Racism & Narcissism: The Work of Carl Bell, MD

I reviewed Dr. Carl Bell’s collected papers, The Sanity of Survival: Reflections on Community Mental Health and Wellness in a previous blog (all quotes referenced by page number are from this book). This volume includes two papers that are worth dealing with at length as so many people are trying to understand how racism in the United States could be getting so much support from elected officials and even the president. Dr. Bell published “Racism, Narcissism, and Integrity” in the Journal of the National Medical Association 1978; (70):89-92 and “Racism: A Symptom of Narcissistic Personality Disorder” in the Journal of the National Medical Association, 1980; (72):661-665. Dr. Bell was not looking at politically motivated and politically encouraged racism, but racism in general. We will circle back around to the issue of politics, racism, and narcissism at the end of this paper.

One of Dr. Bell’s many interests, during his career, was whether racism should be considered a form of mental illness. In these papers he addresses racism as an expression of narcissism.

“Covert racism is a psychological attitude and as such, should fall under the scrutiny of psychiatry as a psychopathological symptom of personality disturbance,” (406).

“The racist individual suffers from a psychopathological defect of developmental processes involving narcissism, which precludes the subsequent development of such qualities as creativity, empathy, wisdom, and integrity,” (406).

Dr. Bell draws on the theoretical and clinical work of Kohut, Masterson, and Kernberg and sees the core lack of the development of empathy as common to “racists…murderers, child abusers, child molesters, and sadists” he has treated, (407). The behavior of these kind of crimes against humans has its roots in dehumanization and a lack of “respect for human life,” (407). Racism, says Dr. Bell, can thus lead to “violation of basic human rights” secondary to the racist individual’s “grandiosity, lack of self-boundaries, and dehumanization,” which are traits of narcissistic personality disorder, (407).

What’s Mine is Mine and What’s Your’s is Mine, Too

Dr. Bell noticed that, “Territoriality or boundaries are paramount for racists because of their lack of self-definition and tendency to extend their boundaries, which thus motivates them to make anything foreign a stimulus for protective action,” (407). This could explain the preoccupation with building walls and keeping out the “bad guys.” Even keeping medical supplies and protective equipment for the “government” rather than giving it the states and people could be seen in this light (consider “Trump’s use of medical stockpile veers from past administrations, leaving states in the lurch,” Shannon Pettypiece, NBC News April 6, 2020, and Daniel Dale, “Trump administration edits national stockpile website a day after it contradicted Jared Kushner,” CNN April 3, 2020, ).

Seeing the Other as Inferior and Less Than a Whole Person

Dr. Bell points to the “narcissist’s internal fragmentation” as leading to the inability to see others as whole people – in essence projecting off fragments on to others that one is unaware of in one’s self, (408). This is the essence of what Carl Jung called “the shadow,” which, if not owned and made conscious, gets projected off on to the “other.” What should be an internal psychological issue becomes an interpersonal, and even political, issue. Dr. Bell quotes the psychiatrist and activist, Frantz Fanon, “It is the racist who creates his inferior,” (408).  

The Stress-Induced Racist, the Socially Misinformed Racist, and the Narcissistic Racist

Dr. Bell develops three categories or explanations for racist behavior: 1) the stress-induced racist (where racism arises only during stress); 2) the socially misinformed racist (due to ignorance and cultural indoctrination); and 3) the narcissistic racist, (418-420). The difference between socially-misinformed racism and that due to narcissism is in “the degree of hostility directed toward the perceived inferiors,” which stems from what is called narcissistic rage, (408).

These types of racism would require different kinds of responses. For the stress-induced racist, learning self-soothing skills from at a personal level and alleviating sources of economic stress at a collective level. For the socially misinformed racist, education and corrective experiences might suffice, if provided within a peer context. Sometimes this happens with military veterans who are acculturated into hating the “enemy” and seeing them as less than human. After returning home, the larger culture no longer supports such a degree of dehumanization of others and no longer condones using violence for problem-solving. For the narcissistic racist, none of these interventions or appeals will have any weight, because the narcissist is only motivated by self-interest.

