NBS seminar - "broken brains"?

Paul Grobstein's picture

Welcome to the on-line forum associated with the 2008 senior seminar in Neural and Behavioral Sciences at Bryn Mawr and Haverford Colleges.  Its a way to keep conversations going between course meetings, and to do so in a way that makes our conversations available to other who may in turn have interesting thoughts to contribute to them.  

Thoughts this week about 

and our conversation based on them ...

 

Ian Morton's picture

Difference and Morality as Culturally Relative Concepts

As Emily points out, culture is no simple concept to define; a whole book could be written just on how to define culture. Emily’s principle defining characteristic of culture as something requiring at least two people is an important one; culture is indeed a social phenomenon. And as Emily said, it does logically follow that within a social group there will be inherent differences or degrees of “abledness” amongst the subjects. It seems justified to derive from this that “disabled” is therefore a socially constructed term to describe a socially relative concept, a notion that resonates in many posts (see Danielle, Elliot, JaymElaine)

However, while many people recognize that culture and its labels are relative, or non-universal/objective, only Jessica K. seems to acknowledge that deviancy is also a culturally relative concept. From the discussion in last week’s class, and from some of the posts on this forum, it seems to me that many people in our class allude to or assume a concept of universal morality. Even though the word “moral” was only used once in last week’s discussion, I believe the concept of morality is relative to this conversation on culture and disability.

I do not believe that ethical doctrine is universal or a priori (categorical imperatives). Rather, I believe ethical doctrine is both culturally/socially derived and tentative/subject to revision. If one needs examples, one can consider sexual practices such as incest, pedophilia, and homosexuality, all of which have been both condemned and accepted by various cultures across time (ancient Greek boy-loving, ancient Egyptian royalty incest etc.). With this understanding in mind, one must consider whether or not he/she has a right to push one’s own cultural ethical values on another.

However, what about social obligation? Social obligation is here used to refer to the sacrifices expected of individuals in exchange for the benefits awarded through living in a society. For instance, a chimp must be willing to sacrifice some immediate benefits/desires such as a mate choice or access to a food resource in exchange for the greater ecological/fitness benefits of group life such as protection from predation. Likewise, it seems that an individual living within a society has some degree of responsibility to sacrifice some personal desires (such as a blind person’s desire to drive – as an extreme – or an individual’s desire to speed – as commonplace) when those desires conflict with the values of that society in exchange for the privilege of living within that society. As Krosania proposes, criminals need to adjust to the society they occupy.

I will attempt to bring this rambling together. Throughout our discussions it seems that people are open to others’ differences as long as those differences do not cross a moral/ethical boundary. For instance, a predominant theme was that of an individual being a threat to him/herself or others (see Elliot, ehinchcl, Stephanie, Emily). Jessica K. also guides out attention to the importance of recognizing that one’s differences/disability have a powerful ability to hurt those who are around/close to the individual. With these concerns in mind, it appears to me that many people are of the mind that society should be open to others’ differences, so long as those differences do not cause harm. This therefore enters the realm of freedom and points to the question/problem of freedom.

John Stuart Mill takes up this problem of freedom. As I read Mill, he argues (similarly to our class) that an individual should be entitled to one’s negative freedom (negative freedom refers to a lack of external constraints; e.g. societal standards) so long as that person does not cause harm to others. Mill thereby goes further than us to suggest that an individual has the right to cause harm to him/herself, but he remains similar in his argument to us by saying that society can interfere with an individual’s freedom if that individual could harm others. It is commonly cited that the problem with Mill’s harm clause is that he does not specify what qualifies as harm. For instance, while Mill suggests a man has a right to become an alcoholic, this man’s alcoholism could likely cause harm to those near him. Mill also seems to suggest that man has the right to take his own life, which causes no direct (physical harm) to others, but what about the psychological pain it will give those who knew this man?

With all of the above notions in mind, I think it would be pertinent to consider what we define as harm, what right society has to prevent harm, an individual’s responsibility to society, and whether or not our beliefs about harm are valid on a universal level. I do not want to suggest that because some people in the world don’t consider murder to be morally wrong (murder therefore not as universally wrong) we should allow an individual to go around killing people. I only think it would be interesting to pursue this line of thought a bit further. Though perhaps this would stray to far from the direct issue at hand.

atuttle's picture

Using the same standard

 

I want to begin by thanking Kara Brown, who quoted me in her post. Following up on this idea further, I noticed the discussion last week seemed to reflect an inherent discrepancy between the ways we view mental, versus physical, disabilities. Specifically, it seemed that people had a (relatively) easier time identifying and categorizing physical states as “disabilities” than examples of mental illness. For example, while autism or bipolar depression cases were described as differences in thinking, the general consensus regarding physical differences which limit an individual’s abilities to fend for herself (e.g., paraplegism) were disabilities. Interestingly, the discussion about physically handicapped individuals was less couched in moral terms (i.e., “better than”, “worse than”, etc.) Rather, the class seemed to agree when I mentioned that there are inherent differences between physical and mental disabilities, and reasoned that physical states which hinder independence can be safely (i.e., without a moral connotation of inferiority or superiority assigned to the definition) deemed as “disabled.” To illustrate this point, when faced with a case of an individual in a vegetative state many of us would not hesitate to deem this individual as disabled, rather than “different” or “alternative.”

Why is the benchmark regarding “disability” easier to determine in a physical, versus mental hypothetical? Several students bring up the issue of evolutionary survival as a benchmark. Amelia, for example, believes that individuals “who are no longer able to take care of themselves” can be classified as disabled. As Jessica points out, however, humankind has recently bucked the trend (so to speak) from a traditional hunter-gatherer society and the problems associated with this type of lifestyle. As humans have continued to negate the effects of “natural” evolutionary forces, however, so too have we created a new set of challenges for survival in the modern world. As a social species, it makes sense that many of today’s competitive arenas (work, school, dance clubs, family reunions) place a significant amount of stress on an individual’s cognitive and social abilities. And as individual differences in a person’s physical state yield varying amounts of survival success throughout our evolutionary history, so too these new challenges reveal differences in an individual’s adaptive fitness to the new “super-social “ environment. Individuals are different from one another, both in physical and mental terms. Some of these differences facilitate an individual’s survival, whereas other differences create additional challenges. I agree with Felicia: The problem we need to address is the stigma that is attached with the term “disability.” Essentially, we should use the same standards when comparing mental and physical abnormalities, without attaching moral values to these definitions.

 

~Alex Tuttle

Haverford '08

Amelia's picture

Thoughts on culture and disability

After last week’s discussion, I started to think about what I consider the definition of disability how we were using it in class. To me, a disorder is not something that is intrinsically“less good” but instead something that hampers someone’s ability to participate in a society as a whole. While we were saying that we see people with autism as“less good”, we label it a disorder because they are unable to participate in the dominant culture, not because their ways of communicating are less good. In that sense, the man in the story “in the land of the blind, the one eyed man is king” was suffering from a disability in terms of what society he was in. He could have adapted to their way of life and been able to function in the community even if he still had his eyes. In that community however as it was, having eyes was a disability since he was not able to participate and (maybe?) to do so successfully he had to lose eyes.

I think the line that needs to be drawn between a difference and a disability is when the person, for physical or social reasons, is no longer able to take care of themselves. Severely autistic people, for example, are usually unable to take care of their own daily needs.  Perhaps the autism spectrum needs to be re-evaluated to separate those who simply participate in society with a different view point and different way from those who seem completely isolated from society.

Someone made a comment on Tuesday that maybe what is needed for everyone to function best is for us all to be in our own societies. While I’m not sure if the person truly meant this, if this were to happen there would be no culture and no society, just isolated individuals. We need culture to survive and all are making some adaptations to participate to our utmost ability in the one that we live in.

I also believe that the dominant culture has a responsibility to not ‘correct’ someone with autism (or other disorders) but to let them reach their highest ability of functioning in the society while adapting to their uniqueness and needs.  Many children with autism are now given typewriters, or picture books where they can point to what they need or want, in an attempt to communicate with the dominant culture. While it might be best for us all to just understand them as they are, as of now we are not yet there and these are huge steps being made by the dominant culture to adapt for the minority.

