#models of disability

[capricorn-0mnikorn]

There's the Medical Model of Disability, and the Social Model of Disability. There's also a third one...

The medical model of disability frames the disability as starting and ending with the individual and their impairment. And dealing with that means fixing (curing) what is broken about them.

The social model of disability frames disability as emerging from the society in which the individual lives -- that an "impairment" becomes a "Disability" when it is not accommodated or accepted.

I was recently reminded that there's also the moral model of disability, that says that disabilities are punishments for sin, or evil in a person.

In today's "Scientific Age," we (in the industrialized West at least), like to think that we've left the moral model of disability in the past -- that the Puritans in the early American colonies might have believed in that stuff. But we don't believe in demons and curses anymore.

But I actually think that the medical model of disability is a direct descendant of the moral model; modern medical schools may not give lectures on demonology. But doctors and other clinicians still treat disability as some sort of "taint," that the person must be purified of before they can rejoin "normal" society. Cure (or as close to it as you can get) is the first, last, and only, acceptable goal.

If that doesn't smack of exorcism, I don't know what does.

[indizombie]

Readers may have heard of the medical and social models of disability. These take contrasting positions on the root causes and implications of disability. In simple terms, the medical perspective — or what is often referred to as the traditional, deficit or tragedy model — starts from the premise that a person is prevented from full participation because of the category of impairment or condition they have, which itself cannot be therapeutically fixed. An example of medical-model thinking in schooling might be where a student with a processing disorder, which affects their capacity to keep up with their peers, is prevented from learning in the classroom because their teacher is constantly in a rush to deliver a very busy curriculum. In contrast, the social model — which is favoured by advocates, peak bodies and some governments — starts from the idea that what disables people are the socially created barriers that hinder full participation, rather than the conditions they live with. As above, the same student could be included in learning if their teacher acknowledged inclusion in schooling does not mean everyone learning at the same pace.

Dr Ben Whitburn, ‘It’s the socially created barriers that disable students, not the conditions they live with’, ABC

[neurotypicalabusesurvivor]

This is a friendly reminder that none disabled people often do benefit from the same accommodations disabled people benefit from.

[spoonielivingfree]

The problem with the biopsychosocial model of disability

The biopsychosocial model is a model of health and disability that states that illness is a result of interactions between a range of factors, including biological, psychological, and social interactions. On the surface this makes sense. Of course our conditions and the impact of them aren’t purely physical. Society isn’t accessible which is a social factor increasing our level of disability, and…

[softandorsweet]

being fat is hard because you don’t just run into inaccessibility that affects only you. for example, if i’m bigger than a car seat is built for, then i inconvenience those sitting next to me. if i’m bigger than a room is built for, i encroach on others space. it makes the fat person feel like it’s a personal fault, and skinny people are often not kind to fat folks who take up space. i want to make this clear: it is Not the fat persons fault AND i understand the strain and shame it can cause fat people. this world is built to exclude fat people. fitting of my favorite phrase inspired by the social model of disability; it’s not the fat persons fault, it’s the worlds fault.

[raccooninapartyhat]

kinda confused about why the dialogue surrounding disability has changed from "we are still worthy and have personhood even if we can't do the things everyone else can, and we deserve to participate in society" to "nobody would be disabled if society was just shaped the right way"

like I'm pretty sure that I'd still be blind and unable to play most video games even if every video game included accessibility features. I'd still be deaf and unable to understand people over phones and intercoms even if everyone knew how to sign. I'd still find it hard to walk around even if there were ramps and elevators instead of stairs

disability doesn't just vanish with accessibility, it just means we are more likely to be able to participate in life

and also, when did people start to be so afraid of accepting that some of us will be disabled no matter what access arrangements we have in place? why do we lose our worthiness? why do we lose our personhood?

[beatrice-otter]

The Other Half of the Social Model of Disability

Lots of people in fandom are aware of the Social Model of Disability, which is a direct contrast to the Medical Model of Disability. Problem is, most of those people only understand half of the Social Model.

If you don't know what I'm talking about, the "in a nutshell" version is that the medical model views disability as something that is broken and which needs to be fixed, and little or no consideration is given beyond trying to cure it (and little or no consideration is given to the needs and wishes of the person who has it). The social model of disability, on the other hand, says that the thing that disables a person is the way society treats them. So, for example, if someone is paralyzed and can't walk, what disables them from going places is buildings that are not wheelchair accessible. (Or possibly not being able to afford the right type of wheelchair.) Inaccessible spaces and support equipment you can't afford are choices society makes, not a problem with the disabled person.

