learning disabilities What connections exist between the body and ‘learning disability’ or ‘mental retardation’? We assume that there is a realm of mental nature separable from physical nature, at least for investigative purposes; we also often see mental disorders as being analogous to physical ones, or physical conditions as causing mental ones. We assume that mental ability or disability is a part of an individual's make-up, and therefore that what is congenital is also largely incurable. All these assumptions are modern, in the historian's sense of the term: they belong to the last three centuries.
According to
Galen, the supreme medical authority before modern times, human reason was activated by ‘animal spirits’ which moved around the brain and, if sluggish, caused
amentia (mindlessness); however, any normal individual could experience this condition temporarily. Sometimes a landowner's heir might suffer from congenital incompetence, but this was a problem for lawyers, not doctors; it was not distinguished from the assumed incompetence of the entire labouring population, and where people did not own property there was no problem. Nor was congenital incompetence necessarily permanent: God might cure it providentially. People whom we might now call ‘learning disabled’ were depicted by artists; but neither their behavioural gestures and bodily features, nor their social role, were clearly distinct from those of jesters and professional fools whose minds were perfectly sound. Medical writers did not research the causes of mental (or physical) monstrosity, since these were God's responsibility; rather, monstrosity demonstrated His marvellous creative powers. Only mavericks among them, such as astrologers or followers of the derided Paracelsus, had a specifically medical interest in connections between the body and permanent lack of reason. Even for them, reason tended to mean divine illumination rather than the personal mental equipment described by modern psychology.
In the seventeenth-century roots of that psychology we begin to find a learning disabled type recognizable to ourselves, defined by the purely mental characteristics of an individual. The influential philosopher John Locke summarized these as a lack of ability to think ‘abstractly’, and psychology has refined this picture very little since then. However, the approach to physiological phenomena associated with ‘idiocy’ (as it was then technically known) has changed frequently. These changes have social and political connections. Locke was also a leading Whig theoretician, and saw idiots as people who lacked the mental equipment needed to exercise their individual autonomy, the basis of the new Whig political philosophy of government by consent. As a medical practitioner himself, he thought this lack might be caused by their having different bodily mechanisms. He did not investigate further, possibly because the discipline of anatomy was controlled by his political opponents. His Tory contemporary, Thomas Willis, believed there was an anatomical distinction between the brains of ‘stupid’ and ‘mad’ people, although he also continued to believe Galen's hypothesis of slow-moving ‘animal spirits’. Descartes's discussion of the mind (one of the sources for modern accounts of a distinctly human psychology) located the reasoning soul in the
pineal gland, which previously had been merely a valve controlling the flow of animal spirits. Anatomists under Descartes's influence, dissecting the corpses of mad people and idiots, claimed that the former possessed excessively flexible pineal glands, the latter excessively rigid ones.
Eighteenth-century medical theorists opened up an empire of the mind, developing psychological classifications in terms similar to those of bodily disease. At the same time their interest in the physiology of idiots largely reverted to external characteristics, particularly facial features (
physiognomics) and skull shape (
phrenology). In the mid nineteenth century, with the rise of colonialism and
anthropology, theories of idiocy and race were united. The mental characteristics of idiots were identified with the alleged psychological inabilities and corresponding external physical characteristics of non-whites. Fetal development was thought to retrace the primitive stages of human history which the non-white races still exhibited; sometimes development was arrested, a notion embodied in the ‘mongol’, whose facial features apparently betrayed a low level of psychological competence comparable with that of the mongoloid races. Segregated institutions and then sterilization programmes arose from this culture, with the aim of improving the health of the race. Administered largely by practitioners of physical medicine, they appeared first in the Anglo-Saxon countries; in Germany the same culture led to mass exterminations of learning disabled people at the end of the 1930s.
Since then a rapid refinement in the diagnostic technology of chromosomes and genes has renewed our interest in internal bodily causes. There has been a correspondingly rapid increase in the number of psychological labels attached to syndromes (e.g. ‘fragile X’); the human genome project now promises to locate DNA markers for the lower band of a socially determined ‘normal IQ’. This profusion of learning disabled conditions has interacted with rapid changes in their social status and acceptance. Pathology advances in some directions while retreating in others. At the time of writing, for example, genetically-related autism has fanned out into an autistic ‘spectrum’, annexing and reinventing ‘Asperger's syndrome’ as a mild variant which may affect the apparently normal population. Its socially segregating effects are inseparable from the diagnosis itself, by which autistic people are said to belong mentally in a separate world from others; this notion reinforces a separate professional specialization, creating more research and labelling. In a simultaneous but contrary tendency, numbers of prospective parents reject termination after a positive test for Down's syndrome, partly because children and young adults with this condition have become increasingly integrated in the community.
People began by wanting a physical diagnosis of learning disability, for various religious and political reasons, in the seventeenth century when biochemistry was inconceivable. But whatever the precision of today's diagnostic techniques in this respect, it has not been matched, either in psychology or in cognitive and behavioural genetics, by a corresponding precision in the diagnosis and description of the ‘mental’ aspects; these remain as fluid and subject to social context as ever.
Christopher Goodey
Bibliography
Wright, D. and and Digby, A. (1996). From idiocy to mental deficiency: historical perspectives on people with learning disabilities. London.
Trent, J. (1994). Inventing the feeble mind: a history of mental retardation in the United States. Berkeley.
See also
intelligence.
