From Idiocy to Mental Deficiency

Historical Perspectives on People with Learning Disabilities

Anne Digby, David Wright

• Publisher: Routledge
• Year: 2002
• ISBN:
  9781134831982
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

From Idiocy to Mental Deficiency is the first book devoted to the social history of people with learning disabilities in Britain. Approaches to learning disabilities have changed dramatically in recent years. The implementation of 'Care in the Community', the campaign for disabled rights and the debate over the education of children with special needs have combined to make this one of the most controversial areas in social policy today.
The nine original research essays collected here cover the social history of learning disability from the Middle Ages through the establishment of the National Health Service. They will not only contribute to a neglected field of social and medical history but also illuminate and inform current debates.
The information presented here will have a profound impact on how professionals in mental health, psychiatric nursing, social work and disabled rights understand learning disability and society's responses to it over the course of history.

1

CONTEXTS AND PERSPECTIVES

Anne Digby

Historically, the social marginality of people with learning disabilities has been mirrored by their academic marginality. Even when the ‘new social history’ of the 1960s and 1970s had focused on ‘history from below’ and made visible a number of social groups previously neglected by historians, people with learning disabilities at first did not come into view. More recently some excellent, but as yet unpublished, doctoral theses have taken this group of people as their subject.¹ A Society for the Social History of Medicine conference entitled ‘From “Idiocy” to “Mental Deficiency”: Historical Perspectives on People with Learning Disabilities’ attracted considerable interest at home and abroad when it was held in London in 1992.² This book is the outcome of papers given at that conference and will, it is hoped, stimulate further studies in the history of these individuals.

This introductory chapter provides a broad contextualisation and period perspective which aims to enhance an appreciation of the more detailed case studies in the volume. The chapter begins by looking at the language of difference, and earlier attempts to locate the nature of that difference. A discussion of the institutional response to learning disabilities from the eighteenth century to the twentieth century, of the social and intellectual climate in which this developed, and of alternatives in the form of familial or community care then follows. The chapter also highlights some human rights issues.

Pragmatic tests for idiocy (notably those in relation to property), were based on establishing orientation, intellect, judgement and memory. Ad hoc questioning ascertained whether individuals were aware of knowing where they were, what age they were, what day of the week it was, if there was an ability to count to twenty pence or do a simple literacy test, as well as determining whether there was an orderly weekly religious attendance at church.³ As Richard Neugebauer indicates in Chapter 2, during both the medieval and early modern periods it is interesting to discover that naturalistic tests rather than demonological criteria were used to evaluate mental impairment in English court hearings that involved the Crown’s incompetency jurisdiction over property. From the thirteenth century onwards there had been a legal dichotomy between idiocy and lunacy. Idiots (for a time also termed natural fools) were seen as having a disability that was permanent, a condition involving absence of understanding from birth. This was distinct from lunacy which was a postnatal event. By the seventeenth and eighteenth centuries, as Peter Rushton points out in Chapter 3, intermediate categories had been introduced. Legal decisions often effectively validated the viewpoint of families or endorsed the popular reputation of the individual as an idiot. A common-sense familiarity or lack of embarrassment towards eccentricity, lunacy or idiocy was indicated by the richly nuanced language describing them.⁴

Social negativity grew stronger as more widespread institutional care resulted in a distancing of idiots and imbeciles from the community. Closer social, medical, or educational attention was also focused upon these institutionalised individuals. At first this specialist focus was not necessarily associated with any great precision since, for example, those born deaf and dumb continued to be legally presumed to be idiots.⁵ Idiots were seen as less able to reason than imbeciles, and an additional term, the feeble-minded, was borrowed from American writings in the 1860s. The fluidity of the latter enabled a variety of social problems to be conflated with it; late nineteenth-century fears of miscegenation and degeneration in Britain associated the feeble-minded with class and, in the Empire, with race.⁶ In medico-legal terms the states of idiocy and imbecility were only gradually distinguished from lunacy. The Report of the Metropolitan Commissioners in Lunacy in 1844 recognised congenital idiots and congenital imbeciles as two of its nine categories of lunacy. Under the Lunacy Act of 1890 an insane person was defined as either an idiot, a lunatic or a person of unsound mind. Legally, however, it was not until the twentieth century that lunacy excluded mental disability. Twentieth-century legislation was interesting linguistically since successive mental health and education acts referred to feeble-mindedness, idiocy and imbecility (1913), mental sub-normality (1944 and 1959), and mental impairment (1983). In Britain, as in the United States, however, lay confusion of mental illness and idiocy/imbecility continued.⁷

Historically, therefore, the subject is confused by a multiplicity of terms, while current notions of political correctness and enablement have helped fuel an increasingly rapid change in nomenclature. For example, after forty years of existence as the ‘Spastics Society’ the organisation felt it necessary in 1994 to be renamed as ‘Scope’, with the subtitle ‘for those with cerebral palsy’, because it considered that the original name, ‘spastics’, had become a term of abuse.⁸ With present-day equal opportunities policies, and with a more widespread adoption of a human rights culture, the stigmatising of people with learning disabilities – in which yesterday’s definition becomes today’s term of abuse – as in ‘fool’, ‘idiot’, ‘moron’, ‘cretin’, or ‘imbecile’ – may become harder. Today, it is society that the impaired themselves now perceive as disabling for the individual, and human potential will, it is thought, be achieved through anti-discrimination legislation. This may offer a better way forward than concern directed at stigmatised labelling. All too often debates over linguistic political correctness have produced semantic ingenuities – ‘intellectually challenged’, ‘developmentally retarded’, or ‘differently abled’ – which have done little to improve the actual civil rights of the disabled. It is this perspective which has informed the decision to use the terminology of the period under discussion in different parts of this chapter, as well as a belief that the language used historically helps us to understand past values and social attitudes.

