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American Pragmatism, Sociology and the Development of Disability Studies
Heilpädagogik online, 2003, Stand: 01.07.2003, 2. Jahrgang (Heft 3), Seite 22-50, Köln, Dortmund, Brühl: Eigenverlag, Online-Ressource, ISSN: 1610-613X
Mit den Disability studies ist die Heilpädagogik in jüngster Zeit auf ein neues Forschungsfeld gestoßen. Die Entwicklung dazu nahm in den USA ihren Ausgang. Der Autor, ein amerikanischer Sozial- und Kulturwissenschaftler, bietet einen Überblick über die Entstehung und die Wurzeln dieses Forschungsfeldes in den USA.
American Pragmatism, Sociology and the Development of Disability Studies
Disability is increasingly in the public consciousness for a myriad reasons. As populations age and world news concerning illness, disease and impairments is broadcast around the globe, disability is becoming recognized as a universal experience (ZOLA 1989). The visibility of impairments; the personal experience of disability in our lives; the effects of the degraded environment, tobacco, HIV/AIDS, accidents, land mines and civil wars on our well being and that of others; and, vulnerability of the food chain to disability causing agents; neo-natal intensive care; and, escalating health interventions for the elderly all contribute to our awareness of disability (ALBRECHT AND VERBRUGGE 2000; MICHAUD, MURRAY AND BLOOM 2001). As these issues are played out in public, disability becomes a case study of the values, worth and position of people in a society. Indeed, a society can be judged on how it treats it children, women, elderly citizens and disabled people.
Disability studies developed as a field in response to the perceived universality of the problem, academic interest in explaining the place and meaning of disability in society and activist expressions of empowerment, inclusion, normality and the politics of difference. Policy makers and politicians contributed to the growth of the field through their concern with the economic and social costs associated with disability and public discussions of how government support might better be organized to plan for increased numbers of disabled people and the elderly (CHARD, LILFORD AND DEREK 1999; BLENDON AND BENSON 2001). Disability studies, then, is an emergent field that spans the boundaries of academia, personal experience, political activism and public policy.
There are six contentious propositions that shape discussion in the field: 1) people interested in disability share a common universe of discourse, 2) leaders and spokespeople in the field represent all disabled people 3) only disabled people can effectively understand disability or contribute to the field, 4) disability studies is an established field with a home 5) disability studies shares a common history and intellectual tradition across countries and throughout history, and 6) people in the field generally agree on health and welfare policies for disabled people and what constitutes 'reasonable accommodation', 'empowerment' and 'quality of life.' These propositions provoke heated debates in the disability studies literature and the popular press over the experiences, meanings, context and consequences of disability (LINTON 1998; BARNES 1999; GREENHOUSE 2001). They also represent the fault lines in disability studies where politically correct values are applied to argue for a position or to silence dissent. For this reason, it is as important to study the values of participants in the disability discourse, the politics and ideologies of the actors, and the attitudes, values, structure and culture of the society in which the discourse takes place as it is to collect and consider evidence in support of a position. Although there is considerable disagreement among participants in the disability discourse, the passion of their arguments attests to the vitality of the field and importance of the issues (CORKER AND FRENCH 1999; ALTMAN AND BARNARTT 2000; ALBRECHT, SEELMAN AND BURY 2001).
While there are universal questions that have been addressed across national boundaries and perspectives, the maturation of a field is dependent on historical context, experience, intellectual tradition, culture and the political economic system. The development of disability studies, then, should be examined and understood in context. I will do this by discussing how pragmatism and American sociology influenced the development of disability studies in the United States and directly or indirectly addressed the six contentious questions posed above. First, I will consider how pragmatism shaped American thought, social policy and view of the world. Second, I will show how pragmatism combined with the early development of American sociology, including survey research and the social area studies and interactionism of the Chicago School, to provide a framework and method for addressing disability issues. Third, I will analyze how the disability movement organized, exerted political influence in the American context and shaped disability studies as a field. Fourth, I will consider how disability studies in the United States was influenced by the political economy, embodying the American values of rugged individualism, capitalism and democracy. Finally, I will reflect on the future directions of American disability studies.
