Tuesday

Dis Ability


You have, no doubt, overheard or been in a conversation with someone talking about "their" depression or anxiety, or someone else's OCD or ADHD (most likely their child) as if it were a possession. You've possibly seen cartoon depictions of illnesses as monsters in advertisements for medications. You may have even used your personality color as a scapegoat when trying to elude a responsibility in a group assignment, or your love language as an excuse for disinterest.  In each case, an idea or an abstract concept has been externalized, and, as if it were born out of the collective mind, given a body and identity, if only to give us a reason to buy more Zoloft®. In our never-ending pursuit of global conquest though intelligence, we humans have developed an insatiable urge to label everything whether it exists or not.

Granted, there's plenty of justification for naming things which don't exist physically, but merely as ideas. Idea itself, for example, or even the idea of naming ideas has a name: Nominalism. Communication of ideas such as commonalities, comparison, and numbers* are made possible (or at least expedited) by the labels we lend to their fabricated existence. In fact, all nominalizations owe their existence to the organizational efforts of the human mind.

But wait! What does this have to do with illnesses and disorders?! Abstract and physical disorders alike are real, but only as real as the way they affect us. We only call them a "disorder" because they aren't of the order of normality. If it were normal to behave as though one had ADHD, the disorder would be called Attention Durability Hypoactivity Disorder for people who act calmer than average. Or imagine, if you will, a world in which the majority of people (which you are not part of) suddenly developed the ability to fly; would this diminish your quality of life in any way? Would it be fair to label you as a flightless person, and connect your identity to a deficit? Why would your lack of extra ability have anything to do with your identity? And yet, to be treated as if you could fly would be equally inappropriate. Much of the stigma and misfortune of disability only exist within a paradigm of comparison.

But the disparity from normalcy can be poignantly distressing in contexts where comparison is inevitable, and mental illness is horribly real for those who suffer from it. So what is the point of apparently downplaying the objective reality of abnormality? Why call into question diagnosis and labeling? Well, reader, because the way we think about our disabilities can influence their severity.

In an attempt to humanize those affected by physical and mental aberrations, the accepted method of labeling, known as "people-first language," takes the form of person with disability descriptor (e.g.: a child with ASD; click here for more examples). Though a step in the right direction by separating deficit and identity, the externalizing language figuratively (by now do you understand why it's not "literally") puts the disorder out of reach. Psychologically speaking, it promotes an external locus of control; in other words, the belief that what happens to you determines the quality of your life. Expressing an external locus of control is nearly ubiquitous among people experiencing depression.

There are few things more depressing than to be told you "have" depression. Similarly, worrying about having anxiety can become a self-fulfilling prophecy. As Forest Gump's mother taught him, "Stupid is as stupid does," so it is for most labels. For example: anxiety is as anxiety does; therefore, if you don't feel anxious, then in that moment you don't have anxiety. We all have moments of introspection each day where we must choose how to respond to external influences. One could blame a wave of distress on an external force which would only add helplessness to the situation, or one could respond to the distress by looking for a remedy instead of fixating on a cause. While holding a needle, have you ever been horrified by your own thought to plunge it into your eye? That is what's called an intrusive thought. Assuming OCD exists externally, as does a communicable disease, one might begin to obsess over that intrusive thought—"have I been stricken with the OCD?!" Obsessing over that Compulsion could become a Disorder (see what we did there?). Knowing that intrusive thoughts are strangely common (like that one you had to jump off the balcony for a brief, dizzying moment, or the more benign "did I lock the door/turn off the oven?") keeps them from becoming a problem. They only become a problem once you start believing they are. By understanding that diagnosis (barring disease) is merely a label, it has less power over you than your own perception of it.
Of course, there are many disorders which will not be alleviated by a mere change of perspective; in some cases the right medication is helpful or even needed, but these cases are rare. Whether it be an abstract label, a deficit compared to the majority of the population, or a disease, understanding the meaning of the diagnosis is an essential step on the path toward acceptance. Distancing by externalization rather than acceptance of disability does as much for disability as "color blindness" and white guilt do for racism—lock it up tight enough to preserve it. Also, seeing the person "behind" the disability is as curative as feeling better about obesity by imagining one's "true self" is skinny. These more inconspicuous forms of denial seem helpful, but delay the process of acceptance, and the delusion is hard to keep up in moments of distress. Acceptance and self-worth are what's needed to feel at peace with reality.

So, for those of us dealing with difference, whether it has a label or not, try to see yourself the way MrRogers does. And for those of us observing the differences in others, in the rare case that it's even our business, please at least use people-first language.

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