In Nazi Germany​ paediatric psychiatrists served as consultants to youth groups, welfare offices and schools. It was the form their ‘national service’ took. They tracked subjects through childhood, shaped what was considered normal behaviour, and identified and codified what was not. Ernst Illing claimed that he could make a call about a child at the age of three or four – he could spot what he called ‘Gemüt poverty’. Gemüt meant ‘soul’ or ‘spirit’, but also gestured to a person’s capacity for tribal belonging: for feeling and emoting spirit, as in national or school spirit; and for social competence. None of these meanings was new, but how ‘Gemüt’ came to matter was. Gemüt-poverty was a medico-spiritual diagnosis that could send children to their death at a place like Spiegelgrund, a children’s killing centre in the outskirts of the Vienna Woods, part of the Steinhof mental hospital. Illing was the medical director of Spiegelgrund from 1942 till 1945. One of his predecessors was Erwin Jekelius, who claimed to have an aptitude for spotting teenagers with poor Gemüt. And he was a close associate of Hans Asperger, who developed a new label for classifying children, ‘autistic psychopathy’, which he couched in terms of poor or absent Gemüt (‘a qualitative otherness, a disharmony of feeling’), diagnosing them with ‘unfeeling malice’.

Asperger’s work was rediscovered in the English-speaking world in the 1990s, and ‘Asperger’s syndrome’ made its way into contemporary diagnostic manuals as well as colloquial ways of talking about each other. Autism is now believed to involve structural and functional abnormalities in a key brain circuit, which impede the experiencing of pleasure from social interaction; but that is a reading embedded in the fashionable sciences of our own time, brain imaging and neuroscience. Another fashionable science, genomics, has yielded new understanding about causes. ‘Refrigerator mothers’ used to be implicated; now the pesticide DDT is among the culprits.

Edith Sheffer argues in Asperger’s Children that, regardless of the science, and regardless of whether autism is one condition or several, it remains steeped in the cultural values of its Nazi origins, and in the idea of a model personality: obedient, animated by collective bonds, socially competent, robust in mind and body. Rooted in years of meticulous archival research, Sheffer’s book has already had an impact on activists who have called for the burial of Asperger’s syndrome along with statues honouring racists. But that’s too easy. Her book does not offer a univocal message. It explores the various ways in which, over time, cultural ideals shape ‘scientific’ diagnoses, and vice versa. It’s about the way words like Gemüt create models, and the way these models help create ‘defects’. It’s about conscious and unconscious complicity, in-the-moment improvisation, and the moral grey areas where so much human action takes place.

None of this is where Sheffer started. Her initial interest was visceral and personal. She came to the subject thinking quite simply to honour Asperger. Her son, like an ever increasing number of boys in Silicon Valley and elsewhere, was diagnosed with high-functioning autism. Asperger, Sheffer assumed, was an early proponent of neurodiversity, someone who promulgated multiple ways of inhabiting the world.

What she found in the archives was far more complicated. If Asperger was ahead of his time, he was also indisputably of his time. He was shaped by and internalised his environment – he called the German youth groups to which he belonged ‘the noblest blossom of the German Spirit’ – but enacted his complicity through the professional milieu he chose to inhabit. Most Viennese operated in ‘shades of grey’, Sheffer writes. They ‘navigated daily choices … extemporising in their personal and professional spheres. Caught in the swirl of life, one might conform, resist and even commit harm all in one afternoon. The cruelty of the Nazi world was inescapable.’

Asperger was precocious, and knew he wanted to be a scientist after being enchanted by a frog dissection at school. In the spring of 1931, having just finished his medical studies at the age of 25, he arrived at the University of Vienna Children’s Hospital, one of the most prominent research hospitals in the world. Although a stilted sort of person, he was lyrical in his letters home about the atmosphere in the Curative Education Clinic, where dissocial children were treated. Along with other researchers, some of whom were Jewish, he set about classifying their minds. Children who had been expelled from school, regarded as unable to fit in with their environment, were observed in open play-like settings. Researchers and nurses sat on the ground with the children, took notes, scrutinised their Gemüt, talked of their heredity, exuded bonhomie, wrote papers, built careers. The word ‘autist’ was used to describe loners who ‘fall out of every children’s community’. Their faces were often ‘inexpressive’ and their speech and interests obsessive or eccentric. At first, like his Jewish colleagues, Asperger did not make judgments about the children: ‘autist’ was enough. However, the hospital was rapidly Nazifying under its new head, Franz Hamburger, whom Asperger revered. In 1934, Hamburger made the 28-year-old Asperger head of the children’s clinic while zealously purging Jews and liberals – in Vienna as a whole, 70 per cent of paediatricians were removed – and advancing a social utility view of medicine. Asperger flourished.