Pragmatism is a diverse philosophy that has had a pervasive influence on American social science and subsequently on disability studies. Pragmatism is a style of philosophy initiated by Charles Sanders PIERCE (1839-1914) and William JAMES (1842-1910) which deeply influenced the work of DEWEY (1859-1952) , SCHILLER (1908) and MEAD (1964) in the early twentieth century and the more recent contemporary philosophical work of SELLARS (1973), QUINE (1969), PUTNAM (1978), RORTY (1979; 1991), HAACK (1993) and WEST (1999). Since the tenets of this work raise many philosophy of science and social policy questions, pragmatism has deeply affected thinking in American social sciences and cultural studies. However, because of its multiple forms and re-inventions, it is difficult to characterize the work of all pragmatists under one conceptual umbrella. In searching for a common thread in this work, Susan HAACK (1996: 643) concludes that pragmatism 'is best characterized by the method expressed in the pragmatic maxim, according to which the meaning of a concept is determined by the experiential or practical consequences of its application.'
The early pragmatists worked in the context of the Industrial Revolution and rapid development of knowledge in the physical sciences. They were attracted by the idea of certainty and the formulation of scientific laws that had practical applications. PIERCE, for example, reacted to the a priori methods traditionally favored by metaphysicians by arguing for a scientific method where the inquirer is ready to 'drop the whole cartload of his beliefs, the moment experience is against them' (PIERCE 1931-58, Vol I: 14, 55). According to his perspective, the scientific investigator is a 'contrite fallibilist' in evaluating the beliefs and evidence she encounters. The purpose was to encourage scholars to pursue a disinterested desire for truth and to produce theories and a body of work that would withstand multiple and severe tests. This approach to scientific method is compatible with POPPER's principle of falsification where theories are proposed and submitted 'to the severest test we can design' (POPPER 1972: 16). The attraction of this version of the scientific method is that it emphasized objective knowledge, realism and universality; truth lay in tested theory and in the 'facts'.
William JAMES placed a different emphasis on pragmatism than did PIERCE. JAMES stressed praxis, the practical consequences of believing in a particular concept or social policy. In discussing the complexities of metaphysical and moral questions, he says, for example: 'The pragmatic method in such cases is to try to interpret each notion by tracing its respective practical consequences' (JAMES 1907:28). JAMES also recognized that there might not be scientific evidence to settle every dispute. Therefore, he posited that 'religious beliefs' which in principle cannot be verified or falsified are often used to make decisions because they fit with the believer's life and have practical consequences. He also supported the notion that truth is socially constructed and can change over time. Both his emphasis on 'religious beliefs' and the social construction of truth acknowledge the subjective and relative aspects of knowledge. JAMES' brand of pragmatism opens the door to later explorations of the subjective meanings of experience.
John DEWEY and F.C.S. SCHILLER moved pragmatism in an increasingly activist direction. DEWEY did not engage in the 'quest for certainty' that captured the attention of PIERCE. Instead, he recognized that knowing is intimately related to practice (DEWEY 1910). He was a reformist in that he advocated that good theories are based in practice and are modified as experience with a program demonstrates the success or failure of an idea. SCHILLER (1864-1937) is more revolutionary than DEWEY. He acknowledges the social construction of reality by arguing that truth is relative and means 'valued by us.' A proposition is true if it 'forwards our ends' (SCHILLER 1907: 8). In terms of social activism, SCHILLER pointed out how values and subjective experience color what we think of as being true or right.
A group of neo-pragmatists, including RORTY, QUINE, PUTNAM and HAACK, recognize that 'objective certitude' advocated by early pragmatists is not a feasible goal for science or epistemology. Yet, they are keenly interested in the question of truth, seeking to find a middle ground between dogmatism and skepticism (HAACK 1996: 656). This work lays a philosophical foundation for many of the issues debated in contemporary cultural studies, including: What constitutes evidence? How is a text to be read? Who can speak about or understand the experience of another? What are human rights? What is just in a given situation?
