Insight Matters
Summer, 2001

Don't Rise Above Your Raisin'
by Paulette Gillig, M.D., Chair, Ad Hoc Committee on Minority/Underrepresented Groups

Chair's note: Our committee would very much appreciate hearing from individuals throughout Ohio who have concerns or observations about issues concerning minorities and underrepresented groups in Ohio. PLEASE email me at paulette.gillig@wright.edu with any information you may have. This is very important so that our committee (Minorities and Underrepresented Groups/OPA) can do its work!

Life in the Appalachian wilderness and the continuing isolation of Appalachian people have made them different from most contemporary Americans (Belinda Di Leo, 1994). The value system of many of the Appalachian people is similar to the value system of early American, and of most immigrants and many other minorities. That is, in general the Appalachian people view life through a prism of religion, family solidarity, individualism, self-reliance and pride, love of the land, patriotism, modesty, being oneself (not putting on airs), and appreciation of nature's beauty. They believe in looking after their own and making do. They hand down roles and traditions from one generation to another, and a son is expected to follow his father's occupation. Appalachians often prefer to do things the way they have always been done, because this reinforces tradition and provides a sense of security and continuity. They do not wish to compete or compare themselves with others. They emphatically believe in putting family first.

Education is viewed as on possible vehicle to improve one's potential for income and ability to support the family, but is of much less intrinsic importance than family relationships and would be sacrificed to maintain family relationships. Appalachians want to "level" relationships, and think of themselves and others as being as good as anyone else but no better. The folksy admonition, "Don't rise above your raisin'" means "don't put on airs and don't think you have become better or superior to other members of your family or group.

To the Appalachian people (as to Native Americans and many Jewish people) the land itself is a sacred place. There is continuity with ancestors who are buried there and descendents who will be sustained by the land (Di Leo). There, one can form relationships with people not physically alive, who are buried there, and whose presence can be felt in that place.

Did you ask, why don't they just move somewhere else to find better jobs?

The history of the Appalachian people is tied to the history of coal mining, oil, timber and other extractive industries that essentially "colonialized" the land and its people. After years of prosperity (which is why the people established their homes there in the first place) the industries left, leaving behind a scarred (but still beautiful) landscape (Di Leo, 1994). This history is related to the paradox of how the Appalachian people are perceived by other contemporary Americans: "hopeless but proud, desperate but industrious, noble first generation frontier people yet somehow ignorant and degenerate" (Di Leo). (Compare these cultural perceptions to the perceptions contemporary Americans have of "American Indians," "Negro slaves" and other exploited groups.)

Some research studies (Flickered, 1980) have found evidence that there are significant differences between how Appalachians view certain problematic behaviors and how mental health professionals view these behaviors. That is, for most Appalachians a person who does not work may be lazy. A violent or sexually acting-out person may be mean, or criminal, or immoral. For the Appalachian respondent, the responsibility and the power to change resides within the individual. Behavior is not determined by outside forces or events, or by "mental illness," but by the person's own will.

Appalachians are not unique in holding this point of view, of course. In a follow-up study (1984), it was found that this view is also held by immigrant Chinese-Americans, Mexican-Americans, and Filipino-Americans, and also by many Native-Americans and African-Americans. Therefore, the fact that many psychiatrists disagree with these views will interfere with communication between ourselves and patients from an Appalachian or other minority background. Pulling rant due to our education and status will make it worse!

By way of contrast, in Appalachia a person with ideas of reference or auditory hallucinations is not necessarily stigmatized. In fact, these qualities sometimes empower an individual because of the belief that the person may be psychic or in touch with God or with the deceased in a special way. Those who have read the book of Ezekial or the biography of Joan of Arc know that Appalachians are not the only people who have held this point of view. If you were chatting with God, would you want some psychiatrist to give you medicine to make God go away?

People from Appalachia want to have a relationship with us if we are willing to get to know them (and let them know us) as people first. In this regard, they are similar to almost all other cultural groups throughout the world EXCEPT other contemporary Americans, who "don't have time for that the way our parents did."

Let's take time, and not rise above our raisin'!