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The medical model and spelling tolerance. 
12th-Nov-2009 05:13 pm
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I first encountered the medical vs social models of disability during a training course on disability awareness about a year ago - to say it opened my eyes would be a fair assessment: I've certainly found it informing my ideas and the way I relate to many many things ever since.

There's good reading in that link, but here's how I understand it:

The medical model says that a disabled person is a person with a disability - and the disability is the problem. Barbara can't make it to the top floor because she is a paraplegic*.

The social model says that a disabled person is a person who encounters difficulties in pursuing a normal life because of the way society is structured - society is the problem. Bobby can't make it to the top floor because there isn't a working lift in the building.

Mr. Murdock can't read the case files because it hasn't been typed into Braille.

Ms. Lucas can't fully engage in this discussion because no one's interpreting for her.**

That's not to say that sometimes talking about the medical causes for the disability isn't useful - but it's primarily useful in actual medical treatment, and frankly isn't the business of society as a whole. As someone who works with the public; as someone who interacts every week with hundreds of people if not more I have never met before, as a member of society, it's not my business why a person might not be having the optimum experience they could have  - my business is how can I make this better?

That's what I took away from that day. But from then on, I kept watching myself and the way I used the medical model to dictate my world view. And what happened when I re-applied the social model.

Let's take, for instance, my long standing frustration with my own difficulties with focus, memory, organisation and anxiety. I asked for referral to an NHS psychologist and I went in with determination: I am going to get myself diagnosed with - or cleared of - Attention Deficit Disorder so I can go ahead and deal with it. Somehow I had it in my head that I couldn't proceed with my life unless I identified an illness that I could 'cure'.

In the meantime - it took 18 months between referral and my first appointment - I continued to listen to zencast and to meditate and to explore Buddhism as a path. And I had constantly this idea that it's unhelpful to define people by their medical 'conditions', rather than accepting each person as an individual and try to change my attitude to a world full of individuals. So, when my therapist asked "well, if anti-ADD tactics work on you, does it matter if you can get a specialist diagnosis or not?" - I didn't really have much to say. Part of me wanted to bring up the maybe possibility of perhaps drugs might fix it?, but the majority of my mind rejected this silent plea, because I'm generally untrusting of brain drugs, given some friends' bad experiences of them and my inclination to want to fix the cause, not tape over the symptom. I prefer behavioural strategies, and Maria was right, there absolutely was no reason not to incorporate strategies into my life to see if they worked.

And they do work***. Maybe one of these days I shall do a post about those strategies. When I remember that I'm supposed to be blogging here again. It doesn't matter if I have this 'condition' or not, what does matter is that I know my brain and know how to get it to work the way I want it to.

Similarly, I remember a discussion with my sister - also an education professional - about new research that showed that techniques used to teach dyslexic children to read can also help 'normal' children without dyslexia. When she described the technique, I laughed; it was the same phonetic ah-buh-ker (rather than ay-bee-see) technique with which I was taught to read. (It's unfair to say that's how I learned - I learned to read three years before any professional teacher tried to use 'techniques' on me). Of course techniques developed for children who have difficulty reading would make reading easier for children who don't satisfy the conditions for the 'learning difficulties' label. It's a technique that makes reading easier. QED.

What I'm trying to say, that talking about disabilities as medical 'things' is, in my experience and training, an unhelpful thing to do. And I was reminded of this fact during a conversation last week about a certain well known political figure last week and a letter he wrote.

According to the Sun, and the grieving mother they paraded out to make the point, spelling mistakes  - including the name of your subject - and low quality handwriting are unforgivable and indicative of all sorts of reasons he's clearly unfit for office - blah blah Sun's agenda blah. Meanwhile on Twitter, I was drawn into a conversation in the same way I often am - I see a point I can make and I make it regardless of whether or not I understand the context. The conversation in question was whether or not it was fair to pick on the handwriting and spelling of someone with partial sight and dyslexia. I was soon challenged to 'prove' that Brown was blind and dyslexic.

I hope I made the point and it wasn't lost - that it shouldn't matter whether he is or not. That it is polite and respectful to spell people's names right, but if I went to a national newspaper every time someone spelled it "Debbie" I'd never get any work done - but more importantly, that the reason "you can't pick on me, I'm dyslexic!" card is old and tired because picking on spelling is old and tired. Demanding that Brown produce proof of blindness and/or a learning difficulty like some sort of note from his mother is pathetic. and plays to the medical model.

I have nothing but sympathy for bereaved mothers and I understand that people lash out when grieving, but I'd like to see more people talk about why on Earth people are still out there, and a little less bitching about whether or not spelling is a required skill for leadership.


*while it is possible to use the medical model without turning verbs that describe people into nouns that define them, such linguistic travesties are a sure sign that you're doing so. Please see also "gays" as opposed to "gay people", "female" instead of "woman" and "blacks", "Asians" and similar. Remember how close these words get to bigoted slurs.

**the same very educational day introduced to me to the concept that people who sign often don't consider themselves as disabled, so much as a linguistic minority; sign languages are not just a way of communicating in English/spoken language of your choice, but separate languages, and the disabling barrier is often not a matter of hearing impairment, but the same linguistic issues I might (and have) encounter in, say, Japan.

