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Understanding Disability: Some Theories and Models

Date: 27/01/22

Author Name: Lavanya Kaushal

Qualifications: B.A. (Hons) in Psychology, M.A. Applied Psychology (Specialisation in Clinical Psychology)

Designation: Former Consultant Psychologist, ACRO Mental Health Services.

Word count: 2,520

Reviewed and edited by: Sareem Ather, Mariyam Mohammed, Ayesha Begum, Navya Peri and Aishwarya Krishna Priya

Disability is a word that holds different meanings in various contexts, in fact, even among other individuals (1,2). Ask one person what they mean by disability, and their answer will likely differ a lot from what another person says it is (3). The meaning of this term has also changed over time (4). Broadly, however, disability reflects an interaction between features of a person’s body and parts of the society in which he or she lives (5,6). The World Health Organisation defines disability as “a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives” (7). Friedman and Owen also give a similar definition of disability as a complex phenomenon that includes preventing or slowing the action, an atypical function, a lack of independence, and a socially constructed obstacle (8).

Disability is most commonly defined with respect to how the person’s body interacts with the world around them.

While there is a multitude of issues that are classified as being a “disability”, these are usually categorised under two broad categories. First are the visible disabilities, which are obvious and easy to notice (9,10). Down syndrome, paralysis, cerebral palsy, multiple sclerosis are a few disabilities that fall under this category of disabilities (11). Invisible disabilities, on the other hand, are the ones that are not very apparent (12). Examples include learning disabilities, mental disorders, and anaemia (13). These disabilities are often more stigmatised and misunderstood than visible ones since they are not obvious (14,15).

The definitions of disability, as mentioned above, are based on a variety of different models, each of which conceptualises disability in a unique manner (16). Some of the most well-known and prominent models of disability are as follows (17).

“I am disabled because God wanted me to be that way”- The Moral/Religious model

The moral/religious model of disability is perhaps the oldest model of disability and is based on the belief that disability is a punishment from an all-powerful entity and/or a result of non-adherence to social morality and religious proclamations that discourage people from engaging in a certain behaviour (18,19). Another belief in this model is that disability is a punishment of a sin that may have been committed by a person’s ancestors (20). This model was particularly common in the industrialised countries, wherein people with HIV/AIDS were stigmatised and ostracised to a much greater extent than today (21,22).

Another way this model plays out is when disability is seen as a blessing from God (23). According to this, Individuals with disabilities are selected by a higher power to carry out some purpose on Earth (24,25). We may have heard of such examples in India, wherein children born with extra limbs or body parts were considered reincarnations of Hindu gods and goddesses and thus revered by local people (26).

Female babies born with extra limbs are often seen as a reincarnation/form of Goddess Durga in India.

Needless to say, subscribing to this model may instil a lot of sense of shame into the individual and their family (27). However, thanks to developing other models of disability based on better knowledge, this model is no longer that common, except in a few theological groups and communities (28).

“I am disabled, I am suffering, and I need your help”- The Charity Model

We all must have seen certain ads that show images and videos of men, women and children suffering from serious physical disabilities and ask for donations to improve their lives (29,30). What do you feel when you look at those ads? Sympathy, or perhaps pity. (31) If that is the case, you most likely view disability through the charity model (32,33). According to Duyan, the charity model sees people with disabilities as victims and the disability itself as a deficit (34). They are seen as being reliant on others and are unable to help themselves (35). Therefore, they must be provided with special care and welfare in order for them to be looked after (36,37).

Many depictions of disability are like this picture, which evokes a sense of pity.

There is no doubt that this model takes on a much more humane and benevolent approach to disability and aims to benefit people with disabilities (38). However, many have questioned whether it is worth depicting them as helpless and destitute (39). Such depictions of people with disabilities as dependent charity cases have aided in getting money through donations as well as garnering vocal support for their needs (40,41). At the same time, this has come at the cost of devaluation of their lives and exaggeration of their helplessness (42).

“My disability is a problem, and I must find a solution”- The Medical Model (43)

The medical model, also known as the individual model, is a model which is in notable use today (44,45). There are two main beliefs that form the foundation of this model. First, disability is located within the individual (46).

