Building belonging: Practicing anti-ableism

hand with rainbow waves of light streaming across it. there is a blue gradient background. Photo by Sarah McCutcheon

There are so many different ways to practice Occupational Therapy. Some of us tighten screws on lateral supports of wheelchairs to position them so that a person can reach for their frying pan and dance with their partner. Some of us coach people in skill-development, self-advocacy, exposure therapy, and stress management so that people can do what they love. Whilst some of us work with businesses and city planners to increase accessibility and community participation. 

We span so many areas of practice, sometimes people get confused about what exactly it is that we do. We work with people so they can do what they need to access what they want and need to live well – such as belonging, survival, safety, their sense of purpose and meaning in life (Whalley Hammell, 2020; Moll et al., 2015). We’re advocates for accessibility and addressing social environmental factors like ableism – we profess that we believe that everyone has the right to participate and belong. So, one would think that it would be easy for us to see all the ways that disabled people can be Occupational Therapists and welcome disabled health professionals with open arms, addressing barriers to employment, promotion, professional development and networking participation within our profession. 

Well, maybe it’s because it is easier for us humans to see our issues in others than within ourselves: we have some work to do to build belonging in the health professions. Many disabled health professional students and clinician’s experience marginalisation and discrimination (Bulk et al., 2017). Since we’re biased to miss our own mistakes, we need to intentionally reflect on how ableism is present in our actions as a collective and as individuals.

In my history of life experiences, I have made mistakes and been ableist when:

  • Before reading Harriet McBryde Johnson’s book, “Accidents of Nature” and watching Stella Young’s Ted Talk, I used to find inspiration porn motivating and inspirational, and share inspiration porn videos with friends. 
  • I believed in the whole “discover limitless abilities” narrative, promoted it, and did not see the ways it can also harm
  • I held the door open to the men’s bathroom for a wheelchair user, thinking I was doing them a favour because it was heavy
  • Recently, I used a condescending tone in a Twitter private message when seeking a professional partnership – I reinforced my power in the conversation, failing to recognize the contributions of the person I was seeking a partnership with (because that makes sense, right?).

In my experience, I have witnessed ableism as:

  • mental illness stigma presented implicitly and explicitly in a textbook,
  • public discourses that health professionals are able-bodied, able-minded, super-humans who experience perfect health and swoop in to save people from their health woes,
  • conferences without seats for presenters, ASL-interpreters, captions, or ramps to the stage,
  • the fear of disclosure (when it is a choice) and potential repercussions in the work, volunteer, student spheres – in the application process and in belonging within the profession
  • financial barriers to university participation.

Part of the reason our actions can be ableist in our profession is because our society is built upon ableism. When we contribute to ableism unknowingly, it often isn’t with the intention of doing harm – however, our ableist actions still do harm, whether we intend to or not. Ableism is something that we subconsciously learn from a very young age – when we read fairytales, share stories, and watch films (see works by Amanda Leduc, Alice Wong, and A. H. Reaume for much more on ableism and disableism in media). It is something that permeates our media – from advertisements promising magic solutions to “make it all better” to “damaged” villains or the “gentle folk with disabilities”. This is not an excuse, nor a comprehensive list of the ways and reasons we express ableism; we need to see, learn, and understand something to address it and shift power.

Unless you’re dead, it is never too late to learn something new and change. Maya Angelou once said, “I did then what I knew how to do. Now that I know better, I do better.” Once you learn something exists, you can’t unsee it – and as you learn more you will see more so there is more potential to change. Even if you have done lots of ableist things in your past, there is still the opportunity to recognise this, learn, and make intentional choices to practice anti-ableism. As a collective, we can no longer pretend and ignore the calls for change and justice in access to being and belonging as a health professional and we must do better. We can recognize and acknowledge each other for who we are and co-create spaces where we all know that we belong, that other people want us here (Laura Bulk – DWYL Podcast episode 9).

