Trigger Warnings #3
The Benefits of Being Disabled
CW: disability, ableism, medical, suicide, depression, anxiety
This article is part of the Trigger Warnings series, examining environmental factors that effect mental health. To get early access to the next articles as they are released, please support Ollamh Counselling through their Patreon. All articles will become available to everyone through Medium, in the interests of accessibility.
Proof of the Stoma
At the end of 2019, my body was ravaged by my Crohn’s Disease, resulting in my left leg becoming clotted, and my colon having to be removed. I now live with a stoma bag, specifically an ileostomy stoma, and occasionally support the ache in my left leg from the blood clot by walking with a cane. I struggle to walk at times and have to live with the fact I will poo[1] into a bag for the rest of my life. I am, for all intents and purposes, disabled. However, the DWP think otherwise.
Without going into too many particulars as to this case — as it is ongoing, and I do not wish to rock the boat more than I have to — the reason for my PIP being denied is due to a discrepancy in how long I can walk and/or stand. This is because our government, and the civil systems that extend from within it, handle disability as merely a series of statistical anomalies, rather than engaging with the idea of disability as something unrelated to the 9-to-5 capitalistic systems we all must live within (if we are English at least, European at middling, and American Imperial at most). Disability is more than merely figures; it is more complex than describing how long it takes to make a sandwich.
What came from this was a bizarre understanding of what it meant to be disabled. Up until this point, I had described myself as a cishet able-bodied white man, and this is pushing it because these descriptives only really came into my vocabulary when I came across anything outside of that heteronormativity; what I mean to say is, I only began to engage with my identity on these levels when I felt I had to, unlike the rest of my country who constantly have to fight for the right to be who they are daily. However, the moment I became disabled the lens in which I view society warped dramatically. The glances when I use a disabled bathroom; the constant phone conversations about how it manifests for me; the early days in a wheelchair made utterly pointless due to the quality of the roads — all of this snapped into clear focus, that this world is not built for everyone. It is appalling that I only noticed these things with truth the moment it became my problem. Up until then, it was just a polite discussion point to prove I cared about others.
Alongside the fact society is not built for disabled people came another strange realisation. I had two years in hospital wards and my childhood bedroom to recuperate. In this time, I wrote the most poetry, plays, and fiction I have ever done. I burst with creativity. I had to focus entirely on my own health (my oxygen mask first, so to speak) and I realised how little a human being needs to be truly content. The capitalistic maelstrom that I must be working myself to the bone was over. I had already done that. My Crohn’s had flared up after a particular bad shift as a substitute teacher, the stress of that profession finally triggering such a bad flare-up I needed surgery, so having to relax, take things easy, one thing at a time — I won’t say it was living in luxury, but being able to focus on my inner world, my artistic output, and centre myself from my previously destructive personality could only have been achieved in that new environment. I do not suggest anyone has their colon removed to escape the grind; the fact this was the first time I had the chance though, indicates our country is surely broken if we need to lose organs to relax.
These ‘benefits of being disabled’[2] do not outweigh the abusive circumstances that surround them. To continue living this life, where I can look after my body, not overextend, find peace with the flow of my particular reality, I have to constantly prove I am disabled to the government. I have to constantly be aware that if I look too abled, the gig is up, a gig that doesn’t end just because everyone else has gone home. As a counsellor, the fact disabled people — some far more impaired than I — are having to consistently prove their worth, is beyond detrimental to mental health. In these first chapters of my disabled journey, I am already anxious about the system I must prove myself to. I cannot imagine what it has been like for those of us where society has never been built for us, from the first day we took breath.
Politically Correct?
“[D]on’t be too precious or too politically correct — being super-sensitive to the right and wrong language and depictions will stop you doing anything” states the governments Inclusive language: words to use and avoid when writing about disability[4]. In this document (taking up less than a side of A4 paper) the government give some guidelines of how to speak with disabled people. Although it is apparent staff are trained not to use the term “spastic”, the document apparently failed to teach DWP employees not to use the term “lying bitch”[5].
