Preamble
Technically speaking, I believe all posts, blogs, articles, and books, addressing the lives of people seen or denied the right to be seen as “disabled” ought to provide contexts for their usage of related words and meanings. We remain trapped in a nonconsensual field of discourse where almost every word employed is contested, afforded differing meanings, or produce contradictions. In this piece, I use words that are socially constructed to convey dominant thinking, while also employing the same words to express alternative views. This is framed within the context of identifying the nature and location of both impairment and disability. (1)
Introduction
Many more people are coming to accept the notion of intersectionality in terms of how different forms of oppression or discrimination can come together to create specific encounters.
The meaning attached to ‘intersectional’ I use is: “involving two or more social categories.” Thus intersectionality is referred to as “the complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups.” (2)
It is common however to see intersectionality referred to as relating to “an analytical framework for understanding how aspects of a person’s social and political identities combine to create different modes of discrimination and privilege.” (3) Personally, I don’t subscribe to this latter description because it is often abused through reductionist and idealist positions. An example being that ‘ability’ is viewed in and of itself as positive/negative power relations. As a consequence of this ‘logic’; “the ability to walk” becomes determined as a privilege over those who “lack the ability to walk”. I hold the view this shares common ground with the ‘individual tragedy model of disability’. (4)
What is this thing called “ability” anyway? There are two distinct meanings attached to the word, however, there is a tendency to ideologically conflate them in particular contexts. Ability means:
1. possession of the means or skill to do something
2. talent, skill, or proficiency in a particular area (5)
This has led to the binary division of ability/disability. The core ideological purchase of this way of thinking establishes what is the excepted/accepted body in terms of bodily functioning. Hence the less a body functions with ‘normal ability’ (sic), more disabled it can be judged to be.
Historically, this has led to the social construction of ‘disability’ as the absence of ‘normality’ determined by the medicalisation of the body. It has been until the 1990s the primarily way capitalist societies have determined social worth.
Maria Barile in 2003 wrote:
“The task is made more difficult given that historically, society has formulated, accepted and constructed its beliefs around the notion that the problem belongs in the pathology of the individual. Financial concerns and the strong paternalistic views of society’s decision-makers play key roles in the construction of institutions which are popularly seen as the best alternative for individuals with disabilities and for society as a whole. This view is maintained and reinforced by the various classifications of disease, impairment, disability, handicap, function, and health, because these reinforce or allude to the idea that the problem is rooted in the individual.” (6)
If this outlines the dominant location of disability as being within an individual’s body and the direct cause of their socio-economic disadvantages, what has happened to the alternative way of seeing disability as located in imposed social restrictions? According to the World Health Organisation they’ve incorporated the best bits into their International Classification of Functioning, but I refute that claim and what follows explains why I do.
Disability as social oppression: the positioning of impairment
In a comment I made on a Penny Pepper Facebook post, I raised a problem with the social interpretation of disability. While it correctly rejected the dominant view that it is impairment reality that is responsible for an individual’s encountered marginalisation or exclusion; it inadequately addressed the relationship between impairment and disability. By just stating we should simply accept impairment reality has, in my opinion, led to an unhealthy situation where all impairment issues are considered personal unless they are placed in the context of being subjected to social restrictions, discrimination and oppression. I also share the view held by Paul Abberley, that discrimination and oppression are not one and the same. They intersect with one another, however, our oppression stems from the fact our bodies are a site of struggle and that there’s a dialectical relationship between how acknowledged impairment and impaired people are viewed, and how groups of people with impairments are treated oppressively. Paul argued that a social theory of oppression had to involve developing theoretical understanding around impairment. I would go further and suggest social theory needs to explore impairment and disablement as intersectional phenomena.
Call me pedantic if you wish, but I see a need to distinguish between encounters with disablement or disablism, and the experiences involved with living with impairment reality inside a capitalist society. The two are interconnected, but they are not one and the same. The former is concerned with how we are ‘disabled by society’ and requires social and political interventions. The latter I would argue, in part at least, ought to be about understanding causes for the creation of impairments and the need to destroy the ideologies that hinder our ability to appraise impairment reality in non-judgmental ways. It is roughly a year since I began a discussion along these lines on my own Facebook page. Fellow scholar activist, Steve Graby, made some useful observations and I want to refer to them within this piece.
As noted above, within dominant thinking, disablement referred to becoming impaired and experiencing functional loss. Early scholar activists adopted this view too, however, in later years Mike Oliver, Colin Barnes, Bob Findlay, among others used the word ‘disablement’ to define disability as understood within UPIAS’ social interpretation. Hence, disablement is the negative result of economic, political, and ideological influences on the structures, systems, values, culture and practice of given societies as experienced by disabled people. This way of seeing disablement therefore is not directly linked to any particular individual and their material or perceived impairment. Where they are linked, as explained in the definition, is through imposed social restrictions including how they are viewed and evaluated.
Where people tend to struggle with comprehending the social interpretation of disablement is the idea that it is not the actual impairment and its impact upon given individuals that causes their social disadvantage or oppression, but rather its societal responses to significant impairment. Paul Abberley referred to impairment as a site of struggle and while I endorse this view, I also believe the implications behind this have been inadequately addressed. This is why I‘ll introduce Graby’s observations in due course.
My starting point for this piece is: if people didn’t experience impairment reality, then they wouldn’t encounter or be subjected to disablement or disablism.
Our failure to develop a social interpretation and/or model of impairment has resulted in sections of disabled communities rejecting the social model and embracing impairment / disability integration. This implies both the impact of the impairment and social environments can be disabling. Breaking the causal link between impairment and social restrictions doesn’t deny impairment reality, but what it does is change the perceived interactions between them. While rejecting the crude reductionism found within the internal logic of the dominant approach which implies the less an individual has the ability to function like a “normal person” (sic), the more “disabled” they can judged to be, the social interpretation of disablement acknowledges that in social environments designed to cater for people without impairments, this situation is likely to disadvantage those who do.
The Disabled People’s Movement’s critique of this oppressive reductionism, and the changing needs of Capital, forced the World Health Organisation and the United Nations to modify their ideologies. The outcome was the International Classification of Functioning which did to a degree increase attention on the social barriers, but at the same time, maintained that individual functional loss provided the conditions for experiencing disadvantages as Barile outlines. The ICF assisted in the creation of bio-psycho-social models such the one the Department of Works and Pensions employ. Of course, in practical terms, these bio-psycho-social models pay scant regard to the social dimension, and still focus on evaluating functional ability.
