Breaking Chains: Drapetomania, Historical Trauma, and the Journey to Mental Wellness

In 1851, Samuel A. Cartwright, a physician in the antebellum South, coined the term "drapetomania" to describe the supposed mental illness causing enslaved Africans to flee captivity. His pseudoscientific diagnosis claimed that a desire for freedom, an inherent human right, was pathological. (Willoughby, 2018) (Massachusetts Historical Society: The Strange History and Career of Drapetomania: The Mania That Caused Enslaved Blacks to Escape and the Man Behind It, n.d.)

This deeply dehumanizing idea exemplifies the systemic use of western medicine to perpetuate racial oppression and psychological control. While drapetomania is no longer recognized, its legacy persists in the form of medical mistreatment, racial trauma, and mental health stigma, particularly within Black communities. (Opara et al., 2021)

The Roots of Historical Trauma

Historical trauma refers to the intergenerational transmission of the psychological and emotional wounds inflicted by systemic violence, oppression, and dehumanization. (Akinyemi, 2022) For African Americans, the horrors of slavery, segregation, and ongoing systemic racism have left a profound imprint on collective consciousness. (Edwards-Grossi & Willoughby, 2024)

Studies show that the descendants of trauma survivors may experience heightened stress responses due to epigenetic changes. For Black Americans, this manifests in higher rates of anxiety, depression, and post-traumatic stress disorder (PTSD), often compounded by daily experiences of racism. (Hankerson et al., 2022)

Racial Trauma and Medical Misdiagnosis

The legacy of drapetomania exemplifies how medicine has historically been weaponized against marginalized communities.

Racial trauma, which arises from both direct and vicarious experiences of racism, remains underrecognized and insufficiently addressed within the mental health field. Symptoms of racial trauma including hypervigilance, emotional numbness, and challenges with trust are frequently mischaracterized or dismissed by professionals (Hwang & Kong, 2024). Today, racial bias in healthcare persists, contributing to misdiagnoses and significant disparities in treatment outcomes (Faber et al., 2023).

For instance, research has shown that Black individuals are disproportionately misdiagnosed with schizophrenia compared to their White counterparts, even when presenting with similar symptoms. This discrepancy highlights broader patterns of inequity in healthcare, where Black patients often face the undertreatment of pain. A common and harmful belief rooted in racial biases, is the assumption that Black individuals have higher pain tolerance due to supposed biological differences. This misconception significantly impacts the quality of care provided to Black patients (Conner, 2020).

Similarly, recent statements by Robert F. Kennedy, Jr. during his Senate hearing for a potential appointment as Secretary of Health and Human Services raised alarming concerns about racial disparities in medical treatment. During his testimony, Senator Angela Alsobrooks, a Democrat from Maryland, confronted Kennedy about his past comments on vaccinations. He had suggested that Black people should receive a different vaccine schedule, arguing that their immune systems are "better" than those of White people. Specifically, he claimed that studies conducted in Poland indicated that Black individuals have a stronger immune response to certain antigens and therefore require fewer antigens in their vaccines (Blanchet, 2025).

Senator Alsobrooks strongly refuted these statements, declaring them to be not only unsubstantiated but also potentially dangerous, warning that Kennedy’s platform could influence parents in harmful ways (Blanchet, 2025).

Kennedy's claims, however, are not backed by credible scientific evidence. The lack of rigorous, peer-reviewed, double-blind studies supporting such assertions is evident, and medical experts have expressed alarm about the potential risks of endorsing such ideas without a sound scientific foundation (Wilson, 2025).

This type of racialized thinking in healthcare is not new. As a Black female licensed mental health clinician, I frequently hear from clients about their experiences with medical mistreatment and misdiagnosis. Many of these individuals are now dealing with serious health conditions that could have possibly been prevented had their providers listened to their concerns and made diagnoses based on a comprehensive and accurate understanding of their health. These stories underscore the critical need for a healthcare system that prioritizes equity, listens to patients, and applies evidence-based practices without bias.

Policing, Systemic Oppression, and Mental Health

Policing plays a significant role in perpetuating racial trauma. The over-surveillance and disproportionate criminalization of Black communities create environments where stress and fear become chronic (McLeod et al., 2019). Interactions with law enforcement often trigger acute stress responses, particularly in individuals with a history of trauma (Alang et al., 2017).

However, Black communities are not the only ones affected by systemic oppression. While African Americans experience systemic oppression at disproportionately high rates, Indigenous, Latinx, LGBTQ, Asian, and low-income white communities also endure its harmful effects. Policing, medical mistreatment, and discrimination all contribute to the marginalization of these groups, though the specific impacts vary across communities. (Braveman et al., 2022)

Moreover, systemic oppression extends beyond law enforcement, encompassing practices such as redlining and employment discrimination. These structural inequities restrict access to essential resources like quality education, healthcare, and housing, creating cycles of poverty and stress that take a severe toll on mental health (The Movement Lawyering Clinic, Howard University School of Law, n.d.).

