AT KING’S SIDE during many a march walked a young doctor with a black bag. Stand close to King, Andrew Young told the young volunteer for the Medical Committee for Human Rights. Never be more than a few people away. Inside the bag, Dr. Alvin Poussaint carried first aid material, in case King was shot. Poussaint also provided medical and psychological support for the marchers. A medical car (usually Poussaint’s own car with an affixed red cross) trailed each march.
Dr. Poussaint, now a child psychiatry professor at Harvard, gave me a firsthand assessment of King’s mental state in the final years of his life. Poussaint knew Dr. King reasonably well from the marches. He recalls an intense period of interaction with King in 1966 during the Meredith march, the beginning of the end of the civil rights movement. “King had a fearlessness about him. . . . He set the pace in marches, he was strolling, not walking fast, nor slow, but strolling, and always right in the front line, which put him at risk. Anyone could run out from the bushes and shoot him.” Poussaint describes how terribly afraid he was many times during the marches, but how King always maintained his composure. Once King marched to a courthouse in Philadelphia, Mississippi, after some civil rights workers had been killed. He was met by two sheriffs on the sidewalk. Don’t take another step, one of them said; they had their hands on their guns. “King was standing there, with his chest out, like he always stood. I thought he was going to walk onto the lawn, and they would then beat or kill him and us.” King knelt on the ground to pray, and everyone around him did the same. Says Poussaint, “You have to realize there was a constant sense of fear on those marches. The marchers never knew if and when they might be attacked or even killed, and since they were enjoined never to fight back, they sometimes felt like lambs going to sacrifice. This constant fear was an extreme test of character, one which King passed, while others . . . did not.”
Poussaint emphasizes that even in the face of all this anxiety, fear, and violence, King projected an abnormally calm sense of “serenity” and “peacefulness.” Some of this may have been a show, to buck up his followers; in private, King would drink and get tipsy, or engage in hilarious jesting. Poussaint did not observe hyperthymic personality traits, such as being hyperactive, talking or walking fast. In fact, he saw the reverse: “He talked slow, and even walked slow, not only during marches, but I remember walking casually with him, just chatting, about nothing of consequence, and he walked slowly.” Poussaint was unaware of King’s adolescent suicide attempts, and when asked what he thinks as a child psychiatrist now, he replied, “It sounds like an impulsive grief reaction. I’ll join [my grandmother] who’s dead. I agree that one would be more likely to do that if depressed already.” Despite the possibility of an adolescent period of depression, Poussaint doubted, from his own experiences and from speaking to others in King’s circle, that Dr. King suffered from much depression otherwise.
I think we can conclude from the firsthand observations of Dr. Poussaint, and from the historical record, that—unlike Gandhi—King did not have a baseline dysthymic personality (with sadness, shyness, anxiety, and introversion). He was not chronically depressed. But, exactly as with Gandhi, King experienced at least three probable depressive episodes in the beginning, middle, and end of his life, the first associated with suicide attempts.
Of the four diagnostic validators of mental illness, symptoms and course both point toward depressive illness, but we can say nothing about genetics and treatment. Regarding genetics, King’s family is private, and the presence or absence of psychiatric diagnoses among family members is not publicly available knowledge. Regarding treatment, during his final depression, some of King’s aides urged their leader to get psychiatric help, but he never did so.
AS WITH GANDHI, King’s depression may well have generated his politics of radical empathy. In fact, King drew an analogy between his politics and psychiatric treatment: the patient was America; the disease was racism. For example, in a 1957 interview with journalist Martin Agronsky, King said, “Psychologists would say that a guilt complex can lead to two reactions. One is repentance and the desire to change. The other reaction is to indulge in more of the very thing that you have the sense of guilt about. And I think we find these two reactions. I think much of the violence that we notice in the South at this time is really the attempt to compensate, drown the sense of guilt, by indulging in more of the very thing that causes the sense of guilt.” Agronsky asked, “You really feel that, you prefer to make this sort of a psychiatric interpretation?” King replied, “Yes.”
This view was widely held in King’s circle, most explicitly by James Bevel, who, as Andrew Young recounted, “put our outrage into perspective when he said that we had to become ‘political psychiatrists’ and view our oppressors as our patients. ‘A psychiatrist doesn’t get angry with his patients when they are violent towards him; the doctor must help his patients to realize that their violence grows out of sickness and insecurity. We must help them, not hate them.’ ” (Bevel’s insight was hard earned: his behavior was erratic, and his colleagues unsuccesfully tried to commit him more than once to mental hospitals.) Alvin Poussaint confirms that the movement leaders saw their mission this way: “By nonviolence, we were trying to cure white people of a sickness. . . . Nonviolence, [King] always said, was a way of life, not just a political movement. It was the way you treat other people. I felt he was trying to model it [in his personal demeanor].”
King’s nonviolent movement was a cure for racism, not a political strategy. Like many treatments, it has healed rather than cured, leaving scars behind. It was a medical metaphor, a political psychiatry, based on the healing power of empathy.
