Ableism, like all other social constructions, is a limitation or denial of personhood by one group over another restricting access to the oppressed group’s humanity. Humanity is comprised of (among many things) access the physical world, political and civic empowerment, education, work, independent living, intimacy and justice. We aspire to live in a world that is inclusive, constantly re-envisioning itself, transforming and challenging its own notions of ability. We can’t dismantle ableism. And, I personally don’t want to deconstruct it. I want to excavate ableism, dig into it, get into the discomfort that is reflected back on me and on us in order to consider how to proceed.
That being said, I personally, don’t want to have my teeth drilled by a blind dentist. I don’t want to have a surgeon with a hand tremor. And, I probably don’t want to work with a therapist who is living with dementia or who is significantly internally preoccupied. Clinicians must be able. But how do we determine that?
Federal law (in the US) says if you can do the job with a reasonable accommodation then you are technically able. The Americans with Disabilities Act requires employers to be specific about the requirements of a job e.g. does the employee need to talk on the phone, does the employee need to be able to ambulate to perform the task? The requirements are defined by physical tasks and accommodations but not by the invisible ones. That responsibility is left up to the clinician their self and, to some extent, the training programs that graduate them.
Photo credit: Maria Hodermarska
As a teacher of drama therapists, I recognize my double bind; I am an employee of a University and a gatekeeper for the larger profession. It is our job to ensure that we are graduating students who demonstrate the competencies required by our State and our national organizations. Standards and ethical practice in clinical training do not specify what diagnoses might prohibit someone from practice. Nor should they. The graduate program in which I work has trained people who identify as living with disabilities (and some who do not identify publically but are) including but not exclusively limited to: people who are wheelchair users, people who are living with traumatic brain injuries, people who are living with mental health diagnoses like bi-polar illness or voice hearing or PTSD, people who are living with significant learning disabilities, people who are deaf or have significant hearing loss. People who have graduated have all demonstrated the competencies required for practice.
Graduate education in the creative arts therapies, however, still privileges the able body and mind. We want students who can work as part of multidisciplinary teams in high stress urban hospitals. We want students who can speak the many languages of the clinical teams on which they work: the language of psychiatry and DSM that is grounded in the medical model; the language of the creative therapeutic modalities in which the students train and work; the emotional-idiosyncratic language of the people receiving care who have their own social, cultural, spiritual ways of understanding their experience with mental illness.
The questions that we need to ask ourselves do not have to do with the ADA accommodations (scribes, translators, etc.) that some people require, although there remains work to do here. It’s the more difficult conversations, the ones we’d like to avoid having, the pose the greatest dangers. Educating clinicians living with mental illness, for example, requires conversations about how people are managing their own symptoms under the stress of clinical internship and coursework and future practice. Educating clinicians living with learning disabilities requires conversations and strategizing about how to manage EPIC note systems in hospitals when spelling or sequencing of ideas presents challenges. How do we support student’s research or capstone projects when the form that research scholarship must take may prohibit the student with certain learning disabilities from completing the task at the standards set by the institution? We have to have direct conversations on topics that can produce a profound sense of shame for people and that place us on legally difficult ground.
One student’s experience with the Master’s thesis process is shared here. Veronica Filson, MA, is a May 2018 graduate of the NYU Program in Drama Therapy. She writes:
As someone who learns differently than what is considered the norm, I have, since I was in elementary school, had to re-teach myself the classroom material in ways that I could process, understand, and enjoy. This required me to step outside myself, consider my strengths and weaknesses, take the material and teach myself what I was not being taught sufficiently by my teachers. Our schools tend to prioritize the linguistic, mathematical, and logical smarts above the interpersonal, intrapersonal, artistic, spatial, kinesthetic smarts. Unfortunately, my mind has always lived in those of the latter, non-prioritized grouping. I would teach myself to spell by making up interpersonal relationships between letters. I would teach myself math by finding the rhythm and pattern in equations. I felt pressured to learn things I wasn’t interested in at the time.
My Master’s thesis was an autoethnography about discovering my identity as a drama therapist through my internship with a counseling team in an elementary school setting. Once I began writing, I discovered that the theory with which I would be engaging felt at times as inaccessible to me as the alphabet of my primary school years. In discussion with my advisor, I decided to apply the same strategies of my childhood to ensure my mastery of the theory. This brought me closer to the students with whom I was working. I chose to create poems out of much of the theory I would be including. I reorganized the words, sometimes essentialized the concepts, as poetry can do so that they were legible to me. I used the poems in lieu of the theory in the autoethnography. The theory-poems would support my assertions or insights. I called this process ‘poeming’. The theory-poems operated on a meta level as a commentary on one of the themes of the thesis—art making is a way of knowing things—but also served to make the autoethnography truly reflect my engagement with the process and my understanding of the material and concepts I was putting forth. By poeming the theory I could see it with new eyes, in a new order and format, and understand it differently, or rather, more deeply and intimately.
For example, a line such as, " Shame is a particularly distressing, yet common, affect in which one’s self is highlighted in the eyes of the other in a negative way … The person’s sense of trust in others is significantly disrupted.” (Johnson, 1994, p 175), would become:
one’s self is highlighted in the eyes of the other
one’s sense of trust in others
This process of poeming was one of the many creative therapeutic interventions and learning accommodations that I made for myself to progress in my graduate education.
In this particular student’s case, how the theory presented itself in a Master’s thesis became a pedagogical tool for learning the theory. It was born out of a need to be flexible and creative about the form and (theoretical) content of a research document that could better support the student’s learning outcomes. We are making efforts across education and training in creative arts therapies, to dismantle the hegemonic “habits of thought” (Paolo Friere) and to build our capacities to think and act from humble, multi-lectic perspectives in order to take affirmative, hopeful action with the people in our care and in the world. The ableism embedded in the teaching, learning, and scholarship of creative arts therapists remains endemic and problematic.
Confining ourselves to training a certain kind of “able” person, we miss out on other ways of knowing. Ableism, like the whiteness, patriarchy and classism of the academy is another barrier to knowledge acquisition and dissemination. What is privileged in the academy is a mind that has mastered certain ideas and concepts and ways of presenting that information, a mind that demonstrates a quickness and facility with certain forms of expression that excludes so many people. An effective approach to critical pedagogies in the creative arts therapies will include people with disabilities in the dialogue.
Maria Hodermarska is a Licensed Creative Arts Therapist (LCAT), a Registered Drama Therapist (RDT), a Credentialed Alcoholism and Substance Abuse Counselor (CASAC), and an Internationally Certified Alcohol and Drug Abuse Counselor (ICADAC). Her work spans both the creative and applied psychological uses of the theater arts, most often within NGOs, community-based mental health programs and alcohol/substance abuse treatment programs serving un-served or under-served populations. She is a core faculty member of the Drama Therapy program at New York University.
Veronica Filson is a recent graduate of the M.A. Program in Drama Therapy at NYU. She grew up throughout Canada from Ontario, to Saskatchewan, to Quebec where she obtained her B.A. degree in Theatre and Development at Concordia University. She has over ten years of experience working with children in different capacities and hopes to contribute to the learning and discourse around what it takes to work with children, from the lens of the creative arts therapies.
Freire, P. & Macedo, D.P. (1995). A dialogue: Culture, language, and race. Harvard Educational
Review, 65(3), 377-402.
Johnson, D. R. (1994). Shame dynamics among creative arts therapists. The Arts in
Psychotherapy. 21(3) 173-178.