In a Different Key summary

Different societies have had – and continue to have – different responses to mental illness. In fifteenth-century Russia, for instance, mental afflictions were thought to stem from the divine touch of God. The mentally ill were looked up to as holy fools and enjoyed the protection of their community.

This is quite different from how early twentieth-century American society viewed mental illness. A telling term – “mentally defective” – was used to describe the mentally ill, and the general consensus was to purge, not protect, these people.

The term “defective” was coined in 1902 and applied to anyone with any sort of cognitive abnormality: epilepsy, Down’s syndrome, traumatic brain injury or any other affliction of the brain. The general treatment for these people was to hide them away in institutions.

Despite its current negative connotations, “defective” wasn’t intended as a cruel or derogatory epithet; it was a purely clinical way of indicating abnormal functions.

Similar clinical terms were also introduced at this time. The term “idiot” meant that a patient had the mental capacity of someone under the age of three; “imbecile” denoted the mental equivalent of a child between the ages of three and seven; “moron,” the equivalent of a child between seven and ten.

Another unfortunate part of autism’s past was the eugenics movement.

Eugenicists believed that only the fittest people should breed. Anyone with a genetic or mental disability was seen as a social menace, capable of interfering with humanity’s pure lineage and thereby undermining its glorious future. Such a menace was best removed from the equation.

During the 1920s, this philosophy was quite popular among doctors and biologists – and even among politicians like Theodore Roosevelt. It was promoted in the classrooms of Harvard and Yale, in the pages of the New York Times and by social activists like Margaret Sanger, the founder of Planned Parenthood.

Around this time, 17 states ended up legalizing forced sterilization – and there were others that wanted to take it a step further.

In 1942, neurologist Robert Foster Kennedy wrote an article in the American Journal of Psychiatry that endorsed the “mercy killing” of what he called “nature’s mistakes.”