People then take this to mean that the only problem with disability is the society that surrounds it, and therefore in some utopian future where capitalism is no more and neither is ableism or any other form of bigotry, all problems disabled people have will be solved.

Except that what I've just described is not actually what the social model of disability says. Or, rather, it's only half of what the social model of disability says.

The actual social model of disability begins with a distinction between impairments and disabilities. Impairments are parts of the body/brain that are nonstandard: for example, ears that do not hear (deafness), organs that don't work right (e.g. diabetes), limbs that don't work (paralysis), brain chemistry that causes distress (e.g. anxiety, depression), the list goes on. The impairment may or may not cause distress to the person who has it, depending on the type of impairment (how much pain it causes, etc.) and whether it's a lifelong thing they accept as part of themselves or something newly acquired that radically changes their life and prevents them from doing things they want to do.

And then you have the things that disable us, which are the social factors like "is there an accessible entrance," as described above.

If we ever do get a utopian world where everyone with a disability gets the support they need and all of society is designed to include people with disabilities, that doesn't mean the impairments go away. Life would be so much better for people with impairments, and it's worth working towards, but some impairments simply suck and would continue to suck no matter what.

Take my autism. A world where autism was accepted and supported would make my life so much easier ... and yet even then, my trouble sleeping and my tendency to hyperfixate on things that trigger my anxiety would still make my life worse. I don't want to be cured of my autism! That would change who I am on a fundamental level, and I like myself. My dream is not of a world where I am not autistic, but a world in which I am not penalized for being autistic and have the help I need. And even in that world, my autism will still sometimes cause me distress.

There are some impairments--conditions that come with chronic pain, chronic fatigue, etc.--where pretty much everyone with that impairment agrees that the ultimate goal is a cure. But nobody knows how long a cure will take to find (years? decades? centuries?), whereas focusing on the social things disabling you can lead to improvement in your daily life right now.

In conclusion: the social model of disability is very valuable, and much superior to the medical model on a number of levels. But: please don't forget that the social model makes a distinction between disability and impairments, and even if we reach every goal and get rid of all the social factors that disable people, some impairments will be fine and cause no distress to the people who have them, some will be a mixed bag, and some will still be major problems for the people who have them.

Also on Dreamwidth

[irul]

THE FUTURE BODY IS A DISABLED BODY //

[drdemonprince]

Thousands of people did not just suddenly stop using headphones one day because they felt like it, or because they stopped caring about people with sensory sensitivities like me. No, people stopped using headphones because cell phone manufacturers stopped including headphone jacks in their products. 

My sensory-processing issues are a physical element of my disability that would absolutely still exist in a world without capitalism. Like my poor fine motor control and reduced muscle tone, my sensory processing issues debilitate me: there are tasks I simply cannot perform because of how my body is wired, and this makes me different from most other people in ways that are non-negotiable.  Still, my physical disabilities are worsened quite clearly by capitalism: Because large corporations have both a profit motive and a vested interest in reinvesting those profits into advertisements, and because the internet does not receive public financial support, my daily life is bombarded with bright, noisy, flashing, disruptive advertisements, which makes it far more difficult for me to process relevant information and can swiftly bring me to the verge of a meltdown.  If the internet were funded as a public utility and was therefore not sandblasted in ads, I would be less disabled. If my local streets were less plastered in billboards and littered with junk mail advertising chain restaurants, I would be less disabled. 

Because companies like Apple financially rely upon consumers replacing their phones on an annual basis (despite how unsustainable and murderously cruel continuing to mine cobalt in Sudan for the production of all these new phones is), I must replace my phone regularly. With an updated phone model I lose my headphone jack and have to adapt to a new operating system and layout, and so my sensory issues and executive functioning challenges are exacerbated.  In a world where phones were produced in order to help human beings function rather than to make money, I would be less disabled.  Thanks to capitalism, I cannot exist in public if I am not purchasing anything. I cannot simply be present in a store, coffee shop, or even public plaza, enjoying my surroundings and taking the sight of other people in. I must contribute to the economy in order to justify it. If the brickwork of a nearby building fascinates me and I crave to feel it against my palms, I have to pretend that I wish to buy it, and be prepared to tell anyone who asks that that’s what I intend to do. I can’t even stand on the corner and feel the sun on my face without worrying my neighbors might find it unusual and send the cops.  As an Autistic person, I often can’t fake being a perpetual consumer well enough. My desire to simply elope around my environment and take in new, interesting sensations registers as suspicious or concerningly mentally ill. And so I am further disabled and excluded from public life. 

