Tag Archives: Blogging Against Disablism Day

There is ableism somewhere at the heart of your oppression, no matter what your oppression might be.

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If you are oppressed, then you face ableism. It’s that simple.

You’re probably not used to this concept at all, so I’ll explain(1).  Bear with me, because this is quite important whether you know it yet or not.

From my perspective, there’s two main ways that oppressions collide with each other. One is horizontal. One is what I’d call vertical or embedded. This post is about vertical or embedded oppression, which very few people discuss. Horizontal oppression, on the other hand, is very fashionable to dissect in detail at the moment, and I’ll leave that to the people who are much better at it than I am.

Horizontal oppression works more or less like this: Sexism and homophobia can go together because lesbians exist, who are both gay and female. Racism and transphobia go together because there are trans people of color. Etc. The connection is a side-to-side one.

Vertical oppression works more or less like this: Sexism and homophobia are connected vertically, because sexism is embedded within homophobia: You can’t have some of the core aspects of homophobia, without also having sexism. This applies not just to lesbians, but also to gay men. Because a large element of homophobia against gay men involves comparing them to women, and applying many of the same sexist attitudes towards gay men that would normally be attributed to women. That’s where you get the idea that there’s something wrong with gay men because gay men are sissies, effeminate, possess feminine attributes, etc. They’re first equated with women and then degraded in ways that have to do with women. You can’t have homophobia minus the sexism and have it take anything like a recognizable shape. It depends on sexism. That’s the big difference between horizontal and vertical oppression. Another big difference is that horizontal oppression is symmetrical (sexism + ableism = ableism + sexism) but vertical oppression is not (sexism is embedded in homophobia but homophobia is not embedded in sexism).

Every kind of oppression is connected to every other kind of oppression horizontally. But not every kind of oppression is connected to every other kind of oppression vertically. Some kinds of oppression are not embedded in any other kind of oppression at all. Other kinds of oppression are embedded in just one or two kinds of oppression. Other kinds of oppression are embedded in many forms of oppression.

Ableism is, to my knowledge, the only kind of oppression that is embedded in every other kind of oppression I have heard of. I have my theories as to why, but they’re not relevant here. When I say things like this, people think that I’m trying to make a case that ableism is the worst kind of oppression, or that I’m trying to get in some kind of pissing contest or another with regards to whose oppression is more uniquely terrible than anyone else’s. I’m not. This has nothing to do with that kind of comparison. It’s just that some kind of oppression had to be the one embedded in more kinds of oppression than any other, and ableism happened to fit the bill.

I’m not the only person to notice this. I think I’m the first person to coin the idea of horizontal versus vertical oppression, although I’m sure there are other people who have put similar ideas in different words. But disabled people have been talking about the pervasiveness of ableism in other forms of oppression for a really long time. We have tried to convince other oppressed people that our fight is, by necessity, their fight. Generally people don’t understand what we’re saying and find ways to ignore it, forget it, or even belittle it.

But people really should pay attention when we say this. Because when you have another form of oppression embedded within your own, you can’t possibly address your own oppression without addressing the other. Not because of a horizontal connection that only exists in certain circumstances. But because of a vertical connection that you can’t possibly get away from: Your oppression would not be the same kind of oppression without that other oppression stuck very close to the center. If you’re gay and you truly want to end homophobia forever, you can’t get away from having to deal with sexism. You can’t. You can pretend that you can, but you can’t actually do it.

So now I’m going to describe some specific examples of ableism in the forms it takes when it’s embedded in other forms of oppression. These are just examples. Later on, I’ll give you some guidelines for how to spot ableism quickly and easily, and where to look for ideas about fighting it. So here are some ways that ableism embeds itself in other forms of oppression:

  • When gay people are considered to have a psychiatric disease.
  • When men’s rights activists claim that the women’s Olympics are just the Special Olympics under another name.
  • When people of color are painted as inferior and deserving of unequal treatment because their IQs are supposedly lower than white people.
  • When women’s bodies are seen as a deviant and irregular version of men’s bodies, all medical testing is done on men first and women only as an afterthought, ordinary experiences of women are considered medical while ordinary experiences of men are not, etc.
  • When eugenics is applied to poor people and people of color in addition to disabled people. (Eugenics is fundamentally an ableist idea, all applications of eugenics are applications of ableism.)
  • When black men involved in riots are deliberately diagnosed with schizophrenia and brain studies are done on them in order to pathologize them and by extension their political stances.
  • When political dissidents of all kinds (including those involved in anti-oppression work for their own groups, whatever they may be) are locked up in mental hospitals.

These may seem like scattered examples of specific kinds of treatment, but they’re not. They all have certain core traits in common, and they all combine central characteristics of their own oppression with central characteristics of ableism. Such that it literally does not matter what kind of oppression you face, you’re guaranteed to face ableism as a component part of it. You can’t get away from ableism.

You can try, of course, and many people do try. The most common way other oppressed people deal with ableism is by not really dealing with it at all. Instead of addressing the ableism that forms the core of the problem they’re facing, they distance themselves as far as they can from disabled people.

What do I mean? Take the IQ situation. Nondisabled people of color who are classified as having lower IQs than white people, rarely look into how IQ has been used to oppress disabled people ever since it has existed, pretty much. They don’t look into what cognitive ableism is. They don’t look into the self-advocacy movement by people with intellectual and other developmental disabilities and the many ways they have criticized IQ testing and the way it is used against disabled people. Instead, they try to prove that people of color don’t really have lower IQs than white people.

Mind you, that’s an important thing to prove, if it’s true. But you can’t stop at proving that. Plus, if you really do end up having lower IQs, then you’re basically screwed. Stopping at “They’re wrong about our IQ score, we’re just as smart as anyone else” leaves you vulnerable in addition to inadvertently contributing to the oppression of disabled people. Looking into how the idea of being smart got equated with having a certain IQ score? Looking into how IQ has been used against people who score low on IQ tests (for all kinds of reasons) throughout history? Looking into the general shape of cognitive ableism in general and IQ-based cognitive ableism in particular? Understanding the basics of what ableism is and how it functions – by taking a certain kind of person and saying that we’re biologically inferior and this justifies seeing us as having less value, making fewer contributions to society, and being oppressed and discriminated against?

You have to do all of that. Proving that scientific racism is actually pseudoscience is important. But understanding the ableism that underlies scientific racism is just as important if not more so. Because if you take what happens when you have one of those things and not the other? Proving it’s pseudoscience leaves you forever vulnerable to the claim it’s actually real science. Dealing with ableism means that whether or not your IQ score is technically lower than someone else’s (and if you really look into ableism, you’ll see how meaningless that question can get, because it assumes that people actually have some kind of innate trait called IQ), the core oppression will not be there. And as a bonus you’ll have contributed to lessening oppression against actual disabled people as well, rather than inadvertently contributing to ableism itself.

This will all make a lot more sense when you understand what some of those core characteristics of ableism are. And understanding what some of those core characteristics of ableism are, will make it much easier to spot ableism within your own oppression. I pretty much guarantee that as soon as you understand the basics, you will start seeing it in places you’d never expected. So here are a few very simple aspects of ableism that you can spot within other kinds of oppression:

  • Any time one group of people is considered biologically or psychologically inferior to another group of people, and unequal treatment or oppression is justified on that basis, you’re dealing with ableism.
  • Any time you deal with eugenics, you’re dealing with ableism. Whether you’re dealing with “pure” eugenics aimed at disabled people in particular, or the more common situation where it’s intermingled with race, class, ethnicity, criminality, and other real and purported traits. You’re probably used to hearing of eugenics in terms of racism, classism, or anti-Semitism, but eugenics originated in ideas about disabled people and those ideas were then applied to all these other groups.
  • Any time you deal with medicalization (including psychiatric medicalization), you’re dealing with ableism.
  • Any time people are compared on the basis of what they can and cannot do, and that comparison is used as the basis for viewing or treating them differently, ,particularly in a bad way, you’re dealing with ableism.
  • Any time you’re dealing with “scientific” proof that a group of people is inferior to another, there’s a really good chance you’re dealing with ableism. If the “science” is couched explicitly in terms of medicine, biology, or psychology, it’s almost definitely ableism. So basically, if you hear that your oppression is justified on “scientific” grounds, perk your ears up for ableism, you’ll probably find it.
  • Pretty much any time you’re dealing with a situation where one sort of person is given access to part or all of a society, and another sort of person is barred from that access, and it’s justified on the grounds of ability in some manner, it’s ableism.
  • Any time your oppression is framed in terms of people like you being sick or having a medical problem for some kind, there’s ableism involved.

Keep in mind that for all of this, it doesn’t entirely matter whether the purported sickness or diminished ability level is real or not. The ableism is going to be there whether a person is actually possible to classify as disabled, or not. This is one reason that disfigurement is considered a disability in a lot of contexts. It’s also why laws like the Americans with Disabilities Act often contain a piece that says that it’s not just disabled people, but people who are mistaken for disabled people, who are protected. What matters to make something ableism is not whether or not the person qualifies as “biologically inferior,” whatever that means – it’s how people are treated based on that purported inferiority.

Once you start to see the basic patterns involved in ableism, you can see why it’s behind core aspects of every other kind of oppression:  Every form of oppression uses ableist ideas, actions, and concepts to further some of its most fundamental goals.  You’re going to always have your oppressed group being ranked in a hierarchy based on ability and found wanting.  You’re going to always have your oppressed group face some degree of medicalization.  You’re going to always have your oppressed group treated in ways that disabled people are treated, and the same sorts of reasons used to justify such treatment.  And unless you address these things, you can’t address the way your oppression plays out.  They happen in areas too central to how the oppression works — you can’t pretend the ableism doesn’t exist and get rid of the whole oppression at the same time.  Your form of oppression would be unrecognizable without ableism as a core feature.

You can learn a lot more about ableism by looking into what disabled people have already figured out about it. If all you can find is lists of “ableist words” with people telling you that stupid is a slur or something, you’re not usually going to find much depth there — whether or not you think stupid is a slur, that’s just not that fundamental to what ableism actually means. And frequently that sort of shallow take on things is what you’ll find if you just look up ableism. But if you look into the hard-core stuff within the zillion different branches of the disability rights movement, you’ll find a lot.

One of the best general introductions to modern disability-rights thinking about ableism in general, that I’ve found, is the book Pride Against Prejudice by Jenny Morris. There are tons of other entry points, that’s just one of the clearest, from my perspective.

You don’t have to agree with everything a disabled person says about ableism. Disabled people don’t all agree with each other.

Some disabled people seem to concentrate entirely on language and insist that it’s the most important thing because it changes people’s thoughts and changing people’s thoughts changes their actions and so forth. I think that’s a dangerous misconception, and I don’t honestly care so much what people think as much as how they treat me – if they think I’m inferior and treat me with respect anyway, then their thoughts are their business. I’d rather deal with someone who treats me with utter respect and calls me the worst ableist slurs I’ve ever encountered (IMHO, “retard” and “vegetable” and “empty shell” are all up there), than deal with someone who knows all the right words but treats me like shit. Other people have other ideas entirely about these things.

You get the idea: We don’t all agree . You don’t have to agree with all of us. You can’t possibly agree with all of us anyway. A lot of times people embroiled in identity politics get really wrapped up in the idea that the oppressed person is always right about their oppression. That’s bullshit. We can be as wrong as anyone. However, we have on average thought more deeply and for longer about our oppression than other people have, so you can benefit from our experience when dealing with the way your own oppression takes the same shape as ours.

And what specific situation you’re talking about will determine a lot about which disabled people you want to go to first. Want to deal with critiques of IQ testing? Go to people with intellectual and other developmental disabilities first. Don’t be fooled by stereotypes, we have a long-standing self-advocacy community who have been developing ideas about this stuff for decades.

And there are also always general ideas about disability that can be applied across the board, but in slightly different ways. The idea of accessibility was once focused entirely on wheelchair access. These days, there’s also a concept of cognitive access. Where interpreters in disability context used to concentrate entirely on translating between signed languages and spoken languages, there are now interpreters who assist people whose speech is hard to understand, and there are cognitive interpreters or English-to-English interpreters who interpret between the words and gestures of someone with a cognitive disability and the words and gestures of someone without a cognitive disability. The social model, like most aspects of mainstream disability theory, was once only for physically disabled people, and is now being applied to cognitively disabled people as well. Neurodiversity was once used in a context that was almost exclusively about autistic people, and now it’s about anyone with a neurocognitive disability.

Understand – I’m not endorsing any of these concepts. I hate some of these concepts. I think some of them are misguided or dangerous or simplistic or all kinds of other things. But I don’t want to decide that for you. I’m just giving you resources as a jumping-off point and you can make up your own mind. Hell, I’m not even that heavily into the idea of analyzing oppression in the way I’ve done in this post. I just think it’s important and useful for someone to be doing it somewhere so that people can see the underlying issue here – which is that you can’t address your own oppression adequately without addressing ableism, no matter what your oppression is, whether you’re also disabled or not.

So with all that in mind, I want to give you some keywords for common disability communities or disability-based ideas. Again, none of this is an endorsement of any of these communities or ideas or the views contained within them. They’re just places to start looking. I get frustrated when people say “Google things, it’s easy” and then won’t even tell you what to Google. Most people don’t even know enough about ableism to know that ableism is fundamentally about unequal treatment on the basis of real or purported biological and psychological characteristics. Most people who have heard of ableism have only heard of it in the contexts of word lists. There’s no way someone in that position is going to even know where to begin on Google, and it’s unfair to have that expectation of people. I’m perhaps more sensitive to that kind of thing specifically because of understanding cognitive ableism – and that’s precisely the sort of situation where an understanding of ableism can be useful throughout any oppressed group. I guarantee as you really learn what ableism is – really learn the depths of it – you will find concepts you can use in fighting your own oppression.

One more note about the keywords: All of these communities and ideologies and intellectual traditions, come from vastly different places. All of them accept some forms of ableism and reject others, that’s pretty much inevitable. Some of them are groups of people formed together mostly by life experiences, others are groups of people formed together mostly by shared diagnostic categories, others are a mixture of both. Some, like the concepts of developmental disabilities and psychiatric disabilities, are more accidents of history than categories that have an automatic, genuine meaning. Some, like psychiatric consumers versus psychiatric survivors, fall within the same broad category of people but differ based on how they interpret their own experiences, which aspects of the medical system they accept and which aspects they reject. But all of these are groups of people, and ideas formed by groups of people, who have formed significant ideas about the rights of disabled people within an ableist society. While the faction wars can be absolutely infuriating at times, the diversity among disabled people in terms of both life experiences and Ideas about those experiences, can be a great strength. You can find really important ideas within every single one of these groupings without ever having to believe everything they say wholesale.

