A History of Intelligence and 'Intellectual Disability'

Front matter

BR

A History of Intelligence and “Intellectual Disability”

The Shaping of Psychology in Early Modern Europe

Introduction

Part1 Problematical Intellects in Ancient Greece

Part2 Intelligence and Disability: Socio-economic Structures 3 The Speed of Intelligence: Fast, Slow and Mean

Part3 Intelligence and Disability: Status and Power

5 In-group, Out-group: the Place of Intelligence in Anthropology

6 Honour, Grace and Intelligence: the Historical Interplay

7 *Souls Drowned in a Lump of Flesh": the Excluded

Part4 Intelligence, Disability and Honour

8 Virtue, Blood, Wit: from Lineage to Learning

9 *Dead in the Very Midst of Life": the Dishonourable and the Idiotic Part5 Intelligence, Disability and Grace

11 The Science of Damnation: from Reprobate to Idiot

Part6 Fools and Their Medical Histories

12 The Long Historical Context of Cognitive Genetics 13 The Brain of a Fool 14 A First Diagnosis? The Problem with Pioneers

Part7 Psychology, Biology and the Ethics of Exceptionalism 16 The Wrong Child: Changelings and the Bereavement Analogy 17 Testing the Rule of Human Nature: Classification and Abnormality

Part8 John Locke and His Successors

18 John Locke and His Successors: the Historical Contingency of Disability Works Cited Index vil

103 125

151 179

207 219 235

261 281

347 369

Acknowledgements

This book would not have been possible without all those people and their families who, by swapping experiences and ideas with me in the course of applied research and practice, have encouraged my belief in the practical applicability of history. Direct support came from Priscilla Alderson, Istvan Hont, Linda Jordan, Patrick McDonagh, the late Roy Porter, Lynn Rose, Roger Smith, Richard Sorabji and Tim Stainton. I would like to thank the many others who have contributed along the way: students, friends, colleagues and those in the medical and psychological professions who have discussed these topics openly and without fear. The Leverhulme Trust financed the first stages of research. Parts of the book exist in more primitive form in articles written for various journals to whose editors and referees I am also indebted (details are in the list of Works Cited).

Historians should know that freaks, if tolerated — and even flattered and fed — can show astonishing influence and longevity. After all, to any rational mind, the greater part of the history of ideas is a history of freaks.

—E.P. Thompson, The Poverty of Theory

Introduction

Intelligence stands at the core of modern lives. It marks us out from the rest of nature. It is crucial to our sense of self and an instant yardstick for sizing up others. Psychologists measure it, biologists search for its DNA, women demand it of sperm donors; learned professors from Harvard to Heidelberg foresee our descendants turning into transhuman, bodiless intelligences able to migrate as software to other planets. If these are the dreams of intelligence, the nightmare is its absence. This means being denied family, friends and ordinary relationships; doctors give us treatment without our consent and withhold it when we need it; social workers stop us having sex, sterilize us or take away our children; psychiatrists lock us up without right of appeal; police officers frame us; courts acquit the parents who kill us; and politicians fund geneticists to make sure people like us never turn up again. Both dream and nightmare are so vivid it seems they must be based on some hard scientific reality, but the question “What is intelligence?" has only ever been answered by a shifting social consensus. So perhaps, like the stuff of dreams and nightmares, it too belongs in a realm of mere appearances. But in that case so does intellectual disability. Indeed, our anxieties about it may one day seem as strange as some of our ancestors' anxieties do to us. The pioneers of modern science such as Robert Boyle and Isaac Newton were certain that the devil was real, as real as this chair I am sitting on is to me; and while we now know he was a mere figment of their imaginations, this is no guarantee that some of the objects to which we apply our own, twenty-first-century scientific method are not just as fantastical.

Nevertheless, even if intelligence is only a matter of appearances, appearances matter. Social structures have not only flattered and fed the concept but set it to work to ensure their own survival. It is socially active, helping to bind social structures together, to alienate their human creators from themselves and from each other, and to dull our brains with alternating doses of self-flattery and self-abasement. It also identifies certain people we do not like having around, and only if intellectual disability is also seen as mere appearance can the speciousness of intelligence itself be exposed. The concepts of intelligence and intellectual disability are mutually reinforcing. While this book chiefly explores pre- and early modern concepts of disability, it is also about intelligence. Without each other they are nothing.