The full essay is free to read or have narrated to you at drdevonprice.substack.com

[cyanomys]

Calling all body positive ppl

Does anybody have recs for fat & body positive creators I can follow. Especially about movement and intuitive eating.

But also just seeing other fat people doing hobbies and being visible on the internet would be nice. I like gaming, books, the usual nerd package.

I’m having so much trouble searching for these sorts of creators without getting suggested fatphobic or pro-ED content instead which is very upsetting :(

Even if you don’t have answers please reblog so I can find people who do!!

[comfymoth]

mcyt physically disabled week day four: invisible disability | flare up

i just wanted to draw something related to chronic pain for my own sake, and i figured if i was gonna draw the thing i have i might as well be self indulgent about it!! you know i’ll take any excuse

[carnivorous-toothache]

I definitely think there's Something (TM) to say about the portrayal of "off-human" characters in modern media adaptations as having (particularly facial) deformities and/or learning disabilities.

Robert Louis Stevenson was fully like "this is my OC, Hyde, who represents the impact of a complete apathy toward your fellow man. There is nothing extraordinary about him except that his rancid vibes make people uncomfortable which adds to the core theme of the role of morality in humanity, so its really important that he's physically normal so the audience can recognise that it's what's inside that's most important," and every film adaptation was like "mmkay. Yeah, no, I've got it. We can show that he's evil by using prosthetics and making him non/semi-verbal, which, as we all know, are the True Measures of Evil."

[neurotypicalabusesurvivor]

The fact "empaths" don't have empathy for childhood trauma survivors (ASPD, NPD, systems) is funny actually.

[daybreaksys]

Neighbourhoods of poor vampires in the lowest, ever-dark parts of fantasy cities, vampires who aren't wealthy because they're a racial minority and the system was designed to keep poor people poor.

Poor vampires who are functionally disabled because they can't take sunlight in the only hours services are open and have to fight stereotypes of them being all snob nobles.

A nonprofit program immersed in the neighbourhoods paints portraits of vampires for free so they can see themselves for the first time because they can't use mirrors or cameras. Some cry, some don't recognise themselves, some are weirded by their unexpected appearances.

Mixed-race vampires who struggle to navigate their neighbourhoods having to advocate for themselves reminding people they are vampires as well as their other ethnicities.

[nothorses]

I saw your tags on the post about trick or treaters not speaking and I am v interested in hearing more of your thoughts on the concept of “developmental delays”! I‘ve seen the idea that disability is a construct, but I’m not as familiar with the idea that development is also a construct. You have really great takes as an educator and someone who like, actually GETS how kids work, so I am interested in your thoughts!

I also know that posting on this subject might be poking the bear, so it is 1000% cool if you would rather not comment 💜 Tysm!

Oh I'm happy to talk about it! I love talking about this stuff, thank you for asking me to 💙

This isn't exactly new ground; there's been plenty of research into and writing on the subject, and deconstructing "development" as a static concept was, ironically, a huge part of my most recent development class.

The idea is that our understanding of "benchmarks" of development, which informs the larger concept of development as a whole, is heavily rooted in the assumption that Western culture is The Standard. We prioritize walking, talking, reading, and writing, which means we cultivate these skills in our children from a young age, which means they develop those skills more quickly than they do others.

To use one of my favorite examples from Rogoff, 2003, Orienting Concepts and Ways of Understanding the Cultural Nature of Human Development:

Although U.S. middle-class adults often do not trust children below about age 5 with knives, among the Efe of the Democratic Republic of Congo, infants routinely use machetes safely (Wilkie, personal communication, 1989). Likewise, Fore (New Guinea) infants handle knives and fire safely by the time they are able to walk (Sorenson, 1979). Aka parents of Central Africa teach 8- to 10-month-old infants how to throw small spears and use small pointed digging sticks and miniature axes with sharp metal blades: "Training for autonomy begins in infancy. Infants are allowed to crawl or walk to whatever they want in camp and allowed to use knives, machetes, digging sticks, and clay pots around camp. Only if an infant begins to crawl into a fire or hits another child do parents or others interfere with the infant’s activity. It was not unusual, for instance, to see an eight month old with a six-inch knife chopping the branch frame of its family’s house. By three or four years of age children can cook themselves a meal on the fire, and by ten years of age Aka children know enough subsistence skills to live in the forest alone if need be. (Hewlett, 1991, p. 34)" (pg. 5)

