“During times of universal deceit, telling the truth becomes a revolutionary act.” George Orwell

Wednesday, May 08, 2013

Disability as impaired relationships

Disability as impaired relationships

Disability might be defined as a characteristic of individuals, something that impairs social relationships. Impaired relationships are possibly because a person may have an impairment in themselves that makes it difficult to form social relationships.  For example, someone might have autism.  Impaired relationships are also possibly because of discrimination by a society that does not want to develop a relationship with someone who has the characteristic called impairment.  This definition recognizes there are characteristics of individuals (impairments), and characteristics of environments, (discrimination or lack of caring or embracing the relegation of responsibility to governments, paid agents, etc.), which come together to define what disability is.

Because many people with disabilities have an impairment that impacts forming relationships (once again as above in that they have a personal impairment or experience discrimination because of their impairment), then the result is that society has to pay people to be in relationship with them because society will not choose to be in relationship with them otherwise.  These individuals are “paid relaters” or “almost friends" (Baca & McNair, 2013).  These individuals are potentially problematic in that they take the place of natural relaters or friends.

There's a degree to which the investment of society in making a bodily impairment something that does not impact function, will impact the opportunity that a person has to form relationships with others.  However, I might actually orchestrate a particular type of functional impairment and then design human services in a way that that would 1) provide control over the commodity of disability, and 2) maintain the particular form of functional impairment that needs me as the service provider.  I will not encourage community integration as that might reveal, that the separatist functional impairment that I have created is not real, and that people may actually be able to function in the community with much diminished supports being provided by the government (ie., they don't need me as a human service provider).

So the question is, to what extent have existing human services a been created by making disability a commodity?  To what extent is the creation of “paid relaters” or "almost friends" assent to the fact that disability is something that impairs social relationships?  That is, rather than working to address impaired social relationships by changing both the individual and society, I exclude people from community integration and pay workers to be in relationship with people with disabilities.  I would therefore monetarily benefit from my recognition that disability is impaired social relationships.  Human services would continue forever to be based on a medical model because a medical model both maximizes my extensive knowledge on how to evaluate individuals (whether or not I know what to do with that information in terms of interventions or actually care whether people are in natural relationships), and minimizes my lack of understanding of social environments in terms of facilitating changes in those environments such that they would lead to social relationship development (leading to interventions which could be counterproductive to my medical model of providing “paid relaters”).

“Paid relaters” are also a wide range of people.  They include every one from physicians to teachers, to social workers, to job coaches, instructional assistants or other entry level human service workers.  All of these faces in the human services crowd have at least one commonality: they need there to be something wrong with a person that “only they” can address.  Whether the thing that is wrong is real or fabricated is somewhat irrelevant.  Whether what is wrong can be attenuated by means other than what they can provide may also to some extant be irrelevant.  Whether their services make a difference is often irrelevant.  Oftentimes the services they provide are the only game in town so people can go to them or not receive services.  Are the services provided are what is best for the individuals being served?  The answer is arguable either way.  Services might be evaluated on the basis of criteria set by an agency or service provider, however, they are too frequently are not evaluated on the basis of what is best for the individual receiving the services.

Paid relaters are largely government agents from various agencies who appropriate relational positions which should be filled by community members.  Do human service agencies ever evaluate social environments to determine whether the “supports” they are providing might be filled by free agents in the community?  Do they exert any effort to facilitate the development of community relationships?  There is a huge literature on natural supports which seems to have been either lost or ignored, perhaps in part because such supports were not sought in the correct venues.

In times of fiscal restraints, the menu driven services may be attenuated, however, alternatives that would not require the services of those being paid to provide them are not explored.  We are probably not interested in cheaper services being provided by neighbors and community agents.  This is evidenced if only in the manner in which the community is not engaged when it might be.  For example, individuals with developmental disabilities living in group homes in the community are totally socially isolated from that same community in which they live.
If for the purposes of service provision, disability is defined medically, there is no real reason for community integration as disability is housed in the individual.  Expanding one’s mind to invite the community into the life of someone with a disability, only invites the discrimination which characterizes a social model of disability.  Apparently, the best thing to do, therefore, is to keep people away from a discriminating community and allow the “paid relaters” to rule their lives.

One means of intervention would be figure out how to address impaired relationships.  To what extent are impaired relationships due to characteristics of the individual in terms of their own impairment?  To what extent are impaired relationships due to a discriminatory environment?  To what extent are impaired relationships a natural outgrowth of the manner in which human services are designed, funded and provided?  Are existing services simply due to a lack of creativity?  If our definition of disability revolved around relationships, then we might evaluate the success of intervention programs on the basis of the presence of typical relationships with regular community members in the lives of people having the characteristic of impairment.

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