We tend to assume that "intellectual disability" is a permanent historical fixture, that all societies would have recognized the same thing in the same human type. But the idea of an intelligence that defines membership of the human species is itself modern. And if we sent people we now call intellectually disabled in a time machine to ancient Greece and asked if they resembled the people in that society with some seemingly equivalent label (“fools,” etc.), the answer would be no, even though such an experiment would yield a positive result for physical disability and in part for mental illness. Of course there are always people around who seem unable to grasp certain complex everyday activities. What changes, though, is the content of those activities and their centrality to the life which the rest of us in any one era expect to lead. At any given historical moment, the people thus excluded seem to be a separate and permanent natural kind, but in fact their psychological profile alters radically in the long term along with the social context feeding it.

All this may seem to reflect a current propensity to turn differences previously thought of as natural into identities (ethnic, gendered, sexually oriented, etc.) that have been socially constructed by human beings themselves. And yes, it is certainly true that people may be “intellectually” disabled in one social institution or context but not necessarily disabled in some other, concurrent one. It is true, too, that labelling and separation from ordinary life may be causes of disability rather than outcomes; a person's identity, who they are or might be, is stolen from them in infancy or at diagnosis and is then refashioned by the special institutions in which they are segregated and which turn their personal characteristics into a "psychological object." Nevertheless, to say that intellectual disability is a mere social construction 1s to ignore problems of everyday life which, even if they are only the creation of a particular society, are for certain people and for the time being real enough, or oblige us to behave as if they were; some of us will need greater support to lead the ordinary lives that others take for granted (even if the various professions and services are institutionally primed to avoid, at all costs, the provision of support for just such a purpose). Disability is always historically constructed, however, because the problems change from one era to the next. History is anthropology with time rather than place the variable.

My starting hypothesis, therefore, is that intelligence and intellectual disability, likewise intelligent people and intellectually disabled people, are not natural kinds but historically contingent forms of human self-representation and social reciprocity, of relatively recent historical origin. Following this introduction, Part 1 discusses the relationship between psychological and social inferiority among the ancient Greeks. This is a necessary exercise because early modern writers use Plato, Aristotle and others as a reference point and modern psychology often identifies them as the first primitive stabs at a psychological science, when in fact the gulf between the Greeks and ourselves is profound. Part 2 analyzes the history of intelligence and disability in European socio-economic and administrative structures, and the ever-increasing importance attached to speed of thought. Parts 3 to 5 look at the conduct manuals and the religious and literary texts that present intelligence (“wit”) as a self-referential mode of bidding for status, classifiable with concepts such as honour and grace, and juxtaposes these with their corresponding concepts of disability. Part 6 pursues the same themes into the history of medicine, looking at doctors’ changing descriptions of problematic intellectual states and of their relationship to the structure and functions of body and brain. Part 7 examines the historical roots of the modern doctrinal fusion between biology, psychology and ethics, and at the early modern invention of abnormality, its place in natural history and accompanying doctrines of cause. Part 8 describes the influence of the sixteenth and early seventeenth centuries on Locke's extensive comments on “idiots” and “changelings,” and how his essentially theological doctrine in turn influenced eighteenth-century theories of behaviour and thence modern educational and cultural practices.

Each chapter begins by looking at long-term, cross-historical elements which modern and pre-modern concepts may share in spite of my starting hypothesis, and then briefly at relevant aspects of the recent, short-term history of the formal disciplines (psychology, medicine, etc.): briefly, because there is already a substantial literature on this. There then follows the main business, which is the medium term: the shaping of modern psychological concepts of intelligence and disability, starting in the late Middle Ages but concentrated in the “early modern" period that runs from the Reformation to the Enlightenment. It can be used as a starting point for further investigation into other areas of early modern psychology. I regret not having had the time to extend this investigation beyond intelligence and intellectual disability to other basic psychological concepts of the early modern era: the emotions, for example, or the will (and the first question would be whether in fact such conceptual categories were then or indeed can now be safely distinguished from each other). Others will have to have to take up where I have left off.