The Confluence of Pragmatism, American Sociology and Disability Studies
Pragmatism was influential in the development of Sociology and subsequently of Disability Studies in the United States because it provided a conceptual framework for thinking about the critical issues confronting social scientists and suggested the types of data and analysis that should be used to construct arguments. Social scientists were concerned with developing theories, methods and a body of knowledge addressing social behavior that would be credible and useful. Over the years, pragmatism shaped the pursuit of these desiderata in the discipline of sociology in three important ways. First, early pragmatism emphasized that if sociology is to be a science, it should follow the 'scientific method' of the natural sciences by embracing the epistemological principle of falsification. This principle, elaborated and disseminated by POPPER (1972), suggests that scientists put forward a theory, initially as an uncorroborated conjecture, and then test its predictions with observations to see if the theory stands up to the test. If carefully designed tests of hypotheses prove negative, the theory is experimentally falsified and the investigators will modify the theory or build a new one. If, on the other hand, the tests and data support the theory, scientists will continue to use the theory on the basis of its undefeated hypotheses to further test and extend the theory. According to PIERCE, the extension of this approach leads to the development of 'laws' and points to what is true. Thus, pragmatism inculcated an early interest among sociologists in gathering 'objective' data through observations, surveys and censuses that would describe social phenomena, help develop theory and serve as evidence testing an argument.
Second, the pragmatists exemplified particularly by William JAMES, encouraged the anchoring of analysis in practical realities and social policies. JAMES stated that a pragmatist 'turns away from abstraction and insufficiency, from verbal solutions, from bad a priori reasons, from fixed principles, closed systems, and pretended absolutes and origins. He turns towards concreteness and adequacy, towards facts, towards action, and towards power' (JAMES 1907: 31). Through such arguments, JAMES laid the foundations for grounded theory, the study of social problems, observing behavior and gathering data in the 'real' world, formulating social policies and testing their effects on behavior and an examination of the distribution and exercise of power in society. For JAMES, pragmatism involved seeing if theories and policies really made a difference. In this sense, JAMES encouraged social action theory among pragmatists and sociologists alike.
Third, the evolution of pragmatist thinking moved away from the strict 'objectivism' and application of the scientific method advocated by PIERCE towards the recognition of the importance of subjective experience, relativistic and culturally different conceptions of behavior, paradigm shifts in the gathering and interpreting information and competing communities of discourse. RORTY (1979; 1991) is an example of these positions. He dismisses claims to objectivity as wishful thinking, arguing that our standards of evidence and our scientific and social policy practices are cultural conventions. RORTY has been a powerful influence on cultural studies, including disability studies, in so far as he stresses the importance of engaging in conversation about issues and analyzing texts in a open discourse taking into account the subjective differences and cultural grounding of the participants. This perspective in social science and the humanities highlights the reading of situations and texts and analysis of both the observer/ reader and that which is observed or is the text. RORTY's brand of positivism also emphasizes cultural and historical context. This approach to understanding raises important questions such as: Who has the right to speak and interpret? What constitutes a community of discourse or a community of scholars? What are the criteria of admission to such communities? How is an argument comprised and evidence presented that would convince others of its truth and usefulness? How does cultural context and history affect the definition of the situation and how the 'facts are interpreted? How is evidence, theory and argument translated into social policies that have the power the change the behavior of others, rearrange status hierarchies and the structure of institutions? In reviewing this broad range of pragmatic positions and their use, it is noteworthy that there are not merely different but radically opposed forms of pragmatism. However, they do address many of the same fundamental questions of how we acquire and use knowledge and they share the important principle that knowledge ought to be evaluated in terms of its utility and the consequences of its application to practical problems.
These three themes in pragmatism had a powerful impact on the development of sociology and later of disability studies in the United States. They have conceptual and historical links to five methodological, substantive and theoretical approaches to social research: quantitative, qualitative, historical/contextual, social action/social policy and integrated work. While there is considerable intermingling of these methodological approaches to social research, they each have their own constituency under girded by a particular philosophy of science, intellectual context and projected use of the results.