So here’s a list of keywords you might find useful:

  • Disability rights, disability rights movement
  • Disability culture
  • Crip culture, crip, gimp
  • Self-advocacy, developmental disability self-advocacy, intellectual disability self-advocacy, learning disability self-advocacy, self-advocates, I/DD self-advocacy
  • Cognitive disability, physical disability, psychiatric disability, intellectual disability, developmental disability, sensory disability
  • Autistic self-advocacy, autistic liberation, autistic rights, autistic community, autistic culture
  • Deaf community, d/Deaf community, Deaf culture
  • Psychiatric survivors, psychiatric consumers, psychiatric ex-patients, consumer/survivor/ex-patient, c/s/x, mad pride
  • Neurodiversity, neurodiverse, neurodivergent
  • Patient advocacy, patient’s rights
  • Disability theory, disability studies, social model of disability, radical model of disability
  • Cross-disability
  • Disability access, accessibility, universal design, visitability
  • [Insert disability, disability-type, or disability-tool name here] access, [Insert disability, disability-type, or disability-tool name here] accessibility – for instance, wheelchair access, wheelchair accessibility, blind access, blind accessibility, screenreader access, screenreader accessibility, cognitive access, cognitive accessibility, etc.
  • Cognitive interpreting, English-to-English interpreting, sign language interpreting, [insert specific sign language here] interpreting, speech-to-speech relay
  • Ableism, disablism, ablism, disableism, disphobia, handicapism
  • Cognitive ableism, psychiatric ableism, physical ableism

I know I’ve left plenty of people out, and this is obviously centered on English-speaking cultures. But that’s more than enough to start with. If you’re looking for specific ideas tailored to specific experiences, then learn what these terms mean so that you can look up those experiences when you need to. Different movements, and different parts of the same movement, will give you very different ideas about the same problems, and that can be incredibly useful.

So I hope by now I’ve convinced you that not only is ableism about more than whether or not it’s a slur to say the word ‘stupid’, but it’s a vital part of understanding any other form of oppression you might face. I also hope I’ve given you enough places to start, that you can make a good start on finding any resources that might be useful to you in beginning to understand ableism and the experiences of disabled people in the world. And again, I guarantee that if you begin to truly understand what ableism is, you will find the concept useful in contexts you never dreamed of.

If you’ve made it this far, thank you for listening.  I really appreciate it.  Getting this idea out there means a whole lot to me, even the parts of it I’m not so sure I agree with.  It’s stuff that someone needed to say, so I said it.


(1) I’m putting what would normally be an introduction, down as a footnote, just so it won’t distract from anything in the actual post. The post is far more important than the introduction. So here’s what I was going to write as an introduction: 

 

This was an extremely difficult article for me to write. I understand the underlying idea easily enough. But to put it into words has taken me a long time, and a lot of effort. This is more abstract and intellectual than my posts tend to run.

But I felt like while a lot of disabled people alluded to this idea, nobody was expanding it enough for nondisabled people with no connection to the disability community to understand it. When I tried to tell people in short form, they assumed I was saying something totally different than what I was saying. So I developed these ideas until I could articulate them, and then over the past six months or so I have worked very hard at writing them down.

I still barely finished in time for Blogging Against Disablism Day, I wasn’t actually sure I could finish in time for Blogging Against Disablism Day. I’m still shocked that it’s happened at all. This was the original post I intended to write for BADD 2016, one that dealt with ableism as a whole rather than one particular disability experience. 

I’m very relieved to have finished It, not least because I am always pigeonholed as an autism blogger, I don’t see myself as an autism blogger, and it’s frustrating to sometimes only be able to write posts that reference autism a lot. Autism is not my only disability. It’s not my central disability – I don’t exactly view myself as having one of those. It’s just a word that psychiatry coined for a bunch of people, tat’s become useful enough that I’ve felt compelled to use it in certain circumstances. But I find that even in disability contexts, hell even in contexts with other autistic people, the idea of autism begins to overshadow your personhood in a way that few other disability labels match in my experience. Nobody considers me a ‘myasthenia gravis blogger’ and writes about my entire life and all of my ideas as if they can be encapsulated by the idea of myasthenia gravis, but that’s exactly what people do with autism. I can write about things that have nothing whatsoever to do with autism and still get most of my responses back about autism. It’s kind of ridiculous but nobody questions it, not even most autistic people.

So this year I really wanted my post to be about something that could not be tied back to autism like that. I mean I’m sure somebody somewhere will try, but there’s nothing about this post that is even remotely autism-specific, unlike my other two contributions this year. There are lots of other posts I wish I could have made this year, but I’m going to rest happy knowing that I made this one post, at least. 

And I hope that it can serve as a resource for people who are just beginning to learn about how ableism affects oppressed people who are not themselves disabled. Because it does, and it does so in specific, predictable ways that are pretty consistent across every form of oppression. And that’s important. And someone had to say all of this.

A lot of my posts in general seem to fall under the category of “I couldn’t find anyone saying the thing I wanted to find someone saying so I said it instead.” And this definitely falls into that category. There’s a lot of ideas contained within the post that I don’t even necessarily agree with, but that are necessary to the way the post is written. So this is very much not a personal post, and very much a post about a general idea that I think is important to communicate, even the parts of it that I don’t wholly agree with. What other people take out of it is their business, but I hope each person can find something useful there.

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Don’t ever assume autism researchers know what they’re doing.

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This is my post for Blogging Against Disablism Day 2016.  Like many of my posts, although it focuses on one specific situation (autism research) it applies to a much more broad set of circumstances if you look at it closely.  I was originally planning on doing something much more ambitious for BADD, but reality (and the reality of being a disabled person) got in the way of that.  So here is a different post that was fortunately written long in advance.  I hope it can serve as a resource for a lot of people, because I’ve been asked about this test a lot, and I usually only manage to describe part of it.  This is the first time to my knowledge that anyone has said all of these things at the same time in one place.  Apologies for the lack of sourcing, but I’m a blogger, not an academic, and if I had tried to do that I would never have been able to write it.  My inertia already prevented me doing what I wanted to do today, so I’m not going to let it prevent me from posting this.  So, with no further introductory babbling on my part:

Reading The What In The What?

The state of autism research is pretty uniformly terrible.  There is good research out there, but most research is bad.  The bad research includes some of the most popular research used to support the most popular theories about how autistic people think, and why.  Psychiatric research in general has low standards for quality control, and autism research seems to have lower standards than most.  If you can come up with a theory, it doesn’t matter how hare-brained it is.  If you have the skills to get it published, someone will publish it, whether your theory holds water or not.

The research is often so bad that I can see through it.  I have no formal training in research methods or techniques. And I have no formal training in autism.  Yet I’ve been able to see through the holes in autism research so well that I have been sought out by researchers to critique their own research ideas and suggest better avenues for research and techniques to use.

One research tool that has angered and frustrated me for years, is Simon Baron-Cohen’s “Reading The Mind in the Eyes” test.  It is most often used to show that autistic people lack empathy and the ability to figure out what other people are thinking and feeling based on body language and facial expressions.  Unfortunately, the test has very little real validity:  It measures all kinds of things it claims it doesn’t measure, and fails to measure the things it claims to measure.  And very few people understand this.  They take Simon Baron-Cohen at his word, especially because he’s a Big Name Autism Expert.  But he became a Big Name Autism Expert with research that for the most part is just as bad as this test

So for a long time, I’ve wanted to tell people what I thought was wrong with the test. The way I experience it, I feel all the wrong things at once. That makes it extremely difficult to communicate.  I feel the urgency of how wrong it is and how that wrongness is affecting autistic people around the world on a daily basis.  And I get frustrated that I can’t communicate ever single problem I see in the test. I’ve done it before, but it’s always exhausting and overloading, and I never feel like I’ve gotten all the information out there.  That’s why I am making this post.

Understand that when I bring up a potential problem with the test, I’m not saying that I absolutely know that it is a problem.  I just know that it is a potential problem, and that most of the official writing about the test does not address any of these problems.   There are possible solutions — other ways to test for the same things — but they would have to be done carefully.  And probably not by Simon Baron-Cohen, because he’s proven over time that he’s more interested in creating research that appears to support his theories, than he is in finding out what is actually happening with autistic people.

So what is the test?

The Reading the Mind in the Eyes test works like this:

A pair of feminine eyes in heavy makeup in a black and white photo with four words written around it: joking flustered desire convinced

A sample question from the Reading the Mind in the Eyes test.

 

 

You look at a black-and-white photograph cropped to only include a person’s eyes.  There are four words for different emotions.  You pick which emotion you think most closely matches the emotion conveyed by the picture of the eyes.  You do this with a large selection of eye pictures.  Then they score you by comparing your answers to the answers given by nonautistic people.  If your answers match the most common answer given by nonautistic people, you are scored as being correct.  If you answers do not match the most common answer given by nonautistic people, you are scored as being incorrect.  Then your scores are compared to a particular set of norms, to see whether you “pass” the test overall, or not.

I have a lot of problems with the design and administration of this test.  As I said, some of them might prove to be real and some of them might prove to be unreal.  But I can’t imagine that the test is so good that it overcomes every problem that I see with it.  So I’m going to discuss each element that I find wrong with this test.

These are still photographs.

Like many other elements of this test, this is different from how emotions occur in real life.  When we observe someone having an emotion, we don’t observe a still photograph.

The photographs are in black and white.

Unless we have achromotopsia, we don’t observe the world in black and white.  When someone is having an emotion in front of us, they do not turn into a black and white photograph.

The photographs are cropped to include only one part of the body.

We don’t know all the different ways that autistic people might read emotion.  We certainly don’t know it well enough to crop out every other indicator of emotion in order to focus on the eyes, and then make inferences about people’s understanding of the mental and emotional states of others, based only on one body part.  Since we don’t even know whether autistic people routinely pick up on body language, let alone how, it’s irresponsible to crop the image to one body part and assume that this is how we will tell whether and how autistic people pick up on body language or facial expression in general.

The photographs feature a part of the body that autistic people are notorious for having trouble looking at, and therefore avoiding, in real life.

Lack of eye contact is a very common autistic trait.  So common it has sometimes ended up described in the diagnostic criteria.  If autistic people avoid looking at people’s eyes, then it stands to reason that it’s possible we have no practice reading people’s facial expression through the eyes alone.  So why crop an image to the one part of the body we tend to look at the least, and then make broad inferences about our ability to read body language based on our ability to understand what’s going on with people’s eyes.

Different autistic people’s descriptions of why they avoid eye contact differ.  And some autistic people make eye contact, some even make more of it than nonautistic people do.  But many autistic people describe making eye contact as involving intense anxiety, physical or emotional pain, sensory overload, terror, or a sense of being flooded with the other person’s emotions.  Any of these things could prevent an autistic person from making a lot of eye contact, or from looking at people’s eyes in general, even as pictures on paper.  If there’s something that a person has spent their entire life not looking at, then obviously they’re not going to have skills that most people get from looking at eyes.

There’s a tendency in autism research to view autistic people’s abilities in ways that other disabled people’s abilities are not so frequently viewed.  Blind people can’t usually read facial expressions.  Deaf people can’t always hear tone of voice.  But people don’t assume that blind or deaf people lack theory of mind because there are elements of nonverbal communication they don’t understand due to sensory impairments.  But that’s exactly what is done to autistic people over and over — there are things that we just plain can’t perceive for various physical reasons, and then those are used as evidence that we don’t even know other people have minds at all.

And, of course, we don’t even fully know that autistic people don’t perceive those things.  Quite often, autistic people’s abilities are compared to nonautistic people’s abilities, and not taken as possibly having ability patterns of our own that are quite different:  Many autistic people report being able to read body language but not the same body language that we’re expected to be able to read.  Many autistic people report being able to read other autistic people’s body language — or some other autistic people’s body language — but not nonautistic people’s body language.  When nonautistic people can’t read autistic body language — which is usually — they’re not told they lack social skills, they’re told it’s because there’s no body language there to read, or because we lack social skills.  But when we can’t read theirs, we’re told we lack social skills.  But that’s a completely separate problem in and of itself.

The photographs are created from actors.

An actor playing an expression is not the same thing as a person spontaneously experiencing an emotion.  Acted expressions — and understanding them —  relies as much or more on popularly understood stage conventions, as it does on understanding what emotions actually look like in real life.  So this test is essentially a test of your ability to read stage conventions In a particular context, and to do so similarly to the way nonautistic people would.  If autistic people pick up on unconscious body movements that actors would not be able to change (because they’re used to only changing movements that nonautistic people perceive, and leaving alone movements not perceived by most people), then this test would not test things accurately at all.  Like all these situations, we don’t know if that’s the case but we definitely don’t know that it isn’t the case.

The correct answer in the photographs doesn’t rely on what emotions the actors said they were playing.

The correct answer was arrived at by asking large groups of nonautistic people what the person in the photograph was feeling. The most common answer became the correct answer.  So there’s a chance that the emotion the actor was playing, is totally different from the emotion that everyone says they have.  And this is not addressed at all.

The test assumes that the most common answer given by nonautistic people is the right one.

This assumption basically makes the test a circular argument:  Nonautistic people are better at reading emotions than autistic people, because we have created a test where the correct answers were created by looking at the answers of nonautistic people, thereby ensuring that nonautistic people are far more likely to get the right answer.  And then when autistic people give different answers than nonautistic people, it’s used to prove that we don’t understand what’s going on in the photographs.  Can you see how completely circular the reasoning is there?  The way the test is created, anticipates its own solution.  If autistic people’s reading of body language differs at all from nonautistic people’s, then we must be wrong.

So what if the most common answer given by nonautistic people is wrong?  Nothing about the test even allows for this possibility.  it’s created wit the assumption that nonautistic people are right, and that the only way for autistic people to be right is for our answers to resemble the answers of nonautistic people.

The test sometimes seems to rely more on how people feel looking at the eyes, than on how the person with the eyes must feel.

I chose the particular photo from the test for a reason.  The image is of a woman’s painted eyes, looking stereotypically sexy.  The correct answer is supposed to be “desire”.  It’s not clear to me at all that this has anything to do with what the woman in the photograph is supposed to be feeling.  It seems to me that it has much more to do with how the person looking at the photograph, feels in looking at a seductive pair of eyes.  I don’t actually know what the woman in the photograph is portraying for real, but I have a strong feeling that it’s not actually desire.  Desire is what people feel looking at her.  And if this is happening in this photograph, it’s possible that it has happened in others as well.  That the feeling evoked by the eyes is seen as the same as the feeling of the person with the eyes.  Another photo of a very similar pair of eyes, by the way, gives the correct answer as “fantasizing” or something like that, and again I can’t help but suspect that’s the way the person felt looking at her, rather than what she felt when the picture was taken.

The test requires a person to process nonverbal and verbal information simultaneously, or very close together.

Many autistic people have trouble processing information quickly, and have trouble multitasking.  This can take many different forms.  But it’s fairly common for autistic people to be in a situation where we can either process nonverbal or verbal information, but not both at once.

