Psychological Problems in Mental Deficiency

Sarason argued that mental deficiency must be understood as a psychological problem, not merely a medical or psychometric classification. A 1950 review of the first edition noted that Sarason's book 'manages to give the mental defective a personality and to demonstrate psychotherapeutic potentialities' [citation:6]. This was a significant departure from the prevailing view, which treated intellectual disability as a fixed organic condition and focused on diagnosis and institutional management. Sarason emphasized that individuals with mental deficiency have emotional lives, respond to therapeutic relationships, and present diagnostic complexities that purely quantitative approaches miss. The book synthesized research on etiology, diagnosis, and treatment while consistently arguing that psychological factors—motivation, personality, social context—were central to understanding and helping this population.

The book appeared in at least four editions across two decades. The first edition was published in 1949 by Harper & Brothers [citation:6]. A second edition followed in 1953, also from Harper, with 402 pages [citation:2][citation:8]. A third edition appeared in 1959, published by Harper & Row, with a second part co-authored by Thomas Gladwin [citation:4]. The fourth edition, published in 1968/1969 by Harper & Row, was co-authored with John Doris and included chapters by Frances Kaplan and M. Michael Klaber; it ran 483 pages [citation:14][citation:16]. Each edition updated the research base and reflected Sarason's evolving thinking about psychological approaches to intellectual disability.

The 1950 review by M. Simmel in The Journal of Abnormal and Social Psychology offered a balanced assessment. Simmel praised the book for outlining the field, showing what methods had been used, and exploring problems of diagnosis and etiology [citation:6]. The reviewer especially noted that Sarason gave the mental defective a personality and demonstrated psychotherapeutic potentialities. However, Simmel identified two weaknesses: the book was a compilation of studies rather than a systematic treatise, and its intended readership was unclear—it included elementary discussions of neuroanatomy and the Rorschach Test alongside material too difficult for beginning students [citation:6]. The review concluded that the book lacked criticism where it would appear most essential, suggesting Sarason was sometimes too deferential to existing research.

Psychological Problems in Mental Deficiency is the foundation of Sarason's career-long concern with how institutions shape the people within them. His later work on schools—The Culture of the School and the Problem of Change and Schooling in America—extends the same analytic stance: settings have their own cultures, regularities, and assumptions that must be understood before change is possible. The 1949 book applied this to institutions for people with intellectual disabilities; the later books applied it to public education. Sarason's consistent argument was that psychological problems are inseparable from the social and institutional contexts in which they occur, and that reform efforts which ignore context are doomed to fail. The book thus represents the origin of a theme that would define his entire intellectual career.