Autism was not a new term, but Asperger gave it new meaning. He identified a spectrum, ranging from the ‘original genius’ through the ‘weird eccentric who lives in a world of his own’ to the ‘contact-disturbed automaton-like’ individual already identified by others. He came to call the spectrum ‘psychopathic’ and emphasised the children’s malice and recalcitrance, Sheffer suggests, in response to Nazi ideals of how to be. Not fitting in was a form of sociopathy. But he also hailed the ‘special abilities’ of those at the higher end of his spectrum at a time when the intellectually gifted were regarded as almost by definition Gemüt-impoverished. Those who had special abilities could fulfil their roles in the national organism ‘better than others’ – a ringing endorsement – as ‘mathematicians, technologists, industrial chemists and high-ranking civil servants’. They might not merge with wider society, but they could be socially useful. Asperger championed boys like eight-year-old Harro, whom one could talk to ‘as an adult’. Harro couldn’t be bothered with school, didn’t play with his peers and answered only those questions that interested him; he coined words to fit the moment, and ‘let his talk’ run along ‘its own tracks’. But Asperger was sure he was clever. Six-year old Fritz was expelled from Kindergarten because he attacked other children and did not ‘align’ with any community. Asperger noted his ‘fine and aristocratic features’, and his ‘rare maturity of taste in art’. Asperger developed elaborate programmes of intervention for these boys which, Sheffer says, resembled those used today.

Despite their alleged lack of Gemüt, he argued that they were ‘educable’: with ‘proper understanding, love and guidance’, they could be made to grow up ‘correctly’ and ‘find their place in the organism of the social community’. Their Gemüt-ful aspects could be uncovered. There’s a photo showing Asperger sitting opposite Harro, intently engaged in what might be called Gemüt-transference. He was presumably cueing him into ‘passable assimilation’, as it was called. That was the purpose of the clinic: to teach the educable to pass. The child, he said, should receive ‘uninterrupted reciprocity with his caregiver, constantly building up his response’.

The archives tell a story of enlightened benevolence towards these boys – but also one of relentless eugenics, especially after the Anschluss in 1938. Teaching some to pass meant also weeding out those who couldn’t. ‘Paradoxically,’ Sheffer writes, ‘it was Asperger’s eugenicist focus on the “favourable cases” in his thesis that obscured the extent to which he was eugenicist.’ The flipside of curing was killing. Death was a ‘treatment option’. Asperger didn’t get his hands dirty – he didn’t kill children himself – but his diagnoses were essentially death warrants. If he was a hero in saving some, he was a monster in dispatching others. He was a ‘conscious participant’ in the Nazi machinery, Sheffer concludes.

His benevolence did not apply to certain categories of girl, or to the dozens of children he sent to Spiegelgrund ‘to be dispatched for Jekelius action’ (a lethal injection of barbiturates), who included children with Down’s Syndrome, with partial paralysis, with epilepsy, with autism. He dispatched a five-year-old girl, Elisabeth Schreiber, who had motor unrest and could only say ‘mama’; she tried to communicate with sign language. As for obstreperous, nonconforming adolescent girls, they seem to have been objects of particular distaste to Asperger, as they were to the regime. He found 14-year-old Christine Berka vulgar, rude, oppositional and, Sheffer surmises, oversexed: she was not a worthy Reich breeder-to-be. Digging in the archives, Sheffer finds letters in which Christine, channelling the values of the Reich, nonetheless dreamed of tending to children in a happy household (her own stepmother didn’t want her). Asperger didn’t seem to think autism applied to girls (except in America, where girls were ‘masculinised’), but he condemned Christine as ‘antisocial’. Another adolescent girl, Margarete Schaffer, did not ‘swing’ with the group. He found her superficial, insincere, unable to take part in games and, again, probably oversexed. She stole soap from the other girls. Elfriede Grohmann was diagnosed, essentially, as ‘ineducable’. Asperger sent them to Spiegelgrund. Elfriede knew she was being sent to her death. ‘I’ll tell you only one thing,’ she wrote to her uncle, ‘we will not see each other again.’