The Role of Religion and the Black Church

Historically, the Black church has been a pillar of resilience, fostering community and providing sanctuary. However, it has also played a role in perpetuating stigma around mental health. In some cases, mental health struggles are framed as spiritual shortcomings, leading individuals to seek prayer instead of professional support (McDade, 2021).

While spirituality can be a powerful coping mechanism, an overreliance on religious solutions may discourage a holistic approach to mental health, contributing to spiritual bypassing (Richardson et al., 2024).

Furthermore, traditional Christian teachings have at times reinforced patriarchal and heteronormative norms, alienating those who do not conform and deepening feelings of isolation (Richardson et al., 2024).

Breaking the Stigma: Reclaiming Spirituality and Wellness

Healing from historical and racial trauma requires a multifaceted approach that combines mental health care, spirituality, and community empowerment. Here’s how we can move forward:

1. Acknowledge Historical Trauma: Recognizing the lasting effects of slavery and systemic racism is crucial. Educators, healthcare providers, and policymakers must be trained to understand and address racial trauma.

2. Culturally Competent Care: Mental health professionals need to provide culturally sensitive and trauma-informed care. Black therapists and practitioners rooted in African-centered approaches can bridge the gap between traditional healing and modern therapy.

3. Decolonizing Mental Health Stigma: The Black church can play a transformative role by embracing mental health education and integrating it into spiritual teachings. Leaders can encourage congregants to seek therapy as an act of self-love and liberation.

4. Community Healing Spaces: Programs that blend traditional African practices, like drumming and storytelling, with modern therapy have proven effective in addressing trauma. These spaces can also foster intergenerational dialogue to break cycles of silence and shame.

5. Advocacy and Policy Change: Addressing systemic inequities in policing, housing, and healthcare is essential for creating environments where Black individuals can thrive. Advocacy for equitable policies can help dismantle barriers to mental health care.

Conclusion

The shadow of drapetomania and its dehumanizing legacy draws attention to the urgent need to address the intersections of race, trauma, and mental health. (Naragon, 1994) By reclaiming spirituality, dismantling stigma, and demanding systemic change, Black communities can transform historical wounds into pathways for healing and empowerment. (The Historical Roots of Racial Disparities in the Mental Health System, n.d.) True liberation requires not just the breaking of physical chains but also the healing of minds and spirits.

The journey to wellness is complex, but it is also deeply rooted in the resilience and strength that have carried generations forward.

So remember, healing yourself is a powerful act of resistance, best captured by Audre Lorde’s words: 'Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.'

Continue to care for yourselves, and remember—you are not alone.

Fanicy Sears, LPC-S, LMFT, NCC

Clinical Director

eMotion Therapy, LLC

References:

Akinyemi, A. A. (2022). Historical trauma compounds experiences of racial injustice. Nature Human Behaviour, 6(9), 1183. https://doi.org/10.1038/s41562-022-01435-2

Alang, S., McAlpine, D., McCreedy, E., & Hardeman, R. (2017). Police Brutality and Black Health: Setting the agenda for public health scholars. American Journal of Public Health, 107(5), 662–665. https://doi.org/10.2105/ajph.2017.303691

APA’s apology to Black, Indigenous and people of color for its support of structural racism in psych. (n.d.). https://www.psychiatry.org/news-room/apa-apology-for-its-support-of-structural-racism#:~:text=Inequities%20in%20access%20to%20quality,enact%20corresponding%20anti%2Dracist%20practices.

Blanchet, B. (2025, January 31). RFK Jr. Called Out for Saying Black People Should Have Different Vaccine Protocol than White People: 'So Dangerous' People.com. https://people.com/rfk-jr-called-out-dangerous-claim-black-people-vaccines-8783821

Braveman, P. A., Arkin, E., Proctor, D., Kauh, T., & Holm, N. (2022). Systemic and Structural racism: definitions, examples, health damages, and approaches to dismantling. Health Affairs, 41(2), 171–178. https://doi.org/10.1377/hlthaff.2021.01394

Conner, K. O., PhD. (2020, October 1). Historical traumas have lasting consequences for individuals and communities. Psychology Today. https://www.psychologytoday.com/us/blog/achieving-health-equity/202010/why-historical-trauma-is-critical-understanding-black-mental

Edwards-Grossi, È., & Willoughby, C. D. E. (2024). Slavery and its afterlives in US psychiatry. American Journal of Public Health, 114(S3), S250–S257. https://doi.org/10.2105/ajph.2023.307554

Faber, S. C., Roy, A. K., Michaels, T. I., & Williams, M. T. (2023). The weaponization of medicine: Early psychosis in the Black community and the need for racially informed mental healthcare. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1098292

Hankerson, S. H., Moise, N., Wilson, D., Waller, B. Y., Arnold, K. T., Duarte, C., Lugo-Candelas, C., Weissman, M. M., Wainberg, M., Yehuda, R., & Shim, R. (2022). The intergenerational impact of structural racism and cumulative trauma on depression. American Journal of Psychiatry, 179(6), 434–440. https://doi.org/10.1176/appi.ajp.21101000