I feel like people were arguing that we aren’t making adaptations for people with autism, but I see  such attempts to give them the most opportunities to reach their highest ‘functioning’ within the society. Also, many people who work with autistic individuals are aware of things that bother them (such as being touched) and avoid doing so. This is an example of an adaptation made by the ‘dominants’ to the minority.

Furthermore, in terms of schools and having special classrooms to help ‘disordered children to reach baseline’ (in which I think it is more of an attempt to have everyone reach their highest potential), we must remember that gifted children are also given extra support and I see this as an example of this attempt. While the main classroom may work for the baseline students, extra classes are needed for those either above or below baseline not to make them baseline, but to have them reach their potential.

WhileI could go on about my thoughts on culture and disability, I’ll just make one more point about evolution. An argument was made that previous cultures viewed females as a ‘disorder’ as our current culture now views autistic individuals. My problem with this argument is that it doesn’t agree with evolution. Females were, and are, necessary for the propagation of the species, while autism and other social disorders is not ‘needed’. While maybe they are the ‘next step’ on the evolutionary tree, at the moment they have not showed an evolutionarily adaptive trait to let them eventually reproduce at a greater success that our culture without autism. In fact, severely autistic people in general (of course this is a generalization) do not reproduce because of their inability to participate in the culture. With this as the case, they will not be the next step from ‘females’ in terms of what is seen as a disorder to later be necessary. While I think that having people with different ways of communicating and thinking is good to have in a society, it is not necessary for the continuation of humans like females are. Without this need, it cannot be seen as adaptive. 

 

Ian Morton's picture

evolution and autism?

Hi Amelia,

I wanted to reply to the last section of your post where you stress your concern about the woman/autistic individual example and its incongruency with evolution. I agree that women are necessary for reproduction, and I consent that currently autism has not proved to be a fitness boost, but I do not see how this is necessarily relevant to the topic at hand. I suppose my greatest concern stems from your argument that people with autism “will not be the next step from females’ in terms of what is seen as a disorder to later be necessary […] [autism] is not necessary for the continuation of humans like females are. Without this need, it cannot be seen as adaptive.” Perhaps I don’t understand your contention, but I do not understand the relevancy of evolution and adaptability to this specific concern.

First, I do not believe that society went from viewing females as disordered to necessary. I am pretty sure women have almost always been recognized as “necessary” for the creation of life. For this reason I thereby have no reason to believe that the change in women’s status from “disabled” to equal, non second-class citizens, has any relation to the recognition of women’s importance for procreation.

Second, I do not believe that Paul’s comparison of women, homosexual individuals, and autistic individuals bears a significant relation to evolutionary concepts. I believe Paul was stressing how these groups of individuals are occupying different stages along the progression from being viewed by society as inferior to being viewed as different but equal. While “inferior” is often used to imply biological inferiority (e.g. intelligence), I do not believe society was motivated to label a group as inferior because it felt the group was less capable of producing offspring.

In sum, I agree that being autistic is not like being female in the sense that one characteristic is necessary for procreation while the other is not, but I do not see why this difference poses a problem for Paul’s example and the topic at hand. Could you clarify for me what you were trying to say about how this relates to evolution?

Ian HC ‘08
Amelia's picture

What I was trying to say in

What I was trying to say in my ramblings is that I think that one aspect leading to the eventual success of women becoming a 'difference' instead of a disorder is time. Autism seems to have become prominent in recent decades and since it is not 'needed' for reproduction (like women), it could fade out in a short span of time (since at the time the causes of it are very debatable). Think about how long it did take women to finally not be classified as a disorder. I wasn't trying to imply that I thought we SHOULDN'T view people as autism as different (instead of disordered), but that our culture probably WILL not since it has not been around (at least at the rate of today) for a long time.

Again, (to your second paragraph), I wasn't trying to say that women are now accepted because they are necessary, but because they have had TIME to finally push pass being disordered. I do think that if autism stuck around for hundreds of years in a prominent way, it would go through a similar transformation.

I don't disagree with the comment that these examples are different progressions of moving from disordered to different, I disagree with what some people were saying after this that maybe autism is the "next step" in the progression of human life. I do not see autism as the next step but a side step. I guess if I have a disagreement with the example it is because I don't see autism being able to move out of its 'disordered' since at the moment it is not yet a major section of the community. I do think that we should move to call them just different, but I don't think it will happen (in any foreseeable future) as it did for women).

I hope this has cleared up a bit what I said, but I'm not sure since I still feel like I'm rambling. Feel free to email me!
Ian Morton's picture

thanks for the clarification

Hi Amelia,

Thank you for taking the time to clarify your sentiments for me. I now see your point and I find it very interesting. I very much agree with you that time is an indispensable factor when considering social change. I also think it is very interesting how you then take this consideration and argue that perhaps the condition (and prevalence) of autism may not be around long enough to undergo a conceptual change in the eyes of society. [Please correct me if I have misinterpreted your proposal.] However, to play devil’s advocate, perhaps we should be more optimistic to the rate at which social change can occur (less than hundreds of years). Though, I admit that it does seem like significant social change would in fact take hundreds of years – this, however is not a reason to not begin the push for social change (a point that I believe you and I, as well as the rest of the class, would agree upon). Perhaps we should consider as a group how we could promote such change? (Education?)

Also, I did not pick up on the idea that people were suggesting that autism is the next step in human evolution. I am glad you brought this point to my attention, and while I find it interesting, I agree with you that it seems unlikely that autism will become the “baseline” of humanity. However, I do believe autism could grow in prevalence.

See you tonight!

-- Ian
ebitler's picture

There are a few things from

There are a few things from the last class that really struck me. In terms of a disability as being seen by the dominant forces as “less good,” I do think that our culture is reaching a point where autism can be seen as a difference that is good in different ways. That’s not to say that it’s a shared belief by most, but just that we’re at a point where our culture is ready for it thanks to claims makers that initiate the identification of our current thoughts as problematic. The one example that kept coming to mind was a girl on the most recent season of America’s Next Top Model. Heather has a mild form of autism and because of the way that she uses her eyes (she doesn’t shy away from direct, intense eye contact) she produced some really amazing photographs with intensity that the other girls just couldn’t pull off. She made it really far in the competition because of her unique abilities as a person with autism and she’s the new face for the “disease.”

 

At the same time, she didn’t win the competition because she couldn’t perform in other areas that are necessary to be a “top model”; she was unable to read lines for commercials or interact well with designers in interviews, and she also didn’t really have to focus necessary for runway. I think she’s a good example of how you can be different with autism and be better at some things and a designer would be wise to book her for photographs and book someone else for runway. The combination of autistic and non-autistic abilities is greater than either can be alone.

 

Heather’s autism also brings up the idea of treatment with medicine. She would not have been able to go as far as she did in the competition (and as far as she will go in the field of modeling) without some form of intervention aimed at making her fit into our culture better. I do think that we shouldn’t medicate someone just to make them who we want to be, but I think it’s also important to recognize that it takes a lot of time to change a culture, and that an individual will likely have a better experience within the culture if they’re able to adapt somewhat. I completely agree with Stephanie that there’s nothing wrong with a two step approach of working to change the minds of people about how they think about those with a “disability” but in the mean time helping those with the “disabilities” to function well within a rigid society.

 

The only other thing that I want to say about whether or not to treat someone is that I think that questions of the physical and mental health and safety of an individual and the others around them should be the priority. I have no problem with letting an adult with bipolar disorder decide whether or not to medicate as long as they’re not a risk to themselves or others. Britney Spears may be a successful artist because of her mental state, but that doesn’t mean that I think her children should be subjected to an unstable environment. If she wants to be a mother she needs to choose the treatment options that will make her a stable mother. And we should help people to feel that their best option isn’t killing themselves, because then their “differences” can’t contribute anything to our society. Suicide is not a Darwinian advantage, it’s just a loss.

tlogan's picture

Doctors as "Cultural Adjusters?"

