Inventing the Feeble Mind: A History of Mental Retardation in the United States (review)

For years, mentally ill persons and mental-health hospitals held the attention of scholars interested in the process by which Western society constructs concepts of “normal” and “abnormal” for its citizens, and then deals with the outcast class. Recently, such scholars have begun to investigate parallel developments with respect to mental retardation. James Trent’s book contributes to this developing body of scholarship.

The book opens by offering a few impressions of how early European-Americans viewed mental retardation as a family and local matter, with mentally retarded persons largely integrated into their rural, agrarian society. As America became more industrial and commercial, however, mental retardation became a problem delegated to the state. Public and private schools, formed to care for and educate mentally retarded children, gradually became permanent custodial institutions to control residents throughout life. These developments served the professional and personal interests of institution officials, Trent stresses. This part of the story is told in the first six of the book’s seven chapters, and constitutes institutional history. Trent relies heavily on the records of a few institutions for mentally retarded persons and of the national associations for professionals working in the field. Very little appears about the condition of mentally retarded persons living outside these institutions.

The picture becomes richer in the final chapter, as Trent ably tells the story of the increasing “normalization” of mentally retarded persons over the past forty years. He explores the role of such extra-institutional factors as the greater acceptance of mentally retarded children within their family structures, the increased public concern for individual rights, and efforts to reduce state spending through closing institutions.

Trent clearly identifies his themes throughout: the shift from care to control, institutional self-interest, and the tendency to value persons based on their economic productivity. I was particularly interested in his analysis of eugenics as a scientific justification for expanding control over “abnormal” persons. Early in this century, institution officials promoted sexual segregation and sterilization to protect society from hereditary “feeblemindedness.” Trent is less convincing, however, when he asserts that officials quickly lost interest in eugenics after 1920, even as they made sterilization a routine condition for parole. The eugenic basis for this ongoing practice continued.

At the outset, Trent identifies his audience as theorists, practitioners, and other experts in the field of mental retardation. For them, and for historians of the topic, this book should become the basic account of the development of institutional responses to mental retardation in America. It will take its place next to similar works dealing with mental illness and other alleged abnormalities.