In this essay I will examine how disability is socially constructed in modern society. I will draw on theories of social constructionism that propose knowledge is produced within culture, linguistically rather than directly reflecting the material world. I will be exploring how these constructed discourses affect the identities of the disabled. I will take the prominent models of disability, medical and social, and analyse the language that establishes the reality in public consciousness. I will consider how the privilege discourse of medicine lends authority to the medical model of disability. I will also look specifically at how the conceptualisation of the self places notions of ability as the acme of existence. The ways in which this ideology operates through linguistic expression establishes it as objective truth. I will explore various terms that seek to reverse the process of the medicalization of disability. These include official terms sanctioned by disability movement and the reclamation of abusive terminology by the disabled community. I will propose that the attempts of the social model to redefine disability are severely hampered due to social constructions of ability that are present in our conceptions of the self.
Before studying the construction of disability I would like to first outline some of the basic principles of post-structuralism and social constructionism that I will draw on later in my analysis. Social constructionism shares much of its theoretical basis with post-structuralism. Both theories seem dissatisfied with the structuralists’ acceptance that the world is constructed through language (Barry, 1995). Post-structuralists do not doubt the power of semiotics in the creation of meaning, but seek to go further than structuralism by questioning the whole concept of objective truth,
It distrusts the very notion of reason, and the idea of the human being as an independent entity, preferring the notion of the 'dissolved' or 'constructed' subject, whereby what we may think of as the individual is really a product of social and linguistic forces. (Barry, 1995:66)
The questioning of notions of objective truth and the individual’s capability for independent thought is central to social constructionism. It proposes that western philosophy values the individual and therefore the notion of individual thought,
The very idea of democracy - each individual endowed with the right to vote - derives from Enlightenment presumptions. Public education also owes its existence to the same investments. (Gegren 1999:07)
The importance that society attributes to the individual determines how we view the self. However the value we instil in the individual is itself socially constructed originating from the erosion of traditional concepts of religious and feudal power. Modernity brought about the idea that people could influence their own destiny. Accompanying this sense of self determination was the notion that people were free to gain knowledge of the world solely through their own experience. Social constructionists dispute this claiming that our experiences only inform us about the world via a set of discourses which pre-exist in culture through language. Knowledge is therefore seen more as a process than a stable structure,
It objectifies this world through language and the cognitive apparatus based on language, that is, it orders it into objects to be apprehended as reality. It is internalized again as objectively valid truth in the course of socialization. (Berger and Luckman, 1966:82-83).
In this way the words we use not only act as signifiers to connote the signified object or concept, but acts to create them in the shared consciousness of the culture. In other words meanings are created through a semiotic process via language and then internalized by a culture which results in the creation of reality, ‘... language is a major ingredient of our worlds of action; it constitutes social life itself.’ (Gregen, 1999:49).
The way we talk about our inner selves using metaphors affects how we perceive emotion. Although we like to believe when we are discussing our emotions we gain our expressions independently from the society we live in, Gregen (1999) proposes that this is not the case, ‘. .the moment we begin to speak we are already "spoken" by a pre-existing structure’ (Gregen, 1999:64). Our internal selves are constructed in various ways using language appropriated from our descriptions of the external word. Gregen (1999) discusses how we conceptualise emotion through metaphor.
There are several basic metaphors that guide much of what we can intelligibly say about our emotions. Because we believe that emotions represent the animal in us, we can say, "he bellowed in anger," or "her feathers were ruffled." (Gregen, 1999:68)
The metaphors deployed to describe inner states often presume a non-disabled self Swain et al (2003) points out that we often conceptualised progress using language of physical motion. These metaphors often describe emotional well-being and self control:
The medical model reflects wider cultural assumptions around individuality, personal autonomy and self-determination within a society in which great value is placed upon 'standing on your own two feet', 'staying one step ahead', 'standing up for yourself', 'walking tall' and 'making great strides' (Swain et al, 2003:22)
The use of these metaphors establishes a link, within society’s collective consciousness. The linguistic habit of terming positive emotional states in this way highlights, but more importantly reinforces, the importance that is placed on physical ability in western society. Instilling an idea never truly vocalised that somehow people who physically stand or walk are emotionally stable. Therefore demonstrating that, ‘Language provides the fundamental superimposition of logic on the objectivated social world.’ (Luckman and Berger, 1966:82)
I will now introduce two models of disability which help explain the creation of disabled identities in contemporary culture. The medical model of disability describes the conceptualisation of physical impairment that has been dominant, academically and culturally, in Western society up until the 1980’s. It views the physical condition of a disabled person as the primary restricting factor in their lives.