In my mind, doctors (and psychologists) play a key role in the meshing of culture and “disability,” as in their role of administering treatment; they must first determine who is sick and who is not sick. In a way, they serve the final judgment of what is culturally acceptable behavior, and provide the definition of “normal” or baseline. Again this is also the role that the DSM plays, that of an adjudicator. I am left to wonder whether those that control the DSM consider what “normal” is in terms of the culture of which we are apart. To define mental pathologies, they must have an internal working definition of baseline behavior, as otherwise they would not be able to distinguish what is considered abnormal. Does this mean that the DSM is inextricably bound to the culture that created, and thus are the definitions of psychopathologies culturally relative? This calls to mind the example provided by Natsu of the boy who would not follow what was culturally understood to be the rules of physical contact, thus could be considered out of the bounds of what is baseline.

On a sidenote: it would be interesting if one could examine what was considered disability historically, and possibly use this information gauge the culture at the time. As Prof. Grobstein pointed out in class on Tuesday, until the 1970s (I believe), homosexuality was included in the DSM, which says much about how homosexuality was perceived at the time. Could it be that bipolar disorder, or autism, or attention-deficit disorder are not pathologies of the mind so much as of the culture? I know that seems far fetched, but it strikes me that doctors do not take into account that these behaviors could be the result of “normalcy” in a different paradigm.

The problem with definition, though it creates more digestible packets of information, is that it also creates a matrix, with defined borders and assigned characteristics within those borders. Definitions are victims of paradigm. When doctors use these, it seems rare that they take into account the idea that they are based on observations made on a limited scope of knowledge. I believe someone also brought this point up in class, in that we would all exhibit symptoms characteristic of one of the pathologies listed in the DSM. I know I have gone on a tangent, but I merely wanted to indicate my discomfort related to the idea that doctors can define shape what culturally acceptable based on subjective observations. I suppose it is exceedingly difficult to reshape the culture that defines our every action.

Andrea G.'s picture

Fixing what isn't broken

Like many people have already mentioned, I've been thinking a lot about "broken brains" since Tuesday night.  We talked briefly about bipolar disorder and whether, for some people, crushing depression is a small price to pay in exchange for incredibly productive periods of mania.  For these people, even though they recognize that their mood fluctuations are not "normal" (whatever that is), they don't consider themselves disabled.  Some might even consider themselves particularly fortunate to be able to be so artistically productive for whatever period of time they are allowed by their manic states.  If a group of people who have been diagnosed with a disorder don't consider themselves to be broken, are we justified in trying to fix them?
I'm struggling with ideas that seem mutually exclusive to me right now.  I can't imagine a world where we don't treat psychological disorders, especially ones that have fairly effective (and always improving) treatment options.  But if we look at things like bipolar disorder as a difference, and not a disability, wouldn't treating it seem unethical?  I'm certainly not arguing that we shouldn't treat conditions that we know can be managed with drugs.  I'm simply trying to reconcile my contradictory thoughts.  I'd be interested to hear what anyone else thinks about the matter.
Mawrtyr2008's picture

Mutual Exclusivity

Andrea,

I've been struggling with that same feeling of mutual exclusiveness, and I like your comment about ethics of treatment, the medical model, and medical paternalism.

I'd like to contrast Jessica and your example of bi-polar disorder with that of Austism. In that satirical website about the Neurotypical, the Austistic authors' clear purpose was to assert that they are not broken at all, that treatment seems more like forced conformity, and that because of many communication differences, conversations like these never really happen.

In observing comments made about bi-polar disorder and austism, clearly these two brain configurations produce people with very different conceptions about their self. For example, bi-polar people may not view themselves as diseased, and autistic people may view themselves as simply different. What's the fundamental difference between these two?

This seems to me to be an important question to ask, especially in light of our critique of the DSM. Would an alternative structure this very useful medical guide include sections on brain configurations from which people who see themselves as healthy/whole emerge (maybe bi-polar?), brain configurations from which people who see themselves as unhealthy/broken emerge (maybe depression?), and brain configurations from which people who see themselves as just one of many variations of humans emerge (maybe Austism?).

Jessica Krueger's picture

Not popular

First off, I'd like to just like apologize for my little "Bi-Polar Freak Out" in the middle of class. My family just experienced my younger sister's first manic episode not too long ago, and we've been living with bi-polar relatives our entire lives. Listening to my sister inform me that she has a profound understanding of our family’s greater purpose because she spoke to my recently demised grandmother and because there are four people in our immeduiate family, which means there are three recipients, which totals seven the holy number, which is all so clear to her now, and that she is divine and will not die, and it’s okay because I understand her words for two hours skewed my perspective and is apparently a sufficiently fresh wound that it can still send me in to a blind, unproductive tizzy.

Which brings me to the thrust of what I'd like my short, potentially counter-productive, point to concern itself with: these "broken brains,' regardless of how they're defined or handled, do not exist in a vacuum. There are people who love them, people who may be more “able” or less “ill” than they are watching them flounder. Fixing these brains doesn’t require an appeal to the evolutionary greater good or society at large, but simply a recognition of a family unit around them that suffers on account of another’s disorder. True, a bi-polar patient feels incredibly lucid during his/her manias, as though s/he really sees and understands, but a quick glance at his/her credit card bill or the state of their interpersonal relationships or their body weight may indicate that the individual isn’t capable of understanding consequences at all. To preserve an individual in this disordered state because they “want” their disorder is incredibly selfish and disregards the other potential victims of the disorder. Preserving the well being of a loved one for the sake of the family may read as selfish, especially when the disease is merely a construct of society, but the pain and suffering of those around the person should not be ignored either.

No one would in their right mind would allow a drunk man to consent to a sex change operation, so how can we allow people whose minds, whose reasoning, whose perception are clearly dysfunctional decide that they shouldn’t be treated? How selfish is it to allow an individual to exist in a pathological state in the hopes that they may turn out to be a great artist, or writer or thinker for the benefit of society? And if, hypothetically, we set about reconstructing our culture such that treatment of bi-polar disorder and autism becomes obsolete in a manner analogous to that which we are presumably attempting with homosexuality, what of those already inculcated with the views and values of the before? Are their sadnesses and experiences really so inconsequential? In closing I realize that this viewpoint is not popular and probably reads as very myopic and unenlightened. But listening to my sister’s broken and frightened voice when she asks me if she’s crazy and the subsequent duress I experienced gave me a profound sympathy for the deeply Catholic father of a homosexual son, the mother whose autistic baby won’t smile at her and the brother of a bi-polar patient who has been called to identify the body.

(Is the suffering of one party necessarily less than that of other? How did we come to recognize the pain of the gay child over the parent and inversely the mother over the autistic baby?)

aamen's picture

Cultural Standards and Disability

I thought an interesting point made during our discussion was the ideathat the process by which people accomplish tasks should not be what is important - what is important is the fact that the tasks are accomplished.  Culture should be willing and able to accept different methods of solving a problem as long as the problem is eventually solved. It seems to me that it would not be fair to classify someone as disabled simply because they go about doing things in a different way than what is considered by society to be 'normal'.  For example, to my knowledge dyslexic children are perfectly capable of learning to read, it just has to be approached in a different manner.  I'm not sure then that is it fair to call children with conditions such as dyslexia learning 'disabled' - as has been discussed, it seems to me that the condition simply results in a difference in learning style that makes some things come harder and some potentially easier.  

 

Paul brought up the issue of whether or not an autistic person's brain can be considered 'broken' when autism can cause a sort of genius in some aspects of life as well as an inability to function in our culture.  People in class were concerned with the issue that minor conditions considered to be 'disabilities' can be argued to be merely differences, but that if you follow this logic on and on, eventually you hit a point where a person is so significantly 'different' that they must be considered disabled.  It seems to me that this is what makes discussing autism so tricky, since there are such varying degrees of autism.  People with more minor cases of autism might have difficulty functioning socially in society, but also may be able to overcome this difficulty, in which case I personally would not consider them to be 'disabled' or 'broken'.  However, severe cases of autism might lead to the inability of an individual to overcome such difficulties.  It is not a matter of reaching a goal through a different path; they are simply incapable of reaching the goal.  In such cases I would be willing to use the term 'disabled' - I guess I think that when an individual has a condition that renders it impossible for them to function normally in our society then they are disabled in terms of whatever it is that they are unable to do.  For example, I would call a blind person 'disabled' because they cannot get around their inability to see. However, I recognize that if this is the case being disabled is completely a function of culture, since I am defining disability as not being able to live up to cultural standards.  