Second, functional and psychological limitations that arise from a person’s disability are seen as the root cause behind their problems (47,48). In other words, overcoming disability is the main theme of this model, and it states that the responsibility for “curing” disability is that of the individual who has it (49). This model is also known as the “personal tragedy” model, mainly because it is seen as an inherently negative thing that is tragic for the individual who has it, as well as their families (50). This model may play out when a lecturer refuses to send a copy of class notes in advance for a student with a learning disability (51,52).

The medical model aims at finding a cure for the disability through means like surgery, physiotherapy etc.

While this model has helped in seeing disability as something that can potentially be managed instead of taking on the “disabled people are helpless” approach of the moral/religious and charity models (53). However, it has been criticised heavily by many disability activists for multiple reasons.(54,55) The main point of their criticism is that this model sees disability as a deviation from what is “normal” (56).

As a result, people who subscribe to this model consider disability as something to be solved and often reduce the individual’s existence to nothing more than the disability itself (57). It does not take into consideration law & policy changes that would aid in making environmental changes to help people with disabilities to master their environments (58,59).

Moreover, this model gives immense power to medical and healthcare professionals to diagnose people based on certain standards of normalcy, which makes it very easy for people with disabilities to be labelled as “failures”, “cripples”, “invalids” and so on, which can lead to increased stigma and discrimination against such individuals (60,61).

“My disability comes from systemic and societal barriers.”- The Social Model (62)

The social model aims to reverse what the medical model states (63). In essence, this model sees disability as a condition that occurs due to an interaction between the individual’s impairment and the environment, which can be disabling or enabling in different ways (64,65). The problem does not necessarily lie within the individual and their limitations, but rather the society which puts up barriers, some of which include poverty and economic dependence, prejudice and discrimination, isolation and segregation, passivity, inadequate education, lack of jobs, inaccessible transportation, infrastructures and services (66). For example, buildings that have stairs but no ramps or elevators, no tactile paving etc., can pose a great problem for those who might have physical or visual disabilities (67).

Another important aspect of this model is the distinction it draws between impairment and disability (68). While impairment is individual and private, disability is seen as structural and public (69,70). Unlike the medical model, wherein medical professionals aim to seek a solution or cure for the impairment, the social model aims to accept the impairment but remove disability, which is seen as a culturally and historically specific phenomenon, not a universal and unchanging essence (71,72).

Provisions like ramps, step-free routes and lifts come from the social model of disability.

Inherently, this model offers a lot of power to change the perception of disabled individuals.(73)The person does not have to change; society does. Rather than feeling self-pity, the person can feel anger and pride in themselves (74,75). Also, by identifying social barriers to be removed, this model has been successful in the liberation of disabled people instrumentally (76). While this may seem like an ideal model, it is not free of limitations.(77) The first problem lies in the extent to which the model neglects impairment and often risks implying that impairment is not a problem at all when in reality, it can be. (78) Secondly, the concept of a barrier-free society can be possible only in some settings like urban cities (79). Barrier-free enclaves are definitely possible, but not a barrier-free world (80,81). How can an individual with motor issues who uses a wheelchair navigate through a rocky beach or an ancient structure?(82)Similarly, how can an individual with visual impairments fully enjoy sunsets or rainbows?(83) It is also important to keep in mind that accommodating people with physical and sensory disabilities is relatively easier (84). It is difficult to define what a barrier free society would look like for someone who, say, is neurodivergent or is having a mental health concern (85).

“Though I am disabled, I deserve the same rights as everyone.”- The Rights-based Model (86)

The rights-based model mainly focuses on the fact that everyone should have fundamental human rights, such as the right to equal opportunities & participation in society (87). As a result, society has to change, not only to remove barriers but to ensure that all people, including people with disabilities, have equal prospects for participation in society (88,89). Quite a lot of times, people with disabilities don't have access to certain basic rights, such as the right to education and employment, or right to healthcare (both physical and psychological) (90). Therefore, laws and policies promote non-discrimination and equal opportunities.(91) Here, the question is not about charity or humanity but basic rights that any human can claim, irrespective of their background (92). Laws and policies, such as the Rights of Persons with Disabilities Act, 2016, are based on this model of understanding disability (93,94).

The rights-based model talks about granting equal rights to every human being, including people with disabilities.

The rights-based model is similar to the social model, but these two models have six key differences (95).

1. The rights-based model takes into account how a person with disabilities is likely to face challenging life situations and argues that such factors should be taken into account if we are to develop relevant social justice theories, unlike the social model, which does not give much importance to individual impairment (96).

