Editor’s Note: This is the first of a two-part series exploring the history of disability, disability studies, and how our understandings of God might change from a deeper awareness of that history. Check back next week for the second half! 

We often choose to ignore history not because it is unpleasant but because we can already see the same patterns emerging, the same root causes alive and well, and the same mistakes being made in our own lives. History is very often a mirror which exposes the worst flaws in the present, so we cover up the uncomfortable bits. It’s tempting to romanticize many of the worst bits of history; soldiers killing soldiers become paragons of patriotic virtue, indigenous genocide becomes early settlers establishing new identities on the frontier. But this article talks about the history of disabilities, and there is simply no way to be aware of the facts and romanticize them at the same time. 

For simplicity’s sake, I’m going to break the history of thinking about disability into three paradigms: Deficient, Medical, and Social. Within each is a wealth of diversity and philosophy, but these are reasonable larger headings. After each, I’ll showcase a bit of theological thinking that stems from these initial definitions. 

Deficiency 
Historian Henri-Jacques Stiker finds deficiency to be the standard model of disability for the bulk of Western history until the 15th century. In one early example, Aristotle writes that ‘men’ are prototypical humans while ‘women,’ given their inability to produce semen, are therefore deficient and inferior to men. Inability to produce semen is, for Aristotle, the defining characteristic of a female: “Further, a boy actually resembles a woman in physique, and a woman is as it were an infertile male; the female, in fact, is female on account of inability” (103). What matters in defining a woman is what is lacking, what isn’t working the way it could in an ideal state.

By identifying this normative, ideal expression of humanity, those whose bodies diverge can be discussed via their various inferiorities. To Aristotle, the standard body is male, produces semen, and is fit; women and those who are overweight are by definition deficient. Disability fits quite readily into this framework. Arms have an ideal proportion to the body, can carry a certain amount of weight, and are dexterous enough to play the lute and shoot a bow. Arms which cannot do these things are deficient – and the less able they are to do these things, the more deficient they are believed to be. This holds true for eyes, ears, mouths, legs, bowels, genitals, and even minds. I do not identify as having a disability, but I (and my runner’s arms) certainly wouldn’t want to be evaluated on this scale.

While deficiency is a conceptual model, it can also be viewed “on the ground” in terms of production-ability within families. With some notable exceptions in ancient Egyptian and Jewish cultures, infanticide was univerally common (and in some places, this continues today). Among those who survived birth yet carried an obvious impediment to either individual or social survival, many were subjected to the practice of “exposure”—left alone in a place in which death was all but imminent. Some children were smothered in their parents’ bed, based on the fear that providing nourishment to a body which could not offer the hope of future provision to others would ultimately lead to scarcity for all. Those who survived into adulthood were marked by their exclusion from economic systems, leaving them indistinguishably mixed among the beggars, prostitutes, thieves, and vagabonds. The rise of physiognomy (measuring the body to determine things like ‘potential for criminality’) in the late pre-medical period illustrated the widely held belief that the body carried a visual pronouncement of character—the disabled were not simply physically or developmentally deficient, but morally so.

What does this mean theologically? Deficiency emerges from a system in which humans are directly under divine authority. Everything that happens is under the watchful gaze of heaven, regardless of who inhabits the throne above. Disability was a sign, a symbol of some interruption in the expected natural ordering of life; therefore some social or religious meaning had to be uncovered or derived from the presence of an unexpected disability. The practice of exposure in Greco-Roman culture was actually often a state-sponsored liturgy, returning the ‘unnatural’ child back to the gods to appease their anger. In both disability and Christian histories, blaming the ‘dysfunctions’ of the child on the sins of the parents is a time-honored tradition. Mothers were routinely told that their lack of affection, or their promiscuity, caused their child’s autism (and many are still told this today). Disability is a punishment, a sign of displeasure or wrongdoing. 

The Rise of Medicine
As illnesses became curable, and the general “Middle Age” world gave rise to the “Early Modern Age” beginning in the 1600s, those who sought to understand “monstrosity” and “deformity” would be forced to choose scientific explanations for disability over and against a sense of divine control. Sixteenth century surgeon Ambroise Paré determined that mental illness had material causes and could be passed hereditarily, illustrating the shift toward a new model. Whereas disability and illness in the deficiency model could be equally placed on a person from an outside, cosmic source, these terms began to separate in this medical model. Be it thanks to newly understood germs or otherwise, illness was still externally caused; however, disability was now contained within the individual. As the medicalization of disabilities and infirmity began to formalize, political action began to exert greater control over the bodies and lives of those deemed “invalids.” At medical centers established in the wake of the Enlightenment, a general rule emerged: disabled bodies must produce for the good of the society in some new fashion.

The Medical model forms from the merger of a state focused on establishing control via care and an increased reliance on medical science to dictate the terms of socially accepted “truth.” Rather than accept human diversity as part of the cosmically-dictated natural order even if unfortunate, as with the deficiency model, the medical model combines the conception of disability as a comparative lack with the ethical prescriptions that come from a reliance on science. In short, the medical model is descriptive (disability is rooted in the body in particular ways), proscriptive (the disabled may not seek care outside of family or State-sanctioned medical practice), and prescriptive (whatever can be fixed must be fixed).