In the Global North*, we are at different points in our learning journeys. In North America, we had our first AHA moment in September – where disabled health professionals and allies came together to strategise about how we can improve the numbers and opportunities for disabled people within the health professions. We meet every 1-2 months, everyone is welcome and they’re organised by UBC Inclusive Campus and NOTPD. In the States, COTAD* is organising IGNITE series 4, which is a call to action on disability inclusion in occupational therapy. As COVID-19 has opened up more international discussions, there are lots of opportunities for us to share knowledge and grow belonging within the health professions across the Global North**.

We are a profession that by-in-large exists to serve disabled people and believes in finding ways that people can do what they love. We need to address the ableism and inaccessibility that permeates our profession so that we can co-create a culture of belonging. When we broaden the diversity of our profession, we will access the strengths of our diversity and there will be benefits for all. The wheels are moving.

* COTAD has some great presentations and resources: they are a “group of individuals from across the United States all working towards a common goal of promoting diversity and inclusion within the occupational therapy workforce and increase the ability to occupational therapy practitioners to serve an increasingly diverse population.”

** largely “developed”, dominant nations in Europe, North America, Australia, and New Zealand. I cannot speak to the experiences in the Global South as I do not have experience there, and don’t want to assume that strategies that work in the Global North will apply in the Global South

Stay tuned for future blog posts related to Reflecting The Diversity of Humanity within the Health Professions. We would love for people to contribute your own perspectives on what possibilities could be there and what could happen if our professions better reflected the diversity of humanity (across disability, gender, race, sexuality, ethnicity, age, class, and more). We can currently only afford to accept volunteer submissions.

Recommended Readings:

To Disclose or Not Disclose by Georgia Vine: https://notsoterriblepalsy.com/2020/04/03/to-disclose-or-not-to-disclose/ 

Applying the PEOP model to placement as a disabled occupational therapy student- Georgia Vine: https://notsoterriblepalsy.com/2021/01/15/applying-the-peop-model-to-placement-as-a-disabled-occupational-therapy-student/

From Patient to Practitioner – Ryan McClure: https://www.lgpersonaldevelopment.co.uk/2020/08/28/from-patient-to-practitioner/

What do you do when your disability keeps you from writing: What I learned when I launched a brute force hack on my brain – A.H. Reaume http://open-book.ca/Columnists/What-Do-You-Do-When-Your-Disability-Keeps-You-from-Writing-What-I-Learned-When-I-Launched-a-Brute-Force-Hack-on-my-Brain

Disability Visibility: Stories from the 21st century – edited by Alice Wong – find it at your local bookstore or online – https://disabilityvisibilityproject.com/book/

Disfigured: On fairytales and making space. – Amanda Leduc https://amandaleduc.com/books/disfigured/

Alone in the Ring – https://rbtcollaborative.ubc.ca/news/featured-project/mar-8-2019-alone-ring

OTalk- Occupational Therapy and Ableism: https://otalk.co.uk/2020/08/11/otalk-18th-august-2020-occupational-therapy-and-ableism/

OTalk – Improving Disability Representation in OT (UK Focus): https://otalk.co.uk/2020/08/23/otalk-25th-august-2020-improving-disability-representation-in-ot-otalk-series-uk-focus/

AHA moments for North American Occupational Therapists and Physiotherapists with disabilities and allies – sign-up at https://tinyurl.com/AmCan-AHA

NOTPD – Network of Occupational Therapy Practitioners with Disabilities and Their Supporters – notpd.org

References

Bulk, L., Easterbrook, A., Roberts, E., Groening, M., Murphy, S., Lee,M., Ghanouni, P., & Jarus, T. (2017). “We are not anything alike”: Marginalization of health professionals with disabilities. Disability and Society, 32, 615-634.

Author: Anna Braunizer 

Twitter: @ABraunizer

Author Bio: Anna is a community-based occupational therapist practicing in Victoria, BC. She writes from the perspective of a European/Caucasian, immigrant cis-woman with lived experience with chronic pain in Canada.

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