Beyond the British social model of disability
The American Disability Movement in particular has an individualistic streak within it through the rights agenda. With no social model of impairment and a distortion of UPIAS’ break with the causal link, people began to develop a cultural understanding of “disability pride” using identity politics. This lay the roots of anti-ableism and an inward focus on impairment as “diverse being”. I will return to a discussion on ‘ableism’ later as I see it as highly problematic and risks collapsing together several linked, but nonetheless, separate issues.
Meanwhile, I want to suggest the cultural understanding of “disability pride”, paved the way for some sections of the global DPM accommodating the ICF under the desire to be included and accepted. Whilst there is often an anti-capitalist element within this approach, I would argue that its core perspective is flawed because of its tendency to maintain the meshing together the nature of impairments and social consequences arising from living with impairments within capitalist societies. In this sense they are what could be referred to as “impairment-disability distinction deniers”. There are disabled scholars who therefore argue that “impairment was disability all along”. (7)
I’ve outlined these divisions inside disabled communities because I believe neither the old DPM nor identity or cultural approaches satisfactorily address impairment related issues beyond opposing discrimination or oppression. The notion of “disability pride” has conflicting and contradictory arguments. I can only allude to these arguments in this piece. A central feature of both identity or cultural approaches and bio-psycho-social models is that they view ‘disabilities’ as an umbrella catch all.
Disabilities as an umbrella catch all
The definition of ‘disabilities’ within the ICF collapses together individual and social issues:
“A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions).”
The emphasis remains on the nature and degree of impairment as the ‘reason’ it is “more difficult for the person with the condition to do certain activities”. There are, of course, more than one way to view interaction between functional capacity and social contexts. To say, “I am proud to be who and what I am” is fine, but what does it mean? It could mean: “I am proud to be Bob who happens to be a cabbage.” On the other hand, it could be understood as saying, “I am proud to be Bob who happened to have been subjected to brain damage which caused cerebral palsy.”
My problem with certain approaches to ‘disability pride’ is that it merely reverses dominant thinking – hence, if you say ‘disability’ is bad, tragic, inferior, etc.; we will claim that it is natural, positive, an example of diversity, etc. I see a need to reject both sides of this view of ‘disability’ because they impose values and assumptions on how we do or should view three ‘relationally’ connected things which are, in my opinion, nonetheless separate phenomena.
Last year, I wrote a post which challenged an unnamed American disabled writer/activist who was arguing that we need to “normalize Disability as being a part of the human condition”. I believe few, if any, ‘impairments’ are in any way “natural” or solely biologically determined. Steve Graby, who is also critical of this type of argument, wrote:
“This of course betrays a lack of understanding of the distinction made in the social model between disability and impairment – though this gets complicated by the fact that this distinction generally isn’t made by American writers/theorists, even those who do have a materialist/social model/disability-as-oppression analysis (e.g. Marta Russell or Nirmala Erevelles).”
Steve went on to point out that this tendency that begun in the States has a bridgehead in the UK:
“However there are now also quite a few theorists and activists in the UK who don’t make a disability/impairment distinction, or don’t see that distinction as meaningful, and thus end up wanting to reframe the word “disability” to mean something positive and desirable, which to me makes no linguistic sense, even if I think it is rooted in good anti-normalisation impulses.”
I agree with this view because it makes no linguistic sense to attempt to transform a word that means ‘WITHOUT ability’ into a positive. Acknowledging and accepting impairment reality can’t be achieved through the use of a judgemental and oppressive word such as ‘disability’ when applied to individual characteristics. As stated in the preamble, nearly all terminology is problematic. Again, I concur with Steve’s observation:
“Sometimes I feel like the word ‘impairment’ is a stumbling block here, and that it would be better if we had a less negatively-loaded word for describing all the divergences that capitalist society responds to with disablement. American disability theorists (and those over here who follow their lead) seem to have taken ‘disability’ to use there. I don’t understand why they want to do that, but part of me feels that we won’t have a good argument for restricting the word ‘disability’ to describing what capitalist society does to us until we have a better word for the meaning that they are using ‘disability’ for.”
There’s perhaps a nuanced difference between my take and Steve’s on the problem with the word ‘impairment’. I questioned in the early stages of UPIAS’ development their acceptance of ‘impairment’ as it implies ‘flaw’. I now see a distinction between the oppressive ideological social construction – applied as a negatively-loaded word for deviation from the expected ‘norm’ – and the material existence of a divergent bodily form. This, of course, is often complicated by the way specific impairments are created/exist and then viewed. I have considered this terrain as being where a social interpretation of impairment could play a progressive and liberating role.
