History of Autism Stigma

This piece was written by Emil Koch.

In 1939, the Nazi Euthanasia Program started, targeted at killing the mentally and physically impaired, and would end the lives of 250,000 people. New evidence ties Hans Asperger, the father of Asperger’s diagnosis, to Nazi eugenics, which systematically sterilized people considered idle, insane, and weak. 

Is that the reason for the widespread stigma surrounding mental health conditions and autism? When movies like “The Accountant” depict autistics as obsessive, empathy-less, and contract killers, the picture of cold serial killers emerges. Neil Brewer et al. (2017) confirmed the potential influence of media exposure on negative stereotypes about autism. Historical accounts linked autistic idiosyncrasies with schizophrenia and shut-in personality of extreme rigidity and social withdrawal. Later, the Swiss psychiatrist Carl Jung wrote in his book Personality Types, published in 1921: 

“In his personal relations he is taciturn or else throws himself on people who cannot understand him, and for him this is one more proof of the abysmal stupidity of man. If for once he is understood, he easily succumbs to credulous overestimation of his prowess…”

Three years afterward, Austrian-Swiss psychiatrist Moritz Tramer published the paper “Singularly talented and gifted mental defectives.” Be it the idea of Eugen Beuler that autistic behavior results from autistics engaging with a personal fantasy rather than the real world, the cold serial killer, the helpless shut-in, the man with hatred against humanity, or the idiot savant, all these perpetuated many stereotypes still seen today – the alien species of people sometimes brilliant but otherwise spooky. In the 1950s, the refrigerator mother theory dominated, assuming that a lack of warmth and rejection by a child’s mother would induce autism. 

Shockingly, nowadays, headlines like “Recipe for a serial killer? Childhood abuse, autism, and head injuries are more common in murderers” link criminality and autism with no found evidence, thereby abusing the power of the media to form negative views on neurodevelopmental disorders. Building upon Joshua Greene’s argument, the dynamics of ingroup loyalty fostering cooperation at a group level can inadvertently fuel out-group hostility, creating an “us vs. them” mentality. Consequently, in-group justifications of moral norms often lead individuals to pass judgment on deviations from these norms. It’s worth noting that in a study conducted by Gibbs et al. in 2022, alarming statistics revealed that 56.8% of autistic individuals experienced sexual violence, while 58.5% endured physical violence. In comparison, only 28.2% and 36.4% of non-autistic individuals, respectively, reported such experiences to the extent of pseudospeciation. Furthermore, in 2020, a troubling 78% of autistic individuals in the UK remained unemployed despite their qualifications, highlighting the pervasive stigma faced by this community.

However, how have we come here? Petitioning for history can provide insights into developments of stigma and what to avoid moving forward. We shouldn’t solely attribute the societal barriers faced by many neurodivergent individuals to external factors. It’s crucial to acknowledge the human tendency to “other” because simply assigning blame to others doesn’t foster unity; instead, it perpetuates segregation. This phenomenon is evident in the enduring prejudices against immigrants, LGBTQ+ individuals, and ethnic groups despite their efforts to raise awareness.

According to Grinker (2020), modern stigma may be rooted in an intricate interweaving of capitalism, ideologies of personal responsibility and individualism, and legacies of racism and colonialism. In the 17th century, prostitutes, criminals, and the homeless lived together in European asylums, with insanity just as one kind of “unreason.” Before the invention of psychiatry, the unifying common ground lay in the failure to be proper members of society, illustrated in many European paintings before the 19th century. What was the driving force to segregate physical and mental illness? Scull (2005) put forward that the increasingly mature capitalist market economy gave rise to a segregative response to madness. Similarly, it is thought that secularism created a new category of being, one where mental illness wasn’t a sign of the devil but a disease of the mind that rendered a person unproductive. This negative connotation of idleness as one attribute of mental health conditions, neurodiversity is often associated with, extended far into the 20th century and made people believe mentally ill people were inherently inferior. Even today, the WHO includes productivity as one criterion for mental health disorders in the sense of US$ 1 trillion per year in globally lost productivity.

In summary, throughout history, the rise of capitalism and the increasing emphasis on productivity and a strong work ethic marginalized individuals with mental illnesses. The Nazi regime put this narrative to a climax with a genocide of physically and mentally disabled people. Regarding autism, stereotypes of autistic individuals as lacking empathy, prone to violence, socially incapable, and mentally unstable dehumanized them. These stereotypes have not only justified violence and discrimination against autistic people but have also positioned them as “the other.” This association between autism, mental health conditions, and idleness may be deeply ingrained in society’s collective brain, leading to the unfair perception that people with atypical behaviors are less competent. New media representation as servant-like only captures a small spectrum while setting the tone that no changes are necessary concerning more inclusion of neurodiversity in society. Given an evident “othering” of neurodivergent and disabled people, the question arises of how to move to the paradigm of “us-ing” in a way all human experiences are considered part of our institution’s structuring.