Research and debate: opening a new arena

Previous writers have examined the history of the segregated long-stay institutions, hospitals and schools that have legitimized social rejection and distaste, plus something of the lives of people incarcerated there.! Yet about the origins of the underlying concepts we know little. Institutional records and official publications are easily located, whereas the conceptual roots are spread across disciplines and periods and so are harder to find. But similar problems have not deterred researchers in the early conceptual history of other disciplines. This research gap reflects social segregation itself: out of sight, out of mind. Moreover, to research the origins of a concept is to admit it had origins in the first place. If a category so basic had a historical starting point, it might imply that there was a time before that when 1t went unrecognized, and therefore that it could lose its currency again in the future. Unstable categories undermine professional confidence. As a result the history has been trivialized, in two ways. First, the disability as we see it today must have always existed, whether people in the past recognized it or not; historical study is irrelevant or unproblematic (“positivism””). Secondly, if the aim is to make things better, then pulling basic concepts up by the roots for historical investigation won't help; history must be seen instead as a march of progress, towards the triumph of current ideas and the right way of doing things, which just so happens to be our own (“presentism”).

What we know about the history of the concept so far has come piecemeal from the extracurricular interests ofa few professionals with varying approaches. The first of these says that since disability is a natural, biological-psychological entity that has always existed in the same type of person, we can unproblematically match current human types to those of the past. Physiologist Paul Cranefield sees certain Renaissance medical writers as the “discoverers” of “mental deficiency” because they seem to describe its symptoms and to use a modern disease model.? Neurologist Richard Neugebauer sees in early accounts of legal competence a proto-modern psychiatric distinction between “mentally retarded” and mentally ill. Psychologist Richard Scheerenberger, aiming at an encyclopaedic history of mental retardation and sometimes coming across periods in which no seeming correspondences with the modern concept appear, simply plugs these gaps with primary sources on physical disability or mental illness instead.* A second approach says that the scientific concept becomes actual only with its psychiatric description in modern times. Psychiatrist Leo Kanner, for example, one of the inventors of autism, largely follows the same disease model as the first group but excludes from his history all the unscientific primitives who lacked a modern expertise; consequently, he says, a history of mental retardation 1s impossible before the nineteenth century? A third approach is based on a seemingly more sceptical view. Psychologist Inge Mans, for example, begins with the words “Once upon a time there were no mentally retarded people." Like the literary historian Sandra Billington, she puts their early history under a broader heading encompassing professional fools and carnivalesque jesters. Nevertheless, ignoring the difference among these types means somehow preserving certain assumptions about a cross-historical condition; “retarded” people may well have existed all along, it is just that there

' James Trent, Inventing the Feeble Mind; Philip Ferguson, Abandoned to their Fate; Mathew Thomson,

The Problem of Mental Deficiency; David Wright, Mental Disability in Victorian England; Mark Jackson, The

Borderland of Imbecility; Trent and Steven Noll (eds), Mental Retardation in America.

? Paul Cranefield, “A seventeenth-century view of mental deficiency," Bulletin of the History of

Medicine, 35 (1961); Cranefield and Walter Federn, “Paracelsus on goiter and cretinism," ibid., 37 (1963); “The begetting of fools," ibid., 41 (1967); Cranefield, “The discovery of cretinism,” ibid., 36 (1962).

3 Neugebauer, “Medieval and early modern theories of mental illness,” Archive of General Psychiatry, 36 (1979); *Mental handicap in medieval and early modern England," in David Wright and Anne Digby (eds), From Idiocy to Mental Deficiency.

^ Scheerenberger, 4 History of Mental Retardation. 5. Kanner, A History of the Care and Study of the Mentally Retarded.

$ Mans, Zin der Zotheid; Billington, A Social History of the Fool.

was once a Golden Age when they had no separate social identity — for these authors a good thing, for Kanner not.