But what was the treatment? How exactly does empathy heal? When faced with injustice, King taught, there are three options: violent resistance, nonviolent resistance, and acquiescence. Resistance of any kind is preferable to acquiescence (which is why Gandhi and King weren’t pacifists; they didn’t oppose violence under all circumstances), but violent resistance usually fails to achieve its goals. What is the nonviolent resistance option? Loving your enemies, King instructed, is not about actually being in love with another (the Greeks called this eros, “a sort of aesthetic or romantic love”), nor is it about even liking another (philia, “a reciprocal love and the intimate affection between friends”): it is about having goodwill toward another (agape, “understanding and creative, redemptive good will for all men”). The difference between agape and philia is why Jesus counseled us to love, not like, our enemies. Despite hate, anger, harm, spite, one reacts with goodwill, seeking to appreciate the good in others, trying to see another’s perspective. King insisted that this goodwill is redemptive: by treating others this way, we change them.
A SKEPTICAL READER might say: Empathy is fine, but King and Gandhi certainly seem like idealists. If depression entails both realism and empathy, where is the realism? This attitude is understandable today. The Martin Luther King of popular mythology is a cardboard icon, brought out once a year on a holiday, with little resemblance to the real historical man. The cardboard King was a pacificist idealist; he wanted everyone to make peace and hold hands. The real King was an aggressive, confrontational realist; he believed that all men were evil in part, including himself; he thought that violence was everywhere and unavoidable, including within himself. “Nonviolence” did not mean the absence of violence, but the control of violence so that it was directed inward rather than outward.
These are not my views; these are the explicit views of Gandhi and King, as I will show, and they are a reflection of their realistic views of evil and aggression as part of human nature. During a Howard University conference on nonviolence in 1963, the comments of Jerome Frank, a prominent psychiatrist at Johns Hopkins, represent an example of the misinterpretation of King’s attitude toward violence:
What do nonviolent fighters do with their impulses to violence? The continual humiliations and threats to which they are exposed must arouse intense anger which they must repress. Psychiatrists b
elieve from clinical experience that emotions that are blocked from direct expression tend to manifest themselves obliquely. . . . [We should not expect] more of nonviolent methods of fighting than of violent ones. No form of waging conflict always wins. The most one can ask for nonviolent techniques is that where they fail, and they certainly will fail sometimes, violent methods would have failed more completely.
Frank’s views, influenced by Freud, ran counter to King, who disliked Freudian ideology. King understood what Freud and Frank did not—that nonviolence is not pacifism; King and Gandhi had found a way to use aggressive impulses to resist injustice without hurting others. Where did the aggression go? The answer, as King would later tell Poussaint, was this: into the courage needed to resist without fighting back physically. Gandhi had clearly seen nonviolence this way (one of his followers termed it “war without violence”). For instance, Gandhi said, “My creed of nonviolence is an extremely active force. It has no room for cowardice or even weakness. There is hope for a violent man to be some day non-violent, but there is none for a coward. I have, therefore, said more than once . . . that, if we do not know how to defend ourselves, our women and our places of worship by the force of suffering, i.e., nonviolence, we must, if we are men, be at least able to defend all these by fighting.”
King felt similarly: he called nonviolent resistance one of three options in response to injustice, along with violent resistance and passive acquiescence. If given a choice between violent resistance and passive acceptance, King and Gandhi both accepted violence. But they saw nonviolent resistance as a better alternative. Like violence, it was aggressive, but it was spiritually, not physically, so. It was active, refusing to accept evil, standing up and resisting without inflicting harm. King stated these ideas many times and in slightly different ways. Here is one example from a 1956 sermon: “The nonviolent resister is just as opposed to the evil that he is protesting against as a violent resister. Now it is true that this method is nonaggressive and passive in the sense that the nonviolent resister does not use physical aggression against his opponent. But at the same time the mind and the emotions are active, actively trying to persuade the opponent to change his ways and to convince him that he is mistaken and to lift him to a higher level of existence. This method is nonaggressive physically, but it is aggressive spiritually.” King did not reject violence per se.
Freud and Frank were right, I think, that violent reprisal is a more natural response to injustice. When one fails to respond violently, he pays a psychological cost. Alvin Poussaint, who was fully committed to King’s movement, came to the same conclusion in a 1967 New York Times Magazine article. Poussaint observed that the civil rights marchers—constantly fearing attack, abidingly alert to danger, with orders not to fight back—were angry; they wanted to fight back, but were taught by King not to do so. “I used to sit there and wonder,” wrote Poussaint, “ ‘Now what do they really do with their rage?’ ” What they did was fight each other: “After a period of time it became apparent that they were directing it mostly at each other and the white civil-rights workers. Violent verbal and sometimes physical fights often occurred among the workers. . . . While they were talking about being nonviolent and ‘loving’ the sheriff that just hit them over the head, they rampaged around the project houses beating up each other. I frequently had to calm Negro civil-rights workers with large doses of tranquilizers for what I can describe clinically only as acute attacks of rage.”