Some of us develop stable adaptations where we always process nonverbal information but never verbal information, or where we always process verbal information but never nonverbal information.  Others of us switch around so that sometimes we process verbal information, and other times we process nonverbal information.  And some of us have a baseline state where we process either verbal or nonverbal information more readily, but can switch to processing the other in certain situations.  Some of us do process both in some situations, but in those situations process both of them mediocre to badly instead of one well and the other not at all, like we’ve spread out our information processing too thin so our abilities in both areas suffer compared to what they could be.  For autistic people who switch back and forth between verbal and nonverbal information processing, we can’t necessarily make the switch at will, nor does the switch always happen in an instant.  Sometimes it takes a good deal of time.

All of this means that a test that requires a person to understand nonverbal information while picking a word out and applying that word to the nonverbal information, is possibly putting an autistic person in a position where they are not able to show what they truly understand.

Because it’s quite possible that when left to our own devices, some of us process the nonverbal information accurately.  Possibly even more accurately than nonautistic people.  But then we are unable to make the switch to processing and understanding words while applying those words to the nonverbal information. For any of a large number of reasons.  So even if we would otherwise make accurate observations, the test may be setting us up to fail.

This test relies on the ability to apply words to observations.

This sounds like my last complaint about the test, and I’ve already described how processing differences could create problems here.  But there’s one other problem.

Autistic people who can apply words to observations at any time — well or badly — well enough to take this test, may be very different from autistic people who are unable to ever apply words to observations (or unable to do so reliably enough to take the test).  There may be some overlap between the two groups, but the two groups may also contain people whose abilities differ enough to be worth noting.

Much research into autistic cognition relies on the abilities of autistic people who can use or understand language.  It’s assumed that autistic people who can’t use or understand language well enough to take part in the research, are the same, just with more severe autistic traits.  So if a verbal autistic person has some ability to get correct answers but not as well as nonautistic people do, it’s just assumed that a nonverbal autistic person would be even worse at this than a verbal autistic person.

There are, however, a number of autistic people whose stated experiences of the world completely belie these assumptions.  I happen to fall into that group of people, myself.  This is people who have spent any period of our lives, with a severe enough difficulty with processing verbal information, that at that time we would be unable to take this test.  Those of us who have spent long enough in such a cognitive state, often report that our brains prioritize nonverbal information over verbal information.  At those times, we are not just a verbal autistic person with more severe social awareness problems.  We are a completely different kind of autistic person, with a completely different cognitive profile, including nonverbal social awareness.

Now obviously you can’t get into the head of someone who has always had and will always have so much trouble processing verbal information, that they will never be able to describe their experience.  But there are autistic people who can now ocmmunicate using words at least some of the time, but have spent enough of our lives with significant enough verbal processing problems, that we can give descriptions of what our cognition was like in the past, even if it has changed now.

Some of us describe being essentially the same as most verbal autistic people, but with additional difficulties (in a wide variety of areas) that most verbal autistic people don’t have.  But others of us describe — and sometimes are observed by others to have — abilities that are completely different in their type and pattern than anything described by the average verbal autistic person.  And some of us describe the ability to pick up nonverbal information from others, at least as well as nonautistic people do, if not better.  And there is no opportunity within this test, to test people who are in a state where their nonverbal cognitive abilities are excellent but their verbal skills are too poor to take the test.

It also doesn’t take into account the possibility of people whose ability to read nonverbal cues is excellent, whose ability to use language in general is also excellent, but whose abilility to apply language to these specific situations is not so good for any of a variety of reasons.  One of which I’ll address in my next point.

This test relies in particular on the ability to apply words to emotional states.

Even autistic people who are highly verbal can have difficulty applying language to emotional states, in themselves or in other people.  This test does not take into account the possibility that a person might be good with language, good with reading body language from nonverbal cues, but bad at applying words to emotions in particular, so they would fail the test even if they knew the right answers.  Because knowing what an emotion is, and knowing that the emotion is called ‘happy’, are two different things.  There may be autistic people looking at someone’s eyes, seeing happiness in those eyes, but not knowing that the word happiness applies to the feeling they are observing.  There’s an assumption that understanding something, and understanding the word for something, are the same thing.  They’re not.  Not for everyone, anyway.

This test gives no possibility to give a different and possibly more accurate answer.

It’s a multiple choice test.  What if all of the choices are actually wrong, and something else is actually right?  Not only is this not considered possible. (because it’s just assumed that the majority of nonautistic people are going to be right about something like this).  But there’s no mechanism to deal with it if it happens.  If the autistic person understands the body language better than the nonautistic people did, and is even able to accurately apply a word to the emotion they believe they are seeing, but the word is not in the multiple choices?  Out of luck.  Maybe an autistic person can read what that woman in the photo is actually feeling, rather than ‘desire’.  Maybe they know a word for it.  Maybe the word is ‘anticipation’ or something — that’s a completely random guess on my part, not intended to be accurate.  But if ‘anticipation’ is not on the list, then even if it’s exactly how the woman is feeling, there’s no way to pursue that as the right answer and get credit for understanding her emotions.

This test assumes that autistic people’s abilities to read body language would work the same as nonautistic people who read body language.

There’s a bunch of assumptions that go into this.

One is that autistic people and nonautistic people would, if processing body language, do it in the same way.  So testing autistic and nonautistic people on the same extremely specific situation, is supposed to give overall information, rather than testing of the specific abilities necessary to get the ‘right’ answer in this extremely specific context.  So this test is seen as testing autistic people’s ability to read body language in general and assign mental and emotional states to other people (and even to know that other people have emotional states).  When it’s actually testing autistic people’s ability to come up with the same verbal answers as most nonautistic people, to a question asked while viewing heavily cropped images of actors deliberately portraying emotional states showing a still black and white photograph of their eyes.

If autistic people have any difference in how — and in what context — we process emotional information from other people in a nonverbal fashion, this test does not allow for contexts that might differ considerably.  Just as an example, what if autistic people understood nonverbal information primarily through watching hand movements, whereas nonautistic people understood nonverbal information through the whole body, or through the eyes in particular?  This test doesn’t allow for that possibility, given that it’s still photographs of eyes.

A closely related assumption that I see happen all the time in autism research, is that the only abilities that exist are the abilities we know about in nonautistic people.  So if there are ways to understand nonverbal communication, they’re assumed that the only possible ways to understand it are ways that nonautistic people understand it.  It’s assumed to be impossible, that an autistic person could be just as good at understanding emotions from nonverbal cues as a nonautistic perosn is, or even better — but that the way we do it is so different that the test doesn’t test for it.

This is one reason that such an artificial limiting of the context creates problems.  You’re assuming that if we had this ability, it would show up in our ability to pick out the same words as nonautistic people, to describe the emotions experienced by an actor deliberately portraying the emotion in a still heavily-cropped black and white photograph of their eyes.  Maybe some of us can read elements of body language that nonautistic people can’t read.  To figure that out, you would need to have as much of the original context of the body language retained as possible.

Ideally, you would test autistic people’s responses to a person experiencing a genuine emotion, in the same room as the autistic person.  That way, the autistic person would be getting all the sensory information possible, rather than getting sensory information that is limited or distorted to include only the parts that nonautistic people find the most relevant.  And if we were observing something like the tightness and sweatiness of someone’s skin combined with subtle unconscious body movements nonautistic people don’t even pick up on?  Where nonautistic people were not relying on that information at all?  Then we would still get that information and be able to give accurate answers.  Whereas it’s possible that the test as currently conceived, shuts out the information autistic people would need to get the right answers.  And then acts like we would never have gotten the answers right to begin with.

Given that it’s well-known at this point that autistic people’s perceptual experiences are significantly different than nonautistic people’s — and from each other, often enough — then there’s no excuse for limiting the context so much that you’re potentially shutting out the information sources that autistic people actually use.  Like, this test might be useful for isolating what differences exist between what autistic people rely on to process nonverbal cues, and what nonautistic people rely on to process nonverbal cues. But it’s not useful for evaluating autistic people’s overall ability to evaluate nonverbal cues. But that’s exactly the kind of broad conclusions leapt to by the author of this test and people who use it in their studies.

This test assumes that when autistic and nonautistic people’s answers differ, the nonautistic person is automatically correct and the autistic person is automatically wrong.

This is similar to something I said earlier but it’s worth repeating:  This test contains within the setup, the outcome.  Because it’s normal entirely on the responses of nonautistic people, who are presumed to be right about these things.  If autistic people’s answers differ from those of nonautistic people, we’re always assumed to be the ones in the wrong.  Always.  When this may not be the case.

I know an autistic woman who had to guess the emotions of live actors as part of her diagnostic process.  She scored terribly on the test they gave her. That basically involved looking at live actors and ascribing emotions ot them.  The problem was, she was reading actual emotional cues, not stage conventions at least some of the time.  So her answers were different — and actually more accurate — than the answers nonautistic people assumed should happen.

I’ve done the same thing in much less formal contexts — been totally unable to read the emotion a person is trying to deliberately project for others, but been better than average able to read the emotion underneath, the one that caused unconscious body movements the person was not controlling.  I’ve had this verified by the actual people having the emotions, and I think the woman who was tested talked to one of the actors afterwards and found out she was in fact describing his real emotions as well.  So there are autistic people who read unconscious emotional cues better than we read deliberate attempts to manipulate other people’s emotional awareness — but the deliberate manipulation is what nonautistic people are reading, and they’re therefore assumed to be right.

This test compares nonautistic people’s ability to read other nonautistic people’s body language, to autistic people’s ability to read nonautistic people’s body language.

There’s a possibility that people read body language more accurately for people more similar to them, either neurologically or culturally.  If this is true, then autistic people would be better at reading the body language of other autistic people — and in particular, people with similar types of autism to our own.  When I say similar types of autism, I don’t mean the official definitions of autism versus Asperger’s, or functioning levels.  I mean deeper levels of similarity and difference in how we think, process information, move, and respond to the world around us.

So if that is true, then this test isn’t a fair comparison.  A fairer comparison would be nonautistic people’s ability to read other nonautistic people, compared to autistic people’s ability to read other autistic people.  And even better — although impossible right now, because we simply don’t have good subtyping systems for autism enough to be used in research in the ways I’m thinking of — would be to have autistic people’s ability to read autistic people who are the most similar to ourselves in terms of sensory, cognitive, emotional, and motor experiences.

I was once invited to dinner with a group of people, some of whom were autistic and some of whom were nonautistic people (parents and research professionals).  I accurately described an autistic man’s level of cognitive and sensory overload, and asked people to help him become less overloaded in particular ways.  The nonautistic people in the room were stunned at my ability to (verified by him) describe his emotional, sensory, and cognitive state in so much detail and accuracy.  They had seen nothing at all wrong.  I had sensed it all over him from a variety of nonverbal information he was blaring out like a beacon as far as I could tell.

But the way that things like this normally go?  When autistic people can’t read nonautistic people, it’s because of a global social skills deficit of some kind in autistic people.  When nonautistic people can’t read autistic people, it’s either because nothing is there to read (we’re just assumed not to be giving off nonverbal cues because the cues we give off aren’t always the same as nonautistic people’s), or because autistic people have a global social skills deficit of some kind.  So either way, a difficulty reading someone unlike yourself becomes entirely the fault of autistic people’s supposed social skills deficits.  Even though it’ she exact same problem going in both directions: A difficulty reading people whose experience of the world fundamentally differs from your own, which may be a nearly universal social skills deficit in both autistic and nonautistic people.

Generally, professionals in the autism field don’t even consider the idea that some autistic people might be as good at reading autistic people similar to themselves, as nonautistic people are at reading other nonautistic people similar to themselves.  This possibility doesn’t even exist.  So even though nonautistic people have huge problems reading autistic people, and are not blamed for that, autistic people’s ability to read people in general is tested based on reading people who are very different from us.  This would be like judging all of nonautistic people’s social awareness and social skills based on their ability to interact easily with autistic people.  Very few nonautistic people can intuitively understand how to understand or interact with autistic people, it’s one reason that autistic people are considered inherently mysterious and confusing, or to lack body language altogether.

I actually have had a bizarre experience that has happened many times.  Nonautistic people have been trying to say they know what’s going on with me, when they don’t.  An autistic person walks into the room and instantly tells them everything that’s going on with me: My feelings, my thoughts, my sensory experiences, my abilities, everything, in great detail.  And almost always, the response the autistic person gets?  “That’s impossible.  Mel isn’t using body language, so you can’t possibly be reading it.”  Nonautistic people are so used to their perceptions being all there is to reality, that some of them simply can’t believe it when autistic people see things about each other that nonautistic people can’t see at all.  I’ve at times said “But this person is completely right about me!  What she’s saying is accurate!”  And still they would talk over both of us, saying that it was impossible for the other autistic person to have figured out what I was feeling, thinking, and experiencing.

It’s not just an either-or thing though.  I am good at sensing unconscious body movements and bad at sensing the meaning of consciously applied deliberate fronts that people put on.  I may pick up on the front, but I won’t always understand what’s going on in that front.  This is with most people in general.  But the more similar a person is to me — and this can be autism-related or in other areas as well, both innate traits and life experiences — the easier it is for me to read them.  A person very similar to me stands out as if they are the only three-dimensional person in a world of flat empty figures.  I can sense every layer of what they are experiencing, both the real and the false, the confusion and the reality, just an astounding level of detail.  And this is far from unheard-of among autistic people, but none of it is measured by this test, which I o quite poorly on despite explicit verification from other people like me that I read them shockingly well in a level of detail well beyond what is covered by a test like this.

Whatever the reality ends up being, it’s bound to be very complicated, and the way this test is set up is not a fair demonstration of our abilities.  Not fair as in, what we’re being tested on is not an equal task to what the nonautistic people this is normed on, are tested on.

The experiences centered on in this test are the experiences that are important to nonautistic people.

This is a variation of the last thing I just described, but it bears saying outright:  This deals specifically with experiences that nonautistic people find important.  Now, it may be that autistic and nonautistic people find at least some of the same experiences important to understand in ourselves and in other people.  But it may also be that there are experiences specific to autistic people, that we are better at picking up in ourselves and other people, because they are so important to us.  And those are not tested on a test like this — artificially elevating nonautistic people’s scores and possibly lowering autistic people’s scores as well, by elevating their priorities over our own.

One example of a thing that’s important to autistic people is overload.  It’s not just one thing.  It can come from sensory input, thoughts, feelings, movements, effort, all kinds of things.  And it can take many forms, and have elaborate nuances to it.  Most nonautistic people can’t pick up on overload at all without being taught how, let alone pick up on any nuances of overload, shutdown, and our responses to overload.  But an autistic person looking at an overloaded autistic person may be able to see all those things in great detail, as well as emotional experiences related to them.