2. Second, while the social model provides an understanding of social factors that shape the concept of disability, the rights-based model additionally provides a framework on the basis of which affirmative action can be encouraged (97).

3. This model incorporates not only civil rights but also economic, social and cultural rights and thus is broader in scope (98).

4. Unlike the social model, the right based model recognises the importance of individual identity and also looks at the specific socio-cultural backgrounds of individuals with disabilities (99).

5. The rights-based model advocates for properly formulated policies that may or may not involve the prevention of impairment, while the social model is against it (100).

6. The social model offers an explanation of disability, while the rights-based model can offer solutions to improve the lives of people with disabilities (101).

“I am disabled, and therefore you need to protect me”- The Social Paternalistic model.

The paternalistic social model of disability is similar to the charity model, suggesting that people with disabilities are weak and in need of protection (102). As a consequence, it is the duty of the more “powerful” members of the society- non-disabled individuals- to take care of them and make decisions for their wellbeing (103). This model can be illustrated with an example of a person who does not invite a disabled individual to a party, assuming that they would feel uncomfortable (105). Here, the decision has been made on behalf of the person with disabilities without actually knowing their opinion (106).

People with disabilities are considered to be dependent on those who are not.

The crux of this model is the idea of “can’t do”. This is quite alarming because frequently being told that you “can’t do” certain things are likely to develop a mindset among people with disabilities that they are restricted and have to rely on others for everyday tasks (107). While this model is not intended to be harmful, invariably, it creates and encourages dependency and also limits opportunities for growth (108).

“I am disabled, and I can change the way people see me”- The Empowerment Model.

The empowerment model states that people with disabilities are responsible for changing how non-disabled individuals perceive disability (109). It puts major emphasis on the fact that people with disabilities must advocate for themselves, and it is not sufficient to just say that society must change its approach (110). They have to take matters into their own hands and change the perception that others have of them. This can happen only if they can prove they are not “helpless” individuals as others think (111). As per society, a person cannot be treated as non-dependent if they are dependent on someone. Nondependent, however, does not mean complete independence and not needing any assistance (112). All human beings need assistance and aid at different points in life, and it is unrealistic to assume that a person can live in isolation without being dependent on anyone (113). Rather, non-dependence means that, to the greatest extent possible, people with disabilities need to be the leader in identifying their needs and then instruct others in ways of helping them, to accomplish their needs and goals in life (114).

The empowerment model focuses on what people with disabilities can do by themselves.

Building strong self-esteem is one of the key factors in the empowerment model of disability (115).This does not mean to imply that all people with disabilities have a poor opinion of themselves (116). Because of the ways in which people with disabilities have been treated over the years, it can be expected that many individuals with disabilities have learned to be dependent on the ever-changing attitudes of those who are not disabled (117).

While this model offers a lot of agency to people with disabilities to change and direct their lives in their way, it fails to acknowledge the extent to which an individual also faces systematic oppression and discrimination (118). Individual effort can only be effective till a certain limit, after which it has to be addressed at a societal level (119).

So, which model of disability is the most ideal?

The answer to this question is not direct, because as mentioned above, each model has its own unique strengths and limitations, and each of the models may be suitable depending on the context (120). It also may vary from one individual to another. For instance, a person may be following the medical model and investing money to improve their life (121,122). Contrarily, another individual may not want to focus on the impairment, and would rather advocate for changes in social structures and policies. Would that mean that one is better than the other? Not really (123). It is important to understand that these models simply provide an opportunity for us to understand disability in different ways (124). Finally, what matters is how the individual who has that lived experience chooses to construct it (125). It is also important for their non-disabled counterparts to be open and respectful to their perspectives to create a more inclusive society (126).

True inclusivity is when we respect and appreciate people irrespective of their disabilities.

Photo Credits

1. Photo by CDC on Unsplash

2. Photo by Sonika Agarwal on Unsplash

3. Photo by Ilya Ignatiev on Unsplash

4. Photo by Natanael Melchor on Unsplash

5. Photo by Natanael Melchor on Unsplash

6. Photo by Amy Elting on Unsplash

7. Photo by Zhuo Cheng you on Unsplash

8. Photo by Audi Nissen on Unsplash

9. Photo by Nathan Anderson on Unsplash


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