March 23, 2016

Hidden Disabilities: A Social Dilemma

Posted in: Daily Living

by Dan Roberts

Margaret’s Story

I was making my way down the sidewalk. I heard the clack-clack of skateboard wheels coming at me head-on. I couldn’t see which way to step, so I just froze in place, hoping the child would have good maneuvering skills.

He didn’t. He collided with my bad hip, and his ride escaped into the street. He ran after it, and I was startled at the sound of a blaring horn and tires scraping on loose gravel.

He returned unharmed, thank goodness, and slammed his skateboard back onto the walk. He stood in silence for a few seconds, probably scowling at me and waiting for an apology. Then, before I could explain my visual impairment, he was off again, leaving me standing there, pondering how I should get my mail from then on.

Why did this happen?

The simple answer is “lack of understanding”. Dr. Thomas Behler, a sociology professor, sees increased awareness and more frequent interaction as paths to better social understanding of disabled individuals. Professor Behler credits government intervention and organizational advocacy with improvements made over the past several decades. He is concerned, however, that the evolution has been slow, and mistakes are still too frequent. (1)

Few will argue that awareness and interaction are important to understanding, but what is the catalyst? According to the Centers for Disease Control, “Disabilities can affect people in different ways, even when one person has the same type of disability as another person. Some disabilities may be hidden or not easy to see.” (2)

How could the boy have known?

It is easy to identify obvious physical limitations in a person, and then to interact with that person compassionately. One cannot, however, as readily identify conditions that do not obviously restrict a person’s mobility or physical capabilities. The CDC says that hidden conditions can seriously affect a person’s vision, mental abilities, communication skills, hearing, and social relationships. So how can a person avoid misunderstandings and social gaffes when dealing with individuals who display no immediate signs of disabilities? Is the woman in the checkout line visually impaired, or has she never learned how to count change? Is that student hard of hearing, or is he simply not paying attention?

Where does capability end and disability begin?

An inherent problem is that the definition of “disability” is vague. At what point does one move from capability to disability? Merriam-Webster says disability is “a condition (as one present at birth or caused by injury) that damages or limits a person’s abilities.” (3) The Department of Health and Human Services holds that “disability doesn’t mean unable, and it isn’t a sickness. Most people with disabilities can – and do – work, play, learn, and enjoy full, healthy lives.” (4)

The Americans With Disabilities Act defines “disability” as a legal term, rather than a medical one, including people who have a record of such an impairment, even if they do not currently have a disability. (5)

The Social Security Administration publishes a “bluebook” of disabilities qualified for benefits, and the list is updated or modified as new cases are addressed. (5)

In another attempt to clarify, The World Health Organization has published the International Classification of Functioning, Disability and Health. This provides “a standard language for classifying changes in body function and structure, activity, participation levels, and environmental factors that influence health [in order to] assess the health, functioning, activities, and factors in the environment that either help or create barriers for people to fully participate in society.” (6)

A number of writers have tried to refine the meaning of “disability” by differentiating it from similar terms, such as “inability”. Without getting bogged down in semantics, however, suffice it to say that the search is not yet over for the most appropriate term and definition to satisfy all circumstances. And this confusion can make appropriate social interaction challenging.

Something is missing

If awareness and interaction are necessary for understanding a disabled person, and the disability is not visible or well-defined, and no intermediation exists, then this stool has only two legs. Maybe the missing third element is something like empathy, the ability to understand and share another person’s feelings. One may be aware of another’s disability and even spend a good deal of time around that person, but without empathy, compassionate interrelation will not occur.

In her book, On the Problem of Empathy, early 20th-century German phenomenologist Edith Stein wrote that the capacity for empathy can be innate (“primordial”), and it can also be “given” via relationships with others. It can be activated by memories of one’s own personal experiences, but it cannot be forced to occur [i.e. taught]. Having walked in someone else’s shoes is the best way to learn it, but to be empathetic, one must possess good listening habits, confidence in one’s own position, and honest self-concepts. (7)

Psychologist Daniel Goleman, Ph.D. distinguishes three types of empathy:

1. Cognitive empathy, the ability to see the world through others’ eyes.
2. Emotional empathy, the ability to tune in to another person’s feelings.
3. Empathic concern, an expression of caring about another person. (8)

A truly empathetic person (empathist) innately possesses cognitive and/or emotional empathy in all situations. Empathy in most people, however, is selective, limited to situations that have already passed the owner’s personal tests of awareness and interaction. A woman might, for example, feel compassion for a crying infant on an airplane, while she might roll her eyes at a grown adult suffering an anxiety attack. Selective empathy is not helpful to disabled people who must interact with society in general. Outside of their personal support systems, they are vulnerable to ignorance and lack of empathy. They are fortunate when a true empathist comes along.

Whose fault was it?

The boy was evidently unaware that Margaret could not see him, and he expected her to clear the way. Margaret might have taken her long cane with her, which would have signaled her poor vision, but she probably knew the short route well enough that she didn’t think she needed it.

Neither the boy nor Margaret were totally at fault.  The boy may be more careful next time, but what about other people who have not had his opportunity to learn? Even if she takes her cane along, how can she expect to feel safe during future walks to the mailbox?

Unfortunately, Margaret cannot count on society to change overnight, if ever. It may be on her to become proactive. Perhaps she could make an effort to socialize more with her neighbors in order to provide them and their children information about her vision impairment. She might even ask the boy to accompany her to the mailbox as a special skateboard police escort. This kind of proactivity would incorporate awareness and interaction, which might lead to better understanding all the way around. And, as an extra benefit, the people who could then become empathetic to her situation might be able to generalize that empathy and apply it to other circumstances.

The Bottom Line

Awareness and interaction can lead to understanding, and empathy transports a person from understanding to compassion.  If individuals with disabilities are to be treated fairly – for that matter, if anyone is to be treated fairly – society unequivocally needs to embrace this principle. Until then, disability will continue to be a handicap.
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SOURCES:

1. Eyes On Success Podcast 1501 Sociology of Disability (Dec. 31, 2014) 

2. www.cdc.gov/ncbddd/disabilityandhealth/types.html

3. www.merriam-webster.com/dictionary/disability

4. adata.org/faq/what-definition-disability-under-ada

5. https://www.ssa.gov/disability/professionals/bluebook/

6. www.who.int/classifications/icf/en/

7. www.amazon.com/On-Problem-Empathy-Collected-Volume/dp/0935216111

8. www.danielgoleman.info/empathy-101/

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