Another black political leader, also a psychiatrist, Frantz Fanon, argued that to overcome psychological servitude, blacks must violently attack their white oppressors. Fanon, a favorite of Black Power advocates, saw violence not only as political necessity but as psychological imperative. Violence was the cure for the disease of racism. Poussaint was inching toward that view in his article, expressing the standard psychiatric view (shared by Fanon and Freud) that it is better to express one’s aggression than to repress it; otherwise depression ensues. The Black Power movement was an expression of these psychiatric facts, Poussaint concluded.
To remain allied to King, Poussaint needed a way out. He called it “constructive assertiveness”: “James Meredith . . . said: ‘If Negroes ever do overcome fear, the white man has only two choices: to kill them or let them be free.’... Since this assertive response appears to be growing more common among Negroes, the implications for American society are clear: stop oppressing the black man, or be prepared to meet his expressed rage.”
Shortly afterward, when King visited Boston, he complimented Poussaint on the article, expressing agreement with it. Here we see the coming together of apparent irreconcilables: rage and peace, violence and nonviolence, Frantz Fanon and Martin Luther King. But seeing this convergence as a paradox reflects misunderstanding of King’s philosophy. King did not advocate an attitude of peaceful beatitude toward others; he was an angry man, affronted by injustice; he just advocated expressing that anger in a nonviolent way. As King’s close friend Harry Belafonte said, “Martin always felt that anger was a very important commodity, a necessary part of the black movement in this country.” Thus as documented above, King’s nonviolence is not about being nonaggressive; it is about being aggressive in a nonviolent way. Rage is natural, part of being human; one cannot deny it without painful psychic consequences. But rage can be channeled in a constructive manner, going outside insofar as it resists injustice, and going inward insofar as it supports the higher courage needed to suffer rather than inflict suffering. This cure for racism benefits both the oppressed and the oppressor.
LIFE IS FULL OF EVIL, King believed. All of us have to decide, again and again, how we are going to react to the plethora of evil in the world. The two most common reactions are violent resistance or passive acquiescence. Either approach is conformism; the masses of men acquiesce all the time to all kinds of evil and injustice; some resist violently, only adding more evil to the evil that already exists. King’s advocacy of nonviolence was a third way that required, above all, nonconformism with the other two accepted paths. This is why King emphasized the need for nonconformism, not just as a feature of leadership, but for everyone, as a basic human attitude. These ideas are expressed most directly in a sermon that interprets the biblical phrase “Be not conformed to this world: but be ye transformed by the renewing of your mind” (Romans 12:2). Said King:
Many people fear nothing more terribly than to take a position which stands out sharply and clearly from prevailing opinion. The tendency of most is to adopt a view that is so ambiguous that it will include everything and so popular that it will include everybody. . . . The saving of our world from pending doom will come, not through the complacent adjustment of the conforming majority, but through the creative maladjustment of a nonconforming minority. . . . [We are reminded] of the danger of overstressing the well-adjusted life. Everybody passionately seeks to be well-adjusted. We must, of course, be well-adjusted if we are to avoid neurotic and schizophrenic personalities, but there are some things in our world to which men of goodwill must be maladjusted. . . . Human salvation lies in the hands of the creatively maladjusted.
Psychiatrists ask: Where does the aggression go? By trying to repress it, we become maladjusted, unhealthy, abnormal. We must, above all, be normal, mentally healthy. King disagreed: we must accept unhappiness, suffering, depression, even—God forbid—becoming maladjusted. His friend Reverend Joseph Lowery understood. To achieve social change, he remarked recently, “you have to be a little crazy. All the leaders of the movement were a little crazy. Including Martin.”
PART FOUR
RESILIENCE
CHAPTER 9
STRONGER
In our first appointment, Liza barely spoke. Suffering from severe depression, she could not think or talk logically; it seemed to me she barely heard and understood every third word I spoke. Her daughter tried to explain her sixty-year-old mother’s life to me.
“Mom had a horrendous childhood,” the daughter began.
I saw her depr
ession and had read about manic periods in her chart, so I knew Liza had bipolar disorder. But since childhood trauma is not a particular cause of bipolar disorder, I was only mildly interested in starting with childhood, especially as the clock ticked along and I knew we had complex decisions to make about which medications to prescribe for her condition. But I recalled the old lesson I learned in my residency: Meet patients where they are. So I listened:
“Her parents moved her twenty-three times.”
I looked at Liza, who sat impassively. “Twenty-three times?” I repeated, afraid to ask why.
Liza finally spoke. “Yes. Mother couldn’t keep still . . . manic, just like me.”
As a child, Liza had also endured unwanted sexual attention from siblings and other relatives. I’d heard enough about her childhood to know that it was not one any child should experience. And yet here she was at age sixty, depressed, yes, but alive and whole—a mother herself, with a normal adult daughter beside her as well as four other healthy children and ten grandchildren, none of whom suffered as she had.
THIS IS WHAT psychologists mean by resilience—“good outcomes in spite of serious threats to adaptation or development.” Resilience isn’t simply something one is born with; it grows out of an interaction between factors that promote it (like hyperthymic personality) and harmful life events—producing a good outcome in the end. In psychology research, two lines of evidence support this notion. First, when people experience harmful events, some are injured psychologically, but others are not. Second, sometimes people even get stronger after such events, a “steeling” effect that protects them against future stresses.
A First-Rate Madness Page 11