 

I also don't think (as I'm sure most people agree) that it is fair forthe term 'disability' to have the stigma that it does.  In labeling people with certain conditions as 'disabled', I would not want to imply that they are somehow less than people who are notdisabled, simply that there are things they are unable to do.  I think the real problem lies with the connotation of the term, although this is something that would be very difficult to change.

JaymElaine's picture

Disability...Yay or Nay?

Disability, as I have defined it, is a condition that has been deemed as "not normal" in our everyday society. Having a disability means that you may not be able to function "normally" or participate in even the simplest of routine activities, such as brushing your own teeth or feeding yourself without any help. I use the word "normal" in quotation marks and very loosely because I still question to myself and to others today, "what is normal?" With this question in mind, we begin to think about disability in our culture. Should we see disability and help those who we have labeled as disabled to become more acceptable in society, or should we instead change our ways/culture and not see disability as just that, a disability? Well, I say a little bit of both.

We should notice disability in our society, but not so much as a disability in the context that we use it today; instead, we should see it more as a difference. Those with disabilities such as autism, multiple personality syndrome, or schizophrenia will clearly be noticed in society and can perhaps be a danger to themselves and others. So yes, in these cases, we need to recognize these differences and lend our helping hands when needed. And let us be realistic as well; could you imagine a society without disability? How would the world change? As I mentioned in class last Tuesday, us scientists and researchers rely on the world’s disabilities to give us jobs! Are we not trying to cure cancer, find the gene for autism, and make better medicines for mentally ill patients? Face it, we need disability; for physicians and scientists, it brings purpose.

On the other hand it would be nice if culture as we know it today could change our views of disability. My goodness, the way things are going these days, everything is going to be a disability someday! I have IBS (irritable bowel syndrome) so does that make me disabled? My brother has frequent panic attacks; is he also disabled? Both of us take medication on occasion for our symptoms, but we both function well in society. This leads me to another question; if the answer is "no" to my above questions, than how do we label the severity of a condition and label it as a disability? Do we instead have degrees of disability that can be mapped on the disability spectrum? And while we are thinking about all of this, we must then ask yet another question; aren’t we all disabled? It seems as though everyone has at least one problem that can be medically treated/fixed, whether its something more serious like schizophrenia or something less serious like frequent headaches.

Thinking about disability in today’s culture is tedious! There is so much to think about and so much to question; unfortunately, we do not have all the answers.

 

Jayme E. Hopkins, '08

kbrown's picture

The treatment of disabilities and the Evolutionary Approach

Hi guys,

   So one thing that I found particularly interesting in our discussion last tuesday centered around how the evolutionary perspective comes into play when we talk about categorizing disabilities as "difference" or "absence of ability".  The first article that we spoke about in particular seemed to bring this topic into play when it said that culture itself provided challanges and problems for citizens to solve, and it was solving those problems which created the category of disability.  When reading this, it seemed to me that instead of culture, the word "natural selection" should be inserted into the sentence. 

Possibly because I am just coming out of a class on primate evolution and these ideas were fresh in my mind, the fact that natural selection is the means by which specific individuals best suited to the challanges created by the environment are able to survive.  Now cleary things in modern day society are such that we don't need to worry about "survival of the fittest" in the same way that our ancestor's did.  However, we are in fact a product of those ancestors that for one reason or another were better suited to the environment than those who did not survive.  For that reason alone I'm not sure that it makes sense to question whether it is better to have eyes or be blind, simply because from an evolutionary perspective if we didn't need eyes we wouldnt have developed them.  If we were in a world which had no sun perhaps people who could see would be at a disadvantage.

It is true, however, that our society today is one in which we have become so advanced as to make many disabilities no longer pertinent, such as the creation of brail etc, and I am not sure that the term disability can really be used today.  It is possible, and I think many people stated this on tuesday, that these categories of disability no longer have meaning in our society because they imply a "good" and "less good" spectrum.  I think it is hard to argue that blindness is less good than sight and I don't know anyone who would choose to argue that point, if not for the simple reason that it is really untrue, but also that it goes against a paradigm of equality in our society.  However, for me this seems to be an even stronger reason not to neglect evolution when thinking about disability.  I think I can say that it is clearly wrong for society to deem people less good because it intrinsically making some sort of arbitrary value judgment.  Natural selection, however, seems to be able to perform the same task without any sort of value judgment at all.  Natural selection, because it is not man-made like society, makes decision that, while they may still seem arbitrary, impose no sort of value judgment other than that of "able to survive" and "not able to survive". However, I am not sure the degree to which we should be basing our current day labels on a natural process millions of years old and becoming more obsolete by the minute.

When thinking about "mental disabilities" especially I think it is true that the word disability is not accurate, not only because we have made advances in correcting for disabilities, but more importantly that more so than physical disabilities, mental disabilities can simply be thought of as a different path to the same destination.  I think that for many people with mental disabilities such as autism or dyslexia, they are in a way more capable of thinking in a certain way, and this doesn't necesarily mean that they cannot perform the same functions as the majority of society.  In fact, I think that we can stand to learn a lot from these types of mental differences simply because of the fact that they seem to represent not a deficiency but an ability to think in a parallel way, and that instead of demeaning people with these differences we should instead create ways in which we can benefit from their different perspective on tasks such as problem solving.

 However, I think that it is impossible to talk argue the necessity of the term disability when clumping all mental disorders into one.  Just like Alex mentioned that it is difficult to talk about both mental and physical disabilities together, mental disabilities are clearly an extremely varied group, and clearly there are exceptions to what I have said, such as those who are so mentally handicapped that they are not able to care for themselves, which seems to me a clear disadvantage.

Felicia's picture

Celebrating Difference

After our discussion last week, it's very interesting to me to think about how hesitant I am to use the work "disabled" when describing a person; I'd rather think of "difference". And while I can't help but favor the use of difference over disability, in reality disability is difference (while maybe to an extreme). My hesitation is rooted in this negative connotation that seems to go with disability, that not being able makes one a lesser person. This makes me uneasy, largely because I think that identifying disability, as Stephanie said, can be very helpful. If we seemed to agree on anything during class it's that we aren't going to see a culture that is 100% inclusive to everyone all of the time. So, classifying disability as extreme difference can be helpful if not necessary to simply exist in any culture. The issue as I see it is the stigma that surrounds it.

 

It was brought up in class that perhaps we all just have our own different talents - those who can't see, for example, can hear exceptionally well. While I think that it is certainly true that we have our own specialties, I think it's silly to assume the magnitude of these strengths/weaknesses are the same. I can think of many people who seem to just be exceptionally skilled at most things they pursue, and others, not even those the DSM considers disabled, seem to lag behind in most areas. This is where it gets tricky, and I think some of this difference is attributable to genes and development (nature and nurture, if you will). Perhaps it is society that places preferences on some traits (intelligence/physical beauty) over others (empathy, ...) but I think that it would be great to first of all accept disability. If we (as a culture) can be okay with the fact that yes, we all have our strengths but some of us have weaknesses in some area that benefit from assistance... I guess I'm saying that by making our culture inclusive of disability we won't so much have to change society but instead the mindset that accompanies it. While any one society can't be totally inclusive, I think we should strive for a society that everyone benefits from. That starts with taking the stigma off of disability. (obviously also easier said than done)

Looking over my post it seems jumbled, it was much clearer in my head. I look forward to sorting through it with you all!

