One of the best ways I know to understand connectivity is as a powerful critique of both the medical and social models of disability.
The medical model of disability is based on the premise that you are disabled if you have an impairment. You are disabled, for example, if you are blind, have lost sensation down the left side of your body, or have chronic lung disease.
By contrast, the social model of disability works from the assumption that it is not impairments that are inherently disabling, but social environments that present barriers to people engaging meaningfully in the world.
The medical model has a long history in physiotherapy. Our students are taught what is normal before learning to assess the various physical abnormalities that they will encounter in practice. They learn about normal weight, normal FEV¹, normal end-feel, and so on, and medicine’s reductive model of health and illness becomes well entrenched in student’s minds long before they learn that there are alternatives.
The social model has been a powerful counter-narrative in health care over the last 50 years, however, with many health professionals, disability rights activists and service users advocating for other ways to understand the experience and material realities of disability.
In recent years, a third critical perspective has emerged, drawing on the writings of Margrit Shildrick and Janet Price, but latterly developed by Barbara Gibson and others. This view focuses on the mediating technologies that make it possible for people to engage in meaningful activities. Here, a mediating technology is anything that allows a person to engage meaningfully in the world; be it a communication aid, a wheelchair, a guide dog, another person, or a host of other ‘tools’ that people can use to communicate, remain active, have fun, relax and live otherwise normal lives.
In crudely simple terms, the principles that underpin the idea of connectivity suggest that there are problems with both the medical and social models of disability because both rely on defining the disabled person as ‘other’. While many critical theorists have sympathy for the social model because it challenges the power asymmetries created by biomedicine and works to emancipate the voice of previously marginalised disabled people, there is obviously a problem in perpetuating the notion that disabled people are ‘other’ ‘exotic’ or ‘different’ – even if it is for politically laudable ends.
Connectivity provides a counterpoint to this view and I’ll try to unpack it in more detail in the next post.
If you have any better explanations for these ideas, know of good resources and want to add comments that we might use in our paper, add them below.References
Gibson, B. (2006). Disability, Connectivity and Transgressing the Autonomous Body. Journal of Medical Humanities, 27, 187-196. DOI 10.1007/s10912-006-9017-6.
Shildrick, M. & Price, J. (1996). Breaking the boundaries of the broken body. Body and Society, 2(4), 93–113.
Shildrick, M. (1997). Leaky Bodies and Boundaries: Feminism, Postmodernism and (Bio)ethics. London: Routledge.
Shildrick, M. & Price, J. (2002). Bodies together: Touch, ethics and disability. In, M. Corker & T. Shakespeare (Eds.), Disability/Postmodernity: Embodying Disability Theory. London: Continuum, 63–75.
I think this document could be relevant – although I am aware it is 11 years old now. I have used it, including figure 1 – as referenced below – in curriculum design. Should be able to access pdf from link below, with figure on p29. STAKES (2003) ‘Label Us Able : A Pro-active Evaluation of Finnish Development Co-operation from the Disability Perspective’ page 29. Figure 1. Drawing by David Warner. Accessed on 23 October 2014 from http://formin.finland.fi/Public/default.aspx?contentid=50655&nodeid=15454&contentlan=2&culture=en-US
Originally posted by Lester Jones on 23rd October 2014
Michael Schillmeier’s /Rethinking Disability: Bodies, Senses, Things/ contains a chapter-length theoretically informed critique of the social model of disability, “In Media Res: A Dis/Ability Manifesto” (2010, pp. 101-125). From the sociology side of things, I think it is one of the finest there is.
Historically, in some cases, society has created disability evolving from eras such as the industrial revolution. This in particular has invented and provided practical means and solutions to speed up our lives but at risk of potential harm and injury. Yet once an individual is rendered ‘disabled’ an ostricization occurs from society. It appears with a minimalist level of support to re-enable the individual into society. The medical model and Societies prejudice creates a different perspective towards disability rather than empowering and emancipating.
I have had the absolute privilege of meeting some fantastic individuals that have managed to ‘cope’ with minimalist support whom have achieved what society would deem impossible but to them is part of their everyday life. That to me is laudable.
