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NY Times Op-Ed, April 1, 2018
The Nazi History Behind ‘Asperger’
By Edith Sheffer
PALO ALTO, Calif. — My son’s school, David Starr Jordan Middle School,
is being renamed. A seventh grader exposed the honoree, Stanford
University’s first president, as a prominent eugenicist of the early
20th century who championed sterilization of the “unfit.”
This sort of debate is happening all over the country, as communities
fight over whether to tear down Confederate monuments and whether Andrew
Jackson deserves to remain on the $20 bill. How do we decide whom to
honor and whom to disavow?
There are some straightforward cases: Hitler Squares were renamed after
World War II; Lenin statues were hauled away after the collapse of the
Soviet Union. But other, less famous monsters of the past continue to
define our landscape and language.
I have spent the past seven years researching the Nazi past of Dr. Hans
Asperger. Asperger is credited with shaping our ideas of autism and
Asperger syndrome, diagnoses given to people believed to have limited
social skills and narrow interests.
The official diagnosis of Asperger disorder has recently been dropped
from the American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders because clinicians largely agreed it wasn’t a
separate condition from autism. But Asperger syndrome is still included
in the World Health Organization’s International Classification of
Diseases, which is used around the globe.
Moreover, the name remains in common usage. It is an archetype in
popular culture, a term we apply to loved ones and an identity many
people with autism adopt for themselves. Most of us never think about
the man behind the name. But we should.
Asperger was long seen as a resister of the Third Reich, yet his work
was, in fact, inextricably linked with the rise of Nazism and its deadly
programs.
He first encountered Nazi child psychiatry when he traveled from Vienna
to Germany in 1934, at age 28. His senior colleagues there were
developing diagnoses of social shortcomings for children who they said
lacked connection to the community, uneager to join in collective Reich
activities such as the Hitler Youth.
Asperger at first warned against classifying children, writing in 1937
that “it is impossible to establish a rigid set of criteria for a
diagnosis.” But right after the Nazi annexation of Austria in 1938 — and
the purge of his Jewish and liberal associates from the University of
Vienna — Asperger introduced his own diagnosis of social detachment:
“autistic psychopathy.”
As Asperger sought promotion to associate professor, his writings about
the diagnosis grew harsher. He stressed the “cruelty” and “sadistic
traits” of the children he studied, itemizing their “autistic acts of
malice.” He also called autistic psychopaths “intelligent automata.”
Some laud Asperger’s language about the “special abilities” of children
on the “most favorable” end of his autistic “range,” speculating that he
applied his diagnosis to protect them from Nazi eugenics — a kind of
psychiatric Schindler’s list. But this was in keeping with the selective
benevolence of Nazi psychiatry; Asperger also warned that “less
favorable cases” would “roam the streets” as adults, “grotesque and
dilapidated.”
Words such as these could be a death sentence in the Third Reich. And in
fact, dozens of children whom Asperger evaluated were killed.
Child “euthanasia” was the Reich’s first program of mass extermination,
begun by Hitler in July 1939 to get rid of children regarded as a drain
on the state and a danger to its gene pool. Most of the victims were
physically healthy, neither suffering nor terminally ill. They were
simply deemed to have physical, mental or behavioral defects.
At least 5,000 children perished in around 37 “special wards.” Am
Spiegelgrund, in Vienna, was one of the deadliest. Killings were done in
the youths’ own beds, as nurses issued overdoses of sedatives until the
children grew ill and died, usually of pneumonia.
Asperger worked closely with the top figures in Vienna’s euthanasia
program, including Erwin Jekelius, the director of Am Spiegelgrund, who
was engaged to Hitler’s sister. My archival research, along with that of
other scholars of euthanasia like Herwig Czech, the author of a
forthcoming paper on this subject in the journal Molecular Autism, show
that Asperger recommended the transfer of children to Spiegelgrund.
Dozens of them were killed there.
One of his patients, 5-year-old Elisabeth Schreiber, could speak only
one word, “mama.” A nurse reported that she was “very affectionate” and,
“if treated strictly, cries and hugs the nurse.” Elisabeth was killed,
and her brain kept in a collection of over 400 children’s brains for
research in Spiegelgrund’s cellar.
In the postwar period, Asperger distanced himself from his Nazi-era work
on autistic psychopathy. He turned to religious themes and social
commentary about child rearing. He would probably have been a footnote
in the history of autism research had it not been for Lorna Wing, a
British psychiatrist who tracked down Asperger’s 1944 article on
autistic psychopathy.
She thought it lent important context to the narrower definition of
autism then in use, and by the early ’80s, “Asperger syndrome,” and the
idea of a broader autism “spectrum,” had entered the medical lexicon.
In 1994, Asperger disorder was added to the American manual of mental
disorders, where it remained until it was reclassified in 2013 as autism
spectrum disorder. Yet Asperger syndrome is still an official diagnosis
in most countries. And it is ubiquitous in popular culture, where
“Aspergery” is too often invoked to describe general social awkwardness,
a stereotype for classmates and co-workers that overshadows their
individuality.
Does the man behind the name matter? To medical ethics, it does. Naming
a disorder after someone is meant to credit and commend, and Asperger
merited neither. His definition of “autistic psychopaths” is
antithetical to understandings of autism today, and he sent dozens of
children to their deaths.
Other conditions named after Nazi-era doctors who were involved in
programs of extermination (like Reiter syndrome) now go by alternative
labels (reactive arthritis). And medicine in general is moving toward
more descriptive labels. Besides, the American Psychiatric Association
has ruled that Asperger isn’t even a useful descriptor.
We should stop saying “Asperger.” It’s one way to honor the children
killed in his name as well as those still labeled with it.
Edith Sheffer, a senior fellow at the Institute of European Studies at
the University of California, Berkeley, is the author of the forthcoming
book, “Asperger’s Children: The Origins of Autism in Nazi Vienna.”
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