Quantitative research in the social sciences flowed easily from a desire of sociologists to gain the status of scientists and have their discipline respected for its rigor. According to the dictates of the early pragmatists and methodologies of the natural scientists, theories should guide research, phenomena under study must be measured accurately, events and units counted and hypotheses tested in a deductive fashion. The United States Census, which began in 1790, was one of the early sources of such quantitative data. During the last hundred years especially, the United States Public Health Service and medical scientists have been interested in developing epidemiological data to identify population characteristics, define health problems, suitable interventions and eventually to assess the outcomes of those interventions. Quantitative social epidemiology, strongly influenced by the social ecology perspective of the Sociology Department of the University of Chicago in the 1930's, was path breaking in exploring the relationship between social conditions and such social problems as mental disorder (FARIS and DUNHAM 1939). This focus on quantitative research according to the 'scientific method' persists to this day in American sociology. Journals like the American Sociological Review and the Journal of Health and Social Behavior are replete with articles using quantitative methods to examine the relationship between poverty, race, gender, education, stress, access to resources and employment on outcome variables such as discrimination, disparity in income, access to opportunities, health, well being and equal justice for all citizens. Social science publishers like Sage Inc. have instituted series of methodological primers that guide researchers in how to better measure and analyze data, test hypotheses and build ever more sophisticated models of individual, group and organizational behavior. This vast literature conforms to the spirit of the 'scientific method' proposed by PIERCE and legitimized by research in the natural sciences. At the same time much of this literature is concerned with social problems and issues of justice that carry forth another theme from the pragmatists; the desire to make a difference and to judge the value of research by it practical usefulness.
In the disability arena, these themes were also carried forth into rehabilitation and disability research. In the United States, rehabilitation research typically meant medical rehabilitation of individuals after trauma or the diagnosis of impairment or social rehabilitation through physical and occupational therapy and education that would allow individuals to obtain a job or return to work. Medical rehabilitation research burgeoned after the end of World War II and particularly from the 1960's to the present. This work is most often directed by physicians and aimed at acquiring knowledge that would improve functional status and permit individuals to live independently in the community. Social rehabilitation research was often undertaken by economists and researchers in vocational rehabilitation and special education; sometimes working in conjunction with physicians to develop programs that would help impaired and disabled people return to work. This has traditionally been the major focus of the Veterans Administration and the branches of the Social Security Administration dedicated to disability. Medical researchers employed the quantitative methods of surveys, targeted sampling strategies, double blinded clinical trials and evaluation studies to demonstrate patterns and outcomes that would help in implementing programs to help disabled people be more functionally independent. The social rehabilitation researchers, often including sociologists and economists, also used quantitative methods and statistical models to determine which variables and interventions predicted return to work.
Many Disability Studies scholars in the United States were trained or heavily influenced by sociologists so they carried over the social concerns and research paradigms from sociology to Disability Studies. Quantitative research in Disability Studies is an illustration of this influence. For example, FUJIURA and RUTKOWSKI-KMITTA (2001) point out that counting disability is an important enterprise for disabled people, governments, policy makers and social scientists. Regardless of the heated debates over disability definitions and who and what ought to be measured, if anything, governments need to be able to identify and count disability if they are to provide health insurance, medical and social services and make the environment more accommodating. While there is deep concern over labeling, failing to take disabled peoples' experience into account and giving insufficient attention to the accessibility of the environment, governments could not provide services nor even consider altering the environment unless they could identify disabled people and their needs. FUJIURA and RUTOWSKI-KMITTA (2001:70) observe that : 'Although there are notable exceptions, the organized political state exists to promote the well-being of its people. Data inform this process and help inform the planning and organization of state policy. Thus, the surveillance of health status is both an ancient practice and nearly universal among nation states.' Furthermore, they agree with OBERSHALL'S contention (1972) that 'the demand for extensive and detailed information by 'social reformers, civic groups and philanthropists' was the foundation of much statistical work in the nineteenth century' (2001:70). These purposes of disability statistics still pertain today. The difference is that current methodological and statistical techniques allow researchers to address social, cultural and environmental effects in a more precise and integrated fashion (BROWN 2001). This exercise has stimulated social scientists and disability scholars to refine the theories and models which they use to understand disability and its effects, health and social interventions, the physical and social environment and the outcomes of different social policies.