Wondered whether Mol’s (2002) ethnography of diabetes might be a useful reference point – as a way of conceptualising how (dis)ability is ‘done’ in practice, & its potential to multiply (e.g. everything from an ‘exhibit’ in a Victorian circus or medical ward round to a super-human technologically-enhanced entity) as the body moves through time/space?
In society today there is an increased attention how to construct health interventions
for marginalised groups in a profitable way. Many of these health interventions can benefit from a
physiotherapeutic approach both in medical and social context. The term socially marginalized is defined as individuals living a life which falls outside the common perception of what a good life is. The enormous problem with setting up these two models against another, is that medical excludes psychological, environmental and social factors and social faktors excludes biomechanical factors.
I work on how people can change the lives of homeless people through football. Right now the tournament (homelessworldcup.org) is host in Santiago, Chile.
We are physioteam from Danmark and Norway who is treating players from all over the world and on busy day had around 150-200 treatments a day with all kinds of injuries: dislocated fingers and shoulders, broken bones. Major acute ligaments and muscle ruptures. Minor muscle and ligaments sprains and strains, Burns and scrapes, dehydration, anxiety reactions, muscle sourness, prophylactic treatments and Counseling and suicidal thoughts.
For all the over 1000 participants, we use a football as the mediating technology, and thats helps them to engage meaningfully in the world, communicate, remain active, have fun, relax and live otherwise normal lives.
I think we need better physiotherapy guidelines for how we look interdisciplinary on correlations and causal understanding in studies
– http://andreasbjerregaard.wordpress.com/2013/08/16/we-are-the-oil-behind-the-engine-here-in-homeless-world-cup/?preview=true&preview_id=1939&preview_nonce=85b5857493
– homlessworldcup.org
1) As you note the social versus medical model discussion has created its own classificatory binary. The connectivity premise is a radical departure in that it challenges the parameters of the debate. Instead of focusing on where disability is located ie body vs society, it rejects disability as a (stable) category. Different connectivities can then be analyzed for their effects. Some will be ‘disabling’ some ‘enabling’; often they will be both depending on context and how disability and ability are ordered within that context. Another way of thinking of this is not to focus on what a person is (disabled vs non-disabled) but what the connections (assemblages) do in the world (eg through an ANT analysis) . 2) A potential direction for the paper is to critically examine the success of the ICF in putatively (!) addressing the divide between the social and personal models of disability. The ICF was created in part in response to critiques of the ICIDH and its presupposition that impairment led to disability in a linear cause and effect relationship. A close reading of the ICF reveals that this relationship still lurks in the details of the model. Moreover the ICF still positions disability in opposition to typical or “normal” body structures , functions, activities and roles. The ICF then, while perhaps useful in many ways, functions to categorize persons as disabled or non-disabled in relation to their biological impairments and to normative assumptions of good or poor function.
Originally posted by Barbara Gibson on 23rd October 2014
Very much enjoying this blog Dave! I hope you don’t mind if I add a comment in agreement. I have been thinking quite a bit about connectivity as I work through analyses in my doctoral work. Thinking about ‘connectivity’ offers an immediate shift in perspective – away from the notion that disabled people are ‘other’. Rehabilitation, amidst broader social structures, constructs disabled persons as subjects of a particular type: subjects who need fixing, who need to be normalized, who suffer, who heroically overcome, etc. There is a particular focus on individualized subjects in rehabilitation where what is counted, and what counts almost always relates to ‘individual patient’ units of measurement. As a researcher, thinking about the aims of my research and how/whether I can provide specific suggestions to improve children’s rehabilitation, I am mindful that I risk reproducing this focus on individual subjects – albeit in ways that advocate opening up multiple possible subjectivities including more positive disability identities. Connectivity provides a lens to generate/catalyze my thinking about ‘the problem’ and therefore, potential ‘solutions’, differently, that is, where the ‘problem’ is not located at the level of the individual subject. This suggests, for me, an appreciation of how thinking about how connectivity, and specifically Barbara Gibson’s work on ‘assemblages’, can be fruitful. Connectivity offers a strategy for thinking, not only about how we all accomplish particular actions in our everyday lives, but as way of thinking differently about problematizations that are implicit in rehabilitation e.g. value laden notions of ability/disability, functional/non-functional, enabling/disabling and the ways these mediate our thinking about ‘what’ is meaningful.
Originally posted by Gail Teachman on 24th October 2014