James W. Trent. Inventing the Feeble Mind: A History of Intellectual Disability in the United States. New York: Oxford University Press, 2016. Illustrations, tables. 392 pp. $55.00 (paper), ISBN 978-0-19-939618-4.
Reviewed by Daniel Werges (City University of New York)
Published on H-Disability (January, 2018)
Commissioned by Iain C. Hutchison
The title Inventing the Feeble Mind underlines a core tenet of this book, namely, that the condition we now call “intellectual disability” is socially constructed. This second expanded edition is timely and useful, as “intellectual disability” has firmly replaced the term “mental retardation” in legal, scholarly, and professional settings since the first publication of James W. Trent’s work in 1994 at which time it was subtitled A History of Mental Retardation in the United States. The terms used to describe people with intellectual disability and the classifications by professionals have changed and morphed since colonial times and, considering the history of such terms as “idiot” and “imbecile” and the derogatory use of these words in contemporary time, are insightful in how people with intellectual disabilities were and are valued in American society.
Trent’s thorough examination of the history of intellectual disability in the United States has become a key text for anyone interested in this topic. Though not a historian, Trent has completed thorough archival research and interviewed contemporary witnesses to create a comprehensive, though accessible, introduction to a history that shines a light on the best and worst of the human condition. This new edition updates chapters 1 to 7 with more recent research and references and adds an eighth chapter that highlights some of the debates and developments relevant to the history of intellectual disability and also gives voice to people with intellectual disabilities who have claimed their stake in American society despite historical eugenics and modern eugenics in the form of prenatal testing and abortions. It may be Trent’s training and teaching in social work that gives his work a foundation which values every human life and the right to self-determination.
Chapter 1 explores the lives of people with intellectual disability during colonial and postrevolutionary times. During this period, most Americans knew intellectually disabled people to be part of their communities. This updated edition references some recent work by Parnel Wickham on idiocy in colonial America and a lesser-known family legend about Thomas Jefferson (1743-1826), whose younger sister, Elizabeth (1744-74), was believed to have been intellectually disabled, which is an interesting link to chapter 7 where the reader learns about the intellectual disability of Rosemary Kennedy (1918-2005), John F. Kennedy’s sister. This first chapter moves on quickly to describe the first schools for intellectually disabled people in North America, which were founded in the mid-1800s and inspired by the work of Edward Seguin in France who had become known for his success in educating intellectually disabled children. Chapter 2 is dedicated to Seguin, his approach to physiological education, and the impact of his work on American schools and early institutions.
The history of intellectual disability in the United States is, to a large degree, a history of institutions. In chapter 3, titled “The Burden of the Feebleminded,” Trent describes how “training schools” developed into asylums and custodial institutions at a time that intellectual disability started to be regarded as a social problem in the context of societal changes and economic challenges. During the late 1800s, a number of institutions opened in various states and Trent carefully analyzes the growing influence and often self-serving powers of superintendents of those institutions. Superintendents organized themselves into the Association of Medical Officers of American Institutions for the Idiotic and Feeble-Minded Persons and started to influence social reformers and state legislators in propagating a view of intellectual disability as a growing societal concern. They promoted the growth and expansion of institutions to address mounting social and economic problems. As a growing professional class, they looked to provide custodial care for various groups of people with intellectual disabilities, and a classification system also developed to include moral imbecility, low-grade idiocy, and epilepsy. At the end of the eighteenth century, a model of institutional care had been established, which took account of the growing number of inmates and was described as a colony system with cottages surrounding a central administrative building housing groups of differently classified people in mainly rural settings. Institutions had become an integral part of American society and landscape.
In chapter 4, Trent discusses the living and working conditions in institutions between 1890 and 1920. While early schools for the education of people with intellectual disabilities aimed to return students to their families and communities, it had become the common expectation that most inmates needed ongoing custodial care. This chapter provides a fascinating insight into daily life in an institution, from farm and garden work, to food preparation and recreational activities. For example, many institutions had bands or orchestras and concerts that were open to the public. Trent analyzes changes in the institutional education system, discusses the relationship of families to the institution, and addresses the role of the attendant. This chapter also illustrates how institutions dealt with scandals and investigations, and how abuse and neglect started to be associated with institutional settings, in particular when underfunded.
The eugenics movements and its influence in creating “the menace of the feebleminded” is the topic of chapter 5. Trent describes how eugenics became widespread in the first two decades of the twentieth century and influenced nearly all science in relation to heredity. The eugenics movement incorporated philanthropists, social scientists, and physicians, many of whom looked to better human breeding to create solutions to societal problems. People with intellectual disabilities were often made the scapegoats and regarded as the cause of widespread social vices, poverty, and crime. Superintendents of institutions and other professionals bought into the eugenic ideology and used associated panic and hysteria to their advantage. They argued that “mental defectives,” to use the terminology of the time, were not a menace to society if safely confined in institutions. Indeed institutions had expanded in this time period to an extent never seen before.
