The article brings together contemporary research on autism spectrum disorder and historical sources concerning the medical condition of a 12th century nun, Hildegard of Bingen, to test two hypotheses: first, that Hildegard manifested disabilities that meet the criteria for autism spectrum disorder and, second, that medieval monasticism was unwittingly well-suited to treat Hildegard’s condition. Abundant Hildegardian sources document traces of autism spectrum disorder behaviour in Hildegard’s unusual childhood and the composite picture that emerges, when these individual traits are gathered together, is consistent with an autism spectrum disorder diagnosis. The role monasticism played in helping Hildegard overcome these behaviours is documented and aspects that monasticism shares with modern autism spectrum disorder treatment programs are identified. By recognizing the presence of autism spectrum disorder traits in a major cultural leader of another era and by identifying the type of life she lived while those traits were minimized, we gain insight into the history of autism, medieval monastic life and effective elements of autism spectrum disorder treatment.
Kanner L. Autistic disturbances of affective contact. Nervous Child 1943; 2: 217–250; Frith U. Autism and Asperger syndrome. Cambridge: Cambridge University Press, 1991; and Wing L. Kanner’s syndrome: a historical perspective. In: Wing L (ed.) Early childhood autism. Oxford: Pergammon Press, 1976, pp.3–14.
2.
American Psychiatric Association. Diagnostic and statistical manual of disorders, text revision. 4th ed. Washington, DC: American Psychiatric Association, 2000 [hereafter DSM-IV TR]; Filipek P, et al. The screening and diagnosis of autism spectrum disorders. Journal of Autism and Developmental Disorders 1999; 29: 439–484; and Filipek P, et al. Practice parameter: screening and diagnosis of autism. Neurology 2000; 55: 468–479.
3.
Hozeski B. The book of the rewards of life. New York: Oxford University Press, 1994, pp.9–10; Baird J and Erhmann R (transl.) The letters of Hildegard of Bingen. Oxford: Oxford University Press, 1994–2004 [hereafter Letters]; and Hart C and Bishop J (transl.) Scivias. New York: Paulist Press, 1990. A collection of sources, including ‘Vita domnae Juttae inclusae’ [hereafter VJ], ‘Vita Sanctae Hildegardis,’ [hereafter VSH], and Guibert of Gembloux’s biographical letter, are found in Silvas A, tr. Jutta and Hildegard: The Biographical Sources. University Park: Pennsylvania State University Press, 1998.
4.
Letter 38, in Jutta, pp.103–104.
5.
Ibid 107. Some hagiography offers physical suffering as proof of sanctity but here the parents’ worry is about possible physical danger, not a statement about actual suffering.
6.
Acta Inquisitionis, in Jutta, pp.103–104.
7.
VSH 1:1, in Jutta, p.138.
8.
DronkeP. Women writers of the middle ages, Cambridge: Cambridge University Press, 2001, pp. 147–147.
9.
Guibert, Letter 38.3; 38:13; VSH 1:8; 2:2; 2:3; 2:5; 2:8; 2:9; 2:10; in Jutta, 103–104; 115; 150; 158; 159; 165; 170; 214; 224; 225; 227; and 229.
10.
VSH 2:2, in ibid, p.158.
11.
VSH 1:8, in ibid, p.150.
12.
VSH 2:2, in ibid, p.159.
13.
Letter 38, in Jutta, p.115.
14.
VSH 1:2, in ibid, p.140.
15.
VSH 2:2, in ibid, p.159.
16.
VSH 2:2, in ibid, pp.159–160.
17.
VSH 2:2, in ibid, p.160.
18.
Some think this is a description of migraines. See Flanagan S. Hildegard of Bingen, 1098–1179. London: Routledge, 1998, pp.199–211; and Sachs O. Migraines. Berkeley: University of California Press, 1985, pp.106–108.
Letter 103r, in Letters, 2:23. For medieval understanding of vision and visionary knowledge, see Ranft P. Women in western intellectual culture, 600–1500. New York: Palgrave Macmillan, 2002, pp.55–56.
23.
Scivias, pp.59–60.
24.
Letter 103r, in Letters, 2:23.