From the 19th century on, when doctors believed things just couldn’t be fixed, it was advised that children be abandoned to institutions. This would save the family the embarrassment and scrutiny of having a deficient, medically-flawed child. Prior to WWII, eugenics was a socially acceptable position and many small towns were anointing their “Fittest Family” at festivals based on heredity, so it’s no small wonder disabled children were hidden from public view. In 1924, the same year America restricted ‘undesirable’ races from immigration, Buck vs. Bell legalized the forced sterilization of “the feebleminded” so as to not pollute the genetic pool. Buck vs. Bell has never been officially overturned, and many today are still sterilized without consent despite updated laws. The horrors of the Nazi regime helped make eugenics less acceptable, but certainly did not eliminate it as an ideology. 

The 1965 photo essay “Christmas in Purgatory” exposed the living conditions of those confined to institutions - some 500,000 people. The photos showcased massive overcrowding as well as significant numbers of children bound at the hands and feet, emaciated patients strapped to beds, patients covered in feces, many naked despite the damp cold, and in one case “forty or more unkempt infants crawling around on a bare floor in a bare room.” Medically beyond help according to convention, the institutionalised were believed to have forfeited their humanity – much like those in WWII concentration camps. The majority of large institutions have closed thanks to the work of advocates, but still collectively hold some 27,000 disabled Americans.

Thanks to modernity’s focus on the ideal of the individual as self-sufficient alongside an enlarged reliance on medicine, the shift from naming disabilities separately toward a general social label (e.g., “disabled,” “handicapped,” “special needs”), even as diagnoses develop greater specificity, implies that the expectation is to utilize diagnosis not as an identity but as a means to overcome deficiencies. From their founding in 2005 until 2016, the major charity Autism Speaks held “finding a cure for autism” as a core objective. We continue to see this in other disabilities with discussions of gene editing, selective abortion, and the sense that ‘technology will save us.’

In either initial model - deficiency or medical - the infirm, sick, poor, and disabled are all pawns of the economies in which they are set. It is still legal to pay disabled workers sub-minimum wage. 

What does this mean theologically? Prominently, it means our theological anthropology is severely lacking. When we can highlight the physical rigors of a “healthy” family while institutionalizing a disabled member, we have lost sight of what it means to be created in the image of God rather than the image of a medical textbook. This is in part why theologians like Nancy Eiesland established such a paradigm shift - her work (alongside others) to see her own disability linked to the imago Dei serves to radically disrupt our capacity to physically remove those with disabilities from those without. Practically, this theological shift is exposed in those few, but powerful, communities where the disabled and the temporarily able-bodied can both lead and serve together.

Bibliography

Aristotle (1943). Generation of animals (A. L. Peck, trans., p. 103). Cambridge, MA: Harvard University Press. (Original work published 350 BCE).

Barnes, C. (1998). “The social model of disability: A sociological phenomenon ignored by sociologists?” In T. Shakespeare (Ed.), The disability reader (pp. 65–78). London, UK: Continuum.

Brock, B. (2017, June). How can we talk about disability? Article presented at the 8th annual meeting of the Summer Institute on Faith and Disability, Azusa, CA. Retrieved from http://faithanddisability.org/2017-summer-institute/ 

Chappell, A. L. (1998). “Still out in the old: People with learning disabilities and the social model of disability.” In T. Shakespeare (Ed.), The disability reader (pp. 211–220). London, UK: Continuum. 

Clifford Simplican, S. (2015). The capacity contract: Intellectual disability and the question of citizenship. Minneapolis, MN: University of Minnesota Press.

Creamer, D. (2008). Disability and Christian theology: Embodied limits and constructive possibilities. Oxford, UK: Oxford University Press.

DenHoed, Andrea. “The Forgotten Lessons of the American Eugenics Movement,” April 27, 2016. https://www.newyorker.com/books/page-turner/the-forgotten-lessons-of-the-american-eugenics-movement.

Diament, M. (2016, October 14). “Autism Speaks no longer seeking cure.” Disability Scoop, Retrieved from https://www.disabilityscoop.com/2016/10/14/autism-speaks-no-longer-cure/22884/ on 6 April 2018. 

Finkelstein, V. (1998). “Emancipating disability studies.” In T. Shakespeare (Ed.), The disability reader (pp. 28–49). London, UK: Continuum.

Foucault, M. (2006). History of madness (J. Khalfa & J. Murphy, trans.). New York, NY: Routledge.

Garland-Thomson, R. (2011). “Integrating disability, transforming feminist theory.” In K. Q. Hall (Ed.), Feminist disability studies (pp. 13–47). Bloomington, IN: Indiana University Press. 

Ladd-Taylor, M. (2014, April 29). “Fitter family contests.” Retrieved January 14, 2020, from http://eugenicsarchive.ca/discover/connections/535eebfb7095aa00000

Langtree, I. and L. Langtree (2019, June 12). “Models of Disability: Types and Definitions.” Retrieved 27 December, 2020, from https://www.disabled-world.com/definitions/disability-models.php

Metzler, I. (2006). Disability in medieval Europe: Thinking about physical impairment during the high middle ages. New York, NY: Routledge.

National Council on Disability. “Institutions in Brief.” https://www.ncd.gov/publications/2012/DIToolkit/Institutions/inBrief/

Oliver, M. (1990). The politics of disablement. London, UK: MacMillan. 

Snow, J. (2014, June 19). “It’s About Grace.” Summer Institute on Theology and Disability. Perkins School of Theology at Southern Methodist University, Dallas, TX, Plenary Talk. Available at https://faithanddisability.org/2014-summer-institute/

Stiker, H. J. (1999). A history of disability (W. Sayers, trans.). Ann Arbor, MI: University of Michigan Press.