..the medicalization of disability casts human variation as deviance from the norm, as pathological condition, as deficit, and, significantly, as an individual burden personal tragedy. Society, in agreeing to assign medical meaning to disability, colludes to keep the issue within the purview of the medical establishment. (Linton,1998:11).
The emphasis of this model is to facilitate change in the disabled person in order for them to be assimilated into normal society.
The social model however which was defined by The Union of the Physically Impaired Against Segregation (1976) set a distinction between the term impairment and disability. In the social model the definition of impairment is what the medical model traditionally terms as disability, which is the actual bodily difference that marks the person out as a deviant from the norm. While the term disability connotes:
..the disadvantage or restriction of activity caused by a contemporary social organisation which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities. (UPIAS, 1976, quoted in Swain et al 2003: 23).
The two models are not only different in the ideologies that they promote they also drastically differ in their conception. The social model has been constructed as a counter-narrative to oppose an oppression felt by the disabled community. The medical model is a societal discourse that has developed through the centuries and is therefore interlocked with several other discourses.
We value education as a process which instils objective truth about the world into individuals, we therefore value the opinions of the educated over the uneducated. Of all the academic fields, science is seen to produce the most objective knowledge. Therefore things that fall under the authority of scientists, have their definitions firmly fixed in society’s collective consciousness. However, academic knowledge gained through the formal process of education is no more objective than the beliefs about the world we gain through linguistic relationships.
Scientists seldom carry out research for no reason; typically they have investments in some vision of the good, some benefit that will derive from their work. These investments enter into the research at every point, from the words selected to frame the problem to the description of the subjects' actions. It is disingenuous to cloak these investments in the language of neutrality. (Gregen, 1999:91).
The medicalization of disability is therefore lent authority from the established objectivity of the scientific discourse. The medical model positions disabled people as different to the norm and therefore sets-up a binary, which is inherent in the linguistic construction of reality.
Consider, for example, the disciplines of medicine, psychiatry, sociology, anthropology, education, and the like. These disciplinary regimes, as Foucault called them, generate languages of description and explanation - classifications of selves as healthy or unhealthy, normal or abnormal, upper or lower class, intelligent or unintelligent - along with explanations as to why they are so. (Gregen, 1999:39).
Foucault claimed that society organises people in terms of categories, via such disciplinary regimes that are mentioned above. He suggested that inherent to this system of categorization was the establishing of power relationships. This relates to Derrida’s view of language as ‘as a system of differences’ (Gregen, 1999:27), according to this theory a word only has meaning in relation to the word with the opposite meaning. Gregen (1999) uses the example of the term ‘non-white’ in the description of race. The term only has relevance to a culture that is presupposed to what is signified by the term white. ‘That is, the distinctiveness of words depends on a simple split between "the word" and "not the word."’ (Gregen, 1999) The result of the linguistic oppositions is that it creates semantic oppositions with the word ‘non-white’ totally deriving meaning from the concept of not being ‘white’. When these kinds of words are used to describe groups of people, the power relationships which Foucault describes are created, with the group that is labelled as ‘not’ the subject positioned as inferior.
Before I discuss various ways that society addresses the disabled, and reactions from the community to readdress the negative consequences of these actions, I will first examine the terms ‘disabled’ and ‘disability’. For the purposes of this analysis I will presume the medical model’s definition of disability. The linguistic construction of the words disabled/disability has interesting consequences for a post-structuralist. Linton (1998) proposes the prefix ‘dis’ has connotations of lack of, separation from, or opposition to, whatever term it precedes. In every day usage the prefix is present in words such as: disinterest, disloyal, disfranchise, disingenuous. All these words have negative connotations and, as deconstructionalists would suggest, rely solely on their opposite to be defined. Therefore the notions of disability are dependant on contextualised notions of ability. ‘The prefix creates a barrier, cleaving in two, ability and its absence, it’s opposite. Disability is the "not" condition, the repudiation of ability’ (Linton, 1998:30) The way society makes the distinction between these groups of people positions the one termed disabled has inferior.
However the dichotomy of ability/disability is unequally balanced, not just in the sense of Foucualt’s power relationship. I would suggest the semiotics of disability and ability do not relate directly as a binary. Ability can connote the capability of a vast range of forms to an almost infinite number of subjects and objects. ‘The physical or mental power or skill needed to do something.’ (www.dictionary.cambridge.org, 21/03/2005). This definition does not restrict ‘ability’ to describe power in a certain field. The term can be used to describe the sense of power in explanations: how the mechanics of a plane enable flight; how international law enables world leaders to form resolutions within the United Nations Security Council; or how people are able to conceive worlds that do not exist.