Because language has mostly been created by nonautistic people, there’s not necessarily an easy way to show the things that autistic people are better at perceiving and prioritizing than nonautistic people are.  Because there are often literally no words for the experiences until we invent them, and therefore there’s no standardized words that we grow up hearing the way we hear ‘happy’.  This affects our ability to communicate what we do perceive in other people’s body language, even things that we are quite good at perceiving.

The test doesn’t show where the problem comes from, if it’s a problem of naming emotions.

As just described, autistic people often grow up not hearing good descriptions of emotional and other experiences that are very important to how we experience the world.  But worse, we often grow up getting bad information.  People who can’t read us well, tell us we are feeling things that we are not actually feeling, leading us to associate the wrong words with the wrong emotions, which affects our ability to apply those words either to ourselves or to other people.  This is not taken into account when people ascribe our results on tests like this to purely innate social skills deficits.  The effect of our environment on our ability to learn these things — hell, the effect of nonautistic people’s difficulty reading us on our ability to learn these things — might as well not exist as far as most people are concerned.  Including most researchers.

Not only does the test not show whether this is the case.  But discussions of our results on the test rarely take things like this into account as possibilities.  From what I have seen, good research is supposed to consider all of the possible reasons for a particular result.  But autism research rarely does, it merely gives the explanation favored by the researcher.  If it talks about other possibilities at all, it talks about them in the most brief and cursory way possible, and doesn’t delve into issues like this one at all.

If a proper research paper were written on this test as it is, it would include all of the problems I’ve described and am about to describe, and then describe ways that further research could take these problems into account and work out what’s really going on here.  But it doesn’t, the papers on this stuff pretty much never do.  They’re supposed to.  They just don’t.  Partly for reasons I think are about laziness (autism researchers are given so much license to do bad, lazy research that it’s possible to become incredibly lazy and never even notice the degree of laziness you’ve developed), but partly because the researchers simply haven’t thought of many of this because they’re so used to coming at things from their perspective alone.

This test assumes that all autistic people are essentially alike, and does not account for significant differences between different groups of autistic people.

It’s possible — in fact I find it likely — that there are many different cognitive profiles for autistic people when it comes to processing nonverbal emotional information from other human beings.  The way this test is dealt with, makes it seem as if there’s really only essentially one type.

So there may be:

  • Autistic people who can’t process nonverbal social information at all.
  • Autistic people who process nonverbal social information roughly the same as nonautistic people do.
  • Autistic people who process nonverbal social information roughly the same as nonautistic people do, but not as well or as efficiently.
  • Autistic people who process nonverbal social information more accurately than nonautistic people do, but in a completely different manner.
  • Autistic people who process nonverbal social information about as accurately as nonautistic people do, but in a completely different manner.

And those are just some of the possibilities.  In addition, each of the last two groups?  There may be multiple cognitive and perceptual profiles within each of those two groups.  Such that there may be dozens of different ways that an autistic person processes nonverbal social information, that nonautistic people don’t experience at all.  in addition, there are of course autistic people who are in more than one of the above categories, or somewhere between the above categories, or who switch back and forth between multiple categories.

The way this test is handled does not account for an extremely diverse set of abilities in autistic people.  And that limits its ability to report on what we actually experience, by averaging out everything until you get a sort of ‘average autistic profile’ rather than a profile that reflects the diversity of autistic experiences of the world.

This would be sort of like if you took autistic people who were great at nonverbal things and bad at verbal things and autistic people who were great at verbal things and bad at nonverbal things, and averaged out all their abilities until you got a picture of people who were average in both verbal and nonverbal things.  That’s an oversimplified example but you get the point.  My suspicion from actually knowing autistic people, is that there’s a pretty diverse set of abilities to read body language and ways that we read it and that this test is not allowing for any of that diversity to be showcased both because of the limitations of the testing material and because of the ways the results are interpreted after the data comes in.

Potential Effects of These Assumptions on Future Research

Assumptions about the limitations of autistic people carry over into research in ways that shocked me when I first discovered them.  I once had a conversation with a researcher I really respected, someone who was trying to do right by autistic people and understand our emotional responses and the like.  I asked her the following question:  “I know you’ve talked to a lot of parents of autistic children.  How many of them overall told you that their autistic child is the first person to pick up on emotional tension in their household?”

I’ll never forget her response.  It went something like this:

“Oh wow.  Actually?  I think every single parent told me that.  But until now, I had instantly put it out of my mind.  Because researchers like Simon Baron-Cohen said that autistic people were mindblind, unable to attribute emotional states to others, or unable to read those emotional states in others.  So any time anyone told me anything that contradicted what the experts were saying about this, I just forgot about what I was being told, assumed the parents were just mistaken, things like that.”

She was a very intelligent researcher who was trying her best to get past her biases about the abilities of autistic people.  And it took that question to start putting two and two together.

By the way, I did end up describing to her, in detail, an experiment she could do that would test the abilities of autistic people to read certain emotions in other human beings, without requiring the autistic person to ever have to use or understand language throughout any of the experiment.  It made use of technology and techniques already available to the research lab in question.  And she told me that it was a very good research design.  I hope that she will one day use it, because I want to see if I’m right in what I guess about this situation.  If I am right, follow up research could be then done to isolation what precisely is going on when autistic people accurately interpret social and emotional information from others, and what subgroups of autistic people may exist cognitively and perceptually, both among people who can do this, and people who can’t.

This is just one example of bad research design.

Pretty much all of autism research is littered with the kinds of holes left by things like the Reading the Mind in the Eyes Test.  Much other psychiatric research is just as bad, but there does seem something particularly sloppy about a lot of autism research.  And the things said by autistic people much like myself, are finally being proven right, slowly, by researchers who take a much more accurate approach to the information.

One thing that autistic people have complained about for decades now is the Sally-Anne test.  It’s supposed to test people’s theory of mind — the ability to know that other people have mental states that differ from our own, to attribute those mental states to others, things like that.  It does so by testing whether a person is aware — in a fantasy scenario often acted out by dolls or puppets or the like — that a doll during a test is deceived by the actions of another doll.

The test as normally given, uses some of the most complex sentence structures in the English language.  This is something that I had noticed before.  When autistic people pass the test, which we often do, we are then given more and more nested sentence structures of that type until we can’t do the test anymore.  Those more complex sentence structures are supposed to test ‘second order theory of mind’ and ‘third order theory of mind’ and the like — but really they’re linguistic nightmares with questions like “What do you think that Eric thinks that Sally thinks about what Anne thinks?”  Such questions trip me up at the best of times, even when I understand perfectly well the underlying concepts.

So what some researchers did, was they did some studies of certain groups of children.

There’s a condition called Specific Language Impairment.  Children with Specific Language Impairment by definition cannot also be autistic.  They’re mutually exclusive categories.  Children with SLI have the language problems similar to many autistic people, but not any of the other problems of autistic people.

So they did a test where they had children with SLI try to complete the Sally-Anne test.  They did just as badly as autistic people with the same level of language impairment.   If this were an autism-related problem rather than a language-related problem, that couldn’t possibly happen, because children with SLI are not autistic.

Then, they did a test where autistic children were tested on false beliefs, but in a context that did not require language processing.  The autistic children did as well as — and sometimes better than — nonautistic people did on the same test.

Until these tests were done, everyone assumed that autistic people’s bad performance on the standard Sally-Anne test was because we lacked some element of Theory of Mind — or lacked the whole thing.  Rather than that we did badly because we had language problems and the test requires some pretty high-level language processing.

And another thing that angered me, was the way that they seemed to deliberately set up tests to trip us up in this manner.  Like everyone knew all along, that there were autistic people who passed the Sally-Anne test just fine.  In fact, a very large minority of autistic people.  Not just a tiny number.  And yet they still said that the test results of the people who performed badly, reflected on the Theory of Mind abilities of all autistic people.   Even though there were people passing the test just fine.

But they didn’t stop there.  This is the part that pisses me off the most.  When autistic people did okay on a Sally-Anne test, we were simply given more and more linguistically difficult tests, until one of them finally tripped us up with its ridiculous number of nested sentence structures to process.  So “What do you think Sally thinks” became “What do you think Sally thinks about what Eric thinks?” Which in turn became “What do you think Sally thinks about what Eric things about what Maria thinks?”  Just keep nesting more and more levels of linguistic hell, until the autistic person is tripped up and fails the test.  Then, at that point, say that they lack a different ‘order’ of theory of mind.  You start saying “Well, some autistic people have first-order theory of mind but lack second-order or third-order theory of mind.”

That pisses me off because it was like they were deliberately setting us up to fail so that they could prove we really had the problem that the test showed we didn’t have after all.  So a test shows we have theory of mind. Devise a harder test until autistic people can’t do the test anymore.  Then claim that whatever the harder test is that finally made them fail, was. actually a more sophisticated test of the same thing you were testing them on in the first place.  So “They may have passed a simple theory of mind test, but more sophisticated theory of mind tests showed they still had problems with theory of mind after all.”  In this scenario, it is nearly impossible for an autistic person to win, even if their language problems are relatively subtle most of the time.

How to dismiss everything autistic people have to say about ourselves…

The results of these tests and more, have been used to dismiss the observations of actual autistic people about the workings of our own minds, for a very long time.  It’s true, of course, that everyone can be deceived about how their mind works, and this is one reason that cognitive research exists in the first place.  It exposes things in our cognitive blind spots about ourselves.  But even so, most research assumes that the average person knows at least something about their own mind.

So most psychological research assumes that people are basically accurate in reporting their experiences, but may have certain biases or blind spots that prevent them from understanding some aspects of those experiences.  Psychological research into autism assumes that autistic people can’t understand or report anything of value about ourselves unless it dovetails with what they already believe about us, and that our having insight into ourselves is the exception rather than the rule.  So most people are thought to be basically accurate with some blind spots, autistic people are thought to be all blind spot and little to no accuracy.

And this includes accuracy about things where literally the only person who can say how they experience something is themselves.  Like, if you think in pictures (which some autistic people and many nonautistic people also do), you know that because you see the pictures inside your mind.  Nobody else can come along and say “you’re just deluded, you don’t actually see pictures in your head”.  Because that’s a purely subjective experience, that only the person reporting it can know for sure whether it’s real, and how often it’s real, and in what manner it is real.  But many researchers act like autistic people can’t even know those things about ourselves.  We’re thought to have no capacity for any insight into uur inner lives and experiences.  Even though, when lots and lots of autistic people report a particular experience (spontaneously, without being pressured or coerced into believing it in some way), pretty much always that experience is eventually shown to be accurate, by scientific research.

Another thing that happens is that random things we can’t do get described as having to do with particular theories, when this makes no sense as an assumption.  For instance, our ability to read body language is constantly equated with mindblindness and lack of theory of mind.  Blind people can’t read body language, but people don’t say they’re constitutionally incapable of understanding that other people have subjective experiences of the world.  When autistic people can’t read body language, however, it is always cited as support for the idea that we are constitutionally incapable of understanding that other people have subjective experience of the world.  Even though our reasons for being unable to read body language may be as sensory-based as blind people’s are.   Similarly, language processing problems were for a long time — and it continues to this day, despite research showing why it’s a bad assumption to make — used as the core piece of evidence that autistic people lacked Theory of Mind.

So it’s sort of like, they already decided we lacked Theory of Mind, and then no matter what thing we could be shown to do badly at, that thing was written up as if the thing we did badly at, we did badly at because we lacked Theory of Mind.  So any and every ability we could be shown — rightly or wrongly — to be bad at, was a sign we had poor to nonexistent Theory of Mind.  And entire theories of what autism is, have arisen with those studies at the base of them.  And even though those study results have been seriously called into question by modern research, the Theory of Mind theory continues to be trotted out as if it is meaningful.  Even though it’s built with no foundation whatsoever.  It’s like we’ve done the research that removes the foundation, and yet we keep building on that foundation as if it’s still there.

And again understand — I have no training in research design and no training in autism.  And yet I can see all these holes in autism research, holes that actual well-regarded researchers such as Morton Gernsbacher have specifically and publicly praised me for noticing.  Imagine if I did have the training to understand research design much more intricately than I do.  Imagine what holes I’d be able to point out then, and what research I’d be able to design.

And I’m just one person.  There are tons of autistic people who are capable of similar insights into how messed up the current research is.  Autistic people are not automatically capable of seeing these holes.

Some of us buy into everything we’re told by Autism Experts about being autistic.  Researchers have specifically told me they picked me to work with because I pretty close to never do that these days (I certainly used to do it to a larger extent than I do now).  Whereas a lot of the autistic people they knew, filtered their experiences so heavily through things like Mindblindness and the Extreme Male Brain theory and the like, that the researchers were afraid they weren’t getting accurate information out of them, just regurgitated information.  There’s a related problem where autistic people will hear something from another autistic person, and assume that they have to be similar to that other autistic person.  So if Temple Grandin says autistic people are picture thinkers, suddenly you’ve got all these autistic people saying they’re picture thinkers because Temple Grandin is one.  Even if they’re actually not.

And there are good reasons autistic people do this, some of which are related to general human traits, some of which are related specifically to autistic traits, some of which are related to traits about how autistic people are treated throughout our lives.  So some autistic people may be doing it for reasons that relate to the thing where the more often you read a statement, the more true it feels, something that is true of most human beings whether autistic or not.  Some autistic people may be doing it for reasons that have to do with common autistic traits such as echolalia, poor spontaneous expressive language, language comprehension problems, and difficulty with certain aspects of sensory processing.  Some autistic people may be doing it because of how we have been treated all our lives for being autistic — if you grow up with nobody ever listening to you, being told always that you are wrong and can have no insight into yourself, being (deliberately or otherwise) ridiculed or punished whenever you communicate something of your experience accurately?  You may well start repeating what you’ve been taught to believe about yourself, rather than what you actually experience.

So there are lots of good reasons that autistic people can have trouble reporting our actual experiences around researchers.  But most of us can do it well at least some of the time.  And when we do so in large enough numbers, we usually turn out to be shown to be right.

I also worry about minorities within the broader group of autistic people.  Because I have a lot of traits that are relatively unusual for an autistic person who can use language.  Because those traits tend to make people less likely to develop language.  Not make it impossible, just make it harder.  So a larger number of autistic people without good enough language skills to describe their experiences, exist, than exist people like me who can at least some of the time describe our own experiences.  So anyway — at least within the realm of autistic people who can talk about our experiences, I often find myself an extreme minority.  An extreme minority both in my areas of greatest weakness and in my areas of greatest strength.  People like me get left out of the research results because research takes all autistic people in averaged-out form.  When you average out a huge group of people’s experiences, outliers like me get drowned in the greater sea of data, and you miss out on the great diversity that exists within a group of people like autistic people.

