Looking back: Learning disability - from the Devil to DSM-IV

How long have human beings been putting each other into boxes? Certainly from long before psychology existed, as a formal discipline. However, these boxes haven't always been the same. Some of our ancestors' categories connect awkwardly with ours. What, for example, do modern ideas about intelligence and learning disability have to do with honour or grace?

Honour and grace were the desirable personal qualities if you were born in, say, 1600. That was how you made your bid for esteem: honour gave you social status, grace a religious one. During your 17th-century lifetime, 'reason' would begin to feature in this same class of subjective, inborn qualities. And it was from interaction among all three that modern ideas of intelligence sprang.

So too did learning disability, as I have described in detail elsewhere (Goodey, 2011). While today we define the 'learning disabled' person by characteristics such as inability to process information, think abstractly or reason logically, an equivalent-sounding label from before 1600 – 'natural fool', for example – will display a totally different set. Natural fools could be marked by a penchant for dressing up, proneness to catarrh, licentious behaviour, or denying the existence of God.

What are we to make of such a strange, disparate list? The first item is a reference to court jesters; the second to ancient medical theory, which held mental states to be merely organic facets of physical disease; the last two to moral panics about atheism. The natural fool's characteristic behaviours were dishonourable and graceless: they transgressed social and religious norms that were very much of their time, not ours.

References to information processing, abstraction and mental logic do nevertheless appear in medieval theories of the mind. It was a time when church and state were rapidly expanding their powers, and needed a complex bureaucracy staffed by literate clerks to record, file, 'process' and 'abstract' information. The skills required to manage this new, unwieldy social administration would eventually define modern intelligence. So if the men servicing church and state could boast such abilities, who was it lacked them, if not natural fools?

The answer is the majority of the population. The word 'idiot' at that time meant lay people, commoners in general, and women of all social classes: most people except the honourable elite. You did not need information-processing abilities to get the harvest in or keep house. Abilities which modern psychology sees as characteristically human were absent by definition in the masses. And if, by contrast, you were born a gentleman, your honourable station just was your superior intellect: the word 'ability' denoted, indiscriminately, both intellectual ability and what we would now call social power (e.g. possession of a hereditary estate). They were a single concept. And to lack one kind of ability was to lack the other.

Social status was first complemented, then superseded, by religious status. By 1600 many people in Protestant cultures were overwhelmed with anxiety about their state of grace. God had already decided, before you were born, whether you were 'elect', bound for heaven, or 'reprobate', on a one-way ticket to hell. People were desperate to know which box they fell into. This Calvinist law of predestination was akin to today's genetic determinism: nothing you did could alter your fate. Reprobates were marked by their inability to reason. However, this meant inability to rationally examine their consciences for the signs of grace; in everyday affairs, they were assumed to function normally. So their lack of intelligence, like that of 'natural fools', bears little resemblance to how we define learning disabled people today.  

Archaic though honour and grace may seem, they were not just thrown in the dustbin of history. A continuous path leads from past to present, from these utterly strange categories to our utterly taken-for-granted, modern ones of intelligence and disability (which may one day, of course, become strange in turn).

Evidence for this comes, first, from the history of the discipline itself. The very word psychologia was first coined in the 1580s, to describe the new interest in individual self-knowledge that sprang from anxious scrutiny for the signs of grace in oneself. It also provoked interest in the precise workingsof the minds of others (you wanted to know if your neighbour was saved or damned), and thus to the very stuff of psychological inquiry.

Moreover, some of these older themes got smuggled into the modern discipline. John Locke's 1690 Essay Concerning Human Understanding, its most seminal text, describes the detailed intellectual operations by which we are able to reason logically and to abstract from empirical sense-data. Breaking with his medieval predecessors, Locke believed that all of us possess these operations, irrespective of social class, gender and race. Nevertheless, Locke's aim was not democratic but religious. The reason everyone should possess them was to prepare them intellectually and morally for the Second Coming.

This goal of intellectual growth and perfectibility, as a precondition for being saved, gradually became secularised. This has had serious implications for anyone deemed incapable of such growth. Many of our own basic notions in developmental psychology have roots in Locke's theology – thanks to 18th-century educators who introduced his ideas into popular textbooks on schooling, child development and behaviour.

These writings outlined the personal qualities we should aspire to develop. The elect, regarded with growing optimism as the majority, gradually became people of normal intelligence. Reprobates, correspondingly smaller in number, became the pathological group of the learning disabled. Likewise, assessment methods followed an almost seamless historical evolution from the church catechism, which elicited signs of election and reprobation, to the psychometric test, which elicits signs of intelligence and disability.