Mawrtyr2008's picture

"Othering" Culture

Examples of how easily culture can be changed are so far missing from this conversation. Just to rattle off a short list of ways that we’ve all likely experienced or heard about: talk therapy used in conjunction with drug therapy, any education system that offers students specialized care but also integrates them with other types of learners (maybe like Montessori education?), the reciprocal education program at BMC/HC where staff and students have sessions and swap skills (a commonly used example is teaching a staff member how to use a computer in exchange for car repair tips), and any of the diversity discussions on campus that get people from many different backgrounds and cultures in the same room talking about issues that affect everyone. Not only is collaborative cultural change possible, it’s happening on our campus daily.


I think one of the most interesting points that has been made in this forum is that precisely because brains are capable of change, so too are cultures. What’s interesting about this situation is that culture isn’t an iron curtain of norms and values because brains are capable of empathy. For this reason, a person can go to another, for example, country, and still find value in other people’s way of doing things without feeling that their own self-worth is threatened. Also for this reason, Natsu’s account resonated with me and I understood why she made the choice she did. However, a key problematic component of the ability to hold two contrasting ways of operating in one’s mind has to do with “othering” one of them. The natural extension of the question becomes why can people easily regard different religious traditions, education systems, labor division systems as valuable but have such a hard time accepting mental illness in a comparable way. In other words, what makes mental illness so prone to value assignment and necessitates “fixing” in many people’s minds?


In discussing disability, I feel it’s important to bring up a caution about invoking evolutionary processes like adaptation and fitness as a catchall explanation for difference. One of the most pervasive myths about evolutionary processes, one that was expressed repeatedly during this discussion, is that natural selection continually improves and enhances populations towards a progressive, idealized morphological goal. Hands down, the most interesting thing I learned in taking Evolution last semester was that random mutations are responsible for much of the variation we see today. From our discussion and a basic background in genetics, it’s clear that all disabilities are rooted in allelic variation, accounted for by mutation. To build on this, it’s also interesting when discussing evolution as an explanation for disability that the process takes enormous amounts of time. Furthermore, consciousness as we understand it completely convolutes this process in ways that are difficult to understand but easy to see the effects of (like climate change). To take this further, our way of doing things, our culture, our norms and values, are transitory. It’s not that they might change, it’s that they certainly will change. The question is, how? What I mean by this is, if we’re aware that things will change and we’re aware that we can make things change, how will we create change in a way that is important to us?


Finally, I’d like to toss out a definition of disability as an alternative to Tamara’s suicide, self-negating one. I’m pretty convinced at this point that you can’t talk about life without talking about variation, and that you can’t talk about variation without talking about relative ability. Relative ability then, is a quality of life as we know it, and disability is some construct made to carve up groups of people. I refer to disability as understood as by the traditional medical model criteria, including the lack of communication, lack of capacity to change, lack of ability to realize one’s own “otherness”. Maybe then, the only people that you can really characterize as disabled, are people that we’re not even sure are living. I would imagine people in persistent vegetative states, people in deep comas with little hope for recovery, people in the very final stages of neurodegenerative disorders, etc. fill this role. I hope that argument made sense. If it didn't, please let me know.

krosania's picture

Culture, Disability, and "Broken Brains"

I was really surprised by the discussion we had in class about disability and culture, and at how many people seemed to agree that the responsibility lies with individuals and not the culture to correct or accommodate any deviations from the cultural norm. I definitely think the society as a whole should take on the responsibility for ensuring all of its members are equally valued within a culture, regardless of the differences among individuals. I agree that in extreme cases, such as individuals that engage in criminal or sexually deviant behavior, it is the individual that needs to change and not the culture, but I think that we can all agree that the term “disabled” as it is currently used applies to far more people than those that fit in either of these two categories.

I feel like I voiced my opinion a lot on this subject in class though, so I want to move on to the issue of the current conception of mental disorders, because I think it’s a really interesting one. I really agree with what some people have already said about the DSM model of mental disorders being fundamentally flawed. One of the main problems with it in my view is that for any particular disorder, a person can fit the diagnosis by displaying any combination of a varied assortment of symptoms. This means that two people who supposedly have the same disorder can look completely different from one another in terms of their behavior. Additionally, giving a name to a group of symptoms tell us nothing at all about the origins of these symptoms. For this reason, the diagnosis itself is not all that useful in determining a possible means of treatment for the patient. Neuroscientists like to think that we can match underlying neurological causes to particular mental disorders (for example, depression being caused by a deficit of serotonin). However, if this is the case, then why are there so many different types of antidepressants, some of which work for some patients and others not at all? It seems to me that labeling all people who exhibit the symptoms listed in the DSM under Major Depressive disorder as depressed does not really do much to help these people. I understand that most of these problems are due to limitations of our knowledge, but I think as a society we need to be careful about pretending we know more than we actually do. Until we know what actually causes the differences in behavior that are listed in the DSM as “disordered,” we as a society need to be more careful how we talk about, value, and treat these differences. I think in many cases it can do more harm than good to label someone as “disordered” (or, similarly,  “disabled”), especially in situations where neither the society nor the individual is equipped to do anything to remedy or accommodate the “disorder.”

Jessica Krueger's picture

The issue I take with the

The issue I take with the first paragraph of your post is that that which is considered "deviant" is also culturally defined and subject to augmentation. There are some researchers in the world who feel that pedophilia is simply a sexual orientation analogous to homosexuality (1). So why should society be restructured to allow homosexuals to engage in their preferred sexual practice, but not such that adults who wish to engage children in sexual intercourse may do so without repercussion? Is the trauma of childhood molestation merely a cultural construct, an artifact puritanical prudishness? If we cannot define sexual intercourse with a child as fundamentally wrong, what allows us to define rape or female genital mutilation or any supposed human rights violation of a sexual nature? Can a human do unto another something that is fundamentally wrong across cultures?

 

(1) http://www.spiegel.de/international/spiegel/0,1518,441199,00.html

Marissa Patterson's picture

Can (should) we eliminate disability?

Many people have been bringing up the idea of difference and whether or not we should (or can) make the kinds of interventions we have talked about in class and here in the forum. Stephanie metioned her belief that a child with a speech/language disorder should be helped to communicate so that they can thrive in this community. However this made me stop and think: how much is our desire to provide this help based on helping the child integrate into the community and how much is to help the community? It is very hard on a teacher to communicate with a child who is hard of hearing or speaks another language, and her job would be made vastly easier if all of her students could communicate in the same way as each other and as she does.

Professor Grobstein brought up the idea that teachers and schools should adapt to students who learn in different ways and that society should shift as much as possible to incorporate those who have a "disability" or a "difference." However, I still wonder to what extent that is possible. For example, if a hearing couple has a deaf child, one would anticipate that they would learn sign language to commuicate with their child. Perhaps the child's siblings would as well, and maybe even their grandparents. But as the connections get weaker, it is hard to know what else would happen. What about the mother's best friend, or the child's great-aunt, or his third cousin. Should we say that everyone should learn sign language just in case?

Well ok, so now everyone knows sign language, but a child is now born deaf and blind, and so all of the rules change again. There are millions of conditions and "differences" that would need to be adjusted for in order for society to be accessible to everyone.

So let's get rid of difference. Has anyone read The Giver? In this culture, everything has shifted to "sameness" and there is no color, no difference. Everyone wears the same clothes as their yearmates, everyone is assigned a job, a spouse, and even children so that there are no "poor choices" being made, and anything that would mess this up (such as identical twins) is eliminated by "being released," or killed, essentially, without being brought into the community. Additionally, there are strict rules that try to prevent any kind of embarassment or acknowledgement of any difference that still remains, in order to reduce any sense of someone being "better" or "more able" than another.

Anyways, this is a vision of a society that seems in many ways to embody the conditions of total acceptance we have been talking about. However difference has reduced, and instead of celebrating (or discriminating against) difference, it is totally ignored. Is this the only viable alternative to the way our society is? Or is it somehow actually possible to build the kind of world that Professor Grobstein envisions.

Another little thought--is it possible for it to be in a nationwide (or even global) community? The Giver takes place in a small town--are smaller "cultures" easier to control? Just a thought...

Jenna's picture

Should brains be fixed?