To conclude this section of my argument, I believe disabled people have been hindered in their ability to address living with divergent bodily forms within capitalist societies by the way the notion of ‘disabilities as an umbrella catch all’ as been employed and the undermining of the social interpretation of disability by the “impairment-disability distinction deniers”. At no time has the social interpretation of disability denied impairment reality, what it challenged was how the relational interactions that do or are assumed to exist between people with impairments and their social environments were addressed. Unfortunately, in my opinion, only one side of these interactions were politicalised by the majority of disabled people and the minority who did try, ended up as sharing ground with the “impairment-disability distinction deniers” because they sought to conflate what should be within a social interpretation of impairment into the social model of disability. (8)
Impairment effects and impairment reality
Carol Thomas believes in her work that it is possible to aid our understanding of the relationship between impairment and disablism by introducing the notion of “impairment effects” which she defines as:
“…. the direct and unavoidable impacts that ‘impairments’ (physical, sensory, intellectual, emotional) have on individuals’ embodied functioning in the social world. Impairments and impairment effects are always bio-social and culturally constructed in character, and may occur at any stage in the life course.” (9)
She argues that through employing the idea of impairment effects it is possible to discuss and acknowledge that:
“…. impairments can and do have a direct or immediate impact on daily life – but without undermining their prioritisation of the importance and centrality of disablism in everyday experience.” (10)
I want to focus on Thomas’ usage of impairment effects as opposed to my understanding of impairment reality. This is more than a pedantic exercise because it centres upon the issue of whether or not individual experience of living with an impairment can be served by talking about impairment effects and then giving consideration to how the concept might impact on disability politics. It has been already noted that UPIAS acknowledged the more significant a person’s impairment is experienced in terms of functioning, the less likely the encountered unaltered social environments are going to cater for their needs or lifestyle. Thomas attempts to address this issue by saying:
“My own view is that in any social setting, impairment effects and disablism are thoroughly intermeshed with social conditions that bring them both into being and give them meaning.” (11)
There are a number of issues that need to be unpacked in relation to her views. This includes recognising the risk of trying to square the circle. Talking about people or a person ‘with impairments’ can often obscure many issues owing to the myriad of meanings attached to the word. There are various other conflations involved as well. Firstly, impairment is commonly used to signify that a body has been affected by “an injury, illness, or congenital condition that causes or is likely to cause a loss or difference of physiological or psychological function.” (12)
However, this is not only contested in some quarters, the meaning above is also overlaid by socially constructed meanings. Speaking of ‘abnormality’ or ‘defect’ is common. The dominant approach towards disability as we have seen views the nature and impact of the impairment as determining whether or not it creates ‘disability’. So, returning to Thomas’ ideas there are a number of issues that need to be addressed. It should be noted that she says:
“I do not treat ‘impairment’ as a self-evident given or as an unproblematized referent to ‘the body’ or ‘the biological’. However, this does not mean that impairments are treated only as social constructs, as linguistic categories of meaning which bear no relationship to ‘real’ body-related variations.” (13)
She does view them as the body-related variations marked out as “socially, or more precisely medically, defined ‘significant deviations from the normal type’ or ‘abnormalities’” within Western culture. Is this different from what UPIAS or Oliver state? I ask this question because Thomas asserts that Abberley’s work “exposes the biological reductionism in social modellists treatments of impairments” on the grounds that by and large they are social phenomena due to being socially produced. (14) Given how impairments are appraised and assessed within dominant discourses and practice, is it possible or indeed safe to generalise the impact of specific impairments upon individuals or specific groups? There are, of course, common traits that can be identified as a result of particular injuries, illnesses, or congenital conditions, for example, the absence of limbs, sight, hearing, and in specific circumstances other loss of functioning. These traits can lead to observable examples of ‘impairment reality’, but the consequences of the impact of an impairment on a day-to-day basis are not always obvious or knowable without specific contexts. I am not just talking about fluctuating conditions here.
Considering Thomas’ notion of impairment effects, I am left wondering what can be employed to determine what constitutes “the direct and unavoidable” impact of an impairment? This in turn raises questions in relation to what “effects” mean? An effect is “a change which is a result or consequence of an action or other cause”. (15) How do we seek to measure the impact or effects of an impairment? Thomas’ opinion that “impairment effects and disablism are thoroughly intermeshed with social conditions” risks aligning with Shakespeare and Watson’s assertion that they cannot be separated. (16) I would take issue with Thomas’ view that “in any social setting, impairment effects and disablism are thoroughly intermeshed with social conditions that bring them both into being and give them meaning”, because I do not accept all social conditions are disabling all of the while. This is not to deny that disablism can strike at any moment during social interactions.
There is a need to be clear with regards to the different meanings and usage of “impact” and “effects” within the context of personal experience of impairment. The word “impact” is seen as being the influence of an action/phenomenon on something or someone, and “effect” being the consequence or outcome of an action or a phenomenon. Within dominant bio-medical discourses “effect” and “impact” are often intertwined as we have witnessed within both the ICIDH and the ICF’s approaches. What is troubling about the notion of “impairment effects” is the uncertainty that surrounds it. If we recall, Thomas states that impairment effects are “the direct and unavoidable impacts that ‘impairments’ (physical, sensory, intellectual, emotional) have on individuals’ embodied functioning in the social world”. This suggests the nature of an individual’s functionality is ‘knowable’, which I believe is not always the case because, as Thomas herself notes, impairment effects “may become the medium of disability in social relational contexts.” (17) It is the fact effect means ‘outcome’ that causes me to question the concept because it elicits a ‘reading’ of how the impairment is experienced. There is a danger that, despite applying a relational methodology, using ‘impairment effects’ opens it up to being overlaid with common sense evaluations of what the concept means.
It is not my intention to dismiss altogether the consequences of having an impairment because I acknowledge as already stated that in particular contexts the interaction between individuals and their social environments determines if the encounter is disabling or not. How, when, and where we explore these is an important consideration. I wish to forward the argument that both the social interpretation and model of disability sits better with acknowledging “impairment reality” in preference to “impairment effects”
Why do I advocate talking about “impairment reality”? A straightforward definition of reality is that it is “the sum or aggregate of all that is real or existent, as opposed to that which is only imaginary.” Within the context of “impairment reality” I am limiting the term to mean an understanding of the acknowledged physical and/or mental consequences of inhabiting an atypical body. When I speak of “impairment reality” I am therefore referring only to undisputable facts whether known to the individual with the impairment or which can be clearly identified externally by others without conjecture.
In a personal capacity, I can state that my impairment, named as Cerebral Palsy, is a disorder that affects my movement, muscle tone, balance, speech and posture. This said, I would question anyone’s ability to determine the impairment’s ‘effects’ in these specific areas on a day-to-day basis because in the majority of circumstances, the personal tasks I can perform are not solely determined by the impairment alone in terms of functionality. The reality is that the impairment influences my body, but in turn, it is also influenced by the same body and the social environment that my body occupies at a given moment in time. If we single out one functional impairment reality, that is the issue of dexterity, it can be established that many with cerebral palsy have limited fine motor skills. However, the implications in terms of performance at a specific moment in time for an individual with CP can be unknown because the success or failure is dependent upon many factors. Even where outcomes are repeated, there may be different ones reached as a slight change in circumstances. Rather than talk about the CP’s effects on an individual’s dexterity, which can be questioned, the dialogue should be concerned with the fact that for some with CP, the reality is that tasks requiring fine motor skills can prove difficult. It becomes understood as a ‘relational’ issue.
In the example just given I would challenge the wisdom of speaking in terms of the “impairment effects” of a person’s cerebral palsy because I believe it is impossible to ‘isolate’ what that might be beyond the generalised description given or understanding of the complexities involved in an individual’s experience of living in a disabling society. Just to be absolutely clear, I see this as different from what Thomas refers to as ‘intermeshing’. The example I gave of impairment reality related to a person with an obvious physical impairment, therefore aspects of their situation can be externally read; however, it is not possible to “know” what impairment reality means for every individual as both objective and subjective factors can be brought into consideration.