Back in March we reported that two pages from an appeal submission have been posted by a professional welfare rights worker on the Rightsnet website, with the claimant’s permission.
The extract included the following statement by the DWP:
“Although Miss [redacted] has identified a high level of personal restriction, she is entitled to Carer’s. To be entitled to Carer’s Allowance a person must provide at least 35 hours of care to another disabled person each week. In this lying bitches case she is receiving the middle rate carers allowance component for providing day-time supervision to another disabled person. The tribunal may wish to explore this further.”
Although the claimant here eventually won £5000 in compensation, this is the environment in which disabled people have to fight for their rights daily. The government have failed at the first hurdle — in fact, even their Inclusive Language documentation fails to include common, contemporary terms such as “little person”[6] — of being able to educate their own workforce in how to do their jobs. How can we expect these overworked civil servants from being able to account for every application effectively, when the very language they are being taught to use is done in such a flippant manner? DWP employees themselves admitted that the language they employ is abusive[7], “[Dr Jamie Redman and Professor Del Roy Fletcher] were told how “top-down” pressure on staff — through sanctioning tables and off-flow targets that were “legitimised” by the government — acted as a “moral anaesthetic” which “made invisible the needs and interests” of the claimants they were sanctioning.” Although this is from the time of the coalition government, with Dawn Butler being ejected from parliament for saying what we all know[8], that Alexander DePfeffel was incapable of handling the COVID crisis, lying throughout the pandemic, I would be surprised if these kinds of figures & facts have changed for the better.
One JCP worker described how staff would often treat claimants with “disrespect” and use psychological harm as a technique to reduce the number of people claiming benefits, “pushing them until they either just cleared off because they couldn’t take the pressure or they got sanctioned”.
We currently use a medical framework to understand disability. DWP employees are not trained as medical officers — for the most part — and are encumbered with an ever-expanding list of individuals who require help. I am not to condone the use of language like “lying bitch”, however if we are to continue to put strain on people working in systems that plainly do not work, we have to expect that behaviour cannot maintain the levels of professionalism we expect from civil servants. If you have a list of the most vulnerable, and you know you are incapable of helping them all, naturally a tactic to be utilised is to get the vulnerable to opt-out by ‘their own volition’. Punishing and abusing people is never acceptable, but it lowers numbers. And when these employees are taking the majority of their sick days for mental health reasons[9], partly due to Brexit[10], and partly due to the overwhelming numbers of people who just need help, it is no wonder everyone is slipping through the cracks[11].
If the people who determine who is disabled are taking sick days due to depression, and those ringing in for PIP & benefit are struggling from anxiety caused by a range of illnesses & impairments, why are we still using a medical model to determine who deserves what? In this article alone, my language still leans to the medical, implying the disability comes from within the vulnerable person, not due to how society has been constructed — it is in-built, from a young age, that there is a Normal, society is built for that normal, and everyone else just has to suffer.
The social model of disability says that disability is caused by the way society is organised, rather than by a person’s impairment or difference. It looks at ways of removing barriers that restrict life choices for disabled people. When barriers are removed, disabled people can be independent and equal in society, with choice and control over their own lives.[12]
I think of how my disability gave me the freedom to create, explore, and engage with the world during my recovery. In that moment, the barriers were removed. I had to exist as myself, without social moray, without the expectation of a capitalistic country bearing down upon me. What would happen if we applied this to the entire system of benefit? What would happen if we built society on this premise, what wonderful things would we create, and how would our mental health soar?
Eye of the Storm
“This medical model approach is based on a belief that the difficulties associated with the disability should be borne wholly by the disabled person, and that the disabled person should make extra effort (perhaps in time and/or money) to ensure that they do not inconvenience anyone else.”[13] If we are to see PIP assessments (and the systems that come with such application processes) as predominantly focussed on medical explanations, it is no surprise that “at least 69 suicides” have been linked with this environment[14]. Following this, with civil servants pushing applicants out of the system, “[…] in just two years, 1,700 disabled people died within three months of having their claim for personal independence payment (PIP) rejected”[15], I look at my own application, and being accused — in not so many words — of lying, I am thankful for the other privileges I have. Otherwise, it would be likely I would not be here to write this article.