An interesting point which came up multiple times in our conversation was that there can be difference without disability and since it is just a difference they should not necessarily be “fixed.”  However, before it is decided that nothing should be done to help someone who is disabled I think it is important to define what the fixing consists of.  For example, I believe that autistic people can make many important contributions to our culture, but if they are unable to communicate these ideas than they will continue to feel isolated and society will miss out on their important contributions.  In this way, I believe that autistic “treatment” should continue as long as it focuses on how to effectively communicate with other people in their society.  It is not necessary to change how they think or feel but I do think it is necessary to teach them how to act in our culture.  This is similar to the example Natsu brought up about the boy who was touching others.  While it is not necessary to change how he thinks or feels about touching others it is necessary that he learns how to function in his culture or it will be difficult for him to participate in his culture.  Although some people may think it is unfair to ask him to change these actions I would argue that it is equally unfair to ask young girls to tolerate his uncomfortable touching.  Ideally there could be some compromise in which both parties could become comfortable with holding hands or hugging.

 

On a similar note, it was brought up that perhaps the majority of mental illnesses classified in the DSM should not actually be treated.  Although I recognize the importance of this argument, especially from historical examples such as homosexuality, I think that it is important for people to have treatment available if they desire it.  For example, if someone suffers from severe depression and want help to make them happy again they should not be told that this is how their brain is set up to work, it is normal, accepted, and valuable as it is.  This may be an appropriate response for someone who is content with their depression and views it as an important aspect of their self definition, but it should not be said to someone desperately seeking treatment.  I think the DSM criteria could be comforting to someone seeking help for depression and these people should not be denied treatment any more than someone should have treatment forced upon them.  One obvious problem with this scenario is that many people may seek treatment because their culture tells them something is wrong even though they are happy with themselves.  Therefore, I think it is necessary to change society as well as the “disabled/ different” individuals.  Society should work hard to become more accepting of differences and resist the urge to judge, while everyone should work to develop effective ways of communicating with each other and living together.  Although this would be difficult I do not think it would be impossible.  Going back to the previous example about the Japanese boy I do not think it would be impossible to picture the culture in his class changing to accept hand holding.

Stephanie's picture

Benefits of the "Disability" Label

Disability as a label is controversial topic, as evidenced by our class discussion last week. However, I personally feel that these labels can sometimes (not always) be beneficial. I think their benefits outweigh their negatives. I agree with Emily when she wrote, "Brains that cannot function by themselves within a culture (which consists of more than one person) and are at risk for lower chance of survival should be labeled "disabled" (or "different", labels don't matter to me as long as action takes place) so that the rest of the community knows that they must take part in helping this individual survive." I also believe that sometimes by giving people a label of disability, other individuals in the community pay special attention to that individual and attempt to help that individual in beneficial ways.

One instance of this beneficial labeling that I have witnessed is in a special speech & language enrichment program I work in with preschools who have speech & language disorders. By labeling these children with these disorders, they are now recognized and eligible for the help they are currently receiving in this special classroom. In this classroom, we tailor the curriculum and activities to improve their speech & language skills. If I were a child with a speech disorder, personally, I would want as much as help as possible to help me thrive in the community and culture where I live. And in our society, speech & language play an integral part of daily life. I feel that not helping a child with their speech & language disorder and letting them carry on life in our world would be letting the child suffer, which I think would be unjust because currently have the tools and ability to help these children. If someone truly did not want to receive any help, then I do not think we should force them to get help, especially because they are not harming others with their choice not to get help. However, when a child is so young (3 and 4 years old) they cannot make that decision, and it is up to their parents to decide in their best interest. If I were a parent, I would most certainly decide to help my child in any way possible.

In class people mentioned, "changing our culture" so that speech & language disorders are no longer a label, disability, or disorder. I do believe cultures can change, but I believe this change will occur more slowly than the time it takes for a child to improve their speech & language skills with speech therapy. Therefore, maybe in the future we will not need the term speech & language disordered or disabled, however, right now, I believe these labels are necessary to provide certain individuals with the help they need to function and succeed in our society today.

I look forward to hearing everyone else's comments. See you in class on Tuesday!

Jessica Krueger's picture

Thank you for articulating

Thank you for articulating this point again. I completely agree that the label of "diasbled" isn't necessarily a negative thing, especially when coupled the altruistic intentions you expressed. One salient aspect of your post I wish had been discussed more in class was the function of time. While it's true that fifty years ago homosexuals were maligned as deviants and that we've come so much further, when considering a skill as crucial as verbal speech can we really afford to sacrifice some children's speech while we wait for the intractable, inert portions of society to catch up? And how do we ethically choose which children will receive older treatments designed to align them with society as it is now and which to allow to develop in a manner considered disordered in the hopes that a culture can be restructed to include them as they entered the world.
ehinchcl's picture

Knowing the "answer"

As I was the person in class who kept striving for the "answer" to this issue of the 'broken brain' in society, I wanted to share what I came up with after class. I think what we really discovered is that there probably isn't one right answer (somewhat expected, but I think the process of looking for one sparks interesting debate), but that there are some things that need to change about our society today. I think philosophically we all agree that it would be nice to live in a culture that is completely accepting and open to others-- but again, this can create a problem in itself (take pedophilia-- should we be open and accepting? I think the issue of hurt, either to ones self or another comes in here).

I do however, think the point mentioned above is valuable: " that we all potentially have something to contribute to as well as something to gain from everyone else. Difference, in these terms, is not "disability" but the potential for mutual empowerment, for gaining things by interaction with others that one might not be capable of alone." We are in fact dependent on society and culture, and I think what really came out of the discussion was that we should take what we can from culture and discard the things we do not like (ex. the medical model of disability and overprescription/treatment).

How this actually would play out is hard to say, as I still believe that there will always be some sort of majority that imposes their culture on others and some sort of marginalized minority. I know that we have these grand ideals for a society in the future-- and as was brought up in class, it is possible for the norms to change and the groups in power to recognize unfair treatment. But the realist in me doesnt see that society could ever completely give up this power structure, I cant picture what such a culture would look like. This utopian ideal would be great, with no one creating a "baseline" and everyone accepting that some are good at some things and others are good at others, but I just don't see exactly how this would come about.

 Looking forward to hearing everyone else's thoughts.

Elliot Rabinowitz's picture

"Broken Brains" - What to do...

“Culture” and “disability” are certainly difficult words to define. Personally, I like the definition of disability as “recognition of a difference with a judgment of needing to be fixed.” I agree with many of the sentiments expressed about valuing difference. Living in a world where everyone is the same would definitely be a bland existence. However, it is challenging for many people to see difference as simply “difference” without the associated ideas of something “lesser” or “worse.” This has been made evident time and time again throughout history. There seems to be a need to marginalize those who are different, almost in a way to qualify oneself or one’s shared community (culture?) as better than “the other.”

Just because disassociating “difference” and “disability” may be challenging, it does not mean that individuals and societies are exempt from at least trying to change their ways of thinking. Creating a world in which all people could happily, functionally, and peacefully live with one another would be great. And though it may be idealistic, working to generate such a world is a fantastic goal. One way to do this would be to help people understand the idea that everybody has different strengths and weaknesses. Working to recognize these in all individuals and value them would help people respect each other and work to create a better community. This was written effectively in our third reading – “The primary objective of mental health professionals ought to be not to "fixing problems" but rather to encouraging and facilitating the potential inherent in each individual to be continually shaping and reshaping their own lives.” Though that phrase speaks specifically to “mental health professionals,” I think opening it up to an objective for all people could help our world immensely.

We should support a community that strives to praise people for what they can do well. That definitely includes people who currently may be classified by the DSM as “suffering” from a “disability”, whether it is autism, depression, or something else. However, I do not think that this is the only solution and will work for everyone. Changing societies and the world is difficult. That is not to say it should not be done or is not the right thing to do, it is simply a rational recognition of the challenge. Therefore, while working to create a more accepting and compassionate community, it is natural for other methods of change to be supported. For example, if someone is depressed and wants medication or regular meetings with a counselor, that person should be supported in their autonomous decision even if it is the society/culture in which that person lives that has made them feel like those are their only or best options. Ideally, that society would want to support the person for their differences and could successfully help the person value their differences and not feel like they need to change or be “fixed.” However, I think that is not always possible, and thus other actions must be taken, especially in extreme cases such as when people pose a threat to others or themselves.