Centring upon individual experience of living with an impairment is therefore problematic. Thomas presents the example of not being able to hold a spoon or pan in her left hand. She says this:
“….if, for example, people in positions of power decide because I cannot perform such actions then I am unfit to be a paid care worker, or a parent, and therefore denied employment, or the privilege of becoming a mother. In this case, the disability resides in the denial of rights, or the refusal to assist me in overcoming functional limitations ….which would compensate for not doing things ‘normally’. ” (18)
Thomas here distinguishes between ‘the personal’ (bodily) as opposed to ‘the social’ (interaction) in this example with ‘impairment effects’ referring to “restrictions of activity which are associated with being impaired but not disabilities in a relational sense.” (19) Whereas Thomas would refer to not being able to hold a pan as “impairment effects”, I believe it is more assertive to refer to this as “impairment reality” because it demands respect over having to ‘explain’ or ‘justify’ the role of the “impairment”; this after all, is the methodology and politics behind UPIAS’ definitions. This assertive approach would also challenge the disablist values of ‘people in positions of power’. The design of objects often do have a disabling effect upon functioning ability in terms of dexterity, bodily movement, emotional response etc. This change of focus was the basis for breaking the causal link where the impairment was identified ‘as the problem’ for an individual and the social context being largely ignored. Some people may argue Thomas and I are largely saying the same thing, but using different terms to describe things. In my opinion, there are differences and similarities in our approaches.
Recognising the social relational approach does open up the potential of identifying differences between UPIAS’ social interpretation and Oliver’s social model, but too much can be made of these differences. Neither seeks to explore ‘personal experience’ of impairment management or individual encounters with disablism, but rather the imposition of social restrictions ‘out there’ in a society which create barriers to social integration. UPIAS’ focus was on deinstitutionalisation and integration into work and communities, whereas initially Oliver’s model was an interventionist tool to assist professionals and disabled people to identify disabling barriers ‘out there’ as the first stage in transforming policies and practices. It is not clear in Oliver’s work how to employ the social model, but I want to suggest the ways oppression differentially impacts on different groups of people requires adopting a social relational approach which explores how different groups among people with impairments interact or fail to interact within particular social environments.
Policies, procedures, and practices are developed at macro and micro levels of society; therefore understanding the myriad of ‘interactions’ that existed prior to and after implementation is far from straight forward or uniform in nature. Some degree of understanding with regards to the contours around impairment reality need to be part of the equation. At a micro level of society, for example, in terms of service delivery the twelve pillars of independent living can be employed as a means of exploring the lifestyles of given individuals with differing impairment realities and can also use a social relational approach. (20) This however is different from trying to engage with personal experience of encountering disabling barriers in order to formulate policies, procedures, and practices.
Outlined here is both the UPIAS’ approach which sees impairment reality ignored or oppressively addressed within mainstream society and Oliver’s social model which seeks to address how this is manifested within the social organisation of society. I believe the social interpretation of disability remains valid, however, in terms of Oliver’s social model, I hold the view that its original historical materialist methodology has been lost. There’s no need to reclaim or improve Oliver’s social model, what is required is a clearer description of its methodology in terms of applying it within this present moment in time. If Mike was around I would seek to suggest that a radical eco-social approach was needed alongside the development of a social interpretation and model of impairment. What would adding an ecological dimension to applying the social model of disability mean in reality?
At the moment the idea of a radical eco-social approach is unfamiliar to most people, but in essence it is simply recognising the need for us to build coordinated, sustainable communities which are inclusive and engaging.
Central to this way of thinking is to have an understanding that Earth is a holistic entity made up of interconnections between living organisms within a much larger system. Drawing from several eco-social models, I hold the view we can identify some of the characteristics conducive to the transformative changes we are seeking as disabled people; including:
• Adopting a holistic worldview which perceives every aspect of life as interconnected within a much larger system, as reflected in Indigenous perspectives.
• Fostering inclusive practice and coproduction, which reflects an appreciation for cultural diversity within contributions made to community living.
• Adopting fundamental ecological values within the development of community-based services, which requires challenging dominant ideologies that accept growth as an unquestionable goal rather than looking at sustainability and de-growth.
• Reconceptualising an understanding of well-being to embrace holistic, environmental, and relational attributes. It can’t just be about individual wellbeing. Consideration about personal, individual, collective, community and political dimensions of wellbeing need to be considered within planning, developing, and delivering service.
• Acknowledging ‘supported living’ requires a holistic approach capable of identifying ways of addressing restrictions to participation within communities and wider society. (21)
I would argue however that to achieve these transformative changes, we still need to address the positioning of impairment in relation to disability from a materialist and not an idealist perspective.
What would a social theory and/or model of impairment look like?
A number of scholar activists, for example, Paul Abberley, Mike Oliver, Karen Soldatic, Ellen Clifford, and myself, have spoken of a social theory or model of impairment, but as far as I know there hasn’t been a description of what this might look like. It is also unclear as to whether or not there would be an agreed agenda or perspective between the four of us. Paul Abberley was the first scholar activist to acknowledge a distinction between the nature of oppression experienced by disabled people and other forms of oppression. He wrote:
“….if the inferiority embodied in impairment is understood as purely or primarily biological in origin, the suggested analogy with racial and sexual oppression appears to be an inherently dubious one, since the core of such theories is that disadvantage is ultimately a social and not a biological product. A theory of disability as oppression then must offer what is essentially a social theory of impairment.” (22)
An early response from Oliver in his book, The Politics of Disablement, simply stated:
“While, from an epistemological point of view this may be the case, for present purposes it is a social theory of disability as social restriction that is being considered. However, it is possible to show that both impairment and disability are produced in similar ways.” (23)
In Oliver’s first sentence he refers an epistemological point of view [which relates “to the theory of knowledge, especially with regard to its methods, validity, and scope, and the distinction between justified belief and opinion”], but then I believe he implies this has little to do with developing a social theory of disability as social restriction. (24) Whether or not Oliver is correct in making such an assertion is difficult to determine because there are a number of issues which hinder our ability to judge.