The Narcissistic Racist

Dr. Bell mentions the work of Adorno and Allport looking at how so many people went along with fascism in World War II, for instance the work on “the authoritarian personality.” Milgram’s studies showing that study subjects were willing to punish others when told to do so by a man in a white coat (Milgram, Obedience to Authority: An Experimental View, 1974). Dr. Bell describes the symptoms of narcissistic personality disorder (as given by the DSM-III which was the edition at use at that time):

  1. Grandiose sense of self importance or uniqueness
  2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. Exhibitionistic: requires constant attention and admiration
  4. Responds to criticism, indifference to others, or defeat with either cool indifference or with marked feelings of rage, inferiority, shame, humiliation, or emptiness
  5. Two of the Following:
    1. Lack of empathy: inability to recognize how others feel
    2. Entitlement: expectations of special favors with reactions of surprise and anger when others don’t comply
    3. Interpersonal exploitiveness
    4. Relationships characteristically vacillate between the extremes of overidealization and devaluation

It may be impossible for many to read this list and not think of one person who is always in the news for the past four years or so. The risk of a narcissistic leader is that they will use the country to play out their own personal pathology. The fact that this pathology requires an “other” is similar between narcissism and fascism – as both seek to blame someone else for social problems and to strengthen us and them divisiveness. If one can magnify and increase social and personal stresses for others, stress-induce racism will increase. If one can exploit cultural narratives of racism, introducing continuous references to inferiority and superiority, one can amplify socially-misinformed racism. Dr. Bell wrote in 1980, “If the man behind the institution is a narcissist of the grandiose type, as was Hitler, then a racist institution is bound to be established,” (420). He quotes Kohut on the narcissist:

“They seem to combine an absolute certainty concerning the validity of their ideas with an equally absolute lack of empathic understanding for large segments of feelings, needs, and rights of other human beings and for the values cherished by them. They understand the environment in which they live only as an extension of their own narcissistic universe,” (Kohut, 420).

In The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess the President, Bandy Lee, MD MDiv (ed.), two of the 37 papers have narcissism in their title and the word appears 62 times throughout the volume. The papers are, “Pathological Narcissism and Politics: A Lethal Mix,” by Craig Malkin, PhD, and “Who Goes Trump? Tyranny as a Triumph of Narcissism,” by Elizabeth Mika MA, LCPC. Two papers focus on race and immigration, “Persistent Enslavement Systemic Trauma: The Deleterious Impact of Trump’s Rhetoric on Black and Brown People,” by Kevin Washington, PhD, and “Traumatic Consequences for Immigrant Populations in the United States,” by Rosa Maria Bramble, LCSW. Many of the authors and clinicians prefer to focus on dangerous behavior patterns and the question of whether professionals “duty to warn” regarding the dangerousness of a person extends to the president.

If Dr. Bell were writing these articles now, rather than in 1978 – 1980, I imagine he would have something to say about our current political situation. Perhaps he would have said it in The Dangerous Case. The DSM-III description of Narcissistic Personality Disorder is almost a biographical sketch of the current president. The Dangerous Case appeared first in 2017 and it was cautionary. It was updated in 2019 and the warnings it raised seemed to be coming true, now, in 2020, we are witnessing greater levels of the behaviors Dr. Bell described and greater levels of fascism and totalitarianism. The example this week is the use of federal law enforcement in unmarked cars being used against protesters in Portland, Oregon, with threats to use them in other cities run by Democrats, whom the president calls the “radical left,” (“Trump Sends Federal Troops to Cities Run by Democrats,” Heather Cox Richardson, Moyers on Democracy, 7/21/20).

Dr. Bell cautions us about narcissistic racism with its “features of grandiosity―lack of empathic linkage…poor self-boundaries, with a tendency to intrude upon or molest others; and an underlying mood of fragmentation with anxiety, agitation, and rage,” (413). He could be cautioning us about the United States, right now.

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