In the US we would view "letting an 8-month-old handle a knife" as a sign of severe neglect, but the emphasis here is placed on the fact that these children are taught to do these things safely. They don't learn out of necessity, or stumble into knives when nobody is watching; they learn with care, support, and safety in mind, just like children here learn. It makes me wonder if Aka parents would view our children's lack of basic survival skills with the same concern and disdain as USAmerican parents would view their children's inability to read.

Do we disallow our children from handling knives because it is objectively, fundamentally unsafe for a child of that age to do so- because even teaching them is developmentally impossible- or is that just a cultural assumption?

What other cultural assumptions do we have about child development?

Which ties in neatly with various social-based models of disability, particularly learning and, of course, developmental disabilities. If your culture doesn't value the things you are good at, and you happen to struggle with the things it does value, what kinds of assumptions is it likely to make about you? How will it pathologize you? What happens to that culture if it understands those values to be arbitrary, in order to accommodate your unique existence?

[trans-axolotl2]

Fuck the DSM. Seriously, fuck the DSM.

The DSM is and always has been used primarily as a method of rationalizing mistreatment of the people it labels as "deviant." When you look at the history of psychiatry, it becomes clear that things like drapetomania, protest psychosis, hysteria, and homosexuality as a disorder were not just thrown into there randomly. Rather, it showcases the power of the DSM: labeling and categorizing ways of being as mental illness opens up new paths of incarceration, social control, and curative violence. I need people to understand that the modern DSM still works like this: these classifications of madness/mental distress/neurodivergence into psychiatric labels encourage society to treat madness/mental distress/neurodivergence with the apparatuses used to eradicate "deviance." Diagnosis is not neutral.

As mad/mentally ill/neurodivergent people, we deserve access to more explanatory models of madness/mental illness/ neurodivergence than what the psychiatric language of normalcy and disorder offers us. Whether this looks like rejecting diagnosis, embracing varying cultural understandings of mental experience, or any million different ways of interpreting our bodymind, we deserve the option to move beyond clinical language that tries to convince us not to trust ourselves. We deserve to view ourselves wholly, leaving room for all our experiences of madness/mental illness/neurodivergence--the meaningful, the terrifying, the joyful, the exhausting. We deserve to have our own relationship with our madness, instead of being pushed to view ourselves as an inherent "danger to self or others" simply by existing as crazy.

Here's another truth: I hate the DSM, and I still call myself bipolar, a diagnosis that came to me through psych incarceration. While I wholeheartedly reject the DSM and the system intertwined with it, I simultaneously acknowledge and believe that many of the collections of symptoms that the DSM describes are very, very real ways of living in the world, and that the distress that they can cause are very very real. When I say fuck the DSM, I don't mean "Mental distress, disability, and neurodivergence aren't real." Rather, I mean that the DSM can never hold my experience of what it is like to be bipolar, the meaning I derive from experiencing life with cyclical moods. The DSM can't hold within its pages what it's like to see my mood cycle not as a tragedy or disaster, but instead as an opportunity, a gift, to grow and shift and go back to the same place over and over again, dying in winter and blooming again in spring. The DSM can't hold the fact that even though I experience very, very real distress due to those mood cycles--they're still mine and I claim that as something that matters to me. I call myself bipolar as a shorthand to tell people that I experience many things both extreme high and low, but I do not mean the same thing when I say "bipolar" as a psychiatrist does.

When we build community as mad/mentally ill/neurodivergent people, I want us to have room to share, relate, and care for each other in ways that isn't calling to the authority of a fucked up system with strictly defined categories. I don't want us to take those same ways of thinking and rebrand it into advocacy that claims to fight stigma, but really just ends up reinforcing these same ideas about deviance, cure, control, and danger. I dream of the day when psychiatry doesn't loom as a threat in all of our lives, and I think part of that work requires us as mad/mentally ill/neurodivergent people to really grapple with and untangle the ways we label and make meaning of our minds.

ok to reblog, if you want to learn more about antipsychiatry/mad studies check out this reading list.