When asked if a review had been instigated after these figures came to light, Ian Duncan Smith said, “”No, we have not carried out a review […] you cannot make allegations about individual cases, in tragic cases where obviously things go badly wrong, you can’t suddenly say this is directly as a result of government policy””[16]; when using the medical model, it puts all the ownership on the disabled individual, not on the systems that create them. It is no wonder the government does not wish to move to a social model, as this would mean taking responsibility for over a thousand deaths[17]. This is long before COVID, with a death toll higher than World War Two, an event in our history we still have a strange, joyous relationship with[18]. We long for sacrifice in England, but the real sacrifice — after the obvious: the thousands dead — is how this is warping the national psychology; our acceptance of the murder of thousands will have irrevocable affects on our generational trauma, and our present mental health.
I call this the eye of the storm, a perfect storm. Our national treasuring of the death tolls of the Somme combined with the literal figures of death Alexander DePfeffel[19] is responsible for during COVID-19, creates the circumstances where the DWP/PIP is designed to increase the death toll of the disabled[20]. It is designed not just to follow a medical model out of love for science (as we all know this can’t be true, seeing how much Alex has rejected scientific advice throughout the pandemic) but because it aligns perfectly with our national identity, that of those willing to sacrifice themselves for the cause. Unsurprisingly, like the words of Shrek’s Lord Farquad[21], it seems we only ever wish to sacrifice other people for this cause: never ourselves.
Countless people are suffering at the hands of a system simply not designed to handle the increasing numbers of vulnerable people in need of financial support. With the effects of long COVID — something I have seen in my family members — we are going to have a young workforce incapable of performing the necessary labour to keep a country going. And this, further combined with Priti Patel throwing (almost literally) all foreign labour into the sea[22], I am uncertain how we as a nation are going to be able to pick apples as Prince Charles[23] asked of us.
Although these articles/essays are intended to focus on the mental health ramifications of such endeavours, I have but one very simple conclusion to draw at this point as a counsellor. We won’t have clients to treat if they are dead. Of those who have survived, it is apparent that living in a country that measures worth by how much a person can accomplish, whilst simultaneously creating a society where many disabled — and the newly disabled due to COVID-19 — are unable to accomplish the levels expected of them, and are wished to be sacrificed for the good of the nation like a WWI child soldier, depression is going to be a key element of the national psychology. Depression is enlivened by the perfect storm of telling people how to be worth something and then giving them no opportunity to do that one thing. IAPT is not going to be enough of an answer.
So It’s Time Nathan Bangs on About UBI Again
I will admit, the majority of my essays will conclude with the notion that Universal Basic Income is perhaps the primary focus all activist counsellors should be working towards at this time. I firmly believe an allegorical 99% of all mental health problems would be alleviated with simply allowing members of a society the basic necessities for survival: a home, warmth, water & food, internet access, and something left over for entertainment. For those reading this thinking that wi-fi & entertainment should not be included in UBI, we must remember that most of my applications for benefit require an internet connection, and that the brain naturally requires entertainment for beneficial mental health. In this essay, I won’t go into those particulars, but anyone working in the therapeutic professions should have a basic understanding that if a human being is not presented with fun every now and again, depression, anxiety, and disassociation are soon to follow.
I have never understood why even capitalists are opposed with Universal Basic Income. Even if I entertain right-wing philosophies when considering UBI[24], I think of that work force Prince Charles wishes to come out of the woodwork. If we perpetually keep killing off the weak in our society — a phrase ripped straight from Thomas Malthus’ Darwinism[25] — who is going to run the businesses, the shop floors, and the factories that allow Richard Branson & Jeff Bezos five minutes on the edge of space? “Basic Income could grow Canada’s economy $80 billion a year — more than Canada’s tourism and hospitality industries combined — and create nearly 600,000 jobs in 5 years”[26] says the Canadian organisation UBIWorks. Why does it seem surprising, that when your workforce is happy, safe, and cared for, they work harder for you? Even before I enter one of my fun rants about anarchism, community living, and other forms of social organisation, even within a capitalistic framework, a healthy workforce is one you can exploit for longer, surely? As therapists we must fight right-wing, fascist ideologues at all costs, but I am still shocked that even the most conservative of us won’t do the basics to help mental health. I can only conclude it is not about the money, but just making sure everyone is suffering.
