Hi Sam. In a recent post about disability you made reference to "the medical model, social model, or biopsychosocial model of disability". Please could you share some more information about these different models? You can just tell me to go google it, but I thought it might be okay to ask since you're clearly very knowledgable in this subject area and I find you are good at explaining things! Thanks.
The Medical Model (or Biological Model) of disability is the one most people are familiar with it. It views disability in the same light as illness. It is something that is wrong and it must be fixed or cured. This is the model that is shaped by doctors and healthcare providers as a whole, and represents the primary view of the medical industry, psychology industry, education industry, and society in general.
The primary problem with the Medical Model of disability is that it makes no room for a disabled person. The person does not matter - what matters is the disability, which needs be cured - whereupon you will be left with a person. This is the driving social force behind inspiration porn, microaggressions, and segregation. An example of this model would be that we must find a cure for autism, regardless of what that cure may be.
The Social Model of disability is the dominant model subscribed to by activists and self-advocates with some notable exceptions that are borrowed from the Biopsychosocial Model. This model of disability removes the medical from the person, and argues that disability is not inherent, it is a social construct. Universal accessibility is attainable (and it is), so the only reason why disability exists is because socially we choose not to attain it. Achieving universal accessibility removes disability by inherently putting everyone on the same footing without requiring special accommodations. Basically, you normalize âmedicalâ disability being ok, and no one is disabled because their life is accessible.
This is a laudable view, but not without its problems. First, it entirely removes the Medical Model from the person. It makes no account for the reality that some of us have unpredictable disabilities that inherently cannot be accommodated. It is also unrealistic. Disability is an infinitely varried spectrum. We will never be able to accommodate everyone, and someone will always be left out. That doesnât mean we canât do better - and we must - but it is unrealistic to expect that we can effective account for all scenarios. This is also the view that spawned person first language - which is a deliberate attempt to remind society that we are people that have a disability not a disability with a person somewhere underneath like the Medical Model. Many activists that subscribe to this model borrow identity first language from the Biopsychosocial Model. Using autism as example, this model states that autism is a neurotype and should not be cured because different is not bad.
The Biopsychosocial Model of disability does two major things. First, it combines the Medical Model (bio) with the Social Model (social). Second, it adds a third element, Psychology (psycho). This is an explicit acknowledgement that there are medical aspects of disability that are very real to the people who experience them, but also an explicit acknowledgement that there are social aspects to disability that are caused explicitly and entirely by society. It also introduces the idea that psychology, and in particular identity, play a large role in how any given individual experiences their disability. This is the model by which it is possible to understand that researching a cure is okay as long as you put that cure in the hands of the people who want it and not in the hands of those who donât. This is the model that supports identity first language.
This model is also not without its problems. The biggest of these problems is that there is a very delicate balancing act that has to be done between acknowledging the medical realities and the social realities of disability. For example, this model recognizes that autistics that want a cure deserve a cure, and therefore we should research a cure. The social reality of this is that the only cure for autism is in utero testing and abortion - eugenics. Weâve seen this with Down Syndrome if you would like a reference. Clearly, this is not good for autistics that want a cure any more than it is for those that donât. But what about a medication that limits meltdowns, or evens out hypersensitivity? Sounds good, but directing society in that direction is horrible difficult fight that isnât even on the radar. In a lot of ways, it can be as unrealistic as the Social Model. It is also exceptionally easy to swing to far into the Medical Model or Social Model, in an attempt to be as inclusive as possible to people with various identities.
So thatâs the general breakdown, in broad strokes. I didnât have the word for it until recently, but my own beliefs align with the biopsychosocial model of disability. I believe that my disabilities are, at least in some ways, medical in nature, and I can and do take steps to alleviate specific aspects. This includes specific aspects of my autism (in particular meltdowns and shutdowns).
I also believe that a large portion of my disabilities are entirely social. A huge amount of my issues with ADHD and autism would simply vanish if true universal accessibility were a thing. Poof. Gone. This would do nothing, however, for the fact that my hands hurt, that the air is touching me, and that these things distress me even when the environment around me is accommodating and accessible. It doesnât matter that I can hip check a button to open the door instead of pulling it, my hands still hurt - which is why the medical model is pertinent to my life.
And I hope it is obvious that I am an activist and self-advocate. I believe that there is a line between these to walk, and I believe that there is a lot of nuance between those two that is exceptionally important and ignored by those two models. I believe that the most fundamental personal right is autonomy, which includes the right to identity and self determination. Put this all together and I am squarely in the biopsychosocial model of disability.
Right oh. So this is longer than I thought it would be, and my wrists are screaming, so Iâm going to end this hear. I hope this is a good beginning, and if you have more questions please feel free to send them.
In the mean time, give a lot of thought to the ideals versus the reality of disability, and be brutal with yourself. Figure out where you really stand on a day to day basis (I frequently struggle with falling squarely into the social model and taking radical stances on topics that, frankly, have a lot more nuance than I understand), and where you really want to be. Then fight for it. Hopefully, we donât end up on opposite sides!