The​ language in Asperger’s research papers, conference presentations and doctoral thesis ‘sharpened’ each year, Sheffer says, becoming ‘ever more judgmental’. In 1937, before the Anschluss, he wrote that ‘it was impossible to establish a rigid set of criteria for a diagnosis’; in 1938, the year of the Anschluss, he wrote of ‘the well-characterised group we name “autistic psychopaths”’; in 1941, he wrote of ‘a group of abnormal children devoid of emotional relationship to the environment’, and in his doctoral dissertation in 1944, he wrote that ‘the autist is only himself and is not an active member of the greater organism,’ a damning diagnosis in a context where only the greater organism mattered. He had saved Harro and Fritz by invoking their social utility, so there are inconsistencies. Sheffer doesn’t try to resolve them. Instead, she reminds us that categories and definitions were a matter of ongoing, in-the-moment improvisation. In another publication in 1944, Asperger expressed disdain for those without Gemüt ‘who go their own way’ and cannot integrate. He may not technically have been a Nazi – he never joined the party, which saved him after the war when, like so many others, he claimed not to have been a sympathiser – but he internalised Nazi ideals of social conformity and social spirit.

In short, Asperger himself was ‘educable’; he fitted himself to his times. There was, however, one unusual and indeed rather startling constant: he was a staunch Catholic. He believed in children’s souls even as he rationalised their deaths by convincing himself that he was not playing god, but aiding god. ‘One serves in death,’ he wrote. He was considered absolutely reliable by his Nazi mentors. He revered Hamburger. He happily consorted with Jekelius. Was he saving his skin? Or simply a committed careerist? When he overdid his ‘Heil Hitlers’, he was told by a collaborator, Josef Feldner, that it came across ‘as a bit too Nazi for your reputation’, suggesting that usually he was less than zealous – yet not reluctant either.

His awkwardness aside, what’s remarkable is how frictionlessly Asperger adapted himself (and his diagnosis) to red and then black Vienna, and then to postwar Vienna. He appears not to have flinched when his Jewish colleagues were purged after Hamburger’s ascension, just as he didn’t flinch in sending children to their deaths. He appears not to have minded Hamburger’s medical experiments on children judged ‘unfit to live’, which must have taken place right next to him at the clinic. When he served in the war in Croatia in 1944, witnessing countless Nazi atrocities, he wrote ecstatically of the culture of ‘care’ that war enabled, locating virtue in selfless brotherhood. After the war, he never mentioned Gemüt again and mostly abandoned his research on autism. He was once again so good at fitting himself to his times that he was the only one of Hamburger’s followers still allowed to teach. He resumed his correspondence with a Jewish colleague who had fled to the US. He said in an interview in 1974 that ‘the Nazi period came, and it was clear from my previous life, as with many “nationalists” – in quotation marks – that one went along with things.’

Populism required individuals who would now be called ‘neurotypical’ – Gemüt-ful in the Nazi context – who could be cued into melding into the Volk and then triggered or choreographed to swarm in one direction. Autism, by contrast, was about being unmoved, solitary in a crowd, impervious to affective communion. The crux of Sheffer’s argument is that autism and Nazism were inverse states. To be ‘cured’ at the clinic was to be brought into Gemüt-ful tribalism. To be asocial or introverted or disobedient or unruly was ‘rubbing against the community’ – which amounted to ‘gemütlosen Psychopathen’.

Put another way, autists were ‘enemies of the people’. But Sheffer turns the screw on a tidy moral reading that makes of all this an exclusively Nazi phenomenon. She reminds us that the welfare state set the stage for socialising children into collective life. Asking what was normal, it then codified what was abnormal. Eugenicist ideas were in circulation in the 1920s and earlier, long before the Nazis; the theory and practice of forced sterilisation was imported from the US and continued there after the war. Nazi psychiatry did not arise out of nothing, and it hasn’t been tidily buried. Thirty diagnoses created under the Third Reich are still in use today, created against the idea of a ‘model personality’.

Sheffer also insists that ‘benevolence’ was a feature, not a bug, of Nazi psychiatry. Gemüt itself is a concept that emphasises in-tribe empathy while condoning murder. Chasing down paradoxes is a scholarly reflex, so it’s hardly surprising that Sheffer wants readers to understand just how saturated Nazi psychiatry was with compassionate rhetoric. Nazi psychiatrists explicitly touted a ‘culture of care’. They saw themselves as national ‘protectors’. Many of the most murderous, including Jekelius, were described as ‘jovial’ or ‘avuncular’. The adolescent loner who didn’t like group pow-wows needed to be educated for the sake of his own mental health into embracing the joys of merging. It would even help his acne, according to Hamburger, not to mention his musculature. Some special-education teachers urged their students with hereditary diseases to volunteer for sterilisation. If others were squeamish about making such recommendations, people like Jekelius assured them that ‘false sentimentality is out of place.’ It was all about being civic-minded.