“Only the vulnerable will be at risk… but your ‘only’ is my everything” says Kirsty Liddiard, Senior Research Fellow at the University of Sheffield[27].
“Such ontologically violent messages have sought to reassure an overwhelmingly anxious public at the expense and distress of some of the most vulnerable. These sentiments also shore up the everyday mundanity of dis/ableism […] social and cultural forces that actively sequester away why we culturally view vulnerability and human value in such ways in the first place. […]
“We also see dis/ableism — and the disposability of disabled and vulnerable lives — most clearly in talk, and now emergency policy, around access to health resources. A lack of resources — the numbers of critical care beds; access to ventilators; and the time and focus of medical staff — means making rational and sensible decisions about distribution. In short, which of us will get lifesaving treatment and which of us will not?”
If we are to continue to view disability as a purely ontological (of the body) mishap in biology, we will continue to sacrifice our friends, our families, and our comrades for a Malthusian ethical model for the nation. The quote above is not to cast aspersions on the amazing NHS workers; these decisions come from the top. The lack in resources is not due to the workers themselves, but those in charge of how we organise society, and time & time again we see that we are building our national psychology — and the systems therein — on a principle of sacrifice. Universal Basic Income does not follow this methodology. Even if we can prove that UBI would be beneficial for capitalists — not even those on the side of the angels, so to speak — it does not fit the mental landscape. England adores sacrifice. It adores misery. We have to perpetually prove our depression & anxiety is worth it, rather than fighting to remove it. In short, ‘if I had to suffer to get here, so should everyone else’. Why should I be the one to make things better? Why couldn’t I have been the one to live in ‘utopia’?
The systems are designed to keep us in this everlasting cycle of believing the sacrifices and the depressive episodes are worth it. For every disabled applicant committing suicide through the PIP process, we can hold another vigil, we can associate another flower to the sacrifices these people made. I do not wish to live in this kind of world. As a counsellor, it is our responsibility to try and help people see other ways of living outside of their depression, outside of their misery. Is not changing the national psychology part of this process? Or am I, once again, blaming the individual for something that society has caused? It’s as simple as the meme: “we should improve society somewhat”. We’re all in this together.
Nathan T. Dean is a writer, artist, trainee counsellor, practicing chaos witch, and founder of Ollamh Counselling.
All of these essays are part of an evolving documentation. Ideas the author may have now may shift in the future. This is the lot of the therapist, who must continuously explore their empathy in radical ways as the environment around them shifts. If you find anything in these documents you find offensive, please contact the author at ollamhcounselling@gmail.com. Without discussion, correction, and open discourse, we cannot benefit our clients as effectively as we might.
[1] One day I will figure out how to describe this in a non-gross/hilarious way.
[2] I am quite proud of this pun.
[3] The Medical Model of Disability was shown me through twitter by Budding Therapy. I am uncertain of the original creator of the graphic, if anyone knows, please inform me so I can credit accordingly.
[4] https://www.gov.uk/government/publications/inclusive-communication/inclusive-language-words-to-use-and-avoid-when-writing-about-disability c
[5] https://www.benefitsandwork.co.uk/news/4139-claimant-subject-to-foul-abuse-by-dwp-awarded-5-000
[6] Although this is American, the terminology carries across the pond (from my understanding), although you should always refer to the terms preferred by the person you are speaking to. Again, something the inclusivity document fails to note is what individual clients/applicants may prefer: https://www.lpaonline.org
[7] https://www.disabilitynewsservice.com/dwp-staff-admit-inflicting-psychological-harm-on-claimants-during-coalition-years/
[8] https://twitter.com/PeterStefanovi2/status/1418571911991267333
[9] I know you have to pay to read it, but that first paragraph says it all. https://www.independent.co.uk/news/uk/home-news/cruel-government-policies-blamed-depression-and-stress-levels-department-work-and-pensions-a7010451.html
[10] https://www.theguardian.com/commentisfree/2019/nov/26/civil-servant-brexit-depression
[11] And again, these figures are going back a fair way. We know things have gotten tenser due to the pandemic, and yet the figures are harder to resolve & discover. We can only presume this has gotten worse, not better.