When Locke identified a category of people lacking the normative operations of intelligence, he called them 'changelings'. This portion of his Essay has been the main historical precursor for our modern category of severe learning disability. Since changelings lack the operations, he wrote, they lack the essence of what it is to be human: a soul, or mind. This led him to propose that infanticide would be justifiable; we are restrained only by the impossibility of discerning the child's intellectual deficiencies so early. Locke anticipated eugenics, and would have surely have approved prenatal termination for specifically 'intellectual' deficiencies.

Locke's choice of the changeling label evoked the supernatural. The new scientists of the Royal Society, such as Robert Boyle, Isaac Newton and Locke himself, took the Devil's existence seriously and sought to establish how he intervenes in natural biological processes. Here, on the threshold of the modern era, the idea that the Devil had a role in producing disabled children was spreading in scientific circles, not receding. The usual assumption is that a formerly religious world-view has been displaced by a secular and scientific one. However, religion was sublimated within modern intelligence, and within its corresponding notions of disability.

The conceptual roots of intelligence, then, are class-based and religious. Plenty of psychologists have agreed that intelligence is a purely relative notion, but not learning disability, especially when described as severe. Yet history shows us that, in words of Dutch psychologist and historian Inge Mans, "Once upon a time there were no mentally retarded people" (Mans, 1998). If intelligence is not the same thing existing throughout history, is learning disability? Are 'people with learning disabilities' a real category?

True, certain types of mental performance can be empirically verified, and would thus always yield the same results. An ancient Babylonian and a modern practitioner would score them the same. But verification is one kind of thought-process: it is a judgement of something that lies outside ourselves. Choosing a category, labelling it 'intelligence' or 'intellectual disability' and deciding which discrete types of performance to include under that heading, is a another kind of thought-process entirely: a sorting of terms, which originates in our own heads and varies according to who is controlling the discussion. Confuse a judgement with a sorting of terms, and you allow the hard, cross-historical reality of the first to underwrite the consensual, temporary reality of the second. In short, you are pulling the wool over people's eyes. And whatever applies to intelligence applies to learning disability no less. Witness the hard bargaining about what (and what not) to include that has gone into the fixing of categories such as autism or ADHD (Nadesan, 2005). These too are temporary cultural creations.

Why, it may be asked, should any of this matter? After all, it is obvious that in the present era, in our own particular society, some people – regardless of whether they are boxed and labelled or not – need help. Forget history. Shouldn't practitioners just get on with their jobs?  Well, anyone who delves into psychology's prehistory cannot help observing that not all categories are so unstable. Concepts of the emotions akin to our own have had longer historical shelf-lives than intelligence and learning disability. So too (pace Foucault) have mental health and illness. Among the latter is a long-term disorder particularly relevant to our topic which DSM-IV lists as 'specific phobia', and a primary example of which is fear of contamination. Anthropologists too have noted this disorder, across societies. It expresses itself as a collective urge to identify out-groups whom we associate with dirt, and whom we therefore place outside community boundaries (Douglas, 1966). The outgroup created by this phobia is merely a template: the categories occupying it change from one era to the next.

'Learning disability' is our category. It overrides the uniqueness of the individual and leads down the path to social segregation, at the end of which lie Romanian orphanages and Winterbourne View. A conceptual box becomes a physical one, with a lid. It stays shut and hides abuse. Historical research thus exposes the sharp end of current practice. The social phobia that takes the form of putting people behind walls – special schools, care homes, sunshine buses, separate activities – seems to be the more long-lasting and therefore the underlying disorder. Is it not, then, the one that needs curing?

History teaches us that if things were different in the past, so may they be in the future. Of course the past offers no golden age. We would not want to ease our learning-disabled outgroup smoothly into the fabric of mainstream communities, only for us to revert instead to our ancestors' phobic scapegoating of (say) witches. Moreover, revising our estimates of benefit and harm so radically would require, from many, a complete change of outlook. But stick or twist, we are all part of history, and are at this very moment helping to make it.

Chris Goodey is a consultant and researcher
[email protected]

References

Douglas, M. (1966). Purity and danger. London: Routledge.
Goodey, C.F. (2011). A history of intelligence and 'intellectual disability': The shaping of psychology in early modern Europe. Farnham: Ashgate.
Mans, I. (1998). Zin der dotheid. ['The
sense of folly', with English summary]. Amsterdam: Bakker.
Nadesan, M.H. (2005). Constructing autism. London: Routledge.