Khalfa, Jean, “Fanon and Psychiatriy, p. 56). Alienation as a form of social factors do interrupt the harmony between self and society (Romdenh-Romluc, 2019) and cause mental illness. Furthermore, social praxis and racism has a huge influence upon the phenomenon of alienation. Social praxis might limit one’s potential such as ban on schooling for female, which could lead to conditions of alienation from social praxis and leads to mental illness. Racism brings wealth disparity and gap of social status between the white and the black, which are two of many ways to pass down the mental illness to next generation. The transgenerational inheritance can also affect the next generation via biological way, epigenetics. This is reasonable in a sense, when it comes to explain why Antillean or Caribbean African is more likely to become schizophrenic or other severe psychoses, even for the next generation. This gives a lot of credit to social factors to be nature of mental illness. Hence, the psychosocial model is more convincing than biological model.

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