For too long, autistic people have been told who we are, instead of allowed to tell the world who we are.  Test like the Reading the Mind in the Eyes test tend to fill me with an instant mini-explosion of rage.  Because I can see each and every thing I just described to you.  Only I see it all at once.  Like just this ocean of wrongness that washes over me.  And I can see all these things wrong, and feel that the are wrong, and understand that they are wrong.  But until relatively recently, it was so hard to tell people why they were wrong, that most of the time I’d just splutter incoherently or tell them one or two things without giving them the whole picture.

This post is designed to give as broad a picture as I can of what’s wrong with that test, and what the consquences are of it being so wrong.  Please refer back to it as often as you have to, if you’re truly interested in figuring out what’s potentially wrong with both this and other tests used in autism research.  I may not be an academic writer, and I may not have credentials, but I’ve been told by people who are, that I do have insight they need and don’t have.  So do lots of autistic people who lack an education in this field.

If you use ideas from this in research or elsewhere, please give me credit.  Autistic people are often not given credit for our ideas when people mine them for research, so this is more important than usual.

To All The Children In Severe Pain Tonight (BADD 2015)

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[This is my post for Blogging Against Disablism Day.  I will also have a post on my poetry blog, once I get around to rounding up all the poems I’m going to put in that post.]

I reach out for my body. It’s an instinct, all young ones must have it. But instead of feeling hands and feet, I feel a blast of burning pain, like stepping into an oven. I retreat back to the murky ocean I float in all the time. The pain is off somewhere distant, but so is my body. “Thoughtful” is a word I hear used a lot, when I stare off into space disconnected from my body.

Later, psychiatrists will call it severe dissociation. They will diagnose me with dissociative disorder, not otherwise specified (DD-NOS). They will talk about a ‘biological predisposition to dissociate’. Even when the extent of pain I am in comes to light, they have trouble seeing the dissociation as a symptom of severe pain, rather than a thing in its own right.

Dissociation got me through 20 years of severe pain. 20 years in which by all rights I should’ve been curled up in a ball doing nothing, yet I was active, I was doing things, I was going to school, I was climbing trees. I didn’t know this was severe pain, I thought it was just another feature of the world. Trees have bark and my skin burns, the sun shines and my skin burns, the sky is blue and my skin burns.

Now they say my mother has small fiber sensory neuropathy, that maybe I was born this way, inherited from her, however our nerves got like this. It responds to Neurontin, and Lyrica, and Trileptal. It acts neuropathic, it acts like central pain, nobody knows which is which for me.

This is a shout-out to all the kids — all the kids living with so much severe pain you wouldn’t believe it yourselves, because it is your normal. And you go on trying to do normal stuff. And sometimes you can’t. Sometimes the pain just grips hold and you have no means to deal with it. But you don’t know you’re in pain, so you push against it, and you think you’re weak, everyone else can do this, why not you?

Why not you? Because you’re in severe pain and you don’t even know it. You may not even recognize it as pain, because pain is such a broad and nebulous category.

My heart goes out to every single one of you. All of us who are going through this now, as children. All of us who survived and made it to adulthood and now know how much pain we were in, and wonder how we got through it. All of us whose pain is being treated as DD-NOS or another psychiatric disorder, because all people can see is our emotional responses to pain, not the pain itself. All of us who are told ridiculous things like “You have pain that gets less on Neurontin? The pain must be part of a seizure.” All of us who are told that if we were really in pain we wouldn’t be able to do what we do now… they throw our expert coping mechanisms back in our faces, and want us to see pain psychologists who will teach us everything we already know about how to manage pain.

Everyone in this situation — I am thinking of you tonight. Together we form a whole constellation of pain, burning bright. And however well or badly we are dealing with the pain right now, we are people who are surviving.

Love, Fear, Death, and Disability

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People fear and even hate disabled people because we remind them that they are both fragile and mortal. They don’t want to remember those things about themselves. And they find ways to physically shut us away, and mentally shut us out of their awareness. And they delude themselves that they are different. That something they do will prevent them from ever becoming one of us. And prevent them from ever dying.

I have lived a long time as what I’d call precariously ill. A person who’s precariously ill isn’t terminally ill. There’s no saying for sure that we’ll die of our illness. But death is a constant possibility.

In my case, my gastroparesis led me to frequently inhale large amounts of stomach fluid at once. I have bronchiectasis, which makes it easy to get infections and hard to clear them. And untreated, severe adrenal insufficiency, which can turn an ordinary infection into an adrenal crisis. That combination made my health, and my life, very precarious indeed.

I have a strong belief that if people were more open about death, people would be less terrified of their own mortality. And thus less terrified of things that remind them of their mortality. Like, say, disabled people and sick people.

I’ve never had what they call a “Near Death Experience” ™ where you come very close to death and have this fairly uniform experience of a light at the end of a tunnel and all that kind of thing. But I’ve had encounters where I’ve gotten too close to death for comfort. Usually I had an infection that wasn’t playing well with my untreated adrenal problems. I would become extremely weak, so tired that it felt like just keeping my heart running and my basic bodily functions going, was too much. and I was losing the ability to do those background things your body is supposed to do effortlessly. And then I’d see death hanging around, it’s the only way I know how to put it. Sometimes other people around me would see it too.

A light would fill the room. It wasn’t a visible light. It was something I’d see on the inside of my head. It seemed to be coming from everywhere. There was a sense of being more profoundly at home than I had ever been in my life. As if there was this one tiny piece of the universe where I fundamentally belonged, and I had finally found it. There was an overwhelming sense of benevolence and peace.

And there was the sense that if I wanted to, all I had to do was relax and stop fighting. All I had to do was rest. And I could be in that intense, profound place of love forever. But if I fought, and won, it would still be waiting for me when my time had come. It did not entirely urge me either way. It was patient. It had all the time in the world.

But while it didn’t actively urge me to die, death did have a gravitational field. That’s what I called it during my first conscious encounter with it. I was ashamed, at first, to tell my friends what it had felt like. I was afraid they’d think I was weak, or cowardly, or that I had a death wish. So with some disquiet, I told my friend what it had felt like the first time I encountered death in this manner.

It felt, at first, like I couldn’t fight. More than that, I didn’t want to. I couldn’t even conceive of fighting. I had a strong urge just to rest. To allow my heart to stop and my breathing to slow and to surrender myself completely to death. The closer I was to death, the stronger this feeling was. So I started referring to it as a gravitational pull. It was only when I gained a lot of strength back due to medical treatment that I even had the will to resist, let alone the power.

My friend gave me an explanation that made me feel much better about my reactions. It was not that I was weak-willed or wanted to die. It was entropy at work.

Entropy involves a system trying to go to the lowest energy state. In order to survive, living things are constantly fighting entropy. We do this by feeding off of other living things and converting it into fuel to give us the continued energy to survive. If we simply allowed ourselves to go to the lowest energy state without a fight, we’d be dropping dead right and left. Most of the time, we are good enough at temporarily cheating entropy that we don’t feel its pull on us.

But when we are severely ill enough that death is a possibility, then we begin to feel it. We feel how strenuous it is to stay alive. And if we are sick enough, and exhausted enough, we begin to feel an overwhelming desire to allow ourselves to go to that ultimate rest. To allow our bodies to wind down forever. And that is the gravitational pull we have to escape if we are to live.

Much like a black hole has a point of no return, death has an event horizon too. I’ve obviously never been past it. But I’ve seen people and animals who have. And I saw (in my head, not with my eyes) that same intense light around them, that seemed to come from everywhere and nowhere at once. I felt that same profound, unconditional love.

This is how I know that death is nothing to be feared. In fact, even though the separation between us and our loved ones can cause tremendous pain and grief, death itself can be a beautiful process for the person who is dying. It can be for those around them, too, if everyone lets it be what it is.

I want to emphasize something though. Yes, I believe that death can be benevolent, friendly, necessary, and even beautiful. But I also believe all those things about life. And given that we only get one shot at this lifetime (even if reincarnation exists, which I don’t pretend to know) then it’s very important to resist death until it’s actually our time to die.

Our life is something we owe not only ourselves, but the people and society around us. Whether or not we understand our contributions, we each have one, and the world loses something without each of us in it. Disabled people in particular get a lot of messages saying that we are burdens on society, that we do not contribute, and that it’s best if we’re dead. And that’s completely wrong. In fact it’s despicable, unforgivable, to do anything to convince someone that these things are true of them.

So I am not saying “Death is beautiful, surrender to it the first chance you get.”

I am saying “Life is beautiful and you are an important part of the world, whether you can see it or not. You have obligations to the living world, to stay here as long as you possibly can. But when your time truly comes, don’t be afraid. Death is a necessary part of life. And it can be friendly, benevolent, and beautiful in its own right. When your time comes, it’s possible to die with love, without fear.  And if you have ever existed, then some place in time, you always exist.”

One thing that facing death can do, is force you to reexamine your priorities in life. And that can be scary. It can be especially scary if there’s something in your life that you’ve been running from, hard, for a long time. As you near death, you won’t be able to keep up the fences in your mind that allow you to deny things like that. If you learn to face these things long before you get close to death, then death is less scary. And if there’s something you’ve done wrong that’s been a burden on your mind, it can be important to remove that burden before you die. That’s why some religions practice confession before death, but it doesn’t have to be in a religious context if you’re not religious. But the sooner you deal with things like this, the less they’ll hang around and make your death unpleasant.

But the biggest thing I have found, any time I’ve even faced the possibility of death. Even if I haven’t come close enough to feel that gravitational pull. Is that it’s forced me to examine what is really important in life, and what is trivial. And it’s actually pretty simple:

Love is all that’s important. The experience of love, the expression of love, living love and compassion as your highest and only principles in life. Living for what you can do for others, not what you can do for yourself alone. Everything else fades into the background.

I can remember an ambulance ride after aspirating stomach fluid. When that happens, you don’t know how long you’ll survive. You could get an infection and get over it, or it could do you in within a week. You don’t know if you’ll get lucky, at that point. And everything narrows down.

At that point, I always find myself faced with one question: “Have I loved enough, and have I expressed that love enough throughout my life?” Everything else falls away. That’s the only thing my conscience cares about in the end. Have you lived your life as a strong enough expression of compassion and love? The best way to have few regrets when you die is to get started living that love right now. Easier said than done, but worth the struggle.

This doesn’t mean becoming touchy feely and hugging everyone you meet. It doesn’t mean being serene and peaceful all the time, or never getting mad. (In fact anger is sometimes — sometimes — an expression of love at a particular moment. Not habitual anger problems, but anger as a reaction in a particular situation when everything fits together in a way that requires it.) Love is an active thing that requires constant evaluation and action. It’s not holding hands and singing kumbaya. It’s not feeling soft and fuzzy all the time. Expressing real love can be fierce and intense, difficult and demanding, even scary sometimes.

But if you want to have as few regrets as possible at the time of your death, it’s best not to wait: Get started living a loving life right now. And start facing things you’re trying to run from. And unburden your conscience from anything that’s been weighing on it. Because you don’t want to die terrified, fighting against yourself, feeling the pressure of unrelenting guilt or shame. It’s best to live your life now in a way that will leave you with no regrets when you die.

But that’s a hard thing to do. I’m aware of this stuff, but I can’t claim to be living the perfectly loving life that I want to be living. I know there are things I could be doing for others, right now, that I desperately want to do for others, that somehow never get done. Despite that, I know deep down in my bones that love is the only way to live a good life or die a good death.

It’s hard for even disabled people to talk about what a good death looks like, because we are under so much pressure from society to accept that death is better than disability, that death is an acceptable alternative to the unbearable suffering that we are supposedly enduring, that we will be happier dead than alive. The media is full of stories where nondisabled people kill us and we’re said to be better off, our deaths are said to be understandable. And stories where we become suicidal and instead of trying to prevent our suicides, our societies rally behind us to give us a ‘right’ to an easy death. That stuff is everywhere, and it makes it very hard for us to look at what a good death would actually be.

It’s especially hard to talk about accepting death, because people are always pressuring us to accept our deaths long before we are ready to die. I would quite possibly be dead already if I hadn’t had a lot of the online disability community fighting for me last year, when doctors tried to persuade me not to get a feeding tube. (They couldn’t deny it outright, because they knew I needed one. So they came into my hospital room every day while I was sick and weak and exhausted from pneumonia, and tried to persuade me that life with a feeding tube was so awful that ‘the alternative’ would be preferable.) I clearly disagreed with their assessment of when is the right time to die, and I disagree with anyone who tries to make it sound as if living with a feeding tube, on a ventilator, or with other ‘artificial’ means of living, is somehow the point at which disabled people should give up and die.

But there is a point when giving in isn’t a bad thing. And it’s not a matter of how many machines you’re on to keep you alive. It’s not a thing that can be quantified. It’s that nebulous time “when your time has really come”. At that point, there’s no shame in giving up the fight, because fighting when you’re truly beyond death’s event horizon just makes death more unpleasant, it doesn’t keep you alive. But I’m afraid to even say this, because I know someone, somewhere, will twist it around and use it to persuade disabled people to give up and die before our time is really up. It happens all the time, and disabled people have every right to be extremely wary of talk of ‘giving in’ as a good thing.

But regardless of that, death still has an event horizon. And once you know, for sure, that you’re beyond that point of no return, then there is nothing wrong with simply surrendering to love, surrendering to the light, surrendering to whatever gods you do or don’t worship, whatever you want to call it, however you see it. And you will become part of the rest of the world, and that is right, and true, and beautiful. And heartbreaking for those you leave behind.

Between my experiences lately, and serious medical experiences my parents have been having, I’ve been thinking a lot about death.

Normally, I write about the ableism involved in pushing disabled people towards our deaths. The ableism in thinking that disabled is just half-dead and that dying is good if you’re disabled. The ableism in thinking things like “They keep people alive too long these days, it’d be better if people just died without a long drawn-out time where they’re disabled before they die.”

But now, I’m writing about a different aspect of ableism and death: The way ableism against disabled people is tied to nondisabled people’s fear of sickness and death and physical imperfection, fear of their own mortality. And dismantling fear of death dismantles that aspect of ableism. Nothing I say here should be taken as supporting ableist ideas about how disabled people should just accept our deaths and go quietly. Instead, I’m talking about a more universal acceptance of death, one that should happen when our time has truly come and not before.

And I’m talking about love, because I deeply believe, more deeply than ever, that love is the only thing that can make things right in the world. Love that comes from the depths of what it is to be a person, love that comes from everything good in the world, love that demands a lot of us and changes us and is intense and powerful and fierce and real and sometimes demanding and scary. Love that leads to compassion that leads to actions people undertake for each other, not for ourselves.

And most of my sense of this love comes from my encounters with death. I don’t know why it works like that, but it does. I’ve talked to others who have had similar experiences. Sometimes facing your own mortality can make you scared and twisted up and angry and bitter. But sometimes it can open you up to new depths of love and caring about others, that you didn’t know were possible. And even if you start out scared or angry or bitter, it’s possible to change bit by bit, more and more towards enacting that love in the real world.