While the purposes of measuring disability and counting disabled people are reasonably clear, these activities are fraught with difficulty and controversy. This is because disability is a 'complicated, multidimensional concept' (ALTMAN 2001:97), the endpurposes of disability measures are multiple and identification can have negative consequences, such as labeling and discrimination, for disabled people. Debates over these issues can be vividly seen in the on-going controversies regarding the World Health Organization's development and use of ICIDH codes to classify disability and the Global Burden of Disease Project jointly sponsored by the World Bank and the World Health Organization (ALTMAN 2001; FUJIURA and RUTKOWSKI-KMITTA 2001). Regardless of ideological position or predilection for a particular scientific method, this quantitative research on disability reflects the influence of sociology and some key principles of pragmatism on disability studies.
The pragmatic theme of undertaking investigations where the results are likely to produce work that shapes social policy and politics is also reflected in the qualitative and socio-historical approaches to sociology and disability studies. Both the pragmatists and neo-pragmatists exert their influence on contemporary sociology and disability studies. Among qualitative and cultural studies scholars today, there is a strong emphasis on the social construction of reality, the importance of individual experience, culture and context on interpreting behavior and texts, listening to the 'voices' of the people being studied, and 'discourse' among and between scholars and the people being studied. Harvard University and the University of Chicago were two institutions, among others, where pragmatism and qualitative and sociohistorical research provided a foundation for entire areas of sociological work and disability studies. This is not a teleological tale in which there is a direct causal link between individuals, disciplines and departments. Nevertheless, pragmatism and compatible sociological 'schools' have flourished at both Harvard and Chicago for years. William JAMES was at Harvard at the turn of the century where he had a significant influence on numerous sociologists including the extraordinary African American scholar, W.E.B. DU BOIS (1961), who studied with JAMES and called himself a 'realist pragmatist' (KLOPPENBERG 1998: 539). Today Cornel WEST and Hillary PUTNAM are neo-pragmatists at Harvard who have an impact on current sociologists and cultural studies scholars including William WILSON, a recent past President of the American Sociological Association and Theda SKOCPOL. WILSON's work on the meaning of work for inner city Blacks, social policies for poor minorities and social justice is representative of this influence. SKOCPOL's contributions have been in understanding the welfare state in historical and cultural context. Interesting, both WILSON and SKOCPOL came to Harvard from the University of Chicago, another intellectual center influenced by pragmatism. Both Harvard and Chicago have a long history of sociologists who used both quantitative and qualitative methods to study social problems in work that had serious policy implications.
Two important early pragmatists, John DEWEY and George Herbert MEAD, did some of their most important work at the University of Chicago where there seemed to be a commonality of interests between the pragmatists and groups of sociologists (BLOOM 2000). As ABBOTT (1999) points out, however, there is less a singular University of Chicago 'school' than central themes and diverse groups of academics who made significant contributions to sociology in terms of social ecology, social psychology, demography and social organization.
The interactionist perspective in sociology proposed in the work of WEBER (1946) and SIMMEL (1955) emphasizes the importance of understanding the social world from the viewpoint of the individuals who act within it. This approach was influenced by DEWEY and elaborated by MEAD (1934) and BLUMER (1969) at the University of Chicago into what is now known as symbolic interactionsim. BLUMER later moved to the Department of Sociology at the University of California, Berkeley where he trained many students in this research tradition. Students of MEAD and BLUMER at the University of Chicago, like Howard S. BECKER (1961), Erving GOFFMAN (1959; 1961) and Anselm STRAUSS (1975; 1990; 1993), used symbolic interactionism as a framework to produce path breaking books in medical sociology and in qualitative research methods.
Symbolic interaction is a form of social psychology that examines the interactions between people in terms of symbols like signs, gestures, shared rules and written and spoken language. Symbolic interaction was originally applied to analyses of individuals and groups but only more recently to organizations and the more encompassing social structure. The essential point of this perspective is that people do not respond to the world directly but instead place social meanings on it, organize it, and respond to it on the basis of these meanings. Thus, we live in a symbolic as well as a physical world where social life involves a constant process of assigning meanings to our own acts and those of others and interpreting them within this framework. Other people use similar techniques to understand us and our behavior. Symbolic interaction highlights subjective experience and the interpretation of social reality but also allows individuals to take the place of others symbolically to better understand their behavior.