First, we have the question of language and meaning. Abberley, for example, speaks of ‘[a] theory of disability as oppression then must offer what is essentially a social theory of impairment’, whereas Oliver speaks in terms of ‘a social theory of disability as social restriction’; in my opinion they’re not one and the same. I believe Abberley and Oliver hold differing views on what they mean by ‘disability’ and ‘oppression’. I forward this view on the basis that Abberley writes:
“In summary, to usefully apply the notion of oppression to the complex of impairment, disability and handicap involves the development of a theory which connects together the common features of economic, social and psychological disadvantage with an understanding of the material basis of these disadvantages and the ideologies which propagate and reproduce them.” (25)
Paul in his paper still speak of the triad definition of disability as found in the work of OPCS, therefore, it is difficult to unpack aspects of his argument. (26) My broad interpretation of his argument is that in order to uncover the roots of disabled people’s oppression, one has to explore how impairments become into being, what creates and maintains their existence, and the ideological and material consequences that flow from praxis associated with how society addresses impairment. Without this ‘social theory of impairment’, it is difficult to challenge the ideological and material underpinning of disabled people’s exclusion from or marginalisation within mainstream social activity. I will return to this interpretation shortly, however, in the meantime I wish to focus on Oliver’s assertion.
If I’m right in believing he implies that a theory of disability as oppression [which is ‘essentially a social theory of impairment’] has little to with developing a social theory of disability as social restriction, then I would have to disagree with this line of argument. I disagree precisely because he states in the second sentence that it’s possible to show that both impairment and disability are produced in similar ways.
I would suggest the creation or production of impairment is intrinsic to any historical materialist social theory of disability. This is different from saying an individual’s impairment is directly responsible for their social disadvantage. Oliver was criticised for saying ‘impairment had nothing to do with disablement’; I believe what he wrote was a clumsy formation because, on the one hand, it is a correct statement regarding the breaking the causal link between impairment and (imposed) social restriction; however, on the other hand, it was a false statement within the context of a theory of disability as oppression. I maintain the opinion, as I believe Carol Thomas did, that there are methodological differences between Vic Finkelstein, Mike Oliver and Paul Abberley. (27)
Now is not the time or place to discuss these differences. Instead, I want to suggest that a theory of disability as oppression must inform a rounded historical materialist theory of disability of disablement. To develop theory along these lines a number of operations need to be brought into play. My starting point is to acknowledge that Abberley offers both a logic and framework for taking this forward when he writes:
“A theory of disability as oppression, then,
(1) recognises and, in the present context, emphasises the social origins of impairment;
(2) recognises and opposes the social, financial, environmental and psychological disadvantages inflicted on impaired people;
(3) sees both (1) and (2) as historical products, not as the results of nature, human or otherwise;
(4) asserts the value of disabled modes of living, [whilst] at the same time as it condemns the social production of impairment;
(5) is inevitably a political perspective, in that it involves the defence and transformation, both material and ideological, of state health and welfare provision as an essential condition of transforming the lives of the vast majority of disabled people.
While the political implications of such an analysis are apparent, the conceptual consequences are also profound, since such a notion of disability as oppression allows us to organise together into a coherent conceptual whole heretofor isolated and disparate area of social research, and potentially to correct the results of such theoretical myopia.” (28)
I believe these five points legitimise the view that impairment as a material presence as well as an ideological construction is the basis upon which disabled people’s oppression is built. It is impossible therefore to understand and address disablement without taking this on board. Among operations needing to be brought into play is the development of a social model of impairment. This would seek to explore the social origins of impairment and the geopolitical dynamics Soldatic and others see as vital to enriching social justice.
Developing a social model of impairment along these lines would also open up an exploration of the implications of living with impairments within capitalist societies, alongside critically evaluating the social production of impairment. Some disabled people mistakenly believe this is a form of eugenics as it involves exploring how to avoid creating social produced impairments, but this fails to understand the nature of what is being proposed. The focus is not on eradicating impairments, and therefore people with impairments, but rather on the oppressive social conditions which produce impairments. No one I hope would promote war or not wearing seat belts as these can result in creating impairments. Crucial here is the difference between adopting attitudes and action towards the social production of impairment, and adopting attitudes and action towards valuing and respecting the lives and lifestyles of people with impairments.
I view this aspect of developing a social model of impairment as contributing to the creation of an eco-social approach to addressing disablement. Increasingly, activists are acknowledging the interconnectedness of natural and social environments; the centrality of sustainability, and the need for coproduction. All these things make me question Oliver’s own understanding of the positioning of impairment in relation to disability or disablement. In the particular context of addressing social restrictions in terms of policy and practice, he writes:
“Using the generic term [disabled people] does not mean that I do not recognise differences in experience within the group but that in exploring this we should start from the ways oppression differentially impacts on different groups of people rather than with differences in experience among individuals with different impairments.” (29)
Whilst agreeing with this methodological approach, I want to highlight this key statement: ‘we should start from the ways oppression differentially impacts on different groups of people’.
This raises once again the problematised area of language and meaning because I believe Oliver, Barnes and Finkelstein view oppression as turning upon “the oppressive relationship between people with impairments and the rest of society”. While not disagreeing with this view in general terms, I do have a problem with how Oliver and Barnes articulate their take on the ‘oppressive relationship’. They wrote in 2012:
“The social model therefore shifts attention to disabled people’s common experiences of oppression and exclusion and those areas that might be changed by collective political action and social change.” (30)
I believe in their work it isn’t always clear what they identify as being common experiences of oppression and exclusion, especially within the context of starting from ‘the ways oppression differentially impacts on different groups of people’. I accept the social model can be used to explore and seek to address aspects of collective experiences of oppression, but I question at the same time its capacity to address all aspects of the oppressive relationship that exists. As stated earlier, Oliver designed the social model for a particular purpose. Many disabled people have viewed ‘the social model’ has being or ought to be the all singing and all dancing explanation of all things to do with disabled people’s lived experience. It isn’t and was never intended to be used in this way.