Chapter 6 explores sterilization, parole, and routinization. The 1920s witnessed the infamous Supreme Court decision that upheld expanding state laws allowing for the sterilization of people in institutions. Justice Oliver Wendell Holmes (1841-1935) wrote the opinion of the court and his summary includes the often quoted words “Three generations of imbeciles are enough.” The case is based on Carrie Buck (1906-83), who as a pregnant teenager was committed to the same Virginia institution where her mother already lived. Sterilization was a major focus of the eugenics movement aimed at avoiding the breeding of the “unfit.” Interestingly, according to Trent, superintendents had largely turned their backs on the eugenics movement by the 1920s but used sterilization widely as a mechanism of control and as a justification for parole. Using letters and first-hand accounts, Trent’s descriptions of the parole efforts, allowing institutional inmates to work in surrounding communities, achieves a fascinating insight into how institutions of this time period functioned. Due to the economic conditions of the Depression, parole efforts were limited, and, during World War II, those inmates who had been eligible for parole became a new source of labor in institutions caring for lower-functioning inmates, as attendants were drafted by the armed services.
Chapter 7, “The Remaking of Intellectual Disability,” covers the decades following World War II. It is not well known that during the war conscientious objectors were assigned to work in institutions and some of their reports led to the postwar exposés of horrific and dehumanizing conditions in institutions. The parent-confessional literature contributed to a different way of seeing people with intellectual disabilities, namely, as perpetual children instead of as a threat to society. Parent organizations sprung up in the 1950s, which advocated and worked for better supports and services in the community. In 1962, during President Kennedy’s time in office, Eunice Kennedy Shriver (1921-2009) wrote that parents should not be ashamed of mental retardation and revealed the family secret that her sister Rosemary was mentally retarded. While these factors contributed to a shifting and more accepting attitude toward intellectual disability, institutions continued to grow. Between 1946 and 1967, they saw a 65 percent increase in residents. It took further public and media revelations of institutional abuse and neglect, parent advocacy, and legal changes to achieve the beginning of the deinstitutionalization movement. Trent gives credit to Wolf Wolfensberger’s (1934-2011) “normalization principles” and analyzes the legal and societal changes that helped to establish supports in community settings. Trent concludes this chapter with the sobering analyses that many of the achievements of the 1970s and 1980s were limited to those with resources and that the rhetoric of mainstreaming and inclusion was often more prevalent than the reality.
The last chapter, which at first glance appears disjointed, nevertheless accomplishes a lot in not only looking at the state of intellectual disability services in the 2000s but also exploring high profile news stories from this time period that relate to the history of intellectual disability. Trent starts the chapter by discussing the art and lives of Henry Darger (1892-1973) and Judith Scott (1943-2005). Both were fascinating and talented individuals who were considered outsider artists. By looking at their lives and art, Trent questions the historical and current definitions of intellectual disability. This chapter then looks at the current professional definitions of intellectual disability and interprets the current state of intellectual disability services in institutions and the community. It is perhaps telling that in 2009, President Barack Obama thought it necessary to declare “The Year of Community Living” as, despite tremendous efforts on many fronts to promote inclusion, too many Americans still lived and worked in institutions or institutional settings. Trent also reflects on the long reach of eugenic policies, which in 2002 led to a newspaper exposé of the sterilization program of the state of North Carolina. The chapter closes with the 2007 story of Daniel Miller, which appeared in Vanity Fair. Daniel, born in 1966 with Down syndrome, is the son of playwright Arthur Miller (1915-2005), and based on common professional advice at that time, he was placed as a baby in institutional care. Trent uses this high profile story to ask why people with Down syndrome have become more present by their absence and briefly discusses “new eugenics” in the form of prenatal testing and modern calls for the killing of severely disabled children by philosopher Peter Singer (b. 1946).
Trent closes his book with an epilogue, which summarizes three major themes of his work. Firstly, he summarizes the important role of superintendents in caring for and controlling people with intellectual disabilities but also criticizes their striving for professional legitimacy and personal privilege. While at times it might appear that Trent gives superintendents too much agency in the history of intellectual disability, his reflections help any contemporary professional to examine their role in supporting people with intellectual disabilities. Secondly, Trent questions the medical-pathological approach to viewing people with intellectual disabilities throughout history, and thus challenges researchers and professionals alike to consider alternative views of disability, which do not identify the person as the problem but rather look to change disabling attitudes, structures, and environments. Lastly, Trent considers the larger context of a capitalist society in which people with intellectual disabilities are almost inescapably exploited. While the reader might see these closing remarks as a call for another economic order, and think of the famous quote popularized by Karl Marx (1818-83) “From each according to his ability, to each according to his needs,” a purely economic view of intellectual disability negates many approaches that value disability and difference. While Trent’s work in its second edition remains a seminal accomplishment, it also encourages further research into a history that has too often been sidelined.
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Daniel Werges. Review of Trent, James W., Inventing the Feeble Mind: A History of Intellectual Disability in the United States.
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