Intolerance and psychopathology: Toward a general diagnosis for racism, sexism, and homophobia.
Racism, sexism, and homophobia do not fit into any current diagnostic category. The authors propose that those who engage in such behaviors display a form of psychopathology deserving of its own category. The common denominator seems to be intolerance. The authors explore the possibility of an intolerant personality disorder, outline likely symptoms, and suggest some possible treatment considerations.
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Conclusion
IPD has been presented as an idea whose time has
come. As in the case of antisocial and narcissistic disorders,
there are many persons around the world who
are being harmed by the intolerant person, as
described here. This is a disorder that deserves full
acknowledgement as a psychological problem unto
itself. It is not enough to merely note the harm or
lament the damage. Researchers and therapists need
to develop treatment approaches that have the
capacity to alleviate it. Courses that address issues of
diversity and therapy would do well to teach such
approaches to intolerance. Courses on psychopathology
might be enhanced when considering the
possibility of IPD.
As the world becomes an increasingly smaller
place because of technology in the forms of readily
accessible travel and nearly instant communication,
our civic and social responsibility compels us to interact
with and accept increasingly diverse groups of
people. In contrast, persons displaying the symptoms
of IPD routinely harm others while knowingly or
unknowingly inflicting pain on themselves. In contrast,
those who embrace diversity can draw on a multitude
of life perspectives and incorporate them into
their own conceptual view of the world. Those who
are destructive toward individuals who are different
or diverse do not, and this can be best understood as a
form of psychopathology.
Beginning with the third edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM)
compiled by the American Psychiatric Association
(1980), disorders are categorized and included only
after they have been substantiated by relevant statistical
data and research literature (American Psychiatric
Association, n.d.). This present narrative serves as an
initial call for the consideration of an intolerant personality
disorder. Therefore, we affirm that there is a
necessity for research and encourage an open discussion
of the ideas introduced here. If time and research
warrant the inclusion of IPD in a future addition of the
DSM, some key questions must be raised: (a) In the
face of a psychiatric community that draws most of its
members from the dominant and privileged culture,
how will the possibility of intolerance toward
nonprivileged members of society be addressed?
(b) Although beginning steps have been made
away from racism and oppression in DSM–IV–TR
classifications, what part might racism or oppression
(viz., intolerance) continue to play in the consideration
of the DSM mutliaxial diagnosis system? and
(c) How will the recent trend away from the acceptance
of intolerance in psychotherapeutic treatment
approaches be accommodated in future descriptions
of psychopathology?
It is crucial to focus on the development of greater
degrees of empathy in therapists, especially in situations
where they work with clients who are from
different cultures or subcultures. In our experience,
success in therapy when client and therapist are from
different groups is directly related to the ability of the
therapist to display empathy for the client and his or
her culture. It is also important for the therapist to be
able to show empathy for the group that has been
harmed. For example, a male therapist working with a
sexist male client must necessarily be able to display
genuine and accurate empathy for the women who are
victimized by such attitudes.
Accepting intolerance as a personality disorder has
the potential of achieving a twofold benefit. First, persons
who are diagnosed and successfully treated for
IPD can relieve the pain and discomfort associated
with low self-esteem, lack of empathy, existential
anxiety, personal trauma, or any combination of these
four. Second, the therapeutic rehabilitation of empathy
in such persons leads to increased tolerance that
can contribute to a reduction in the amount of discrimination
experienced by individuals and groups
who are routinely the victims of intolerance. Both of
these benefits can combine into a significant contribution
that the mental health profession can make to society
as we venture into the 21st century—the century
of diversity.
Guindon, M., Green, A., & Hanna, F. (2003). Intolerance and psychopathology: Toward a general diagnosis for racism, sexism, and homophobia. American Journal of Orthopsychiatry, 73(2), 167-176. doi:10.1037/0002-9432.73.2.167.
Does intolerance make sense?
