View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Stellenbosch University SUNScholar Repository Conceptualising psycho-emotional aspects of disablist discrimination and impairment: Towards a psychoanalytically informed disability studies Brian Paul Watermeyer Dissertation presented for the degree of Doctor of Philosophy in the Department of Psychology, Stellenbosch University Promotor: Prof. Leslie Swartz December 2009 Declaration By submitting this dissertation electronically, I declare that the entirety of the work contained therein is my own, original work, that I am the owner of the copyright thereof and that I have not previously in its entirety or in part submitted it for obtaining any qualification. Signature:……………………….. Date:…………………………….. Copyright © 2009 Stellenbosch University All rights reserved ii ABSTRACT Since the 1970s, the international disability movement has galvanised around the "social model" of disability, as an adversarial response to traditional, individualising "medical" accounts of disablement. The model foregrounds "disablist ideology", identifying systematic exclusion and discrimination as central mediators of disabled life. Latterly, feminist authors within disability studies have problematised the "arid" materialist orientation of the social model, for its eschewing of personal and psychological aspects of disability, and poor theorising of embodiment. Social model orthodoxy construes the psychological as epiphenomenal, diversionary, and potentially misappropriated in the buttressing of pathologising accounts of disablement. A legacy of "traditional" psychoanalytic theorising on disability implies causal links between bodily difference and psychopathology, eliding a critical interrogation of oppression in mediating the severely marginal social and economic destiny of the disabled minority. The new "critical" psychoanalytic approach to disability interprets broad social responses to disablement as the enactment of defences engaged in reaction to the universal unconscious existential conflicts evoked by disability images. The present work seeks to elaborate the integration of psychoanalysis into disability studies, towards development of a politically situated psychology of disability oppression, which creates theoretical links connecting ideology with the nature of individual subjectivity. Conceptual ideas to begin describing the psycho-emotional aspects of disablist oppression and impairment were developed via an integration of clinical data with a renewed, psychoanalytically informed critical synthesis of disability-related research from a range of disciplines. Clinical data was gathered via psychoanalytically oriented group psychotherapy with severely physically impaired university students. Full transcriptions and in-depth field- notes were utilised as a record of data, which was then analysed via interpretive, psychoanalytic and "interpretive auto-ethnographic" methods. Follow-up interviews were held to assess the resonance and utility of new concepts. A range of theoretical contributions was combined in illuminating the modernist cultural and political underpinnings of oppressive responses to the impaired body, and integrated with accounts of the psychological and relational predicaments of disablism gleaned from the clinical record. Topics drawn from literature, critically evaluated, developed and re-synthesised included narcissistic culture, the family, "medicalisation", social mirroring, internalised oppression, liminality, and representations of disability in charity, art and modern bioethics. The nature of countertransference dynamics in therapeutic work with disabled people was considered. Key concepts from the clinical data were developed and progressively reformulated; these included the distortion of boundaries, the discourse of loss, control, independence, identity, complicity, trauma, and the imperative to silencing the subjective experience of disabled life. iii OPSOMMING Die internasionale gestremdheidsbeweging mobiliseer sedert die 1970’s rondom die “sosiale model” van gestremdheid - in afwysende reaksie op tradisionele individualiserende, “mediese” diskoerse. Dié model plaas die kollig op “gestremdheidsideologie”, en identifiseer sistematiese uitsluiting en diskriminasie as die sentrale bemiddelaars van die gestremde lewe. In die laaste tyd word die “droëe” materialistiese benadering van die sosiale model egter deur feministiese outeurs binne gestremdhiedsstudies geproblematiseer, spesifiek as synde ontwykend van die persoonlike en sielkundige aspekte van gestremdheid, en vanweë die model se swak teoretisering van beliggaming. Die ortodokse sosiale model beskou die sielkundige as ‘n epifenomeen, ’n afleiding, en potensieël kaapbaar in diens