The failure or deliberate act of not wishing to understand, acknowledge or support the politics behind the social interpretation and social model led to calls for the model to be ‘rectified’. Vic Finkelstein rounded upon those who sought to transform it into what he called a ‘potpourri’ model of disability. He wrote:
“By the year 2000 the ‘rectifiers’ were secure enough to state: ‘We need to produce an updated social model of disability that; includes a positive statement about us; recognises our diversity and difference; recognises institutionalised discrimination; talks about choice; recognises that not all the things that exclude us are about society’s barriers; and talks about barriers (attitudes and access).’” (31)
While I fully agree with Finkelstein’s criticism, I believe it’s necessary to not to place all the ‘rectifiers’ in the same basket. The inadequate way the DPM addressed impairment reality in relation to disablement contributed to the confusion that exists. This became a significant issue in the 1990s when disabled feminist scholars questioned the absence of ‘the personal as political’ within the social model. I believe the muddled debate contributes to my argument that there is a need for a clearer distinction between the emancipation struggle where a central demand is for social acceptance and engagement, including acknowledgement of impairment reality, and the struggles on a day-to-day basis of living with an impairment in a disablist society. The development of a social model of impairment would assist in positioning impairment reality in relation to disablement because, as already stated, it would explore how impairment is a social product, the psycho-emotional consequences of disablism, and creating non-medicalised space for exploring impairment management. Without developing a better grasp of these issues, we surrender ground to those who mistakenly adopt an individualistic approach or conflate issues. I view this as a weakness within Feminist critiques of the positioning of impairment.
The issue of ‘the personal’ within Feminist critiques of the positioning of impairment
I am conscious of the fact that as a disabled male scholar activist, I am directly implicated in this debate therefore cannot claim any neutrality. What I have sought to do is highlight differences in approach and question aspects of the arguments put forward. There are a number of tensions at play within Feminist critiques of the positioning of impairment; there is the question of the personal experience of impairment reality itself, the relationship between impairment reality and disablism, as well the question of viewing ‘the personal is political’. The latter is seen as part of the broader aim amongst feminists to break down the traditional dichotomy between the public sphere and the private sphere. This is based on the understanding that gender expectations can both reflect and reinforce the power imbalance between men and women. Feminists argue that by demanding the private sphere should warrant the same degree of attention as other more conventional considerations, conditions can be created whereby females can escape the stifling confines of behaviour which are expected of them. This issue of public sphere and the private sphere is viewed as problematic in terms of Oliver’s explanations of his social model and Finkelstein’s criticism within the ‘inside out’ and ‘outside in’ debate. A key issue turns on what is the objective of disability politics and the importance of creating the conditions for social change. Finkelstein wrote:
“….we had engaged in a vigorous debate to take control over the way ‘disability’ was interpreted and understood. This involved encouraging disabled people (more so than ‘the public’ or professionals) to focus our attention on changing the disabling barriers ‘outside there’ rather than focusing our attention on the attitudes and emotions we held ‘inside ourselves’ about our experiences of discrimination.” (32)
This relates back to the intersectional issues surrounding differing forms of oppression and whether or not these were fully understood by either male or female scholar activists. Jenny Morris writes for example:
“Feminist analyses of women’s oppression are themselves a way of asserting resistance, of struggling against oppression. Studies of women’s experiences – although they are studies of the difficulties that women face in their lives – rarely present them as passive victims.” (33)
Given this point by Morris, it can be argued that the debates which took place in the 1990s saw little understanding of why each side took the stance they did, but I do accept male disabled scholar activists were rightly criticised for their lack of awareness of the way sexism and disablism intersect and make the question of ‘the personal is political’ so important to disabled women. (34)
More generally, among the arguments Thomas makes is that points raised by Jenny Morris, Sally French and others within Disability Studies, might not have arisen if disability were understood in a social relational sense, because it would then be entirely permissible to acknowledge that there are also impairment effects that restrict activity and impact in important ways upon the lives of impaired people. (35) As indicated earlier, much of this turns on specific contexts and application. For example, Thomas quotes Morris (1993) as saying:
“….they [some male advocates of the social model of disability] have been making the personal political in the sense that they have insisted that what appears to be personal experience of disability is in fact socially constructed. However, we also need to hang on to the other sense of making the personal political and that is owning, taking control of, and representation of the personal experience of disability – including the negative parts of the experience.” [emphasis added – BWF] (36)
What Morris says here could be considered questionable for three reasons: firstly, what does Morris mean by ‘experience of disability’ because the final sentence appears to suggest a conflation of impairment and disability here as from a social model perspective it is hard to see how there can be anything other than negative parts to the experience of disability. Secondly, is it not the role of disability culture to collectively facilitate the “owning, taking control of, and representation of the personal experience of disability” via disability praxis? Taking control of impairment management and our own identities and lifestyles, it has been argued, are outside the remit of the social model; these actions are however part of disability politics because our personal space is often invaded by disablist ideologies and practice. The problem therefore has not been the ‘distancing’ of ourselves from the personal tragedy model, but rather the failure to explore and utilise the model’s insights. Morris also argues the denial of ‘personal experience’ by men who employ the social model indicates, however, this is questionable because there is little evidence to suggest the social model’s purposed is premised along these lines. (37) Similarly, Sally French says:
“While I agree with the basic tenets of [the social] model and consider it to be the most important way forward for disabled people, I believe that some of the most profound problems experienced by people with certain impairments are difficult, if not impossible, to solve by social manipulation.” (38)
Thomas notes that some of these issues are due to the “universalistic version of the UPIAS definition of disability” or the property approach. (39) It is important to recognise that Thomas does acknowledge issues with how some disabled feminists view the social interpretation of disability. She says:
“Morris and Crow have tended in recent debates to conflate ‘the personal’ with ‘the personal experiences of impairment’, leaving the personal experiences of disability aside, and contributing to confusions about the personal and the political. This underlines the importance of making analytical distinctions between the experiences of restrictions of activity, or limitations to social action, which are a result of disability (understood in its social relational sense); the experiences of the psycho-emotional consequences of disablism, or limitations to social being; and the experiences of living with impairment and impairment effects, which include both restrictions of activity and psycho-emotional consequences.” (40)
Oppression and the positioning of impairment in relation to the struggle for self-determination
I view the ambiguity over what ‘oppression’ is, within Oliver’s and to a degree Finkelstein’s writing, lies behind why Abberley questioned Oliver’s approach towards oppression. Among the arguments Abberley makes is that disabled people’s oppression is not just experienced in terms of the imposed social restrictions on being part of mainstream social activities, but also relates to the ideological underpinning of how disabled people are both seen and treated. Abberley therefore sees a dialectical relationship between collective experience of oppression and the differential experience which stems from how specific types of impairment are both viewed and responded to.