While disability is defined as, ‘an illness, injury or condition that makes it difficult for someone to do the things that other people do.’ (www.dictionary.cambridge.org, 21/03/2005). Here we see a definition of disability that follows the ideology of the medical rather than social model. The noun connotes an impairment, that when present holds people back when doing ‘the things that other people do’ (www.dictionary.cambridge.org, 21/03/2005). When compared to the definition of ability, disability seems to connote a much narrower concept. If disability derives its meaning solely from being the opposite of ability, as deconstructionists would suggest, the resulting connotations are of ultimate unworthiness considering the all-embracing definition of the latter term.
The result of the way we construct disability through language ultimately reinforces the legitimacy of the medical model. This process results in the ‘reciprocal typification of habitualized actions’ (Luckman and Berger, 1966:72) in the actual ways disabled people behave and the ways society reacts to them. There is often a lot of input from health professionals in to a disabled person’s life especially in their formative years. Emphasis is loaded on the idea of treatment of the medical disability in order to correct the deviant feature (Linton,1998) . As the process of treatment is carried out on the disabled, traditional concepts of illness are adopted. These concepts are of course articulated and therefore constructed linguistically. ‘The language of professionals and social policy ('sufferers', 'carers', 'special needs', 'patients') reinforce the notion that disabled people are helpless and tragic’. (Swain et al, 2003:80) This helps to establish the role of the patient within the identity of the disabled child. The notion of suffering is acceptable when applied to a temporary illness. This is because it describes the endurance of a bodily impairment that is not normally felt by the healthy person. However, when applied to disability the implication is that the disabled are enduring a permanent state of illness. This divorces the notions of health from the disabled person. Swain et al (2003) apply
Suffering when applied to disability in this way presumes an ablest point of view. The disabled person’s physical or medical condition would maybe quite rightly be termed as suffering if suddenly experienced by a non-disabled person. This attributed suffering is therefore conceptualised from the viewpoint of the non-disabled majority. As well as affecting the way society conceptualises disability this linguistic construction of the unhealthy can lead to inappropriate actions in order to correct such imperfection,
Some disabled people describe how they were subjected to numerous painful surgeries and medical procedures when they were young not so much, they believe, to increase their comfort and ease of mobility as to fulfil their families' wish to make them appear "more normal." (Linton, 1998:20).
The term victim, in relation to disability, acts to separate the physical condition from the disabled individual, Linton (1998) suggests. The use of victim-hood to negotiate the relationship between a person and their impairment objectifies the latter as an alien invasive force. This conception is born from the linguistic construction of the virus within medical discourse.
The use of the term victim, a word typically used in the context of criminal acts, evokes the relationship between perpetrator and victim. Using this language attributes life, power, and intention to the condition and disempowers the person with the disability, rendering him or her helpless and passive. (Linton, 1998:25).
So, both the terms ‘suffering’ and ‘victim’ place the disabled in a weakened position within society. However, as theorists such as Luckman and Berger (1966) suggest the cultural representation of people affect their notions of self, in an internalising process.
As demonstrated in examples above, society is founded on presumptions that the world is only inhabited by the non-disabled. There have been moves within the disabled rights movement and within disability studies to name this phenomenon, ‘. . .the terms ableist and ableism, which can be used to organize ideas about the centring and domination of the non-disabled experience and point of view’. (Linton, 1998:08). Although these terms appear in some dictionaries, they are by no means in common usage, indeed as I write this the terms are underlined in red by Microsoft Word to indicate misspelling. However, the creation of these terms demonstrates the significance that disability studies academics assign to post-structuralist concepts. By labelling the oppression their aim is to eventually establish it within the public’s consciousness,
Currently, there is increased attention to the privileged points on the continua of race, gender, and sexual orientation. […] Similarly, it is important to examine the nondisabled position and its privilege and power. (Linton, 1998:36)
It is therefore hoped that one day the term is as familiar as sexism and racism within society.
Social constructionists offer a way to challenge the privilege discourses of knowledge which influence the way culture constructs reality. They propose the only way to open up knowledge to new forms of discourse is through the use of linguistics.
Thus, if we wish to change patterns of action one significant means of doing so is through altering forms of discourse - the way events are described, explained or interpreted. (Gregen, 1999:115).