Implicit in the language describing these individuals was, and is, the notion of the Other. ‘The changing definitions of difference constitute the history of the mentally handicapped. These definitions have always been conceived of by others, never are they the expression of a group of people finding their own identity, their own history.’⁹ The issue of their relative humanity or animality was the subject of discussion by early psychologists and philosophers.¹⁰ Thomas Willis in a chapter on mental deficiency listed the physical insults to the body that predisposed parents to have imbecilic children.¹¹ Changelings, as the handicapped children of normal parents were called, aroused particular interest from Paracelsus onwards. Locke, in a famous and apparently unproblematic distinction between lunatics and idiots, argued that ‘Idiots make very few or no propositions, and reason scarce at all.’ But Locke’s view of the idiot was far from unproblematic since this was based on a circular identification of idiots and changelings. In reviewing what it was to be human, it has been suggested that Locke provided a much more comprehensive exclusion of the idiot than the earlier one based on particular schema (such as the historical tests discussed above).¹² In Chapter 5 of this volume, Chris Goodey analyses the antecedents of Locke’s thought in seventeenth-century theological debates that developed distinctions between natural and moral disability, probed the reasons why God should have created idiots, and pondered whether they could ever achieve salvation. Goodey demonstrates how Locke extended the discussion into the secular realm of the political nature of consent in a civil society, and so suggests the relevance – both past and present – of the relationship of disability to consent and civil liberty.

Idiocy was seen mainly as a domestic or family problem so that institutional remedies were thought largely inappropriate in the early modern period. The situation became a matter of public concern – and thus of Poor Law applications – only when care broke down, the burden of care resulted in family poverty, or if male adults (often the main productive members of the family), were concerned.¹³ Peter Rushton argues in Chapter 3 that so far from indicating a pre-industrial golden age of social integration this situation suggests that the family was ‘at the centre of the state-enforced system of care’. Thus the English parish only looked after a minority of individuals by subsidising care in neighbours’ homes. And some parishes were so reluctant to shoulder the financial burden for this that payment had to be enforced by the magistracy. In contrast, in Chapter 4, Jonathan Andrews prefers to stress the compassionate nature of these kinds of parochial relief on the basis of his research into a sample of metropolitan parishes during the seventeenth and early eighteenth centuries. Whilst also emphasising the predom-inantly family-based and domiciliary locus of care he also finds that some idiots were sent out to surrounding counties for nursing or lodging. Boarding out with ‘kindly guardians’ was later employed in nineteenth-century Scotland for the mentally deficient. The official – and probably over-optimistic view – of these community-based strategies was that ‘Being dressed like ordinary people … the old village fools seemed at once to disappear from the villages without having really left them.’¹⁴

Only a minority of idiots were placed in institutions. In Chapter 4 Jonathan Andrews suggests that whilst Bethlem Hospital was putting more effort into excluding the incurable, amongst whom were numbered the idiotic, from the late seventeenth century onwards workhouses privileged idiots above lunatics because of the utility of their labour. A process of institutionalisation gradually accelerated within an industrialising and urbanising society. This transition from life in the family or community (which was an almost invisible presence as far as the historical record was concerned), to that in institutions has led to more documentation and hence – for historians – to greater social visibility. But even in workhouses, asylums and prisons idiotic inmates were for some time outside the main focus of concern, not least because it was perceived only belatedly that they were a separate category. From the documentation it appears as if idiots and imbeciles had only ‘walk-on parts’ as criminals, paupers, or lunatics because they were not on the historical stage for long enough to be within the vision of eighteenth-century and nineteenth-century administrators and policy-makers. Ironically, in reality, they might be the longest-stay inmates. This failure to come ‘under the spotlight’ also derived from the circumstances surrounding institutional development. A burst of therapeutic and social optimism had created such establishments. But imbeciles and idiots were not the easiest people for whom to claim recovery or rapid discharge rates, and hence to publicise a ‘successful’ establishment which could then gain additional funding from a credulous public. A lack of understanding of their needs, and of a suitable typology in relation to those seen as idiots and imbeciles, led to them being housed in a variety of institutions. In this spectrum there was a hierarchy of cost as well as of social, educational or medical suitability; general workhouses were cheaper than any of the alternatives. The growth of Georgian and Victorian institutions was driven as much by the desire to safeguard the interests of society as to care for particular groups. Revealingly, the Quaker expert on psychological medicine, D.H. Tuke, stated in 1882 that:

There may be times when, desiring to see the ‘survival of the fittest’, we may be tempted to wish that idiots and imbeciles were stamped out of society. But … there is a compensation for the continued existence of so pitiable a population in our midst in … that our sympathies are called forth on their behalf … those who are strong should help the weak.¹⁵

Once created, for whatever combination of altruistic and self-regarding motives, institutions both highlighted and themselves created problem populations. By the mid- and late nineteenth century the optimism of early reformers had been succeeded by a pessimism in which feebleminded inmates were seen as...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• Notes on the contributors
• 1. Contexts and perspectives
• 2. Mental handicap in medieval and early modern England: Criteria, measurement and care
• 3. Idiocy, the family and the community in early modern north-east England
• 4. Identifying and providing for the mentally disabled in early modern London
• 5. The psychopolitics of learning and disability in seventeenth-century thought
• 6. ‘Childlike in his innocence’: Lay attitudes to ‘idiots’ and ‘imbeciles’ in Victorian England
• 7. The changing dynamic of institutional care: The Western Counties Idiot Asylum, 1864–1914
• 8. Institutional provision for the feeble-minded in Edwardian England: Sandlebridge and the scientific morality of permanent care
• 9. Girls, deficiency and delinquency
• 10. Family, community, and state: The micro-politics of mental deficiency
• Index