There is never going to be only one solution to the question posed in class – “What is the answer?” Working to change the world from multiple angles by recognizing the advantages and disadvantages of different approaches is an important point that I think should be discussed further.

Gillian Starkey's picture

On how "disabilities" are treated in educational settings...

I mentioned in my post last week that I'm really interested in how the topics we discuss pertain to issues of education, so I'd like to take this opportunity to pose some questions about how "disabilities" are handled in schools. While I realize that people generally disagreed on how to define a "disability," it seemed that the some of the class was comfortable with the idea of a disability as a difference that a person shows in comparison to other people from their culture, and that is debilitating in some aspect of their life. For the sake of this post, I'll use that as my definition of a disability. The first example that comes to mind that must be handled in educational settings is an attention disorder.

Schools consider this a disability because it impairs a student's ability to learn in a classroom (it would also qualify as a disability with the definition I gave above). Thus, students with attention disorders are frequently placed in "Special Education" classes once/a few times a day that provide them with more one-on-one guidance. But if a student begins taking stimulant medication, they may be able to focus better in their mainstream classroom.

Since the attention disorder is no longer creating a debilitating problem, technically this renders the student no longer disabled. But, in school settings, these students are still treated as disabled, and are usually kept in their special ed classrooms. This seems pretty illogical to me, and I was wondering what you guys thought. What if these students were to be removed from special ed, since medication meant they no longer needed it, and had to spend all of their time in mainstream classrooms? Would this be unfair to the student? Or, would keeping the student in special ed be unfair to the other mainstreamed students because they wouldn't get the additional attention and guidance? Going a little further back, does medicating someone so that they perform at a "baseline/standardized" level (whatever that means) essentially remove the disability, or are they still somehow inherently disabled?

Jessica Krueger's picture

Maybe an answer to the final question?

I kind of wanted to discuss this topic more as well, though I'm not sure this is entirely germaine to the questions Gillian raises. It is recognized that culture evolves overtime, but what also changes is what culture demands from it's participants. I have no doubt that fifty years ago attention disorders existed, but what didn't exist was a world market demanding literate workers capable of producing white collar product. Farm and factory labor didn't require higher education or much critical and I feel (I'm no historian) that's where most of the population would go. Today's labor force needs to be able to do things that aren't necessarily "natural." Nature had no way to select for successful market consultants, lawyers or middle managers, but if humans in industrial nations want to be successful they'll have to alter their behavior patterns in "unnatural" ways to attain it. To me, this means recognizing that the number of individuals "afflicted" with attention deficit disorder will increase until the demand is augmented. To be frank, I like the many of the prodcuts of this culture's progression to this point; anti-biotics, the internet and theoretical physics are awesome. So while I recognize that these culturally bound"disorders" will increase, I'm not necessarliy opposed to pushing the mean of human behavior "forward" until we see cause and a feasible way to do otherwise. At this point in time, the way to support "success" is to treat individuals whose attention functions "below average" up to the mean. So I guess i see treated attention disorders as not not disabling, and I think the students should be allowed back into regular classes and encouraged to attempt entry into honors or higher level coursework.
natsu's picture

Fixing the brain

A topic that came to mind when I thought of fixing brains was early diagnosis. Though I do not know too much about research on this topic, from experience I know that anything is easier to learn or get accustomed to when we are younger.  In other words, the brain is more plastic and easier to be “fixed” when we are younger.  I think this is one reason why early diagnosis is stressed so much these days for children with autism.  If we can diagnose autism sooner, we can “fix” their brains better.  Going back to the example that I brought up in class, I truly felt that it was important for me to help him learn (or perhaps to “fix” his brain) that it is inappropriate to touch people all over their bodies , when he was younger than when he is a grown up man.  When he was five, it was easy to say, “Look, that girl didn’t like it when you put your hands up her T-shirt, can you say sorry?” and children can make up even after such an incident.  On the other hand, if he still continued such behavior as a 25 year old man, he would probably become ostracized by the society.  While I agree that the culture can change to be more accepting of differences, people also have the right to have different beliefs.  For people with different ideas to live together, they must compensate for and work to understand their differences, and these efforts must occur on both sides.  When I was working with this boy, we tried hard to teach him that he could hold people’s hands if he did so gently and if he asked first, but that touching people’s butt in the classroom was not allowed.  At the same time, we talked to the girls in the class about how he likes to hold their hand, but that if he touches them in places that make them uncomfortable, they can and should tell him in words that he can understand instead of running away or trying to bear it because he has “a disorder”.

Just to clarify though, I did not mean to say that Japanese people will feel offended about the idea of shaking hands.  I just brought up the fact that we do not even shake hands to illustrate how much touching is an unnatural thing to do in the Japanese culture (which I guess may not have been clear, given Emily’s post).  Also, the touching behavior that this boy presented was extreme and would probably make anybody uncomfortable, but I wanted to say that it would be especially inappropriate in a culture like Japan. 

One reason I brought up this example was because there seemed to be several comments on the ideas of superiority and adaptability and how that relates to culture and disability, and I wanted to bring up that there are some aspects of culture that develop for neither of these reasons.  In Japan, do we decide not to hug , kiss or shake hands when we greet people like one might do in western countries because we think that not doing so is a more superior or a more adaptive way to survive in our country?  Of course not.  If asked why we don’t, I think all we can say is that we don’t because that is our culture, not because it is better to do so.  To answer Emily’s question about what culture is, I would say that to me, these common beliefs or customs that develop for reasons that have nothing to do with adaptability or survival is what culture is really about.

I definitely agree with Emily that “a culture must consist of more than one individual”, which is why cultural beliefs can be so distinguished from personal beliefs.  For instance, today when I am at Bryn Mawr, I feel that it is very natural to hug my friends because my friends and I share the Bryn Mawr culture.  Yet, I could not possibly imagine hugging my own father and I know I would feel extremely uncomfortable if somebody forced me to do so, because we share the Japanese culture.  I find it intriguing that the brain can accept one thing when in one culture and but not when in another culture.

Danielle's picture

Setting a Standard for “Broken Brains”?

 

While an interaction between brain and culture exists, we must not neglect the fact that the brain is simultaneously creating culture. Culture is an individual perception that is unique for each person. An individual's method of perceiving the environment for which they interact with, leads to the diversity of opinion and functioning noticed among the human race. Some people who have, what some might call a “disability”, might feel that this diagnosed “disability” does not affect their daily functioning. Other individuals might find that their presumed “disability” greatly hinders their functioning. Further, how a person perceives their level of functioning is simply a reflection of how the culture wants you think. How do you define a baseline level of mental functioning? 

 Since each brain perceives a given “disability” differently, it is inaccurate to assume that one set of standards as noted in the DSM would accurately diagnose and treat all people with a “mental illness” or a “disability”. Culture defines and sets boundaries according to a standard; we feel that everything must be grouped into a limited number of categories. Since there is such a diversity of brain functioning and perceptions, grouping individuals based on differences and the concept of one group being superior to another, is unjustified. 

 

The diversity of brain functioning makes doctors, therapists and experts of the brain want to categorize individuals based on types of “broken brains”. The culture sympathizes and feels the need to patronize those individuals who function differently than the majority. One might ask if we really know how the “ideal” or “standard” brain functions. Are people simply hiding under a false persona to prevent being categorized as “broken”? The DSM was created to identify those individuals who do not follow the norm or the majority of functioning individuals. What is the majority or normal level of functioning, and why does the human race need to find a norm? Our culture feels the need to create standards and similarity among individual people who have different types of brains. Even though we think we understand the category of “normal” functioning individuals, it is inaccurate to think that we really know what normal is.

