By Jeremy Einbinder
As our society becomes more inclusive and equitable, we are starting to see a shift in how we think about disability. While the traditional medical model of disability views it as an individual problem to be fixed or cured, and the social model recognizes disability as a socially constructed experience shaped by societal attitudes, beliefs, and structures, there is another model that offers a more nuanced and complex understanding of disability: the dialectical model.
What is the Dialectical Model of Disability?
The dialectical model of disability, also known as the critical disability theory, is a framework that recognizes disability as a product of the interaction between the individual and their environment. It views disability as a dynamic, ongoing process that is constantly changing and evolving.
The dialectical model is rooted in the philosophy of Dialectical Materialism. Dialectical Materialism postulates that everything constantly changes and develops, and the contradictions and conflicts within and between things drive such change. In the case of disability, these contradictions and conflicts arise from the tension between the individual and their environment.
According to this model, disability is not simply a medical condition or a social construct but rather a complex and dialectical relationship between the two. The dialectical model recognizes that while biological and medical factors can contribute to the experience of disability, social, economic, and political factors also play a significant role in shaping disability experiences.
A 2012 study by Louise Bøttcher and Jesper Dammeyer titled, in part, “Disability as a dialectical concept,” explains as follows, using cerebral palsy as an example.
“The impairments of the child with, e.g., cerebral palsy (CP) have biological origins, but the disability has evolved from the incongruence between the child and its social conditions for development. A child with a disability differs from his peers without disabilities not only due to the biological defect but also because of the defect, and the incongruence it gives rise to makes development much more difficult for this child. From the cultural-historical vantage point, the shortcoming of the biomedical understanding of disability is exactly that it fails to notice how a child with a biological defect has to act in social institutions first and foremost adapted to children with normal psychophysical constitutions.”
This excerpt illustrates that while the phenomena that people with disabilities experience are not wholly contingent on social factors, the idea of what is considered “defective” or “disabling,” as opposed to merely a natural variation of the human experience, varies by context. It may even be highly culturally specific. Overall, there are a few crucial aspects of the dialectical model of disability to remember.
Key Features of the Dialectical Model
Several key features of the dialectical model of disability set it apart from other models of disability. These include:
- Emphasis on Agency and Autonomy: The dialectical model recognizes that disabled individuals have agency and autonomy and actively participate in constructing their disability experiences. Disabled individuals are not passive victims of their disability or environment but active agents who can shape and change their experiences.
- Focus on Social and Political Context: The dialectical model recognizes that disability is not just a medical or individual issue but a social and political issue. Societal attitudes, beliefs, structures, and economic and political systems shape disability.
- Recognition of Diversity: The dialectical model recognizes that disability experiences are diverse and complex. This model does not attempt to reduce these experiences to a single category or definition. Depending on personal and social context, affected individuals can be said to “have disabilities,” be “disabled,” or both. These individuals have different needs, experiences, and identities, which any complete and competent framework of disability must consider.
- Critical Analysis: The dialectical model is based on a critical analysis of disability, recognizing societal power imbalances and social injustices. It seeks to challenge and transform these power imbalances and injustices to create a more equitable and inclusive world.
The study continues to elaborate on how someone classified as having a disability may thrive:
“Dammeyer (2010) studied families with children with deaf-blindness and how they manage the incongruence of the child’s development and the cultural institutions. The parents’ experience of fighting with the public service system was understood as a result of the incongruence. Taking care of the children’s development was difficult because of the incongruence. Bøttcher (2012) has included neuroscience approaches to biological defects in a wider cultural-historical understanding of disability and the children’s developmental trajectories in the complex systems of educational practices and support systems in which exceptional children often carry out their educational careers.”
The critical thing to recognize is that while differences, whether cognitive, physical, emotional, or intellectual, influence disability, the same is true of vice versa. What is considered an impairment may also affect what is seen as a disability. Neither is wholly and separately true, and both phenomena interact and complement each other.
Challenges and Complements to Other Models of Disability
The dialectical model of disability challenges and complements other models of disability, such as the medical and social models.
While the medical model focuses on the individual and their impairment, and the social model focuses on the societal barriers and structures that limit the opportunities and experiences of individuals with disabilities, the dialectical model recognizes the complex and dialectical relationship between the two.
The dialectical model challenges the medical model by recognizing that disability is not just a medical condition but a product of the interaction between the individual and their environment. It also challenges the social model by acknowledging that disabled individuals have agency and autonomy and can actively shape and change their disability experiences.
At the same time, the dialectical model complements the medical and social adapted models by recognizing the importance of biological and medical factors, as well as social and environmental factors, in shaping the disability experience. This model acknowledges that medical conditions or individual impairments are not the exclusive causes of disability, but instead, the dialectical interaction of personal, social, and environmental factors also causes disability.
The dialectical model also emphasizes the dynamic and evolving nature of disability. Disability is not a static condition but a fluid experience that can change over time based on the interaction of individual, social, and environmental factors. As such, disability is not an inherent characteristic of an individual but rather a dynamic and contextual experience that societal attitudes and policies can influence.
Moreover, the dialectical model recognizes that disability is not a monolithic experience but a diverse and intersectional one. Disability intersects with other aspects of identity, such as race, gender, and sexuality, and these intersections can shape the disability experience in unique ways. For instance, a person with a disability who is also a member of a marginalized racial or ethnic group may face additional barriers and discrimination that compound the impact of their disability.
It is for this reason why, for instance, the debate about the merits of “person-first language” as opposed to “identity-first language” becomes personal and sometimes even circumstantial. When describing a substantial challenge a person might have, it might be most appropriate to refer to someone as a “person with a disability.” However, when describing barriers that a person faces due to the physical and social infrastructure in place throughout society, it might make sense to refer to the same person as being “disabled.” Neither of these things can necessarily be separated.
The dialectical model has implications for policy and practice. It suggests that interventions should aim to address both the individual and societal factors that contribute to disability. These interventions could include improving medical treatments and accommodations for anyone who might need them and promoting social and environmental changes that remove barriers and promote inclusion.
The relationship between disability, society, and the self, and how all these things mutually interact, is full of contradictions. An individual’s relationship to each of these contradictions may vary. These contractions are what the dialectical model of disability attempts, in part, to solve.