In Under the Strain of Color: Harlem’s Lafargue Clinic and the Promise of an Antiracist Psychiatry, Gabriel N. Mendes argues, “The Lafargue Clinic represented a landmark in both the history of African American encounters with psychiatry and the history of American psychotherapy’s reckoning with the social sources of mental disorders. The clinic explicitly incorporated the social experience of racial and class oppression into its diagnostic and therapeutic work. Under the Strain of Color shows that in doing so, the clinic was simultaneously a political and scientific gambit, challenging both a racist mental health care system and supposedly color-blind psychiatrists who failed to consider black experiences of oppression in their assessment and treatment of African American patients” (pg. 9). In his focus, Mendes examines the clinic’s founders, author Richard Wright and psychiatrist Dr. Fredric Wertham. The two shared “the belief that psychoanalysis and literature were naturally aligned” for the ability to examine the unconscious (pg. 35). Similar to his subjects, Mendes examines the writing of Wright and Wertham for how it reacted to the racist social order of their time, reflecting their hopes for systemic change while advocating for those whose race or class left them without access to the legal and medical systems.

Of Wertham specifically, Mendes argues that his outsider status resulting from his inability to follow the unwritten rules of his discipline coupled with his social justice advocacy “created a space for him to develop a radical critique of the science of medical psychology. In that space he fashioned a philosophy and practice of psychiatry he termed social psychiatry that culminated in the establishment of the Lafargue Clinic” (pg. 55). Just as Mendes examines Wright’s literary and political interests against the backdrop of early efforts to resist Jim Crow, he puts Wertham’s psychiatric career in the context of early-twentieth-century psychiatry, specifically the shift from heredity-based models to an understanding of psychopathology (pgs. 68-76). Wertham’s second book, Dark Legend, helped establish him as a public authority, but did not elevate his position in the field of American psychiatry (pg. 83). Mendes further identifies the absence of Wertham and his work from historians’ examination of social psychiatry as a glaring omission (pg. 108). According to Mendes, “Wertham’s central argument in both his testimony against segregation and his attack upon comic books was that both contributed to a hostile climate that interfered with the emotional and mental health of young people” (pg. 152).

Discussing the formation of the Lafargue Clinic, Mendes writes, “Three distinct traditions – black intellectual radicalism, Jewish émigré scientific radicalism, and the Progressive black church – met together in the basement of a church in Harlem to address an urgent community need. Beyond the immediacy of providing inexpensive and accessible mental health care within the Harlem community, the founders of the clinic confronted one of the central problems of postwar American society: the psychic fallout of black Americans’ struggles to live a human life in an antiblack world” (pg. 88). Black Harlemites were further denied the ability to seek medical care due to the division of the city into Heath Areas, which precluded them from accessing mental health facilities in nearby Manhattan due to residential segregation (pg. 94). Discussing Wertham’s focus on the effects of segregation from treating black patients, Mendes writes, “He encountered black patients in prominent mental hygiene institutions, and this firsthand knowledge of the manifestations of mental disorder among African Americans coalesced with his habits of mind oriented toward comprehending and challenging both oppressive and repressive forces in modern society” (pg. 117). Discussing Wertham’s most prolific work, Mendes writes, “Wertham’s central argument in both his testimony against segregation and his attack upon comic books was that both contributed to a hostile climate that interfered with the emotional and mental health of young people. Moreover, the argument was founded on evidence derived from the clinical methods of social psychiatry practiced at Lafargue” (pg. 122). Mendes writes of Wertham’s testimony in Gebhart v. Belton, 33 Del. Ch. 144, 87 A.2d 862 (Del. Ch. 1952), “He explained that the children he examined interpreted segregation as punishment. These children believed they were being punished for something not explained to them, for something they had not done” (pg. 143). Further, Wertham identified the psychological damage of segregation in both black and white children. According to Mendes, “Of the five companion cases argued collectively as Brown v. Board of Education, the Delaware cases were the only ones in which the state ruled in favor of the black plaintiffs” (pg. 146). Despite these successes, Wertham’s professional alienation precluded his involvement in the later NAACP-LDEF Social Science Statement.

Mendes’ Under the Strain of Color offers a critical examination of early- to mid-twentieth-century psychiatry and its role in social justice. His study and reexamination of Fredric Wertham’s legacy builds upon Bart Beaty’s Fredric Wertham and the Critique of Mass Culture while his examination of psychiatry expands on the work Jonathan Metzl began in The Protest Psychosis: How Schizophrenia Became a Black Disease. Similarly, his work recalls that of Elizabeth Lunbeck’s The Psychiatric Persuasion: Knowledge, Gender, and Power in Modern America. Those studying the history of psychiatry and of civil rights will find this an invaluable work shedding light on an oft-overlooked experiment, the Lafargue Clinic, and the people who worked for equal access to medical treatment. ( )