van patologiserende narratiewe oor gestremdheid. ‘n Nalatenskap van “tradisionele” psigo- analitiese teoretisering oor gestremdheid impliseer kousale verbande tussen liggaamlike alteriteit en psigopatologie, wat lei tot die weglating van ‘n kritiese ondervraging van verdrukking in die bemiddeling van die uiters marginale sosiale en ekonomiese lotsbestemming van die gestremde minderheidsgroep. Die nuwe “kritiese” psigo-analitiese benadering tot gestremdheid interpreteer breë sosiale response op gestremdheid as die aktivering van verdedigingsmeganismes in reaksie op universele onbewuste eksistensiële konflikte wat deur beelde van gestremdheid na vore geroep word. In hierdie verhandeling word daar gepoog om die integrasie van psigo-analise binne gestremdheidstudies uit te dy, en ‘n aanset te lewer tot die ontwikkelling van ’n polities-gesitueerde sielkunde van gestremdheidsverdrukking, waardeur teoretiese verbande tussen ideologie en die aard van individuele subjektiwiteit gelê word. ‘n Aanvanklike begripsapperatuur ten einde die beskrywing van die psigo-affektiewe aspekte van gestremdheidsverdrukking en –benadeling aan die gang te sit, is deur middel van ’n integrasie van kliniese data met ’n hernude, psigo- analities skatpligtige kritiese sintese van gestremdheidsgeoriënteerde navorsing in ‘n verskeidenheid van vakdissiplines ontwikkel. Kliniese data is met behulp van psigo-analities- gerigde groepspsigoterapiesessies met fisiek swaar gestremde universiteitstudente versamel. Volledige transkripsies en uitgebreide veld-aantekeninge is gebruik as data-rekord, wat dan vervolgens deur middel van interpretatiewe, psigo-analitiese en “interpretatiewe auto- etnografiese” metodes geanaliseer is. Opvolg-onderhoude is gehou ten einde die mate van weerklank en bruikbaarheid van die nuwe konsepte te evalueer. ’n Verskeidenheid teoretiese bydrae is gekombineer ten einde die modernistiese kulturele en politieke stutte van verdrukkende response tot die belemmerde liggaam te belig, en is voorts geïntegreer met beskrywings van die sielkundige en verhoudingsmatige verknorsings van gestremdheid wat uit die kliniese rekord vergader is. Onderwerpe wat uit die literatuur ontleen, krities geëvalueer, ontwikkel en hersintetiseer is, sluit in die kultuur van narcisme, die gesin, “medikalisering”, sosiale spieëling, geïnternaliseerde verdrukking, liminaliteit, sowel as uitbeeldings van gestremdheid in barmhartigheidsdiens, kuns en bio-etiek. Die aard van teenoordrag-dinamieke in terapeutiese werk met gestremdes is ook in oorweging geneem. Sleutelbegrippe ontleen aan die kliniese data is ontwikkel en vootdurend herformuleer; hierdie sluit in die verwringing van grenslyne, die diskoers van verlies, van beheer, onafhanklikheid, identiteit, medepligtigheid, trauma, en die imperatief tot stilswye oor die subjektiewe ervaring van die gestremde lewe. iv ACKNOWLEDGMENTS Prof. Leslie Swartz, my supervisor, teacher and friend of many years, for his insights, support and simple faith in my potential to produce useful work. The members of the psychotherapy group which is part of the subject matter of this dissertation, for what they taught me, and for generously allowing me to document their experience. Especially in memory of A, whose rich energy and character will remain missed by all. My precious wife, Rachael, whose constant love, support and pride in my work surprises and blesses me daily. Chantal Deacon, Tanya Damon, Sonia Fick and Lise Anthonissen, my research and reading assistants, for their hard work, patience, dedication and friendship. The staff of the Disability Service at the University of Cape Town, for their cooperation and interest in supporting the project. Deborah Marks and Valerie Sinason, whose writings and personal communications have, over several years, vastly enriched my thinking on the phenomenon of disability. The South African National Research Foundation, for the doctoral research funding which made this investigation possible. Dr Deryck Sheriffs, my father-in-law, for his immense care in proofreading the manuscript, and for his support and friendship. The many cherished friends who have so generously given companionship, love and support through this process as well as many others. v TABLE OF CONTENTS CHAPTER ONE Introduction and opening reflections .............................................................................................................1 Introduction .......................................................................................................................................................1 Written on the body .........................................................................................................................................10 Disability: The international