I have tried to open up a new arena. The reader will find positivism and presentism here too, of course. I want to add to a store of sound historical knowledge on the topic; and I believe that if the past is a foreign country where they do things differently, there is a future country where they do things differently and better. Others in the field, too, have called for an “inclusive anthropology." Now this should arouse suspicions. Although the history of ideas is useless if it does not generate new ideas, it may also fairly be asked whether evidence can be proof against contamination by some political or ethical agenda, and whether the evidential base for the history of psychology 1s not just as prone to fabrication as for psychology itself. However, suspicions can only be justified or relieved by engaging with the evidence on a scale no one else has done till now. Moreover, I do not draw on the usual models of radical policy-making in this area (“rights,” “citizenship,” “Justice,” etc.), borrowed from liberation movements of black people, gays or women, as not only are the people we are talking about deprived of such things, they are not entitled to them in the first place because they do not qualify for the founding premise of all such models: namely, that human beings are equal and autonomous by virtue of being rational. Nor on the other hand does my agenda owe much to that seductive form of conflict avoidance which says that, as “bearers of discourse," we cannot stand outside even the thinnest and airiest of concepts, among which the concepts under discussion in this book undoubtedly belong. Finally, to all those who still think that science can speak to our topic, I have to confess that the scientific and ethical questions (How do we know what intellectual disability really is? How do we value the people it describes?) are as inextricable from each other for the historian as they are, minus any acknowledgement of the fact, for the psychologist or cognitive geneticist.

We can begin tackling these questions of definition at the most superficial level, that of names. Here our psychological object seems more problematic than most. On the one hand, the disabled are defined more dogmatically than any other human group. They are still seen as a natural category, the last justifiable bastion of essentialism in an era when gender, race and sexuality (for example) are no longer natural or essential. This definition allows things to be done to them that are no longer justifiable for those other groups; denigration, segregation, elimination and prevention belong to their recent and continuing history. On the other hand, do we really know who they are? I ask because it seems we don't know what to call them. Even within the last century the multiplicity of names for their condition has been extraordinary: backwardness, cognitive impairment, complex needs, cretinism, developmental delay, developmental disability, dullness, educational subnormality, fatuity, feeble-mindedness, idiotism, imbecility, intellectual disability, intellectual handicap, intellectual impairment, learning difficulties, learning disability, mental defectiveness, mental deficiency, mental disability, mental handicap, mental impairment, mental retardation, moronism, neurodisability, neurodiversity, oligophreny, slowness, special needs, etc. One could double the number. This instability of names surely points to a deeper conceptual problem and, as Murray Simpson has demonstrated for the nineteenth century, to the absence of any stable nature linking the people thus described.* Histories of the topic, supposing that names denote the same natural kind across the ages, have tended to proceed in parallel with traditional histories of physical disability, treating it as a history of freaks when actually it is the history of a freak 1dea.

In defining intellectual disability, psychology comes up with a list of particular deficits in what it sees as intellectual ability and (which amounts to the same thing) as characteristically human.

7 Herman P. Meininger, “Authenticity in community: theory and practice of an inclusive anthropology,” Journal of Religion, Disability and Health, 5 (2001).

8 Simpson, Modernity and the Appearance of Idiocy: Intellectual Disability as a Regime of Truth.

In other words, definitions are circular. Now it is professionally acceptable, even commonplace, to say that sanity consists of the absence of mental illness. But it would no doubt be professionally crass to say the same thing about intelligence, which is not just an absence of disability but self-evidently positive, the crowning feature of our species. If intelligence has any historically continuous characteristic at all, this circularity of definition is it. The content of the definition itself changes from one era to the next, making it not only circular but contingent at each point on historical circumstance. Today definitions come, ostensibly, from a theoretical base in the academy, proceeding from there to applied psychology or the genetics laboratory for their evidence base, and thence to the social institutions such as health, education, human and social services, employment, etc.; their final destination is the everyday mind-set, which closes the cycle by feeding back into the academy and providing a covert rationale for the latter's hypotheses. The student, having stumbled across psychology by being “interested in people," makes this journey in reverse. He or more often she, prompted by the mind-set, must at some point face the fact that her chosen profession is not interested in people in any way she may have so far thought of them, but only as parts and props of a vulnerable institutional order which she herself will help to police and of which intelligence is the supreme membership criterion. At this point psychology's enchanted forest will either swallow her up, or she will come to ask about its idea of people, in W.H. Auden's words, “Was it to meet such grinning evidence / We left our richly odoured ignorance?"