This perspective has been used by disability scholars to ask fundamental questions: How does an impairment become a disability? What does disability mean to people with different impairments and in diverse cultures? What is the subjective experience of disability? How do others perceive, define and react to disabled people? Is disability in the individual, in the environment or in the interaction between the two (IMRIE 2000)? How do medical professionals and service providers act towards disabled people and why? By addressing these questions from a symbolic interactionist perspective, disability scholars have deepened our theoretical and experiential understanding of what it means to be a disabled person.
Social interactionism is well equipped to analyze how social problems, behavior and institutions are socially constructed. As ROBERTSON (1977: 135) aptly remarks, 'We are not born with any sense of time, of place, or cause and effect, or of the society in which we live. We learn about these things through social interaction, and what we learn depends on the society in which we live and our particular place within it.' According to BERGER and LUCKMAN (1963), reality is socially constructed through three processes: externalization, objectification and internalization. Externalization occurs when people produce cultural products through their social interactions. Examples of this in the disability arena are lip reading and signing among deaf people and group cohesion among spinal cord injured individuals due to the visibility of and meanings attached to wheelchair use. Objectification occurs when these externalized products take on a meaning of their own. For example, the wheelchair symbol is used worldwide to denote parking spaces and bathrooms that are intended to be accessible for disabled people. Internalization takes place when people learn purported 'objective' facts about reality from others through the socialization process and make them a part of their own subjective 'internal' consciousness. Thus, individuals socialized in similar cultures share the same perceptions of reality, rarely questioning where these beliefs originated or why. Stigmatization of and attitudes towards persons with mental illness are an example of such an internalization process.
Within this intellectual tradition, Irving Kenneth ZOLA made a substantial contribution to the development of disability studies as a medical sociologist and as a visibly disabled person. He was trained at Harvard in medical sociology but his work is strongly flavored by social interactionism and the ethnographic work characterized by Chicago sociologists. ZOLA's dissertation explored differential perceptions of pain and differences in help seeking behavior for medical care among three diverse cultural groups in Boston: Irish Americans, Italians and Jews (ZOLA 1966). His later work highlighted the subjective experience of disability, being an embodied subject, and the universality of disability (ZOLA 1989; 1991; 1993). He was Chair of the Medical Sociology Section of the American Sociological Association, founder of Disability Studies Quarterly which publishes articles, personal statements, book and film reviews and news of interest to the academic disability community and a key member of the disability movement responsible for the Americans With Disabilities Act of 1990, accommodations in the environment and the formation of disability studies as a field. He was one of the moving forces in establishing the Society for Disability Studies. Here was a scholar in the symbolic interactionist mold who incorporated a critical component of pragmatism into his research by combining academic research and activism. He was on the one hand, a member of an National Academy of Sciences Committee organized to identify the critical research issues in need of funding and on the other an activist who could be seen demonstrating on the steps of a Courthouse about accessibility.
Social Movements and Politics
As we have seen from the work of ZOLA, pragmatism and sociology were formative influences on the disability movement. There is a myth that since disabled people have a common experience and similar view of their social worlds, organizing a disability movement to institute changes in social policy and public attitudes was a natural and easy process. This myth does not reflect the reality. In the United States, disability groups originally formed around types of impairment, age, employment status and military experience. There were, for example, powerful groups that coalesced around visual impairment, deafness, polio, spinal cord injury and mental illness. Some of these groups, like the March of Dimes, concentrated on the young while others, like the Vocational Rehabilitation Administration focused on returning disabled people with skills and experience to the workplace. Again, the Veterans Administration is a entire government agency devoted to assisting veterans of military service with medical care and rehabilitation. These groups often fought among themselves for the scarce resources available for medical treatment, rehabilitation, social services, independent living and modification of the environment. Behind the scenes, competition rather than cooperation was the rule of the day. That is why the convergence of these groups behind the Americans with Disabilities Act of 1990 (ADA) was such news.
