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One of the areas of study most neglected by present-day psychiatry is that of subnormal mental functioning. But it is growing more difficult for the psychiatrist to deny his responsibility to this largest single category as it becomes clear through research and treatment that his legitimate domain does indeed include this emotionally disturbed group.
It has been argued by theoreticians, especially Rogers and Fenichel, that psychotherapy and mental retardation are incompatible and that the mental retardate lacks prerequisites for effective employment of psychotherapy. These “lacks” include insight, verbal ability and ability to abstract and cognitively deal with acting-out impulses which are necessary components of intelligence.
I have found that many cases of mental retardation, with or without evidence of organic brain injury, respond to a direct type of psychoanalytic psychotherapy, if there is sufficient intellectual and emotional potential.
It is my belief, along with workers such as Strauss, Sarvis, Rappaport, Rank, and Webster that a person who reacts psychologically and neurologically as if brain-injured, requires the same kind of understanding and treatment whether the injury is substantiated or not.
Through a basic method of communication, preverbal and verbal, it is possible to measure maturity in patients previously diagnosed as subnormal. This growth, I believe, is similar to that found in less regressive and infantile fixated diagnostic states, such as psychosis