I firmly believe that if people were more willing to face our collective fragility, vulnerability, mortality, and death, then we would be less ableist. All of us, disabled and nondisabled.

I’m going to end with a video taken shortly before the death of Eva Markvoort, a young woman who had cystic fibrosis, got a lung transplant, and ultimately died of chronic rejection. I’m posting the video because she so clearly allowed her impending death to open her up to all of the love that the world has to offer. This wasn’t easy for her, it didn’t just magically happen, and it’s not meant to be an inspirational cripple story, which I’m sure she’d have hated — one of those things where we exist only to teach a lesson to the nondisabled world, when we are so much more than a lesson. Yet I hope that we can all face our deaths as well as she did in the end. At least, I hope that I can. When I look at her in this video, I see in my head that invisible solid light that I see whenever I or someone else is sufficiently close to death — it’s all around her, it’s coming through her, and it’s allowing amazing, beautiful things to happen to her and those around her in her last hours.

This was her farewell video to the world, don’t watch it without something to wipe your eyes:

 

She once wrote a love letter that read, in part:

When I sit outside on the ferry is when I most believe in love. I don’t know why. Something about the wind makes me feel alive…the seagulls and the sky…whether its sunny and bright or cloudy and grey or nighttime and I’m surrounded by vast darkness…I just feel…FULL. Full of love and energy….almost as though I’m porous and the wind soars through tiny holes in my body and I’m part of it all…the earth and the people and the relation of everything with everything…as though I don’t matter…but its not scary…its wonderful….i feel so free.

It’s the only time I’m not afraid to die. Cuz I can feel the wind and I know that I’ll always be a part of life…and the love and energy that are contained in my skin will be let loose into the wind and the world will just know how much I care and love and I will live forever. I believe that love is what defines us as human. I believe that my love for you will never die. My heart breaks to think of how lucky I am. How happy and hopeful and full I am. I love you so solidly. I am real and you are real and I hope we will always be real. I am in awe of you. My interest in who you are is infinite. Drop a stone in the well of my desire for you and you’ll never hear it hit the bottom. You amaze me. Your love makes me invincible…no not invincible…immortal. Because when I die I believe my love for you will surround you till your soul joins mine in the wind.

I hope that the world can learn to overcome the terror they associate with fragility, imperfection, vulnerability, and mortality, the terror that currently makes so many people fear and hate disabled people (and, in turn, drive us closer to an untimely death).

I hope that the world can stop fearing death, and stop fearing the disability and sickness that reminds them of death.

I hope that people will understand my meaning here, and not use it to justify the deaths of disabled and chronically ill people who need all the help we can get to survive already.

I hope that the world can learn to love — in the active, difficult, demanding way that deep love entails — and that this can further all of the above. Because active love and compassion, caring about each other on every level possible, is the only thing that digs deep enough to create lasting change.  And love is the only thing that can end fear or hatred.

Blogging Against Disablism Day, May 1st 2014

BADD: Pulling Back Curtains

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Blogging Against Disablism Day, May 1st 2012

This is my other post for Blogging Against Disablism Day (BADD) on May 1, both about caregiver abuse, this one about the most extreme kind. It’s in a heavy topic, but a necessary one given the public’s response to several recent murders of disabled people. The situations I’m describing are somewhat different from the recent murders that have come to light. But what we can learn from them is important to all such situations.

1. Introduction: Pulling Back the Curtains on Hate and Love

This is my first attempt to write about something extremely serious while avoiding a dark, focused state I recently realized was unhealthy. There are good and bad kinds of dark, just like there are good and bad kinds of light. This was the bad kind of dark, not the kind that protects but the kind that consumes and drowns you. It felt as if the entire world was engulfed in this place that was intensely dark, and focused into a kind of false but convincing clarity. Hiding inside that false clarity was a belief that this horrible state of mind was all there really was to the world when you stopped pretending that there was nothing bad going on.

Along with this state went a sense that I was doing the world a favor by constantly immersing myself in it. But while the information I was giving out was important, it was tainted everywhere by this state of mind. I felt like I was telling the world the truth, but it was only one part of the truth. Because the real truth allows for the possibility of fighting this stuff and winning. But the truth I was telling had all kinds of warping around the edges.

I felt like I was lifting away a curtain of ignorance among most people as to exactly how awful the (human, social) world can really be to anyone who isn’t valued. And in a way, I was. But I was not lifting away a second curtain. Behind that second curtain was everything good in the world, that remains hidden from most people as well. Behind that curtain is every possibility for love, compassion, cooperation, and hope. Not the fuzzy greeting card version, but something so powerful, fierce, and solid that it can evaporate all the awful stuff that lies behind the first curtain if enough people act on it.

It was painful events in my own life that led to my conviction that I had to tear aside the first curtain and make everyone stare into the awful facts I was aware of. But in doing it the way I did it, I was allowing the people who hurt me free use of my brain to hurt other people. Not that they were literally sitting there controlling my brain. But their actions caused a ripple effect. I was part of it and by my actions unwittingly allowed their influence to spread wider. This often happens to survivors of abuse and oppression. And it allows terrible things to spread around far beyond the original targets.

If at any point during this post, you end up feeling anything resembling that dark focused state, then try to resist it. Because this topic is scary, but feeling like you’re trapped in a world so horrible and terrifying that the good things about it are a long way off if they exist at all? That plays right into the hands of the kind of people I am going to write about.

2. Caregivers from Hell

The reason I have decided to write about this, despite that risk, is that very few people we aware of it. Some people work out parts of it but few people work out all of it. And in light of the way people have been excusing several recent murders of disabled people, it’s as relevant now as it was when it was written. It shows the flaws in the idea that our deaths are excusable or at least make sense. And it provides information that should make disabled people and anyone who cares about us careful in selecting, interacting with, and checking up on caregivers.

Please be clear: Not all, not even most, caregivers are like this. But just as disabled people have to be careful that caregivers don’t rob our money or possessions, we have to create other safeguards as well, to address the huge power imbalance that allows the events described in this post to happen without many people noticing or caring.

I found it in an obscure, out of print book called Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance? by Dick Sobsey. It’s one of those books that cites sources several times a page, and it’s out of date but as far as I know it’s the only book of its kind. I bolded parts of it for emphasis:

These five considerations for training and service delivery provide important directions for law enforcement. They also suggest two interrelated areas of concern. First, these five stated considerations arise from the perspective of family violence; however, many people with disabilities are victims of institutional violence, which has its own unique considerations. Therefore, police need training relevant to institutional, as well as to family, violence. Second, successful police work will require an understanding of the nature and dynamics of human services systems and the social realities encountered by people with disabilities, as much as an understanding of disabilities themselves. Law enforcement must be prepared to address the special needs of people immersed in the service system and the unique features of conducting an investigation in service environments.

For example, an investigation of 29 highly suspicious infant deaths in Toronto’s Hospital for Sick Children led to the quick arrest of a registered nurse for the murder of the most recent apparent victim (Bissland, 1984). The nurse was charged because she had been assigned one-to-one supervision of an infant whom the police felt certain had been murdered, and they believed that she was the only one who had the opportunity to commit the crime. However, more thorough investigation revealed that the nurse who had been charged was not working on the dates of some of the most highly suspicious deaths and had been relieved on lunch and breaks by other staff on nights that children in her care had died. The murder charges were dropped, and a civil suit for wrongful arrest soon followed. In the end, the probable murder of at least 8, and probably as many as 29, children by Digoxin poisoning went unpunished.

According to Bissland (1984), some of the complexities that thwarted police were a lack of knowledge of hospital procedures, apparent reassure to make a quick arrest so that the hospital could return to its normal routine, and an apparent lack of cooperation on the part of some hospital staff. For example, police were told that critical records of nursing assignments at the time of the deaths had been destroyed, but the missing records resurfaced long after the investigation had gone astray. This pattern of less than enthusiastic cooperation from within institutions is not unique.

Police in Grand Rapids, Michigan, were more successful in securing the conviction of two nurses in the suffocation of six nursing home patients; however, a similar pattern of institutional resistance plagued their investigation (Cauffiel, 1992). Available evidence indicates that similar serial murders in hospitals and nursing homes are likely to be as common, if not more common, than serial sex slayings or thrill killings (e.g., Hickey, 1991) that are typically given widespread public and professional attention. Despite this fact, little research has been conducted on the part of law enforcement to develop profiles of these medical murderers or specific investigative procedures for the institutional settings where these offenses occur.

Better success in policing institutional offenses can only occur when the principles of community-based law enforcement are adequately applied to the ethnographically distinct communities and cultures of hospitals, residential schools, group homes, and other service delivery systems. Police must understand the internal dynamics of service institutions to perform their job effectively within these environments. Before this can be accomplished, police, and society in general, must identify this as a law enforcement priority.

Often this commitment appears to be lacking, and abuse and violence in institutions remain hidden or are rationalized. For example, in the case of the Grand Rapids nursing home murders described above. Cauffiel (1992) quotes Ken Wood, the estranged husband of one of the convicted killers, saying:

How much life did she really take? All of the victims weren’t even living. They enjoyed nothing, experienced nothing and were going to die. The families at the time of death were relieved at the end of suffering . . . I know they had no right to play God . . . but when you decide how much of her life should be taken or lost to prison, shouldn’t it be equal to what was taken from their victims? (p. 485)

Although these were the words of a husband pleading for leniency for his wife, Cauffiel (1992) suggests this was “a view not uncommon in Grand Rapids, in Michigan, or in America, among those who became familiar with the coverage of the Alpine Manor murder case” (p. 485). This view contrasts sharply with the reality that most of the patients killed were not particularly debilitated and perpetrator Cathy Wood’s own statement that “we did it because it was fun” (quoted in Cauffiel, 1992, p. 254). Such rationalizations that trivialize serious crimes against people with disabilities can only be seen as denying their right to equal justice. Progress toward reducing risk of violence and abuse for people with disabilities quirks that equal protection of the law is applied to all members of society.

Elsewhere in the book it describes people who deliberately go into caregiving fields for the purpose of finding easy victims. So not only that. But this kind of serial killer is at least as common, probably more common, than the kind you hear about on the media, that popular culture is obsessed with. Some of them are suspected of killing hundreds of people. And yet the media doesn’t give a shit and neither does law enforcement. So you never hear of it.

And people are willing to excuse it on the grounds of caregiver stress, our purported lack of a life worth living, the idea of mercy killing, and all kinds of other bullshit. Even when the description of our impairments doesn’t match our actual ones, which happens pretty much any time anyone kills us for any reason. And even when the killers specifically state they did it for fun. Which happens far more often than you’d think. I remember one account of a woman who killed patients in a hospital or nursing home so that their names spelled out words. Of course even when caregivers are burned out, even when they believe they’re acting in our best interests, even when our purported abilities seem to match our real ones — that still excuses nothing. But it’s amazing how much the public want desperately for those things to be true even when they clearly aren’t.

You do hear of some people like this though, just hidden in various ways under other guises. Many famous figures in the right to die movement were either murderers/serial killers or wannabe murderers/serial killers, people who clearly got off on death, rather than people who had any ethical interest in the subject. And you can bet there’s more hiding in plain sight that we don’t know about. I know someone who is almost certain his significant other, active in that movement and obsessed with serial killers, has killed people in their job as a nurse. But lacking evidence he can’t do anything about it.

Mind you, even if I don’t agree with them, I know there’s plenty of people in that movement because of a sincere commitment to their personal ethics. But it takes naïveté or wishful thinking not to notice that some of the leaders are really creepy and appear to be motivated by something other than wanting to help terminally ill people die with a minimum of pain and suffering.

One reason I oppose the right to die is not because there aren’t situations that, in a fair world, I would be fine with it. But rather because, in this world, it would make things too easy for would-be murderers and serial killers. And despite claiming to be all about autonomy, many right to die organizations jump in the moment they hear about it, to support parents who murder their disabled, non-terminally-ill children without the children’s permission. That tells me way too much about the motives of some of the leaders. Things are already too easy so I can’t support anything that makes it even a little easier. But I’m getting a little off track here.

And not only all that. But even though this is known to be a big problem, the media doesn’t care much and neither does law enforcement. Which is about typical when any of the “wrong kind” of people get killed on a regular basis, whether it’s disability or something else.

But what this means is that disabled people have plenty of reasons to be wary of our caregivers. I thought of posting this because I said I refused to be alone with a caregiver after they know they’ve been fired, and someone told me they’d never thought of the power imbalance there. This sort of thing is exactly why. You never can exactly predict who will become abusive, whether it’s emotional abuse, physical abuse, or even killing. I found that out the hard way in mental institutions, where I am absolutely certain that some of the people who worked there had actually succeeded in killing other people even if they didn’t succeed with me.

But as I said before. Being completely terrified about this only plays into the hands of the people who do it. Be aware. And be careful. And take precautions. But don’t let this sort of people have control over your emotions, because that doesn’t help anybody.

Please tell people these facts though. Because few people seem to even realize that not everyone in healthcare or caregiving professions is there for good reasons. Let alone how many serial killers there have been. One group of caregivers is even suspected of 49-300 murders according to this book. That puts them up there among the worst of other kinds of serial killers.

It must seem perfect to such a person, to get to kill people without as much chance of getting caught, and even if you do get caught people may still make you out to be a hero. People die all the time in nursing homes, even people whose conditions shouldn’t be terminal. That’s taken as normal by people who equate disability with being halfway towards death anyway. In most kinds of institutions colleagues will cover for you — that’s how you get so many deaths from “heart problems” and “seizures” in people who didn’t have heart disease or epilepsy. And lots of people think disability is worse than death so killing us is doing us a favor. Or if not that, they’ll at least excuse it on the grounds of caregiver stress and burnout. And the cops don’t investigate much anyway, since we aren’t valuable to them. It all adds up to a situation where any serial killer who truly didn’t want to get caught, would jump at a chance to take that kind of job.

So let people know about this. Let people know it happens at at least the rate of other kinds of serial killing if not more. (I suspect far more, because of the ease of hiding it.) And take precautions with even caregivers you trust. But don’t get trapped in fear or despair, that’s what such people want of us. It helps them, not us. Always remember there’s that second curtain that needs pulling back, especially when dealing with truly horrific situations like this. Behind it you will find all the love and compassion required to take a stand even when nobody seems to listen.

3. Commenting guidelines

As with many such posts, I’m explicitly making clear that I won’t accept comments that in any way excuse, justify, or condone murder. Including comments that deliberately skate close to the edge. And including comments that seem to be all about compassion… except it’s always for the murderer. Those are suspect because the only murders where there’s such an outpouring of compassion for the murderer, are ones where the murder victims were a type of person who don’t matter enough for the appropriate outrage to take place. You have the entire rest of the Internet to say things like that, so don’t grumble about free speech either. I want this one little tiny corner of the Internet to be a place where disabled people don’t have to put up with that bullshit. Don’t even try to ruin that.

