This post follows on from my earlier review.
Disability is sometimes characterised as a social construction, nothing other than a negative, discriminatory, label placed on individuals by a powerful and oppressive society. This idea started in the s late 1980s, when there was a shift from understanding disability as something residing in the individual, to viewing it as imposed by a society that does not accommodate their needs. A person is only disabled because of society’s expectations that people are generally able bodied.
This was the era in which the ‘Social Model of Disability’, drawing on the above, replaced the ‘Medical Model of Disability’. With the former always being ‘good’ and the latter’ bad’.
I’ve seen the widespread influence of the Social Model of Disability across social work and similar disciplines. Textbooks are full of it. It also extends to the understanding and treatment of mental illness. I taught an undergraduate module – I had no part in writing it – which was squeamish about using the word ‘illness’, preferring the words ‘distress’ or ‘suffering’ when discussing mental illness. It was clear that authors of the course material disliked the apparatus of psychiatry. Mental ‘distress’ was frequently attributed to poverty, social exclusion, and discrimination. Self help groups were prioritized over clinical diagnosis and treatment. The word ‘distress’ was somehow nicer than ‘illness’.*
ver time, the influence of the Social Model of Disability has led to a critique and rejection of something called ‘medicalisation’, and the model has been expanded to encompass most aspects of postmodernism, especially the rejection of science and evidence based research. Eg ‘Disability is normatively understood through the gaze of medicalisation… where life becomes processed through the reductive use of medical discourse’ ** and ‘disability, like racism or sexism, is discrimination and social oppression’ ***
Hence the idea fo diagnosing, treating, and curing disabilities is rejected, as these processes are dependent on ableist assumptions and are symptoms of high status people (medics) abusing their power. This is the applied postmodern knowledge principle – doctors are no more qualified to diagnose than anyone else. Concomitantly, the theory encourages people to self -diagnose. Some theorists encourage disabled people to subvert social norms and not internalise ableism (false consciousness). Pluckrose and Lindsay deem all this unethical, and I agree.
As the authors point out, disability is being theorized out of existence. Perhaps it is everywhere and nowhere, like racism.
However, they argue that ‘physical and mental impairments are objectively real’, they cannot be wished away by changing the language, or by claiming that all doctors are power-hungry. But the Social Model has been hugely influential. Never mind that the binary division into social and medical is a fiction, in practice.
I’ve seen Social Model practitioners criticise parents who worry about the wellbeing of their learning-disabled son or daughter, describing such realistic fears as patronising and discriminatory, reflecting a medicalising, and excluding, process. This is cynical and destructive: it demeans the parents, pushes the client towards an idealised independence, and encourages hostility towards the medical profession. Certainly ‘harmful’ as the book’s title suggests.
And Social Model enthusiasts forget that if you don’t have a ‘label’, a name to call your condition, then you won’t get access to services. But according to the theory, you probably shouldn’t need any.
* the module’s authors had little time for classifications of mental disorders such as those in the DSM- 1V or the ICD – 10 – such classifications being rejected by postmodernism
** Dan Godley 2014, cited in Pluckrose and Lindsay
***Michael Oliver et al, 2012, cited in Pluckrose and Lindsay
This is a guest post by Muncii92