***when I remember to stick to them. This may or may not be a symptom of the same thing I'm trying to counter with them.
Opinions 
12th-Nov-2009 06:05 pm (UTC)
I'm glad to know this since I don't think I've seen it spelled out this way before and as someone who hopes to work in a place that's about making knowledge accessible, its a good reminder.

I think part of the reliance on the medical part is due to the great importance that doctors have been given in our society.

So that can make it hard to say, well there's another way to do that which might open more doors as opposed to putting specific labels on people.

I'll be curious to see what other things you think about and come across and I'm on Twitter too now. I don't use it very much but my name there is the same as this one.
12th-Nov-2009 09:21 pm (UTC)
I very much agree with you. And kudos to you for realising that sign languages are actual languages and not imitations of spoken lanaguages. I learn BSL and every time someone new finds out I get the same ignorant questions, over and over.
Still, I guess by repeating myself over and over more and more people are learning....
12th-Nov-2009 10:22 pm (UTC)
Well, as you're learning I'm assuming it's as an additional language, so rather you educate these people than leave it up to the Sign language users add more to the burden that they have to educate.
13th-Nov-2009 08:39 am (UTC)
yep it is a second language. it's pretty fun too.
13th-Nov-2009 12:38 am (UTC)
Interesting article; I'd never quite seen the differences in modes of thinking spelled out so clearly, though I'd gotten the general ideas from individual lj posts by ljers with various impairments. (And like you I also wanted an ADD diagnosis so I could get medication and academic accommodation if necessary, but, meh. I never did bother to get it, & coping strategies work if I use them, so.)

Randomly, I've always sort of wanted to learn ASL because it was an entirely different language with totally different rules than the other 5 languages I've studied.
13th-Nov-2009 01:22 am (UTC)
Interesting post, I totally agree with you. Reminds me of something my supervisor at work once quipped - "Everyone has special needs."

I don't recall the exact context of the statement, but she has a son with a few learning difficulties of some variety so she's quite familiar with the term "special needs" and its use in regards to schooling children. But her point is that we all have some or other kind of issue - obvious or not - that can make certain aspects of life more difficult than it typically is for other people. Hell, I know I have several mental "issues" that would probable file me under any number of mental illness diagnoses (though I never personally felt much need to seek out an official label for them).

Honestly? I think society as a whole could do with being a little more compassionate. The tyrannical idea that seems so prevalent (especially in the pull-yourself-up-by-the-bootstraps American culture I live in) that anything "weak" has no right to live in the first place is pretty nasty. And while most people aren't going to couch it in such blunt terms, that's really what it is - the notion that if you can't do something yourself, without any help, you don't deserve it in the first place, and God forbid you impose on anyone else to lend a hand. If you can't get to the top floor, you shouldn't be on the top floor, etc.

How many people had to pass before the Samaritan pulled his neighbor out of the ditch? Sad world, really.


13th-Nov-2009 01:49 am (UTC)
I'd vaguely come across the two concepts before but you spelled it out very clearly, thanks.

I have nothing but sympathy for bereaved mothers and I understand that people lash out when grieving, but I'd like to see more people talk about why on Earth people are still out there, and a little less bitching about whether or not spelling is a required skill for leadership.

Exactly how I felt. That is not what we need to be thinking about.

(I was going to ask if you were watching Spn this season, but I guess you answered my question in the examples.)
13th-Nov-2009 09:28 am (UTC)
Well, duh.

I have a post half written about how the whole season is DC Comics' Battle for the Cowl, but I'm taking time sorting out the illustrations.
13th-Nov-2009 10:02 am (UTC) - Flying high
User silveronthetree referenced to your post from Flying high saying: [...] Do you have any favourite pre-1960 movies that you would recommend? An informative post on the medical vs social models of disability by . I never really wished I was a fan of Stargate Atlantis until I saw these icons by . Amazing ... [...]
13th-Nov-2009 11:57 am (UTC)
I work for an information and advice service for people with learning disabilities, and we kind of have to have a foot in both the medical and social camps. A large part of the work we do is helping people to claim the benefits they're entitled to, and the system requires medical proof of their disabilities.

So, on the one hand we're saying these people are no different from the rest of us and have a right to the same quality of life, and then we have to catalogue all the ways they're medically "impaired."

And I myself have terrible handwriting, and I can't claim dyslexia or visual impairment as an excuse. I'm just a sloppy writer! But I don't think that necessarily makes me a bad person.
13th-Nov-2009 12:43 pm (UTC)
I think it's a trade off between using the social model to relate to people and fit them into the world, and acknowledging that The Man uses the medical model to record and register when people need assistance. I think this is the occasions when a medical approach is justified - because you need to identify impairments in order to identify and compensate for needs.
13th-Nov-2009 02:10 pm (UTC)
It can become quite difficult if the tribunal who have to make the ruling aren't very sympathetic, and the claimant then has to go the extra distance to prove that they need special assistance. Then it becomes necessary to throw a stark spotlight onto their disability, which seems very unfortunate.
15th-Nov-2009 07:00 pm (UTC)
Thanks for posting this. It makes lots of sense, and - well, it made me think. Ta.
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