Since Harlan HAHN has a chapter later in this book [vgl. Hinweise zum Ursprung dieses Textes, Anm. d. Herausgeber] on disability politics and the disability movement where he uses a minority group model to understand the evolution of the American disability movement, I will keep my focus on how pragmatism and sociology helped to shape disability studies and crystallize the disability movement. From a social interactionist perspective, the self that people present depends on the role that they are playing. Not all disabled people have disability as their defining role. For example, in an examination of identity, roles and disability culture, DEVLIEGER and ALBRECHT (2000) discovered that inner city, disabled African Americans who lived on the near west side of Chicago did not have a strong disability identity nor claim a disability culture. Instead, their master statuses were more likely to be African American, poor, survivors or gang members. This is one of the reasons why the American disability movement is overwhelmingly composed of white, privileged, educated adults with visible disabilities. When these people speak for all disabled people, many wonder whom they are representing. The disability movement leaders publicly preach unity and inclusion but where are the poor, the people of color, the individuals with non-visible disabilities and the intellectually disabled? Power is about representation. If only some are represented in the movement, the others are without voice (CHARLTON 1998).
The symbolic interactionists have also noted that social life is made predictable through shared expectations and rules. As indicated above, the members of the disability movement often organized around specific disabilities or issues, were in competition with other disability groups and excluded those who did not share their disability or viewpoint. As a consequence their impact was limited and did not include the majority of disabled people in the nation. Erving GOFFMAN (1959), using a dramaturgical metaphor, studied the aligning actions people employed to redirect potentially disruptive interactions. He and other symbolic interactionists suggest that finding a common identity and cause, organizing against an outside force, including people with the same interests, developing organizational signs, symbols and culture, presenting a united front and becoming politically astute are concrete actions that can be taken to unite groups. These are also the strategies most likely to produce social change as expressed in public attitudes, laws, and accessible environment and independent living.
When the diverse disability groups recognized that they had more to gain by cooperatively gathering forces and organizing behind a common set of strategies, they were able to marshal their energies, conceive of a shared plan, take political action, change public opinion and successfully back the Americans With Disabilities Act. Following the dictates of social interactionist theory, leaders in the disability movement employed shared expectations and rules to control internal competition and implement a successful strategy developed around the civil rights model to energize public opinion and pass the ADA. This group cohesion in the disability movement was reinforced by the development of shared signs, symbols and disability culture. People within the movement were able to draw on their subjective experiences and demonstrate that disability is a shared, universal experience to construct disability as a social problem deserving of attention and resources (ZOLA 1989). All of these strategies combined to produce and reinforce a vigorous disability movement.
American Values and The Political Economy of Disability
The preponderance of disability research in the United States has used the individual, families or groups as the unit of analysis. Symbolic interaction began as a social psychology well suited to these types of analysis. However, there is a need to consider disability from a societal and structural perspective as well. There is analysis at this level using social construction and political economic perspectives to understand societal definitions of disability, the organization of a response to disability and the disability marketplace (ALBRECHT 1992; ALBRECHT and BURY 2001).
GORDON and ROSENBLUM argue that sociologists have failed to cultivate the social constructionist model of disability and continue 'to frame disability along 'traditional' or 'individual' lines, that is by focusing on limitations, medicalization, diagnoses, individual adjustment.' (2001:16). They base their observation on a review of 510 articles located in Sociological Abstracts where they found 'that a fairly small proportion' (2001:15), 17% of the articles surveyed, addressed the social construction of disability. First, this study only used Sociological Abstracts as its data source, secondly, 17% of 510 articles (87) is not a trivial number and third, this review overlooks a number of important books. GORDON and ROSENBLUM's sweeping indictment makes a legitimate case but they lose their impact by overstating their argument and overlooking the force of important work in the field. Two key books in the early 1990's, for example, directly address the social construction of disability. OLIVER makes the social and cultural production of disability the central argument of The Politics of Disablement (1990). ALBRECHT'S book, The Disability Business: Rehabilitation In America (1992), is devoted to an analysis of the social construction of disability as a social problem and the development of a rehabilitation industry as an institutional response. While not the dominant themes in disability research, work informed by the social construction of disability, the political economy of disability and analysis of the disability marketplace contributes significantly to our understanding of disability on the societal and structural levels.