[12] http://www.disabilitynottinghamshire.org.uk/index.php/about/social-model-vs-medical-model-of-disability/
[13] https://www2.le.ac.uk/offices/accessability/staff/accessabilitytutors/information-for-accessability-tutors/the-social-and-medical-model-of-disability
[14] https://www.theguardian.com/society/2020/feb/07/dwp-benefit-related-suicide-numbers-not-true-figure-says-watchdog-nao
[15] https://www.disabilitynewsservice.com/hundreds-dying-every-year-after-pip-rejections-and-number-may-even-be-rising/
[16] https://fullfact.org/law/dwp-reviewing-link-between-suicides-and-welfare-reform/
[17] And the cynic in me wonders how much higher this number is, when many of these figures come from the government themselves. If they are willing to admit to 1,700 deaths, how many more are they hiding?
[18] And this is again, before COVID. Imagine the “frothing rage” when we have actual deaths to count: https://www.independent.co.uk/voices/poppy-remembrance-day-cambridge-university-students-soldiers-british-transport-police-a8584956.html
[19] I try not to call him Boris Johnson when I can. Names have power. Boris is the cute, fun, kinda racist uncle we all accept. Alexander DePfeffel is the American Born Trump-supporting Bullingdon Club psychopath running the nation like a business: into the ground.
[20] https://questions-statements.parliament.uk/written-questions/detail/2020-08-28/81702
[21] https://www.youtube.com/watch?v=eH9BhOfJswg
[22] How are we to expect young people to stay on their feet for over 12 hours serving real ale when long COVID has stripped them of the ability to even walk to the shops. Tim Martin even u-turned on immigration when, I imagine, he saw the effects this disastrous government had on his pub empire: https://www.thelondoneconomic.com/news/tim-martin-calls-for-more-eu-migration-as-wetherspoons-is-hit-by-bar-staff-shortage-272908/
[23] Again, how are the young meant to perform this “unglamorous task” when none of us can breathe? https://edition.cnn.com/2020/05/19/uk/prince-charles-fruit-picking-intl-scli-gbr/index.html
[24] Conservatism is predicated on family values and a lack of revolutionary endeavour. If everyone has a home, everyone can have a family. And if everyone has a family, no one is going to be a revolutionary. UBI is pretty much the most conservative thing I can think of. This is why right-wing philosophies are moot, because they have no core belief system.
[25] “[…] we should facilitate, instead of foolishly and vainly endeavouring to impede, the operations of nature in producing this mortality; and if we dread the too frequent visitation of the horrid form of famine, we should sedulously encourage the other forms of destruction, which we compel nature to use. Instead of recommending cleanliness to the poor, we should encourage contrary habits. In our towns we should make the streets narrower, crowd more people into the houses, and court the return of the plague. In the country, we should build our villages near stagnant pools, and particularly encourage settlements in all marshy and unwholesome situations. […] But above all, we should reprobate specific remedies for ravaging diseases; and those benevolent, but much mistaken men, who have thought they were doing a service to mankind by projecting schemes for the total extirpation of particular disorders.” Thomas Malthus, Essay on the Principle of Population. Malthus is the one who came up with the idea of workhouses, so I’ll just leave this here: https://www.buzzfeed.com/alexspence/the-tory-housing-minister-was-in-a-private-facebook-group
[26] https://www.ubiworks.ca/groweconomy
[27] https://www.sheffield.ac.uk/ihuman/covid-19-blog/surviving-ableism-covid-times