In the precincts of Spiegelgrund, which reportedly ran like clockwork, ‘sentimentality’ was bureaucratised away. Children were warehoused. The killings started in the late summer of 1940. Jekelius administered a slow and painful death to his patients for the greater good while serenely touting his benevolence. As for the children, they knew their emaciated bodies could be wheeled out on a wooden pushcart at any time. Sheffer writes in detail about those carts, as well as about starvation, shots of sulphur to induce extreme pain and paralysis, children being given emetics and then having to eat their vomit. The children were also trained to hurt each other. The 70 per cent who did not have quantifiable physiological impairments were divided into three groups based on their ability to conform. One boy, Friedrich Zawrel, managed to escape after finding out he was on the death list. Deemed hereditarily defective because of his father’s alcoholism, he was displayed naked on a podium to new nursing students, his large ears and long arm-span solemnly pointed out as evidence of his genetic and sociological inferiority. After the war, doctors and nurses would say that killing was scientific protocol, and complicity inescapable. Sheffer found letters from parents begging the Spiegelgrund authorities for their children’s lives, and others begging for their deaths as acts of mercy. One female survivor, who later became a nurse, testified that nobody questioned ‘the evil [that] has no name’. After the war, she discovered she had been sterilised.

Was​ Asperger himself Aspergy? Certainly he had aspects of the syndrome given his name by the English researcher Lorna Wing, who discovered his wartime thesis in 1981. He may have identified with boys like Harro and Fritz. He is described as speaking in quotations, and of himself in the third person; as not making eye contact; as being stiff and formal indoors even while earnestly touting the spirit of the German youth movement. He said that being a scientist demanded a ‘dash of autism’. But he would have thought of himself as a Gemüt-ful scientist. And when he wrote that some autists had ‘psychopathic clarity of vision’, he would have identified with the vision part and capacity for abstraction but obviously not the psychopathic part. Like all of us, Sheffer believes, he contained multitudes, and even contradictions. He ‘sang alone at night’ (like the Greek warden in Faust with whom he identified) and he merged by day. After the war, fitting himself to his times yet again, he said that everyone has autistic moments. And that social awkwardness or asociality or introversion are hardly sins, or sociopathic.

Another question the book asks at the very end: why is ‘Asperger’s syndrome’ such a part of our lexicon? Why did its use take off in the mid-1990s? One reason is that Asperger’s thesis was translated into English by Uta Frith in 1991, without its Nazi intellectual frame (the preface); Frith also avoided his term ‘autistic psychopathy’, translating it simply as ‘autism,’ an act of linguistic de-Nazification. But there’s more to it than that. Sheffer is clear: autism in its severe forms is about underlying biology; but what we now call Asperger’s syndrome is a cultural artefact. If the terms ‘autism’ and ‘Asperger’s’ have gained momentum recently, that may be in part because of a rise in environmental triggers, but it’s also because our children’s minds are again under intense scrutiny – though for different reasons. In our era of networking and social media, of ‘ghosting’ and attention-grabbing individuation, we’re anxious about their ability, metaphorically and literally, to get the requisite ‘likes’. We now value a capacity not so much for feeling ‘Gemüt’ – or whatever the quality is that guarantees social inclusion – but for strategically emoting or performing ‘soft skills’. Twenty-first century boys are told they need to get with the programme.

Yet, at the same time, autism in its high-functioning form has also become a somewhat hopeful diagnosis. Self-designated ‘Aspies’ tout their ability to be guided by factors other than fame and fortune; to avoid the biases that muddy ‘neurotypical’ or group thinking; and to tell the forest from the trees. Asperger’s syndrome has been laid to rest in the American Diagnostic and Statistical Manual (though not yet in the international one), but in the popular imagination it has become the province of awkward boy geniuses who create our digital worlds to be, which we ‘neurotypicals’ (itself a cultural construction) fit ourselves to and swarm within. In this turn of the biocultural screw, autism, deserving of death in 1940-45, has become a ‘neuro-platform’ for ‘disruptive innovation’, a cultural good, and a site of identity politics.