In this context, posts supporting the right to die movement aren’t welcome either, even by people who sincerely want to prevent suffering. The reason is that in a discussion of murder and serial killing of disabled people, discussion of situations where killing disabled people might be okay, has the effect of adding support to people who kill us without our consent for reasons that are far from benign. This happens even when the individual person arguing for it doesn’t have that motivation. So I’d like you to respect that this is not the time or the place for that kind of discussion.

Finally, please respect that people are grieving for recently murdered people from several different minorities, including disabled people, right now. The fact that the people who killed them were unlikely to be serial killers doesn’t make their deaths any less awful, and people’s widespread defense of their killers any less despicable. I hope I have created one small place on the Internet where everyone matters, even when we belong to groups of people that those with power hate, fear, and consider insignificant.

There are no unpersons here. For everyone who has ever been killed for who they are, regardless of the reason: Rest In Peace. I will not allow anyone here to speak against you.

BADD: Caregiver abuse takes many forms

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Blogging Against Disablism Day, May 1st 2012

This is one of two posts I’m making for Blogging Against Disablism Day. Both are about caregiver abuse. This one is about misusing power in caregiving relationships. In particular, abuse that most people wouldn’t think of as abuse.

A note on vocabulary. Caregivers are called different things in different contexts. Caregivers, aides, personal assistants, attendants, staff, etc. Sometimes they also have more specific titles like LNA for Licensed Nursing Assistant. Regardless of how any of these terms are used outside of the disability world, every single one of them, in the context of disability, refers to someone with incredible amounts of power over disabled people. Not a person the disabled person has incredible power over. And that goes for even if we hire and fire them ourselves.

I get services from two agencies, a developmental disability agency and a physical disability agency. The DD agency calls caregivers staff. People from the physical disability agency can have all kinds of job titles depending on what their specific job is. The ones I see regularly are called LNAs. None of these terms are considered disrespectful by the agencies using them, or by the caregivers themselves. And when I refer to staff or LNAs, I am talking about people with huge power over me, not people subject to my own power. That will become obvious when I use events in my life to illustrate different abuses of that power.

I recently found this graphic developed by the Wisconsin Coalition Against Domestic Violence and distributed by the National Center on Domestic and Sexual Violence. It’s called a Power and Control Wheel.

At the top, it’s labeled “POWER AND CONTROL WHEEL: PEOPLE WITH DISABILITIES AND THEIR CAREGIVERS”. Around the outer edge, colored black, are listed physical and sexual violence. The middle says “POWER & CONTROL”. In between, in grey, are various forms of abuses of power and control.

Since this is a graphic, and since the PDF file is kind of muddled in terms of the placement of lines that a screen reader might use, I’m going to transcribe what’s on the graphic and then provide examples from my life and the lives of people I know. But first, the graphic and the PDF:

20120430-125810.jpg

A PDF of this file is available from the National Center on Domestic and Sexual Violence here. So on to descriptions of each section of the wheel.

COERCION AND THREATS:

Threatening to hurt the person; withhold basic support and rights; terminate relationship and leave the person unattended; report noncompliance with the program; use more intrusive equipment. Using consequences and punishments to gain compliant behavior. Pressuring
the person to engage in fraud or other crimes.

Threatening to cut off support is a huge one I see all the time. I’ve had people literally walk out the door in the middle of a shift without assisting me with vital things, just because they were angry with me. Or just because of things I can’t even figure out. Like more than once a person has come up behind me and startled me, and I jumped and shrieked involuntarily, and they said “That’s it, I’m out of here” and turned around and walked out the door. That’s basically denying a person disability services on the basis of the person being disabled, but it happens all the time.

Using consequences and punishment to gain compliant behavior is something that pretty much all institutions do, including the kinds of institutions that most people don’t call institutions. My special ed school was huge on that. And the consequences were things like being locked in a dark closet for hours.

I found it amazing that they listed the part about pressuring people to commit fraud. Years ago, I had a staff person who was very manipulative in general. He would do things wrong on purpose and then blame them on other staff, in an attempt to get me to trust him alone and to distrust other staff. I’d experienced that before, so I knew what I was looking at. He also claimed to have been fired from this job in the past because he was “just too political” about disability rights.

But the very last straw was one morning when he came in and explained that he had “connections” at the local hospital. He knew that I was having trouble obtaining a certain medication that Medicaid refused to cover. He claimed that if I was “already in the system”, Medicaid would have covered the medication because they only refused to cover it for people who weren’t taking it already. He told me that he could use his “connections” in the hospital to change my records in the computers so that it looked as if I’d already been taking it, and that then Medicaid would cover it.

The moment he was gone, I contacted my case manager and told him that I was afraid of this guy, and that he’d tried to get me to commit Medicaid fraud. The very last time I saw the guy, he must have seen the writing on the wall. Because he told me he was on the verge of being fired again for “being too political” so he was going to quit before they could fire him.

But one mistake they made was ever allowing him back into my apartment after I’d reported what happened. Caregivers can turn outright violent if they think you’ve reported them for abuse or incompetence. Not all of them do, but given their extreme power over disabled people, it’s dangerous to allow them to be alone with a client once they know they’ve been reported for abuse or that their job may be ending. I’ll get to an example of that later.

The times when people threaten to use more intrusive equipment have usually been when I’m dealing with the medical profession. I once refused to take a pill I was allergic to, and without even stopping to figure out why, a doctor threatened to stick a suppository up my ass. She wouldn’t let up on that and other threats until my power of attorney contacted Patient Relations on my behalf. In the psychiatric system, refusing medication often means being tied down and injected with it. There’s something very punitive about the way these systems handle someone not immediately going along with whatever they want.

I’ve also had people, both medical and otherwise, do things to me in ways that hurt. On purpose. That didn’t have to hurt. I once had a doctor order a blood gas not because I needed one but because he’d decided I was a bad patient. He pretty much said outright that this was why. My problem? Saying that his treatment for asthma wasn’t helping my breathing problem that wasn’t asthma. Because of him, they overlooked an infection that did permanent damage to my lungs. Other times it’s just a matter of providing the same services as usual, only in a violent way. It’s hard to describe the difference. It’s like there are gentle ways and there are violent ways to help someone transfer into a wheelchair.

There’s also the threat of being considered a bad client. The kind who complains too much. The kind who bans too many people from your house. I’ve put up with all kinds of things for the sake of not being considered that kind of client.

That includes sexual abuse. That’s another kind of abuse where sometimes it’s all about the way the person does things. In this case I needed to be bathed in bed and have different lotions appled to various parts of my body. And this woman… I can’t describe the way she did it. It was like a sexual caress. It was all wrong. And yet I put up with it every day because I knew that nobody would believe me, because the abuse was too subtle, because my sexual orientation would be called into it, because I would be told I was misreading social cues, all kinds of reasons. But mostly because I couldn’t afford not to get those services.

One of the worst threats to withhold care was explicit and came from a really bad case manager. Even though prior to coming to this DD agency, I had had one staff person for several years — an eternity in human services — he started spreading rumors that I was always refusing staff before I got there, and switching them all the time.

There were two people that I began refusing to allow into my apartment. One of them had a severe cognitive impairment that prevented him from understanding three-word sentences some of the time, in ways that directly endangered me. I reported this to the agency and he thought I was saying that as an insult. I told them I wasn’t. They told me nobody with a severe cognitive impairment would be allowed to work for them. Years later they figured out he had been hiding his Alzheimer’s from the company in order to avoid getting fired. I never got an apology.

But in the meantime, they didn’t know this. And there was this other guy who was constantly proselytizing to me. Two people out of dozens of potential staff.

Well they started telling me things like “Nobody really wants to work with you, you know.” When staff told me they liked me, this case manager would tell me they didn’t really, and that everyone hated working with me. He kept sending in the two guys I’d said could not come in, and telling me that if I refused them, I would not get services at all. And that he would write me down as unilaterally refusing all services from the agency.

Later he threatened to put me in this agency’s version of institutional care if I didn’t do what he wanted. I filed a complaint about all of this and more, and I won.

Back in California, there was an agency that had a policy of firing staff that clients liked, or pressuring them into quitting. Usually through blackmail, and setting them up to look like they were abusing people. Meanwhile, if any of us reported real abuse, they’d give that person a promotion. It was twisted but very deliberate on the part of two case managers who had the most power and who treated it like a fun game to mess with our lives. I’m not kidding.

One time, even, I reported one staff person for abuse. Later on, a very good staff person, well-liked by the entire company. Was fired for abusing clients. In the same, specific, way, that I’d reported the other person as doing. There was a client who couldn’t write for himself. So he’d dictate an email and they could write whatever they wanted. And so one day they wrote an email, as if from him, accusing the good staff person of abusing him in the same bad way as the person I’d reported. He had no clue what was going on when they fired her.

But anyway. Because of my role in reporting actual abuse. They refused to give me services at all. They blackmailed one good staff person into quitting a day before she was going to be fired. She refused to tell me what they’d done to her, but she was shaking the entire shift. They did this on purpose, because the next day was the day she would train the new staff person about what I needed them to do. This left me with a new, but good, staff person, who had to learn everything from scratch. This amused the case manager.

But then the new, good, staff person, was fired in the scenario I described above. And they just refused to give me services at all for months. This person ended up doing services for me all that time without much if any pay (she got a little from a different state agency) because she couldn’t stand what they were doing to me.

The way they did it, was they’d take careful note of things I couldn’t have in staff — for instance people who couldn’t lift wheelchairs — and then they’d say “We could only find a person who couldn’t actually do anything for you, so you’ll have to accept that or nothing.” It was really weird. At one point they deliberately triggered me into a meltdown, and then smiled at a (good) staff person and said “See what you made her do?” Then blamed her. It was a mess. But it basically all amounted to withholding services because I reported abuse.

CAREGIVER PRIVILEGE:

Treating person as a child, servant. Making unilateral decisions. Defining narrow, limiting roles and responsibilities. Providing care in a way that accentuates the person’s dependence and vulnerability. Giving an opinion as if it were the person’s opinion. Denying the right to privacy. Ignoring, discouraging, or prohibiting the exercise of full capabilities. Raising a hand or using looks, actions, or gestures to create fear. Destroying property and abusing pets. Mistreating service animals. Displaying weapons.

The very first time I saw anyone from the DD agency I get services from, I knew they were going to be trouble. I was in the parking lot before they were going to interview me for services. And what I saw made me nauseated.

A disabled man got out of a car. He banged his leg a little bit. The staff person swooped over to him and said, in exactly the baby-talk voice it sounds like, “Awwwww I kiss your boo-boo all better!”

I knew at that point that if they actually gave a shit about not treating people like children, she wouldn’t be working there, because she was doing it in public in a flagrant way that meant she’d had to have done it in front of people before.

And as an agency, they really don’t give a shit. There’s individual people who give a shit, but a lot who don’t.

The agency that really has problems with privacy, is the physical disability agency who helps me bathe. Yes, they normally see me naked. Yes, they normally clean my private parts in ways I can’t clean them myself. But that does not mean they should be allowed to deny me privacy in other situations. In fact, it means they should be giving me more privacy in other situations.

The big thing is walking in on me in the bathroom. I’ve never had much of a sense of body modesty. But when I learned that puts me at risk of abuse, I’ve been trying to learn it. This is not helped when people walk in and stare at me when I’m taking a shit. There is no excuse for that except in circumstances that don’t apply here. And yet if I complain to the agency about it, they’re puzzled as to why it’s even a problem. If I want to keep them out I pretty much have to lock the door, and then they’ll stand out there loudly complaining about how much time I’m taking.

The rec program from last summer was huge about treating people like children, making unilateral decisions, and all of that kind of stuff. We had to ask permission to do much of anything at all, and… I don’t even have the mental energy to go into everything that happened there. I already described it in another post.

Even otherwise good staff frequently make decisions about stuff without consulting me. Sometimes I agree with them, sometimes I don’t, but people should at least ask.

And providing their opinions as if they were my own? That’s happened to me all the time. It’s made worse by the fact that people will talk to a staff person rather than to me. Then the staff person can answer on my behalf without even asking me what I believe.

ECONOMIC ABUSE:

Using person’s property and money for staff’s benefit. Stealing. Using property and/or money as a reward pr punishment in a behavior program. Making financial decisions based on agency or family needs. Limiting access to financial information and resources resulting in unnecessary impoverishment.

What usually happens with me is more subtle. Which is that people will spend money in ways that really screw up my finances, but nobody holds them accountable.

I have a friend who is very poor. She asked someone to send something by mail or Fed Ex or something, with whatever the normal fare was. They bought the most expensive option, like next day air or something, and brought the expense up to $100. She then didn’t have any money to spend the rest of the month. The person was never held accountable, and my friend didn’t have the cognitive or physical stamina, or money, to fight them in court or something.

I can’t count the number of times I’ve had people do similar things to me. Or they’ll spend over $100 on groceries without telling me. Which is why I now have a ledger system in place where people have to write down how much they spend. But it doesn’t stop people from spending it in the first place.

For someone without very much money, this is a huge deal. And yet there’s very little recourse, either when people spend too much, or when they destroy expensive property.

As far as using my property for their own purposes? I had this staff person years ago, who was always evangelizing to me about his religion. And was always trying to hold me to standards from his religion, when it wasn’t my religion to begin with. But then he began telling me things like “I provide these services for you, so you need to do things for me in return.” What I had to do in return, apparently, was use my printer to print off copies of a pamphlet regarding his religion.

I also at one point had been prescribed Vicodin after surgery. I didn’t use all of it. So a staff person started taking it. As in, taking it and using it. I couldn’t complain because I couldn’t afford to have her not working for me.

WITHHOLD, MISUSE, OR DELAY NEEDED SUPPORTS:

Using medication to sedate the person for agency convenience. Ignoring equipment safety requirements. Breaking or not fixing adaptive equipment. Refusing to use or destroying communication devices. Withdrawing care or equipment to immobilize the person. Using equipment to torture person.

I once lived at a residential facility that made a big deal about the fact that they didn’t use restraints or locks on the doors. What they didn’t tell people was that they used medication and behavior modification to ensure that there were restraints inside people’s heads. The same happens in a lot of systems that claim to be “more humane” than places that use locks and restraints. I’d far rather just be tied down, at least it’s honest.

I remember one staff person who had been great for years, and then something changed. Suddenly she began withdrawing support at random times, that seemed designed to hurt me and make me miserable. She made me sleep on the floor rather than on the only bed in the apartment. She would not allow me to lie down on that bed even when I’d just had a long airplane trip and desperately needed a place to lie down.