The social construction of disability and political economic forms of institutions are contingent on the values, interests and contexts of the particular society being studied. Therefore, an understanding of disability in the United States requires that American values and ideologies be taken into account because they will influence the ways that disability is socially constructed and the institutional/ political economic response to a defined social problem is organized. In the United States, the key values in the culture of rugged individualism, capitalism and democracy have remained remarkably consistent over centuries (DIMAGGIO, EVANS and BRYSON 1996). By contrast, European nations, while also espousing democratic values, are generally more benign to those in need, have more comprehensive and complete health and welfare systems, and manifest less extreme differences in income distribution in society and in services available to those in need such as the unemployed, poor, women, children and disabled people (ARDIGÓ 1995; EVANS 1995; AYANIAN et. al. 2000; HAYWARD et al. 2000).
In the United States, then, emphasis on rugged individualism, capitalism and the American brand of democracy affected how disability is defined and the shared institutional response. Disability is typically described as an individual problem with which the disabled person must deal. While there are substantial government programs for disabled people, they emphasize protection for those in politically and economically valuable occupations like the military, transportation workers and government employees and are often aimed at return to work (MUDRICK 1997; YELIN 1997). Whether in the public or private sector, rehabilitation goods and services are commodities that can be bought and sold. Disability is the focus of a multi-billion dollar business comprised of diverse stakeholders in a capitalistic marketplace where helping disabled people and making money are important goals. The stakeholder groups include health care and medical professionals; hospitals, therapy businesses and home care agencies; assisted care living facilities; the pharmaceutical, medical supply, and technology industries and insurance companies; architects, law practices, banks and accounting firms specializing in disability; government and lobby groups; politicians; and last, the consumer (ALBRECHT and BURY 2001). In this environment, the consumer/disabled person is the stakeholder with the least power.
Such political economic analyses in the United States are important because the American model of managed care, delivery of technical medicine, definitional processes, and social policies are being exported around the world through multi-national companies and government policies. As American capitalism and democracy dictated the definition of and response to disability contingent on one's place in and perceived value to society in the United States, so will these forces operate in the international arena as health, human services and disability become global businesses. Such analyses are instrumental in helping us understand how values, the political economy and the physical and social environment help us to understand a society's treatment of disabled people and to know best how to intervene.
American Exceptionalism and the Future of Disability Studies
As we have seen, American disability studies have been shaped by pragmatism; sociology, including quantitative, symbolic interaction and political economic analyses; and, the particular context in which the discipline has grown in the United States. At the same time, American disability studies have been characterized by general a lack of historical sensibility and a disconcerting insularity. Much needed contributions on the historical grounding of disability studies are finally appearing (STIKER 1999; BRADDOCK and PARISH 2001; LONGMORE and UMANSKY 2001; and FLEISCHER and ZAMES 2001) but there is need of more scholarship like this in the United States and other countries.
BARNES (1999) aptly notes both disturbing trends in discussing LINTON's (1998) recent book, Claiming Disability. BARNES argues that disability scholars, exemplified by LINTON, frequently are 'reinventing the wheel' because they do not have a deep historical anchoring in their disciplines and do not carefully read the work of others: 'It is clear, however, from the recent body of writing coming out of North America, that some of the emergent crop of 'disability scholars' are ignorant of, or choose to overlook, developments on this side of the Atlantic and, indeed, elsewhere' (1999: 577). These remarks are well taken because it is easy for discipline based scholars to have myopic vision when they work in a new and interdisciplinary field. The requirement for disability studies to explore the history of disability and to be open to perspectives and research across borders and disciplines is imperative, if it is to acquire maturity as an academic discipline and credibility in the activist world (BARNES, MERCER and SHAKESPEARE 1999; GLEESON 1999; LLEWLLYN and HOGAN 2000; WILLIAMS, S. 2001).
In conclusion, it is an openness to and respect for others that will permit a shared universe of discourse, discussions of disability definitions and representations, appreciation of diverse intellectual positions, the experiences of others, the vision of disability studies as a discipline, and how theory and research can bear upon practice (WILLIAMS 2001). Disability studies is a product of the intellectual traditions and the cultural settings where it is evolving. It is most likely to mature as scholars, policy makers and activists listen to each other and engage in respectful discourse about the fault lines, issues, theories and applications of the field to the real world. Let the reciprocal dialogue begin.
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