At the centre of the forest — somewhere — is the holy grail of scientific status. Meanwhile the ideological core of intelligence can be glimpsed from the very claim that its social critics are the ideologues. Take cognitive ability tests (IQ), and the fact that they have regularly been modified in response to criticism of their inherent cultural bias. Many psychologists have seen this criticism as an ideological intrusion, motivated by an unscientific egalitarianism which the science disproves. However, the psychometrician's very act of responding to criticism, by moving away from culturally relative tasks towards apparently more abstract ones seemingly possessed of universality, is itself a necessary ideological collusion; the fact that modification takes place at all belies any claim to exact-science status that might be made for intelligence as such, exposing the emptiness of psychology's *Newtonian fantasies" about parity with physics or chemistry, about objectivity and calculability.? Its extremely short-term historical shifts undermine not just the claim that one can measure intelligence but also that intelligence in itself has the long- or even medium-term stability of content that an exact science might expect from its object of study. Of course there is already a whole discipline, the philosophy of science, devoted to doubting whether the subject matter even of physics is real; but doubts about intelligence are of a different and deeper order entirely.

Intelligence is a social construction: enough said?

Disenchantment leads to scepticism. Any champion of the idea that intelligence has a real essence, scientifically classifiable in nature, is countered by others for whom it 1s relative and changeable and who regard the attempt to produce “culture-fair or -free" estimations of it as a nonsense." But this sceptical position usually turns out to be mere bravado. Beneath superficial disputes about whether intelligence is measurable or absolute, in the deeper recesses of the mind-set we still need to make shorthand judgements of our fellows and to establish our own intelligence: otherwise,

? Thomas Leahy, A History of Modern Psychology, 6. 10 See J. Berry, “Radical cultural relativism and the concept of intelligence,” in Berry and P. Dasen (eds),

Culture and Cognition.

to borrow a classic argument, how could our scepticism be a more intelligent stance than the positivist's? For the sceptic, intelligence is relative or absolute according to where advantage lies; there are moments in one's life when the concept cannot be lightly dismissed. At the same time, it seems readily deconstructable in the popular mind: “Rabbit’s clever,” says the famously slow Winnie-the-Pooh, “and he has Brain. I suppose that's why he never understands anything.” And as far as academic critiques are concerned, many have come from within the discipline of psychology itself. But anyone who claims to have dispensed fully with the essential reality of intellectual ability must have dispensed fully with that of intellectual disability too. The moment one takes (say) “severe mental retardation” as a positive concept describing a natural kind, one automatically reactivates the positive concept of intelligence itself. Even among historians who write about “social constructions” and “inventions,” the content of the analysis rarely matches the aim: for example, Paul Michael Privateer's Inventing Intelligence presupposes the natural reality of its opposite, “mental disability,” while James Trent’s Inventing the Feeble Mind, despite its title, does not challenge the transhistorical psychological identity of the population it describes.

Disengagement from the whole farrago is not easy, then. Most sceptics, academic or lay, living in a segregated society, are unlikely to have had much to do with people whose disability they cannot deconstruct unless they can first know some people thus constructed. A professional will at least know the person at first hand, even if social and conceptual segregation has distorted the relationship between them. And as one of those professionals, without a positive belief in intelligence and disability I could not exist. My job is to pass expert judgement on people in a way that distributes and perpetuates these appearances formally, as a series of crediting operations that endow this natural object, intelligence, with social power. It is in this realm, in social institutions rather than the ivory tower, that disputes occur, personal destinies are fought over and injustices become visible. In some institutions, such as education and examination systems, they affect the majority of the population, but how this happens is often hard to pin down. One stark reality alone is universally obvious: the absence of intelligence in the disabled, a separate population whose deficiency is to be regretted, quarantined and prevented. “Intellectual disability” is the reserve tank into which anyone who needs a justification for other, supposedly more arguable discriminations, can dip momentarily, an insurance policy guaranteeing that some of the normal population are more intelligent than others: that is, both individually (I more than you, my child more than yours) and in groups (men more than women, whites more than blacks, self-improvers more than the underclass). A society that congratulates itself on celebrating diversity must understand that signing up to an intelligence hierarchy among individuals necessarily entails, in the small print, signing up to and keeping on the back-burner an intelligence hierarchy among ethnic, gendered and class-based groups.