 

 I think to start understanding “broken brains” we need to step back and erase all pre-understood and pre-decided notions of what we as a people consider to be normal.
Paul Bloch's picture

Disabled in one aspect and very able in another: Autistic Brains

Reading about one who is disabled in one aspect and very able in another made me think of people with Autism. Autistic individuals have social deficits that interfere greatly with daily life.
However, studies have shown great abilities of autistic individuals that average non-affected individuals lack.
See the book review of "Bright Splinters of the Mind" by Beate Hermelin:
http://www.sciencemag.org/cgi/content/full/sci;293/5529/435

"Perhaps the best example of this reliance on memory for noncentral components is the capacity of a musician with autism to reproduce faithfully both the melody and the harmonic chords in a piece of piano music. A skilled musician without autism was able to reconstruct some of the melody but was utterly unable to retain the harmony in this same piece of music."

I think it is amazing how one's neuronal arrangement could render one disabled in one aspect and brilliant in another. So this brings me to my questions: Are autistic brains broken? It seems like the general thought is that despite the special talents, autistic brains are severely disabled in our culture. I'm curious to see what others' thoughts are.

Paul Grobstein's picture

Cultures, individuals, and "broken brains"

Thanks all for rich conversation that certainly moved along my thinking about culture, individual differences, and "broken brains" as an issue.

What most impressed me was the number and vehemence of arguments to the effect that culture can/should/must trump individual differences, ie that even if "disability" is not a property of individuals but a description of their relation to cultural norms, the appropriate remedy is necessarily to correct the individuals, ie to fix "broken brains". Among the arguments I heard was that people who weren't comfortable having to fit into a particular culture should move elsewhere, that culture was a product of evolution and that those who couldn't adapt were by definition defective, that it is easier to change people than to changes cultures, that changing people was the more obvious route when you actually wanted to help particular individuals, and that some deviations (eg, pedophilia) were so self-evidently destructive that they were inconsistent with communities of any kind.

There seemed to be a strong general presumption that cultures can't be changed, as one participant voiced it. Indeed my sense was that many people felt not only that it was hard to change cultures but that there were good reasons why they are as they are. And at least some felt that efforts to change culture were actually misdirected and should be resisted. Other classes have had quite different reactions to the "Culture as Disability" article, often taking it as supportive of their own existing commitments to social change. The upshot is that I can't help but wonder what kinds of prior experiences cause one to see the article and its arguments one way or another and, in particular, how the Neural and Behavioral Sciences concentration influences this. Maybe it encourages a perspective that things significant for behavior exist only at the cellular level, or at least doesn't provide experiences that might challenge such a presumption?

Perhaps relevant along these lines is a question put to me during the conversation along the lines of "As a scientist, we want to know the answer. What is it?". As the questioner and others probably noticed, I declined to give an answer. But I had then and since some thoughts that might perhaps contribute to further conversation. The idea that "one ... will be less abled than the other [in some aspects] and will be more abled in other aspects" seems to me indeed a "valuable point", one that one might well build on.

The objective, it seems to me, is not in fact to eliminate differences among people, to bring everybody to the same state (by, for example, giving special treatment to some and, perhaps, handicapping others). The objective is instead to find a way to think about the inevitable differences among people (and among groups of people) in a way that doesn't lead to unnecessary, and indeed counter-productive, interpersonal and inter-group conflict. And the "everyone is both less able in some areas and more abled in others" seems to me a good starting point for that. What that principle in turn implies is that we all potentially have something to contribute to as well as something to gain from everyone else. Difference, in these terms, is not "disability" but the potential for mutual empowerment, for gaining things by interaction with others that one might not be capable of alone and contributing things to others that enhance them in ways they could not have done by themselves. None of us are in fact capable of living independently of others, and that interdependence is an asset to our lives rather than a failing in them.

McDermott and Varenne are, in "Culture as Disability", quite skeptical about the possibility of creating non-disabling cultures, as the class by and large seemed to be, but I'm not (see the discussion continues). That's not to say I think that moving our culture (or any other) in a direction that thinks of peoples' differences first as potential assets rather than disabilities is easy, but I do think it is both a desirable and an achievable aspiration (see Diversity and Deviance).

With regard to the immediate issue at hand, "broken brains", it seems to me a step in the right direction is to take seriously what seemed to me from our discussion a common dissatisfaction with the DSM and the general "medical model" approach to mental health that underlies it. Useful as the normative approach may (or may not) have been for other areas of medicine in the past, my sense is that it has serious and clear shortcomings in the area of mental health (Models of Mental Health: A Critique and a Prospectus), among them the idea that differences can be clearly recognized and treated as "disabilities", that mental health care is based on "broken brains" that need to be fixed.

An alternative perspective for doctors and therapists (and teachers?) would be to recognize that behavior is always an interaction between brains and cultures, and so to conceive themselves always as a change agent not only for individuals but also for cultures. And to recognize that the most important starting point in dealing with individuals is the presumption they are always a collection of more and less good things rather than defined by a particular problem for which only the doctor/therapist (and teacher) has the solution. In so doing, they would avoid encouraging people to develop a sense of themselves as flawed, and contribute instead to people developing a more realistic sense of both their own agency and its limitations. Finally, doctors/therapists (and teachers?) might in fact find that their jobs are more satisfying to themselves by virtue of what they learn from those with whom they interact that they might not have discovered themselves.

Looking forward to hearing more about what others saw/heard/learned form our last conversation ... and to seeing where we all go with it next.
Emily Alspector's picture

What is Culture?

This word, "culture" is something that I have thought about a lot over my years in the bi-co, in classes on anthropology, psychology, even biology, and though it is one of my main interests, I can't seem to define it. It seems definable in a sense, like love, in that there are no words that can be used to capture its true meaning; it is both undefinable and overdefined. culture can be any number of things, and that makes it difficult for me to take part in conversations about it. At the very least, to me, a culture must consist of more than one individual because members of a culture share something in common. If that is the case, then this issue of "one cannot be disabled alone" is irrelevant. If a culture consists of two people, one of those two will be less abled than the other, and will be more abled in other aspects (this was a point brought up but not really expanded on in class which I think is a valuable point). I dont think this means we can call one "disabled" when it comes to driving and the other "disabled" when it comes to cooking.

The point brought up at the end of the seminar regarding suicidal brains and the idea that these brains think that suicide is the best option for them brings up a lot of good points. First of all, whoever brought up this topic chose, in her wording, to not to put the individual behind the suicidal thoughts at fault for thinking in such a way; instead it was the brain that was thinking this was what was best for it, probably because it was damaged. This separating mind and body and personification of the brain as a separate entity was interesting to me, though I'm not sure what to make of it. Perhaps dualism exists within "broken brains" and mind and body can no longer function as one because they want different things.

Back to the topic, this raised a question in me: are we right in imposing our "culture", this idea that suicide is bad and the brain must be fixed to want to stay on this earth, and how can this cultural imposition be compared to other more obvious examples. Using Natsu's example of the boy who didn't realize he was being inappropriate when he would touch people, if an American shakes the hand of a Japanese person, that is an example of cultural imposition since in the Japanese culture that is not a custom, but if this interaction took place in the US, the Japanese person must adapt to the ways of those around him. If the interaction took place in Japan, the American would be in the wrong, and would have to adapt. However, this American person might not know of the Japanese customs, and unknowingly offends. It seems impossible to learn the customs and avoid being offensive to everyone in every culture, simply because there are so many "cultures", many of which are not readily apparent (ie, colorblindness).

So this problem of cultural imposition has stuck with me for a few years now and I haven't exactly found an answer other than do what you can to respect cultures and differences, but it's not the end of the world if you shake hands with a Japanese person, or ask a colorblind man to help you pick out furniture that matches your endtable (or something equally offensive).

Again, sorry this is so long. My point is that these small things are not what we should be concerned with. The brains that are suicidal (separate from body or not) are the ones that we, as a society, must focus on as needing our help because they are putting themselves at risk. Brains that cannot function by themselves within a culture (which consists of more than one person) and are at risk for lower chance of survival should be labeled "disabled" (or "different", labels don't matter to me as long as action takes place) so that the rest of the community knows that they must take part in helping this individual survive.
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