In naming ableism, activists and academics have no desire to destroy the disabled/non-disabled binary. Even if it was possible to make society no longer recognise disability as different this would have a negative effect on the movement’s quest for human rights,
To fight against the invasive influence of power, is to hold out a promise that we might one day become free - no one controlling or containing us with an alien knowledge. Yet, freedom from the ordering effects of language, from forms of life, from all traditions or conventions is not freedom: it is essentially a step into insignificance - a space where there is no freedom because there are no distinctions, and thus no choices. (Gregen, 1999:40).
Rather the disabled rights movement wish to alter the in-built power relationship of this distinction. The social model then tries to drastically change perceptions of the disabled by attempting to redefine both signifiers and the signified, in the labelling of the social group. Political correctness has created several terms that are meant to avoid the negativity which is associated with the prefix ‘dis’. Terms such as ‘physically challenged’ have entered the public’s vocabulary. This was once seen as progressive by some but now is rejected by the disabled community. Swain et al (2003), suggest this term:
…gives rise to images of disabled people keenly and happily struggling against adversity within a disabling society, while being admired for doing so. It reinforces the notion that society is fixed and that disabled people must 'overcome' what are viewed as 'their' problems if they are ever to become valid members of it. (13-14).
Here we see the term is criticised for essentially its ableist viewpoint. It places the disabled in competition with the non-disabled competing in a social world where physical ability is constructed to be of paramount value.
The terms ‘disability’/ ‘disabled’ has been accepted by disability studies and the disabled rights movement as acceptable terminology to describe an ever increasing social group. This is despite the deconstructionist’s opposition with notions of ability. However, the term ‘non-disabled’ is preferred in favour of ‘able bodied’. This has the effect of centring disability as the norm (Linton, 1998). Adding the prefix ‘non’ to the word ‘disabled’ here is designed to reverse the ableist ethos inherent in our traditional linguistic expression. Taking the deconstructionist view then, the definition of ‘non-disabled’ can only derive meaning from notions of disability. At this point we return to the models of disability and the struggles over definitions. The extent of how progressive the term non-disabled is depends on which model you turn to for a definition of ‘disability’.
Although terms such as ‘physically challenged’ and ‘differently-abled’ promote an ableist viewpoint, the latter presuming ability of the non-disabled as normal, they do offer alternative signifiers to aid in the redefinition.
The social model seeks to retain the signifier ‘disabled’ while changing the signified.
When disability is redefined as a social/political category, people with a variety of conditions are identified as people with disabilities or disabled people, a group bound by common social and political experience. These designations, as reclaimed by the community, are used to identify us as a constituency, to serve our needs for unity and identity, and to function as a basis for political activism. (Linton, 1998:12)
However, if identity is constructed through language, a relational process (Gregen, 1999) the redefinition of words by political activists is limited in its effect. As the dictionary definition of disability, I quoted earlier, suggests the medical model is still very dominant in society. As a disabled person myself when I refer to ‘my disability’, I am referring to my diagnosed physical condition which the privileged discourse of medicine categorises as deviant. When I refer to my ‘physical condition’ in this way am I subscribing to my own oppression, or using a signifier, which is culturally recognisable, to express the signified that I wish to convey? The answer is probably both, but largely insignificant to my point. The very fact that the construction of the world through language is relational hampers the disability movements’ quest for redefinitions.
..social understanding is not a matter of penetrating the privacy of the other's subjectivity. If it were, we could never understand. Rather, understanding is a relational achievement; it depends on coordinating actions - and most frequently, coordination as specified within a tradition. (Gregen,1999)
The term ‘disability’ has got an established meaning in society that is used by non-disabled and disabled alike. The social model asks people to adopt new meanings for the same word despite the connotations of its linguistic form, implications of the prefix ‘dis’ and societal notions of ability. Due to the dominance of the medical model, even when the term is used in a situation where the social model’s definition is intended, the interpretation of the term is likely to presume the medical model.
Considering this, the attempt to centre disability (Linton, 1998) with the use of the term ‘non-disabled’, has mixed results. Engineers of the social model would hope, even insist, that the term signifies someone who is not affected by an under resourced society which, due to an ableist ideology, inhibits others in their daily life. While most people would define a ‘non-disabled’ person as someone without a physical or mental disability, as assigned by the medical model. Adding the prefix ‘non’ before the prefix ‘dis’ to the contextualised notion of ability can be seen as still working within a deconstructionist frame work. We are still leaning towards the traditional linguistic tendency to create oppositions. Social constructionists propose a more radical change in the way we conceptualise the world, ‘If we attempt to use the traditional binaries for purposes of cultural change, reinscribing the world or persons in their terms, transformation is only superficial.’(Gregen, 1999:116). I propose that to totally redefine disability new signifiers would need to be put in place that didn’t rely on binary scale of physical and mental capacity. However, in order to do this we would need to re-evaluate the whole of language. As I have shown above to a large extent society conceptualises itself through physical ability. This attains to the way we describe emotional wellbeing as well as our actual physical prowess. In order to view disability in a more positive light or to reposition it as a social category rather than a medical one society would need to disregard a lot of its central beliefs. The idea that you can redefine a word that is linguistically interwoven into the culture is naïve.
