Disability Rhetoric

disabling writing, in a good way

Monthly Archives: September 2015

The Medical Model Controversy in Disability Studies

This recent blog post comes from N. Renuka Uthappa (renuka.uthappa@wayne.edu), a Ph.D. student at Wayne State University in Detroit. Uthappa is a scholar whose personal experience “puts her firmly within the medical model of mental illness at the same time as that model faces what seems like a fair amount of resistance within the disability community that deals with mental illness. (Catherine Prendergast notes in an essay that she feels awkward explaining that she considers schizophrenia a disease in the face of her own ‘post-structuralist leanings.’ She worries that her opinion “makes me sound at best conservative and at worst, theoretically unsound.”)”

I look forward to posting more, and as always, contact me at dev.k.bose@gmail.com if you’re interested in being a guest blogger for the site, or would like to joint the DS-Rhet listserv. —Dev

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“Like you, I wear many hats in my life. I am a Ph.D. student, a teacher, a wife, a sister, etc. But I’m here today talking to you because I am a person with a mental illness, specifically bipolar mood disorder.” This is the way I have been starting the presentations I give to high school psychology classrooms as part of my membership in a local group known as the Speakers Bureau. Made up of people with a variety of mental illnesses, the Bureau seeks to “put a face on mental illness, developmental disabilities, and substance abuse to overcome stigma and discrimination by sharing successful stories of hope and recovery.” I joined the group in order to research their rhetorical efforts from the inside and to contribute to their fight against stigma.

In the course of my initial research into disability, disability and rhetoric, and the particular rhetorics of mental illness, I find myself in a tricky position. I am steeped in the medical model of mental illness, a model not much in favor outside the mainstream. My decades long acceptance of the psychiatric assessment of a chemical imbalance in my brain and a genetic predisposition to mental illness, as well as my use of medication to successfully treat what I view as a biological illness place me in opposition to at least certain aspects of the consumer/survivor/ex-patient (c/s/x/) model of mental illness.

In her chapter of James Wilson and Cynthia Lewiecki-Wilson’s collection, Embodied Rhetorics: Disability in Language and Culture, Catherine Prendergast states: “For an academic such as myself with generally poststructuralist leanings, to think of schizophrenia as a “disease” makes me sound at best conservative and at worst theoretically unsound.” I can understand her concern. As a fledgling disability and rhetoric scholar, how can I acknowledge and stay open to the well-argued viewpoints of the c/s/x or Mad Pride movement while still living within my conviction that I have a disease that requires specifically medical intervention? How can I say a simple “No!” to their contention that states of what they call “mental distress” represent ways of being on the spectrum of human existence or even natural responses to external factors such as modern isolation or materialism?

At a Speakers Bureau workshop about how to craft one’s story of mental illness, the leader cautioned the group, “Don’t promote broken brain theory.” When I asked her about this statement later, she brought up the idea that certain “states of being” can be considered life experiences rather than “symptoms” and noted that there are varying opinions as to what mental illness is. Is it a medical illness, she asked, or a part of living? Her commentary raised my hackles. I found myself wanting to argue against the idea that mental illness could be considered just another way of being. This idea rang false against my experience of both mania and especially depression, where I found the depth of sadness and hopelessness absolutely incommensurate with anything going on in the outside world. Given that the ultimate endpoint of untreated depression for many is suicide, I found this new (to me), alternative perspective frustrating.

Later on, I told the workshop leader that my experience of deep depression had been incommensurate with anything going on in my life and asked “Doesn’t that suggest that the cause must be biological?” She replied “The purists would say you had not looked hard enough for a source for your sadness.” Slap! We let the matter rest there, but inside I was seething, not at the group leader, who I respected and liked, but at the “purists” who would dare lay their interpretation over my crystal clear experience. (It has not escaped my attention that I am doing the same thing to their experiences!)

Those experiences, I know, have included the reality that people with mental illness diagnoses can in many states be involuntarily hospitalized and legally forced to take medication. I can only imagine the terrifying experience of being forced into a hospital against my will or the frustration of having to take medications in a similar fashion. On the other hand, as someone who worked at one time providing supportive services for mentally ill adults living independently in the community, I have seen instances of very negative personal results when people suddenly stop taking their medications. And I have seen the positive results that hospitalization can sometimes provide once it helps a severely ill person stabilize.

I am hoping the existence of multiple views about the ontology of mental illness does not require me to decide on an absolute definition. In some ways, at present, it seems to come down to a sense of how experiences influence one’s sense of identity. Because I have had mostly good experiences within the medical model, and because it makes sense to me, I use the term “mental illness” and identify as a “person with a mental illness.” This phrase attempts to put distance between my “self,” or my essence, and my medical condition. The more I read, however, (Susan Gabel, thank you for “Depressed and disabled: some discursive problems with mental illness.”), the more I find myself open to questioning my current sense of identity. Thanks for the great scholarship, everyone, and I look forward to any and all responses to this, my first ever blog!

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