Intelligence as the psychologist conceives it owes its existence to metaphor. The early psychometrician Karl Pearson saw it as being like gas particles or planets, at that time the commonest objects for statistical treatment in the exact sciences. Intelligence could be handled as if it were, like them, a material object. They were all things that could be mass-measured; this similarity of method overrode any category difference among them (mind and matter, for example). But stretch our imaginations as far as we like, intelligence is not the same sort of thing as a gas particle or a planet. So we have to ask: if the similarity of intelligence to material objects is merely metaphorical or methodological and no more, then to what class of things does it belong, and what other kinds of thing belong with it?

Calling it a social construction and leaving it at that leads only to the same question begged by the positivist. Countless books and articles of the last generation have had the word construction in the title, as lan Hacking has pointed out: for example “Constructing the self”, “Constructing oral history,” “Constructing quarks,” “Constructing youth homelessness,” even “Constructing the social" — not to mention, in the history of psychology, Kurt Danziger's Constructing the Subject.

What do all those nouns have in common? Obviously nothing. The scope of “constructing” is so broad as to be useless; it comes to mean simply “the concept of,” which can be attached to absolutely anything.'' If I say something is socially constructed, I add nothing to my understanding of it because I have not indicated how 1t differs from anything else so constructed, let alone how the more general categories to which they might belong differ. Talk of the construction of intelligence or its disabilities sidesteps the same question we asked of the positivist: the construction of what exactly? As a member of which class of things? This book tries to answer such questions. Unanswered, the definition and use of the term will always go to the highest and most powerful bidder.

Positivism and social constructionism share a common problem, as we can see from the fact that they often drift across each other's flight paths. Just as the constructionist has to be a bit positive about intelligence in order to think that constructionism is the more intelligent stance, so the positivist suffering from physics envy will admit when convenient that there is no such thing as intelligence. Replying to someone who denied that it exists, the experimental psychologist and militant psychometrician Hans Eysenck claimed he had never said it did: “Its existence is neither here nor there; intelligence is a concept" or, as we might say, a construction. Admittedly he goes on to spoil his unlikely constructionist credentials when he adds “a concept like gravity” (not for nothing do gravity and general intelligence share the same symbol, g).? Nevertheless he was following a tradition in psychometrics of being defiant and dismissive about defining one's object of study. As well as Eysenck, Alfred Binet (“inventor” of intelligence testing), Truman Kelley and Cyril Burt (pioneers of educational psychology in the USA and Britain respectively) can all be found at some point saying openly that a scientific definition of intelligence is impossible, and that this does not matter. It is whatever one likes. The reason it does not matter is that it can be measured, and measurement alone is what matters, since it makes the psychometrician a fully fledged experimental scientist at par with the measurers of gas particles or gravity.

The question as to what class of things intelligence belongs with and what other historical concepts it resembles is dealt with in detail in the course of this book. For the moment, we can say that till now that question has had answers that are either misleadingly metaphorical (intelligence is an honorary member ofthe class of measurable material objects) or uselessly trivial (it is a member of the class of concepts). Of course, philosophers of science have given far subtler accounts of the general debate between constructionists and positivists than the crude opposition I present here. But where the particular topic is intelligence, any reader who probes the subtleties of this debate further (and I do not do so in this book) may well find that they are all ultimately reducible to one position or the other.

Psychologists, for example, frequently modify their position by saying they cannot aspire to absolute truth, only to the closest approximation the evidence will allow. This is false modesty, however — a covert self-identification with physicists and other exact scientists who routinely apply this falsifiability rule to their own objects of study. Then there are Howard Gardner's “multiple intelligences," some of which do not correspond to psychology's usual application of the term; or the (James) “Flynn Effect,” which shows how the average person of a century ago would score as “mentally retarded" in a modern IQ test.!* Yet both authors feel obliged to retain a core concept of intelligence as some specifically human essence that is fixed in nature, when all the while their very