Hwang, W., & Kong, Y. (2024). Addressing systemic racism in mental health care. Review of General Psychology. https://doi.org/10.1177/10892680241289349

Massachusetts Historical Society: The Strange History and Career of Drapetomania: The Mania that Caused Enslaved Blacks to Escape and the Man Behind It. (n.d.). https://www.masshist.org/events/strange-history-and-career-drapetomania-mania-caused-enslaved-blacks-escape-and-man-behind

McLeod, M. N., Heller, D., Manze, M. G., & Echeverria, S. E. (2019). Police Interactions and the Mental Health of Black Americans: a Systematic Review. Journal of Racial and Ethnic Health Disparities, 7(1), 10–27. https://doi.org/10.1007/s40615-019-00629-1

Medlock, M., Weissman, A., Wong, S. S., & Carlo, A. D. (2016). Addressing the legacy of racism in psychiatric training. American Journal of Psychiatry Residents Journal, 11(2), 13. https://doi.org/10.1176/appi.ajp-rj.2016.110206

Naragon, M. D. (1994). Communities in motion: Drapetomania, work and the development of African‐American slave cultures. Slavery and Abolition, 15(3), 63–87. https://doi.org/10.1080/01440399408575139

Neergaard, L., & Stobbe, M. (2025, January 31). RFK Jr. kept asking to see the science that vaccines were safe. After he saw it, he dismissed it | AP News. AP News. https://apnews.com/article/rfk-jr-vaccine-trump-science-autism-9b99621b01f11b7f0bdc81e5a0b82d2b

Opara, I. N., Riddle-Jones, L., & Allen, N. (2021). Modern Day drapetomania: Calling out scientific racism. Journal of General Internal Medicine, 37(1), 225–226. https://doi.org/10.1007/s11606-021-07163-z

Pederson, A. B., Earnshaw, V. A., Lewis-Fernández, R., Hawkins, D., Mangale, D. I., Tsai, A. C., & Thornicroft, G. (2022). Religiosity and stigmatization related to mental illness among African Americans and Black immigrants. The Journal of Nervous and Mental Disease, 211(2), 115–124. https://doi.org/10.1097/nmd.0000000000001576

Richardson, B. T., Jackson, J., Marable, G., Barker, J., Gardiner, H., Igarabuza, L., Leasy, M., Matthews, E., & Zisman-Ilani, Y. (2024). The role of Black churches in promoting mental health for communities of socioeconomically disadvantaged Black Americans. Psychiatric Services, 75(8), 740–747. https://doi.org/10.1176/appi.ps.20230263

Scott-Jones, G., & Kamara, M. R. (2020). The traumatic impact of structural racism on African Americans. Delaware Journal of Public Health, 6(5), 80–82. https://doi.org/10.32481/djph.2020.11.019

Stone, W. (2025a, January 31). Senator calls RFK Jr.’s position on race and vaccines dangerous. NPR. https://www.npr.org/sections/shots-health-news/2025/01/30/nx-s1-5281457/rfk-jr-vaccines-race-confirmation-hearings

Stone, W. (2025b, January 31). Senator calls RFK Jr.’s position on race and vaccines dangerous. NPR. https://www.npr.org/sections/shots-health-news/2025/01/30/nx-s1-5281457/rfk-jr-vaccines-race-confirmation-hearings

The historical roots of racial disparities in the mental health system. (n.d.). www.counseling.org. https://www.counseling.org/publications/counseling-today-magazine/article-archive/article/legacy/the-historical-roots-of-racial-disparities-in-the-mental-health-system#

The Movement Lawyering Clinic Howard University School of Law. (n.d.-a). A growing dilemma: police violence, mental health, and Black communities. In The Movement Lawyering Clinic Howard University School of Law (p. 3). https://thurgoodmarshallcenter.howard.edu/sites/tmcrc.howard.edu/files/2021-09/Mental%20Health%20Report_Mike%20Brown%20Bill.pdf

Willoughby, C. D. E. (2018). Running Away from Drapetomania: Samuel A. Cartwright, Medicine, and Race in the Antebellum South. The Journal of Southern History, 84(3), 579–614. https://doi.org/10.1353/soh.2018.0164

Wilson, J. (2025, January 31). RFK Jr.’s stunning claim about Black people and vaccines sparks concern from medical experts. Yahoo News. https://www.yahoo.com/news/rfk-jr-stunning-claim-black-205907305.html

Suite DH, La Bril R, Primm A, Harrison-Ross P. Beyond misdiagnosis, misunderstanding and mistrust: relevance of the historical perspective in the medical and mental health treatment of people of color. J Natl Med Assoc. 2007 Aug;99(8):879-85. PMID: 17722664; PMCID: PMC2574307. https://pmc.ncbi.nlm.nih.gov/articles/PMC2574307/

Perception of Mental Illness in the African American Church Culture. (2021). Research in Health and Medicine, 1(1). https://www.researchdirects.com/index.php/healthsciences/article/view/11