25.
WetherbyAPrizantBSchulerAUnderstanding the nature of communication and language impairments. In: WetherbyAPrizantB (eds). Autism spectrum disorders, Baltimore: Paul H. Brookes, 2001, pp. 121–121.
26.
Letter 38, in Jutta, p.115.
27.
Letter 103r, in Letters, 2:23.
28.
Letter 38, in Jutta, p.116. Her unpolished writing was not due solely to her Latin: “The things I write are expressed in unpolished Latin, for that is the way I hear them in my vision”.
29.
Letter 103r, in Letters, 2:33.
30.
Dronke, Women writers, p.146.
31.
ibid, pp.146–147.
32.
Dronke, ibid, p.200, also recognizes a disability: “Despite her constant illness – or perhaps because of it, in that it impelled her to concentrate …”.
33.
Quoted in Baron-CohenS. The essential difference, London: Penguin, 2004, pp. 168–169.
34.
See ibid, pp.160–169.
35.
Letter 38, in Jutta, p.104.
36.
Letter 38, in ibid, p.107.
37.
Some ASD individuals develop echolalia, and chanting the Office could function as short-term therapy for this; it forces one to recite the next line but does it within a repetitious cycle.
38.
Wetherby. Understanding, p.121; and Dawson G and Osterling J. Early intervention in autism. In Guralnick M (ed.) The effectiveness of early intervention. Baltimore: Paul H. Brookes, 1997, pp.307–326, identify these characteristics of effective programs: (1) imitation of others; (2) use of language; (3) appropriate play; (4) appropriate social interactions; (5) low staff-to-subject ratio; (6) structured classrooms; (7) visual clues for transitions between activities; (8) visual clues to define expectations; (9) functional approach to problem behaviours; and (10) focus on communication skills. These are also present in monasticism.
39.
VJ, 5–6, in Jutta, pp.71–76.
40.
Jutta had her own peculiarities; she read silently in an age where oral recitation was the norm (ibid, 4, in Jutta, p.71) and she had a prodigious memory (ibid, 2, in Jutta, p.67).
41.
Letter 38, in Jutta, p.111.
42.
Letter 38, in ibid, p.112.
43.
VSH, 1:6, in Jutta, p.146. Such repetitive motion is a particularly vivid description of ASD behaviour.
44.
Letter 75, in Letters, 1:163.
45.
WittensteinL. Our knowledge of the external world, Chicago: Open Court, 1929, pp. 42–42.
46.
Letter 8, in Letters, 1:43.
47.
SchnappJ. Virgin words: Hildegard of Bingen’s Lingua ignota and the development of imaginary languages ancient to modern. Exemplaria1991; 3: 272–273.
48.
Dronke. Women writers. p.194: “Here, late in life, we see how Hildegard had acquired the power to construct complex, fluent, and fluid sentences, apparently quite unaided”.
49.
RanftP. How the Doctrine of The Incarnation shaped western culture, Lanham, MD: Rowan, Littlefield, 2012.
50.
Dronke. Women writers, p.171.
51.
GlazeFMedical writer. In: NewmanB (ed.) Voice of the living light, Berkeley: University of California Press, 1990, pp. 135–135.
52.
Grafma J, Christen Y (ed.) Neuronal plasticity. New York: Springer, 1999; and Filogano G (ed.) Brain plasticity. New York: Plenum Press, 1997.
53.
Baron-Cohen. Essential difference, p.163.
54.
Quotes: Acta Inquisitionis, 6, 3, 4, 10, in Jutta, pp.261–266. The most frequent problems cured were demonic possession and epilepsy; eight witnesses testify to Hildegard’s cure of ‘many' parsons with epilepsy; 25–33% of ASD children develop seizures. See Deykin E and MacMahon G. The incidence of seizures among children with autism. American Journal of Psychiatry 1979; 136: 1310–1311.
55.
Berger M. On natural philosophy: selections from cause et cure. Rochester, NY: DS Brewer, 1999, pp.56–65, where she tells us a fiery light “permeated my whole brain” and then “inflamed my whole heart and my whole breast.” There are also an inordinate number of words for head in lingua ignota.
