The focus in this section is on how disability can impact on communication and relationships in the context of health and social care. The section is structured around four main activities: there are three readings for which you should set aside at least one-and-a-half hours. Activity 26 asks you to consider the issues that people with disabilities raise about their own needs, by visiting one of three online support groups. The final activity is based on a case study that involves exploring what you see as the main barriers to effective communication and relationships in health and social care. However, before embarking on these activities, there is a need to unpack the meaning of the term ‘disability’, which as you might expect is not straightforward.
Richard's story
During the long transition from believing that I was ‘normal’ to believing that I was ‘disabled by an incurable disease’ there were many little incidents which stick in my mind. For example, I remember my boss at the time who joked that I would lose the use of my legs when he spotted me taking the lift to go up one floor. Most people who saw me stumbling about assumed that I was drunk.
(Source: Were, 2000, p. 140)
Exercise \(\PageIndex{1}\): What is disability?
Read the account from Richard Were above who was diagnosed with MS in 1992 when he was 52 years old. Make notes on what this tells you about the meaning of the term ‘disability’.
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I thought it was interesting to note that Richard did not identify himself as being disabled and yet some of his behaviour was marked by the comments other people made about him not being ‘normal’. This suggests it is possible to recognise disability as ‘not normal’. (In addition, being perceived as drunk carries its own prejudices and sanctions.) Richard's boss seemed to make a judgement that might fit into a moral category: that is, Richard could deserve to lose the use of his legs if he squandered them. Whatever your view of these comments, it is clear that people have ways of marking differences between what is ‘normal’ and what is not ‘normal’.
There are many debates about what it means to be ‘normal’ but, for the moment, continue to consider the ways in which disabled people are marked out by society as being different from ‘normal’ people. The term ‘disability’ includes a range of physical and mental impairments but a social constructionist approach would argue that society ‘disables’ by labelling people and by perpetuating stereotypical ideas about what a person with a disability might feel, think or do.
Deborah Lupton and Wendy Seymour are two social scientists who have explored the relationship between the body and technology (‘Technology, selfhood and physical disability’, by Deborah Lupton). As part of their study they interviewed people with disabilities about how they used technology to overcome aspects of their disability. The authors argue that disability is a form of social, political and material disadvantage, as well as being a socially constructed state. They argue further that ‘disabled bodies’ both represent and reproduce meanings. Disabled bodes are usually constructed as being ‘lacking’, ‘deviant’ or ‘grotesque’ and, as such, people with disabilities are marginalised by society. Therefore, since bodies that are ‘not normal’ are usually stigmatised, overcoming the material disadvantage of disability would seem to be both positive and helpful.
As noted in the general discussion of difference in Section 1, and again in the more detailed discussions of ethnicity and gender in Sections 2 and 3, social constructionists would argue that difference is a process, not a ‘thing’. This means seeing ‘disability’ as a process by which society (or institutions within society) ‘disables’ particular people in specific ways. This involves a certain way of thinking and talking about some groups of people, positioning them as ‘other’ on the basis of their supposed physical or intellectual capacities. However, it also involves ‘disabling’ people in very practical and material ways, preventing them from participating fully in society, or in particular aspects of it (such as health and social care services).