I believe Abberley saw the development of social theory of disability as oppression requires us to understand that our oppression extends beyond the experience of exclusion and marginalisation. He said in fact:
“….if the inferiority embodied in impairment is understood as purely or primarily biological in origin, the suggested analogy with racial and sexual oppression appears to be an inherently dubious one, since the core of such theories is that disadvantage is ultimately a social and not a biological product. A theory of disability as oppression then must offer what is essentially a social theory of impairment.” (41)
An early response from Oliver in his book, The Politics of Disablement, simply stated:
“While, from an epistemological point of view this may be the case, for present purposes it is a social theory of disability as social restriction that is being considered. However, it is possible to show that both impairment and disability are produced in similar ways.” (42)
In Oliver’s first sentence he refers an epistemological point of view [which relates “to the theory of knowledge, especially with regard to its methods, validity, and scope, and the distinction between justified belief and opinion”], but then I believe he implies this has little to with developing a social theory of disability as social restriction. Whether or not Oliver is correct in making such an assertion is difficult to determine because there are a number of issues which hinder our ability to judge.
First, we have the question of language and meaning. Abberley, for example, speaks of ‘[a] theory of disability as oppression then must offer what is essentially a social theory of impairment’, whereas Oliver speaks in terms of ‘a social theory of disability as social restriction’; in my opinion they’re not one and the same. I believe they hold differing views on what they mean by ‘disability’ and ‘oppression’. I forward this view on the basis that Abberley writes:
“In summary, to usefully apply the notion of oppression to the complex of impairment, disability and handicap involves the development of a theory which connects together the common features of economic, social and psychological disadvantage with an understanding of the material basis of these disadvantages and the ideologies which propagate and reproduce them.” (43)
Paul in his paper still speak of the triad definition of disability as found in the work of OPCS, therefore, it is difficult to unpack aspects of his argument. My broad interpretation of his argument is that in order to uncover the roots of disabled people’s oppression, one has to explore how impairments become into being, what creates and maintains their existence, and the ideological and material consequences that flow from praxis associated with how society addresses impairment. Without this ‘social theory of impairment’, it is difficult to challenge the ideological and material underpinning of disabled people’s exclusion from or marginalisation within mainstream social activity.
If I’m right in believing Oliver implies that a theory of disability as oppression [which is ‘essentially a social theory of impairment’] has little to with developing a social theory of disability as social restriction, then I would have to disagree with this line of argument. I disagree precisely because he states in the second sentence that it’s possible to show that both impairment and disability are produced in similar ways.
I would suggest the creation or production of impairment is intrinsic to any historical materialist social theory of disability. This is different from saying an individual’s impairment is directly responsible for their social disadvantage. Oliver was criticised for saying ‘impairment had nothing to do with disablement’; I believe what he wrote was a clumsy formation because, on the one hand, it is a correct statement regarding breaking the direct causal link between impairment and (imposed) social restriction; however, on the other hand, it was a false statement within the context of a theory of disability as oppression as Abberley and I would develop. If people didn’t experience or were judged to have or not have impairments, then they wouldn’t be subjected to disablement or disablism.
I also maintain the belief, as I believe Carol Thomas did, that there are methodological differences between Vic Finkelstein, Mike Oliver and Paul Abberley. (44)
In relation to Finkelstein, I believe his writings between 1996 and 2007 sought to address weaknesses in the DPM and Disability Studies approaches towards disabled people’s emancipation and the positioning of impairment in relation to the struggle for self-determination. Whilst not always in agreement with the formulations, language or desire for yet ‘models’, I believe his knowledge and insights would assist us in developing new social theory and models along the lines spoken of already. I believe this quotation indicates that his later work points to an eco-social approach. He wrote:
“….if we look at the conceivable lifestyles of disabled people then we are faced with an infinite variety of situations which might be entered and many diverse activities that could be carried out. Disability, quite simply, is concerned with the barriers that may prevent this. It is not about who we are or what might be wrong with us, as professionals and politicians with abilities would have us believe. A dynamic approach means we look at the total social situation in which everyone interacts and the diverse illnesses we all might face in these different circumstances.” (45)
Developing a social model of impairment as a precursor to a social theory of impairment creation and oppression, is a long way off. As stated previously, there is no agreement on what this would look like. I was personally troubled by what Disabled People Against Cuts wrote in relation to the book by Ellen Clifford (2020). They state:
“…. alongside a social model of disability, we should also have a social model of impairment. According to this, ‘impairment’ would not be understood as something that is wrong with a person’s body or brain. Instead, ‘impairment’ would refer to the disadvantage that a person faces because of how their particular condition is viewed within society. This would enable a wider range of people to identify as disabled – including Deaf people, autistic people, and people living with mental distress – to unite to fight against shared injustice.” (46)
This articulation for developing a social model of impairment, I would argue, calls into question its purpose and risks reducing ‘impairment related issues’ to being about addressing negative appraisals of bodies in terms of consciousness raising. This approach, if a correct representation of Ellen’s ideas, differs from what I would be arguing for. In saying this, I believe within the application of the social model of impairment I have in mind, addressing negative appraisals of bodies would feature but wouldn’t be the central focus. Returning to the ideas of Vic Finkelstein; I see the following quotations from him as illustrating the secondary function that a social model of impairment could play alongside exploring impairment creation. He wrote:
“Disabled people, therefore, have an interest in promoting a clear medical contribution to our well-being while at the same time limiting medical control over our lifestyles. Such demands have commonly been interpreted by the medical profession and professions subservient to medicine …. as being ‘antimedicine’. This is untrue. The intention is to promote clearer identification of medical issues and its appropriate field of intervention from the basic health concerns which require action in other diverse ways. Building a model which covers ‘diverse interactive’ human behaviour, therefore, must also include diverse illnesses alongside the ‘diverse lifestyles’ with its broader social concerns.” (47)
He went on to explain:
“Disabled people, like everyone of course, can get ill – not because we are disabled people but because we are human beings (although our impairments may make us more susceptible to infections and debilitating problems than non-disabled people) – and like everyone we need good medical attention at times. If diverse lifestyles are supported in a national economy by an amelioration service this is bound to cover interventions which promote the development of a healthy environment (for example, good housing, water supply, efficient sewage, ‘organic’ food, etcetera). This approach also includes accessible facilities to enable healthy living (for example, local gyms with equipment for all, changing the rules of sports and sporting facilities so that everyone can participate, an accessible countryside, etcetera). In this way nearly all ‘health’ concerns, activities and facilities would be located outside medical control and there could be no health service. This means most physiotherapy and all occupational therapy could be incorporated in new professions located in the community and beyond medical corruption. Medicine, then, could focus on the cure and alleviation of illness in a national medical service.” (48)
Final thoughts
Perhaps the development of a social theory of impairment along the lines Abberley and I are suggesting hasn’t occurred because to undertake such a mammoth task has to date been too daunting. I hope some people will pick up the challenge.
