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. 😛

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.

4 responses to “Disability vs Impairment: My thoughts.

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  1. You’re missing the point. It’s not about whether impairments *can* be accommodated or not. it’s about whether it’s something about you that is holding you back or something about the environment around you that is holding you back.

    Impairments aren’t automatically “fixable” by accommodations. But they will never even be addressed in the first place in an environment that is not willing to even try to accommodate them. Impairment doesn’t automatically mean the opposite of disabled. Impairment doesn’t necessarily mean able. Impairment just means that it’s the thing that you’re living with. Disabled is what other people do to you as a result.

    If it helps to understand it, think about how often society disabled people who have no impairment. For example, being African-American is not an impairment. There is nothing about having darker skin or the genetic heritage that goes with that that keeps a person from doing much of anything other than absorbing more vitamin D from the sun. But society often disabled black people, for example, the recent quote going around facebook where a man said that he doesn’t hire people with black-sounding names because it will make his other employees feel uncomfortable. That is a very disabling attitude! And it illustrates how impairment and being disabled are such very different things.

    Cara wrote a really good blog entry just today that illustrates this as well. In it, she writes:

    ” I often wonder how much better I could have done had all those barriers not been in my way – barriers, it is important to note, had nothing to do with my actual impairment, but instead everything to do with the environment around me. This is where the social model of disability comes in. I had impairments in high school – I will always have impairments – but it is the societal barriers around me that actually disabled me and prevented me from reaching my full potential.”

    Her full blog entry is here:


  2. Except that what’s holding me back *is* something about me. That’s what I’m talking about.

    I did well in school without accommodations. High school was harder but I still did better than a lot of ADHDers would. The societal barriers around me certainly disabled me a fair bit once I was completely finished with school (and yes they were a big problem in university and especially in the music therapy program I flunked out of).

    When I say I have accommodated my ADHD as much as humanly possible, I am not exaggerating. I am not reaching my full potential because of my “impairment” – that’s why I say I am disabled, not simply impaired. I don’t see the point in trying to divide them – I am disabled whether people expect things of me or ask me to do things or whatever. I don’t really experience much in the way of societal barriers in my life at this point, but I am still disabled.

    THAT is what I am saying. THAT is the problem with the social model of disability. THAT is the problem with trying to make a distinction between disability and impairment.

  3. Just because what holds you back are impairments doesn’t mean being disabled by others doesn’t exist. I am feeling really dense this week because I can’t understand your point; I am seriously failing in understanding why having very impairing impairments and not being very disabled by others leads you to say the social-relational model of disability isn’t valuable. I have been SERIOUSLY disabled by others in the past. Are you saying that because it hasn’t happened to you, you don’t believe it happens?

    I think it is very valuable to distinguish between impairments and disability if for no other reason than that it helps us to see where efforts need to be focused. It also helps us to understand that not all problems are the result of the individual experiencing them but that impairment still is a very real thing that occurs. Before the development of he social-relational model, it was either all your fault for being disabled or all society’s fault for disabling you. The social-relational model admits that it’s a more complex combination of multiple factors at play. Just because any single individual experiences mostly impairment without disability or mostly disability without impairment doesn’t mean the model is flawed.

    • I’m not rejecting the social-relational model; I actually think it makes the most sense out of all of them. What I’m trying to say (and probably not getting it across very well) is that I don’t see the point in this dichotomy.

      So far as I understand it, disability now means “you have trouble doing stuff because society sucks and doesn’t accommodate your — what, disorder? impairment?” — and impairment now means “you have trouble doing stuff because you have a disorder (or something).”

      To me, impairment means something totally different from disability. It doesn’t mean anything CLOSE to the same thing as disability. I don’t agree that disability is just something society does to a person. Period. I don’t like repurposing words; we already have a perfectly good word. Disability is disability regardless of whether other people are doing things to hold us back.

      It also bothers me because it threatens to remove some people’s sense of identity. If you’re disabled in your everyday life quite apart from how other people treat you, then you’re not disabled anymore? Can you really claim that title, then? You’re not disabled, you’re just impaired. The word “impaired” does not mean the same thing as “disabled” — not even close. It means something far LESS than “disabled.” You can be disabled without being impaired. You can be impaired without being disabled. But if you have a disorder that you experience as disabling even away from society, you aren’t disabled anymore you’re just impaired. This doesn’t make any sense to me. It is not a concrete enough concept for me. It is really slippery and confusing.

      I understand the point people are trying to make.

      I don’t see the point in what they are doing in order to make that point.

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