When I moved house, she refused to allow me any role in unpacking or deciding where my belongings went. And that was when I first experienced the part where she began messing with my head. She said, in a tone as if I had requested something ludicrous and impossible, “I am not going to sit here and ask you where to put every single thing!” I began to doubt myself so much that I spent years afterwards asking other staff people, “Is it wrong to ask for that when I’m unpacking from a move?” They all say no it’s not wrong, but I’m still afraid to even write this down lest someone tell me how I’m horrible to staff by expecting them to do things they shouldn’t be expected to do.

Then it started being things where I badly needed something. She had set things in front of the door so that only a walking person could get in and out, but you couldn’t get out in a wheelchair. When I asked her to move these things, way too heavy for me to move, she told me “I’m not your slave.” She convinced me that if I contacted my case manager about her not doing her job anymore, the case manager would see how ridiculous I was being to expect her to do things that she’d done for me for years without complaint.

She later told me that when someone is stopping any kind of relationship with her, she treats them like shit to punish them and to convince herself that it’s not going to be any loss to her. But that’s a really shitty excuse for what she did.

I don’t know who did it, but someone eventually reported her to Adult Protective Services. I don’t know what abuse they witnessed, but it was bad enough that a total stranger reported her. She blamed me and a friend, but we didn’t do it. She wouldn’t believe me when I told her we didn’t. I eventually did tell my case manager what was going on, and she was horrified and said I was not in the wrong.

And yet still. I’m afraid to talk about this. Because on some level I still believe that I’m an unreasonable person who asks staff to do things that they shouldn’t be required to do. Even though since then I’ve asked tons of people and they all said she was in the wrong.

Elsewhere I describe what happens when people outright ignore that I’m typing anything. But another thing happens sometimes. Where they’ll just say to me, “I don’t have time for this” whenever I try to say something. Or they’ll talk over me too loudly for them to hear me, since communication devices don’t usually go up to very loud volumes. There’s this idea that communication ought to be a privilege, not a right, and that I’m only allowed to communicate at times when it’s convenient to others. Or that I don’t get to communicate at all if they’re angry at me for some reason. This becomes even more of an issue at times that I need physical help using a communication device. People seem to think of communication in general as something that’s nice if there’s time but otherwise forget it. It’s all about whether it’s convenient to them, even though times when it’s inconvenient to them are often the times I most desperately need to say things.

MINIMIZE, JUSTIFY, AND BLAME:

Denying or making light of abuse. Denying the physical and emotional pain of people with disabilities. Justifying rules that limit autonomy, dignity, and relationships for program’s operational efficiency. Excusing abuse as behavior management or as due to caregiver stress. Blaming the disability for abuse. Saying the person is not a “good reporter” of abuse.

Caregiver stress is the one that stands out to me here. People have used it to justify literally everything up to serial killing of disabled people. (No, I’m not exaggerating. I wish I was.) And the public buys it. They buy that it is just so stressful to work with disabled people, that abuse is bound to happen. They even say this about murder, even multiple murders, even when the murderers outright admit they only did it for fun.

I’ve done a lot of research into the murders of disabled people, and autistic people in particular. You hear things all the time like “She shouldn’t be sentenced to prison. She already served 15 years of being the parent of an autistic child.” Again, I wish I was kidding.

And if people will use this to justify murders and serial killings, they will use it to justify any abusive thing that happens to a disabled person ever. And they do. All the time. This is one of many reasons that I don’t trust most campaigns for awareness of caregiver stress and burnout. I’m not denying that those things are real. But they’ve become so ingrained in public consciousness, that the instant a crime against a disabled person makes the news, all you hear is “It’s so hard to take care of That Kind Of Person, you really can’t blame them.” Coupled with a lack of focusing ever on the fact that disabled people get burned out from having to put up with caregivers all the time whether we feel like it or not, the usual ways people discuss these things start seeming one-sided and scary.

How bad is it? I know several people who have contacted rape crisis hotlines to report rape by caregivers, and been told outright “You have to understand the kind of stress they’re under, it’s very hard to care for someone like you. They really have your best interests at heart and you should learn to accept that.”

I have told people about things I went through growing up that nobody should have to go through ever. And been told that “being a caregiver is hard, you have to understand that”. As the very first response when I try to disclose horrific forms of abuse. There is no escaping this excuse. And it’s a terrible excuse but people buy it because the disabled person’s side of the caregiver relationship is not taken seriously at all. Even though we’re truly the ones on the wrong end of that power relationship.

Mind you, I know caregiver burnout happens. But any discussion of caregiver burnout has to draw lines about what it’s used to justify. I’ll buy that people will get irritable and snippy. I won’t buy that truly abusing and killing people is ever an acceptable response. Any discussion of caregiver burnout also has to acknowledge the other end, the end nobody talks about. Which is that disabled people get burned out on our caregivers. But that we have no choice but to accept care every day. We can’t take a break without danger to ourselves.

Some places have respite services for caregivers. There are no respite services for disabled people. Ultimately, even if it would make them feel terribly guilty, caregivers can walk away and abandon us without dying. Disabled people cannot abandon our caregivers without dying. That shows one huge power discrepancy in the relationship.

As for all the other things, they are pretty much standard practice in most agencies and institutions. Everything is set up for the convenience of staff and other workers, not for the convenience of disabled people. It’s rare to find a place where this is otherwise. And that means that if abuse happens, it will either be justified as part of the program, or someone will make up ways to make disabled people sound like we’re unreliable reporters.

There was a woman who was a client of the same agency I am a client of. And her caregiver literally would not allow her into certain areas of the house. She insisted that her client could not be home during certain hours. One day, she had a serious bathroom accident at work. Her caregiver refused to allow her to come home. This was reported to Adult Protective Services by her job coach.

The entire investigation basically involved the agencies finding “evidence” that this client was a habitual liar. APS decided that abuse didn’t happen and that the client was lying about it. You hear the same things when it’s sexual abuse. Dave Hingsburger said he went to a rape trial where the agency brought out all the different reasons this person could not be trusted. She tried to say “But I only lie about little things, not about something like this.” As I remember it, nobody believed her. But even when someone isn’t a liar, you can bet that once they report abuse by a staff person the agency happens to like, they will be made into one.

ISOLATION:

Controlling access to friends, family, and neighbors. Controlling access to
phone, TV, news. Limiting employment possibilities because of caregiver schedule. Discouraging contact with the case manager or advocate.

Limiting employment possibilities because of caregiver schedule is the norm for one agency I get services from. They’re the people who provide personal care, which includes things that I absolutely can’t go without.

I don’t have a job and will probably never have a job. But there are two hours a week I ask them not to come, and one day a week where I ask them to come before noon. That’s it. Two are essential meetings with my case manager. One is a day when, if I’m feeling up to it (which is practically never these days), I go to an art program.

I have been told, explicitly, and continually, that even just those two hours a week alone. Without the day when people can’t come past noon. That just those two hours are limiting them too much. That it’s not fair to the LNAs or their scheduler. That essentially if I am not available 24/7, then I have no reason to expect proper care.

They’re the only game in town for the kinds of services they provide, and they know it. So they are able, as an entire agency, to regulate disabled people’s lives so much that if we have jobs, or even a couple meetings a week, we can’t expect care.

As far as isolation goes, the recreational program I was in last summer did that in spades. I was not allowed to use the phone except when they wanted it. When I was extremely ill, like on the verge of needing to be hospitalized, I was not allowed to call my power of attorney for healthcare. And when I tell advocates that we were not allowed to use the phone whenever we wanted, that is enough to send off huge alarm bells. They also only allowed contact with my case manager if they were the ones doing the talking and I was merely in the room. If they didn’t approve of something I wanted to say to my case manager, they refused to tell her what I was typing.

I’ve also experienced a really peculiar form of isolation that isn’t listed here. It’s happened to me several times in several forms with abusive caregivers.

It’s where they try to prevent contact with people, but they don’t do it overtly. They just start dropping tiny little hints here and there, that friends and other staff are not trustworthy people. That they, in fact, are the only trustworthy person in your life. That other people are saying bad things about you behind your back. That nobody else actually likes or respects you. This can be done so subtly that you barely even notice until you realize months later that this is the only person you’re talking to anymore, and they’re being horrible to you.

Related is something I never see discussed anywhere either. Where someone who is incompetent or abusive in almost all other areas, will have one thing they do to make themselves indispensible. It may be working longer hours than they’re technically supposed to, at a time when you’re not getting enough staff hours to meet your needs. It may be cooking you the best food at the cheapest prices that you can possibly imagine. It really accomplishes two things. First, you won’t want to fire them because you’ll lose the above-and-beyond support they’re giving you.

But the other thing is more directly related to isolation. They do all these extra things for you, but they also start doing things to make other staff look bad. It can be deliberately screwing things up for you and then claiming another staff person did it. It can be simply lying outright about someone else’s ability to help you. It can be implying that nobody else would ever do these extra things for you. The result is to elevate themselves while putting all other staff down, and making it so you don’t want to communicate with other staff because you don’t trust them as much as you trust this person.

EMOTIONAL ABUSE:

Punishing or ridiculing. Refusing to speak and ignoring requests. Ridiculing the person’s culture, traditions, religion, and personal tastes. Enforcing a negative reinforcement program or any behavior program the person doesn’t consent to.

I would add to this one something that specifically happens to people who can’t speak and use other means of communication. I have communication devices that speak, but a lot of time I have used ones that don’t speak to save time and energy. This means that someone had to read the screen. Sometimes when staff have been angry at me, they simply refuse to read the screen. That’s a level above and beyond the ordinary silent treatment because it makes it impossible to say a word to them even when it’s important.

INTIMIDATION:

Raising a hand or using looks, actions, or gestures to create fear. Destroying property and abusing pets. Mistreating service animals. Displaying weapons.

The last time I had a staff person raise a hand to me, it wasn’t even my staff person. This is the story I promised earlier about what can happen once you start challenging a caregiver’s power, or once they know they’ve been fired.

In this case, the person was a friend’s staff person. She was really good, except for one thing. She could not stay out of my friend’s stuff. If you asked her not to, she’d either pretend not to hear you, or laugh like you just made a huge joke and do it anyway. In fact, even if she wasn’t already doing it, the moment you asked her not to do something, she’d immediately do it. And it was getting to be a huge problem, because she was arranging my friend’s stuff in ways that made it inaccessible from a wheelchair and impossible for my friend to get any work done.

Every time my friend got out important paperwork, for instance, this staff person would “put it away” without asking, even to the point of putting it at the bottom of a box stacked behind and under boxes that my friend was unable to lift. My friend asked me to come along to help her advocate for herself when she finally drew the line for this person. She wanted to simply not allow this person into her living room.

At first, she laughed and tried to go in anyway. When we made it clear we really meant business, though, she began screaming at us. And I really mean shouting at the top of her lungs. She said that she was going to leave and refuse to cook dinner for my friend, who is unable to cook for herself.

I told her that was a form of caregiver abuse and not acceptable. She kept screaming about how she was “NOT THAT KIND OF PERSON” and that I needed to leave, now, and that she was not going to listen to a single word I said. In practice this meant shouting over the top of my communication device, which can only go to a certain volume. I of course didn’t leave, because leaving my friend alone with a staff person who was that angry would have been a serious danger to my friend.

But neither of us were prepared for what happened next. She actually raised her hand to me and took a swing, stopping short only when her hand was two inches from my face. Then she held it there shaking. After we got her to leave, she hung out outside my friend’s apartment for several hours. She claimed that she was out there doing work for another client, but she didn’t have another client during those hours.

Yes, all of this was reported. No, nothing happened to this staff person. That’s what happens in the system, especially in the kind of agency (most of them) that protect staff and not clients. Even in things like murder investigations this is usually true.

She also seriously distorted what we actually told her, when recounting it to other people in the agency. The things that made her the angriest were when we told her that withholding food is considered a form of caregiver abuse, and that the things she was doing with my friend’s stuff involved a power relationship that she wasn’t acknowledging. We carefully explained why it is that people who have this kind of power, often don’t realize it. We went out of our way to explain why she might not have noticed this and that we knew it wasn’t her fault. When she repeated it to others, it was “They told me that I was an evil, power-hungry person who abuses disabled people for fun.”

This is also an excellent example of why a staff person should never be left alone with someone who has reported abuse, has let them know they won’t be working there any longer, or that kind of thing. This woman gave no warning at all that she was going to turn loud and violent at a mere request to stay out of a specific room. I tell staff to stay out of a particular room sometimes for all kinds of reasons, and have never gotten a response that intense.

So basically…

There are tons of different ways to abuse power, and this only covers some of them. But this is the best description I’ve ever seen of stuff that nobody ever even acknowledges as a problem. Hitting people and sexually assaulting them are not the only kinds of abuse out there, and in some circumstances they’re not even the worst.

Also understand — I’m not saying that all caregivers are abusive, or even that all caregivers who do a few of these things sometimes are “bad staff” overall. But it’s hard to have power and not abuse it. And people need to be aware that caregivers have this unacknowledged power. And that lots of them abuse it. And that very few people care. Getting services is not a walk in the park. You will inevitably encounter people doing all these things and more. And you have to be prepared.

Contrary to what most people believe, caregivers are not selfless, self-sacrificing saints who never do us any harm, yet shoulder a great burden that leads to burnout, which excuses anything they might do wrong. That’s not even true of the best ones. Caregivers are human beings. Human beings do a lot of bad things to each other. Especially people they have power over. Caregivers have that power. And it is not wrong to talk about it, to point it out, and to say that what some of them do is very wrong and destructive, and not excused by burnout or stress.

And I’m not talking without experience here. I’ve provided care for other people. And despite the inevitable stresses, you have to find ways of handling them other than punishing the person you’re supposed to be assisting. You also have to be constantly aware of your own power.

I’ve also had caregivers who, while very good in some areas, did some of these things. And I’ve had to make decisions about that tradeoff. Should I find someone who does things worse overall, but who does fewer of these things? Or should I stay with this person and try to work out ways to manage the things they are doing wrong? That’s a decision a person can only make for themselves, and doing some of these things doesn’t automatically make someone the worst choice in caregivers. It all depends on the circumstances and the people. But it’s good to know these things are wrong, even when you can’t seem to avoid them.

Not everyone even knows these things are wrong to do. So I have a printout of this chart posted in my kitchen, and have given one to my case manager for training purposes.

And here are the contact information for the two places that came up with and publish this stuff:

Developed by: Wisconsin Coalition Against Domestic Violence. 307 S. Peterson St., Suite 2, Madison, WI 53703. 608-235-0539. Based on the model by the Domestic Violence Intervention Project, Duluth, MN. National Center on Domestic and Sexual Violence. 7800 Shoal Creek, Ste 120-N, Austin, Texas 78757. tel: 512-407-9020. fax: 512-407-9022. www.ncdsv.org.