Notes
* Steve Graby’s quotations are from his Facebook page, 8th February 2022
1. Oliver, M. (1996) Understanding Disability: From Theory to Practice. London: Macmillan Press.
UPIAS (1975) Fundamental Principles of Disability.
Abberley, P. (1997) The Concept of Oppression and the Development of a Social Theory of Disability. In Disability Studies: Past Present and Future. Edited by Len Barton and Mike Oliver. Leeds: The Disability Press. p.160 – 178,
2. Word We’re Watching: Intersectionality
What happens when forms of discrimination combine, overlap, and intersect
https://www.merriam-webster.com/words-at-play/intersectionality-meaning
3. Wikipedia on Intersectionality
https://en.wikipedia.org/wiki/Intersectionality
4. Oliver, M. (1996)
5. Difference between skill and ability
https://www.differencebetween.info/difference-between-skill-and-ability
6. . Barile, M. (2003) Globalization and ICF Eugenics: Historical coincidence or connection? The More Things Change the More They Stay the Same. Disability Studies Quarterly. Spring, Volume 23, No.2 pages 208-223.
7. See: Barnes, C. (1991) Disabled people in Britain and discrimination: a case for anti-discrimination legislation. C. Hurst & Co.
Findlay, B. (1999) The Historical Roots of Defining Disability, in Maynard, S. (ed) Disability in Employment – Training Material. Wakefield: Equal Ability Ltd
World Health Organisation, (2001) International Classification of Functioning, Disability and Health (ICF). Geneva.
http://www.who.int/classifications/icf/en/
Oliver, M. (1994) Capitalism, Disability and Ideology: A Materialist Critique of the Normalization.
8. Shakespeare, T. (2006) Disability Rights and Wrongs. London: Routledge
9. Thomas, C. (2012) Theorising disability and chronic illness: Where next for perspectives in medical sociology? Soc Theory Health 10, 209–228, p.211
10. Thomas, C. (2007) Sociologies of Disability and Illness: Contested Ideas in Disability Studies and Medical Sociology. Basingstoke : Palgrave Macmillan. P.135
11. Thomas, C. (2010) Medical sociology and disability theory. In: G. Scambler and S. Scambler (eds.) New Directions in the Sociology of Chronic and Disabling Conditions: Assaults on the Lifeworld. Basingstoke, UK: Palgrave Macmillan, p. 37–56.
12. Northern Officers Group (1999) Defining Impairment and Disability
13. Thomas, C. (1999) Female Forms: Experiencing and Understanding Disability. Buckingham: Open University Press. p.124
14. Ibid.
15. Thomas, (1999) p.133
16. Difference between impact and effect
17. Shakespeare, T. and Watson, N. (2001) The social model of disability: an outdated ideology? In Barnartt, S. and Altman, B. (Eds) Exploring theories and expanding methodologies: where we are and where we need to go. London JAI. p.9–28, p.17
18. Thomas, (1999) p.43
19. Ibid.
20. Ibid.
21. See for example: The People’s Charter for an Eco-Social World
22. Abberley, (1997) p.165
23. Oliver, M. (1990) The Politics of Disablement, London, Macmillan, p.
24. Merriam Webster (2023) Dictionary definition of epistemological
https://www.merriam-webster.com/dictionary/epistemological
25. Abberley, (1997) p.176
26. See: Abberley, P. (1991)
Handicapped by Numbers: A critique of the OPCS Surveys
27. See: Thomas, C. (1999) Female Forms: Experiencing and Understanding Disability, Buckingham : Open University Press
28. Abberley, (1997) p.175/6
29. Oliver, M. (1994) ‘Capitalism, Disability and Ideology: A Materialist Critique of the Normalization’
30. Oliver, M. and Barnes, C. (2012), The New Politics of Disablement, London: Palgrave Macmillan, p.22
31. Finkelstein, V. (2007) The Social Model of Disability and the Disability Movement, p.3
See also: Finkelstein, V. (1996) OUTSIDE, ‘INSIDE OUT’, Coalition. GMCDP, p.30-36
32. Finkelstein, (1996) p.31
33. Morris, J. (1998) Feminism, gender and disability (Text of a paper presented at a seminar in Sydney, Australia: February 1998) pp.5
34The question of the relationship between the public and private spheres goes beyond issues concerned with the impairment and disability relationship. Neither side fully acknowledged the differing sites of struggle involved with living with impairment reality and the intersectionality issues that underpin the encountered oppression at a personal and collective level of consciousness.
35. Thomas, (1999) pp.42
36. Thomas, (1999) pp.65
Morris, J. (1993) Feminism and disability, Feminist Review, 43(Spring): 57-70, 68
37. The charge of ‘patriarchal thinking’ requires us to interrogate the notion of patriarchy in the first instance. However, the underlining issue is the question of ‘the personal is political’ with regards to the application of Oliver’s social model. If Feminists wanted or to develop an alternative ‘social model’ that needs discussion.
See:
Brown, H. (2014) Marx on Gender and the Family: A Summary
German, L. (2006) Theories of Patriarchy, International Socialism Journal https://isj.org.uk/theories-of-patriarchy/
38. French, (1993) pp.17
39. Thomas, (1999) pp.42
40. Thomas, (1999) pp.81
41. Abberley, (1997) p.165
42. Oliver, M. (1990) The Politics of Disablement, London, Macmillan, p.12
43. Abberley, (1997) p.176
44. Thomas, (1999)
45. Finkelstein, V. (1996) Modelling Disability, p.15
46. DPAC (2020) Reinvigorating the Social Model of Disability
https://dpac.uk.net/tag/ellen-clifford/
47. Finkelstein, V. (1996) p.16
48. Finkelstein, V. (1996) p.17
More Than A Left Foot 