My criticism of the redefinition of the term ‘disability’ is not to deny the fact that society does, in effect, disable people through inaccessibility. But I very much doubt the effectiveness of the linguistic acrobatics which seem to be invested with so much significance.
The issue of reclamation of terms does not only pertain to the word ‘disability’, it is generally accepted by disability studies and the disabled rights movement that words such as ‘cripple’ and ‘spastic’ are now acceptable within the community. That is to say they are empowering terms when used to describe oneself if one is disabled.
In reclaiming 'cripple,' disabled people are taking the thing in their identity that scares the outside world the most and making it a cause to revel in with militant self-pride. (Linton, 1998:17).
The problem I have with this goes back to the concept of language being a relational process (Gregen, 1999). The term ‘cripple’ has got a negative history in the description of the disabled. I would suggest that the negativity that is associated with the word can be attributed to the time when the word was an acceptable description of the disabled in mainstream culture. This is to say the term ‘cripple’ is no more inherently negative than the word ‘disabled’, but the fact that conditions were considerably worse at a time when disabled people were acceptably termed ‘cripples’, infuses the term with negative connotations. The negative status of the term ‘cripple’ is demonstrated by other uses of the word to describe a variation of things that are inactive or severely ineffective. For example a ‘crippled economy’ signifies an economy that is on the brink of collapse. This application of the term ‘cripple’ and its derivatives are in the acceptable vocabulary of today’s public. So, when a disabled person refers to themselves or others in the social group as ‘cripples’, it battles against negative usage that is still considered valid when used in different contexts. When used to connote a disabled person the term is only empowering when used by an insider of the social group. This in effect gives minority communities a privileged discourse of terms to describe themselves that mainstream society are forbidden from using. This may not trouble disabled activists who consider this rebalance in privileged discourses long overdue, but doesn’t this reinforce boundaries and create antagonism between groups? The alienating effects of binaries created through language works both ways, ‘..whenever we declare what is the case or what is good, we use words that privilege certain existents while thrusting the absent and the contrary to the margins’. (Gregen, 1999:148). I propose that by alienating the non-disabled community through the use of this reclamation we only reinforce difference. I as a disabled student can term myself a cripple in the presence of non-disabled peers, who if in turn referred to me in the same way could be officially reprimanded. I question also the empowering effect such usage has. Is the disabled community obliged to call themselves every term, once deemed acceptable later denounced as oppressive, in an act of liberation? The presumption that this language spoken in a post-modern world is progressive is naïve. Further still it is a presumption, from my observations that goes unquestioned by disability studies and indeed mainstream society.
Another example of struggles over definitions concerns the term ‘spastic’. This defines the medical condition of the muscles of someone who has cerebral palsy. A charity was set-up to represent the interests of people with cerebral palsy in 1952 called The Spastics Society. In the proceeding years the term ‘spastic’ was an acceptable word to describe someone with cerebral palsy however the term soon developed abusive connotations. If a non-disabled person was deemed to be physically or mentally inferior the term was used, this usage was especially prominent in the playground setting. As a response to this, The Spastics Society changed its name to Scope. The idea was that the charity would rid negative connotations of the word ‘spastic’ from the organisation and therefore distance this negativity from people with cerebral palsy. The word ‘scope’ while interestingly retaining a phonetic echo of the original name implies opportunity and ability. However, the word ‘scope’ soon acquired negative connotations, ‘A new slang word of abuse, scopey, started to appear’ (www.wordiq.com, 21/03/2005). This shows that the negativity associated with disability extends further than the effect of individual words.
In this essay I have outlined how the medical model of disability socially constructs it as a negative phenomenon. I have suggested the ways in which linguistics assist in this process setting up binaries between the definitions of disabled and non-disabled. I have used deconstructionist theory to explore how these binaries are an inevitable affect of language. The social model tries to readdress the balance by redefining the term ‘disability’. I propose although, the negativity attached to the disabled is constructed through language, this occurs as a result of how society conceptualises ability in terms of physicality. I therefore suggest that in order to change perceptions of disability through language society has to change more than the labels that pertain to the disabled and reconstruct notions of ability.
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Swain, French and Cameron (2003) Controversial Issues In A Disabling Society. Buckingham Open University Press.