Archive for September 2013

Disability vs Impairment: My thoughts.   4 comments

Yesterday I shared this link on Facebook with this comment:

This is a good article. I’m rather iffy on the bit in the middle where she talks about “impairment” being the bit you can’t do no matter what and “disability” being the thing society imposes upon you, because I sure as heck don’t feel “impaired” when executive dysfunction kicks in. đŸ˜›

So I was asked how I define “impairment.” Here’s my answer:

The word “impaired” implies that things are not as serious. The distinction she says the social model makes between being “disabled” by society (having ability taken away by something external to oneself) and being “impaired” regardless is cosmetic at best.

When I really want to do something and never get to it because my ADHD decided I should hyperfocus on something completely different (and usually fairly useless), that’s not an “impairment”; it’s an inability to do something I would like to do. That’s a disability. And it’s within, not without.

I feel like sometimes these distinctions are made by people with physical/acquired disabilities and they have forgotten about those of us who don’t fit that profile.

Having said that, I don’t like person-first language either and I am frustrated that the name of my disorder doesn’t lend itself well to identity-first language.

Someone else has now talked about what impairment means and so on, and how “disability” is about social and “impairment” is about objective difficulties with things. But their examples are, again, all about physical disabilities. My response:

Except there aren’t always accommodations that will help. A lot of mental disabilities can’t be accommodated. It seems that the biggest thing for something like what I deal with is often “change your expectations” or “be okay with not being able to do the same stuff as well as you did yesterday” and stuff like that. That’s not an accommodation at all; it’s not allowing me to still get things done (both things I need to do and things I want to do), it’s expecting me to just change my attitude. And that’s not always possible. (Adjusting my attitude has resulted in much better self-esteem and I am much more able to deal with life when ADHD derails my day, but it isn’t an accommodation because it’s not making it so my day stays on track.)

The kinds of accommodations I need from society also aren’t exactly things that you can expect anyone to give. Flexible appointment times for doctors and dentists and so on? It is to laugh. (And by flexible I don’t mean “pick from these available times,” I mean “it’s no big deal if you’re half an hour late because your ADHD is a pain in the butt.”)

And this is the frustration with the social model of disability, and the frustration with the terminology of “impairment” vs “disability.” I don’t experience these things as “impairment”; I experience them as “disability.” As in “I have a lack of ability in this area.” And it’s not something that can be fixed.

I know I’m probably shouting into the wind here. I like the social-relational model of disability a lot, but I don’t like replacing the word “disability” with “impairment” because it implies that it’s not as severe. It implies that if society doesn’t expect my brain to function just like non-ADHD brains, and makes allowances for that and accommodates the difficulties I have because of it, then I am somehow not as disabled/impaired by my ADHD. Like removing stigma and discrimination magically makes my ADHD easier to live with.

It doesn’t work that way.

I know it doesn’t work that way because I have bent and twisted my life as much as possible to accommodate my ADHD, and I am still disabled. I have friends and family who accommodate my difficulties and accept me just as I am, and I am still disabled.

I will always be disabled, even if I wake up tomorrow and everyone believes in and accommodates ADHD.

That’s just how it is.