«Reeve, D. (2002) 'Oppression within the counselling room', Counselling and Psychotherapy Research 2(1): 11-19. This is the corrected version ...»
Disabled people learn about the social model of disability from other disabled people and I do not see that disability counselling should be exempt from this process. On a warning note, it will be important to keep the line drawn between education and evangelising and to appreciate that not all disabled people will want to see disability from a social model perspective. Whilst it is a fact that not all people with impairments consider themselves disabled (Shakespeare, 1996), I still feel that counselling offered from a position of the social model is preferable to ignoring the reality of oppression inside and outside the counselling room.
Disability counsellors need to be aware of the disabling consequences of prejudice and discrimination together with the ways in which these are maintained by cultural representations of disability (Shakespeare and Watson, 1997) - a failure to recognise this could result in the client being blamed for not ‘getting better’. Internalised oppression must be recognised and its effects on the development of identity acknowledged (described in more detail by Corker, 1996). One example of the effect of internalised oppression, in a similar manner to internalised racism (Rose, 1997), is the feeling of hatred by a disabled client towards their disabled counsellor - this transference coming from the disowned ‘disabled part’ of the client being projected onto the disabled counsellor. Like transcultural counsellors, disability counsellors would have awareness of their attitudes, together with information and knowledge about the disabling society, in addition to counselling skills (Lago and Thompson, 1996). I would also expect that training for this counselling approach would require a large emphasis on self-awareness work on the part of the counsellor to help uncover Donna Reeve Oppression within the counselling room 9 attitudes and beliefs about disabled people which have been instilled in counsellors since the first fairy stories of childhood.
Disability counselling could develop links with a ‘psychology of disability’ (Finkeistein and French, 1993) because disability counselling would enable disabled people to deal with their relationship between the experience of individual impairment and the experience of a disabling society (Lenny, 1993). Thomas (1999) introduces the concept of a psycho-emotional dimension of disability that originates from within oppressive social relationships. This concept has meaning for disability counselling in which the oppressive nature of the counsellor–client relationship is being considered.
Finally, disability counselling might also overlap with the ‘social model of impairment’ which places importance on the subjective experience of impairment (Crow, 1996).
Therefore, I would expect that areas of Disability Studies would play an important part in creating a counselling approach which is empowering for disabled people.
Disability counselling must not be seen as a way of recruiting new members for the disabled people’s movement, but it does have its part to play in enabling disabled people to develop a positive sense of identity. Shakespeare (1996) describes how disability identity is composed of three aspects - political, cultural and personal. Part of the process of developing a personal disability identity is that of ‘coming out’, replacing a negative self-identification with impairment (medical model) with a posistart page 17] tive self-identification with disability as social exclusion (social model). Whilst this can be achieved through the process of self-organisation which is a collective context, it can also occur through individual personal awakening. I believe that disability counselling can offer a way of facilitating this individual process of positive selfidentification, and as a result empower the disabled client by ‘opening up the possibility of changing one’s world’ (Shakespeare, 1996: 103).
Whilst I am advocating a new counselling approach for disabled people, I am aware of potential problems this would cause. Do we really want (or need) another way of differentiating between disabled and non-disabled people? Apart from the fact that many people with impairments do not identify as disabled, disabled people are not a homogenous group because of the huge diversity of impairment and experience.
Disabled people, like all other people, are multifaceted - gender, class, race, sexuality, etc., also define identity (Shakespeare, 1996) - and it may not make sense to offer counselling which only recognises the disabled facet of a person. Over recent years there have been moves within the counselling world to develop counselling approaches that view counselling as a social, rather than psychological process. As a result these approaches have moved towards seeing people as unique individuals, rather than labelled according to issues such as race or gender. I now want to consider briefly if these emerging approaches have the potential to provide an alternative solution to that offered by a separate disability counselling approach.
Including Disability Within New Social Approaches to Counselling The existence of many counselling approaches for different groups of people is an indicator of the difficulty of providing counselling in a manner which is genuinely empowering for all clients (McLeod, 1998). New approaches that see counselling as a social and political act aim to achieve anti-oppressive practices, and place emancipation and empowerment as the counselling goals. The ‘user-friendly’ approach is a set of principles for good practice which openly addresses issues such as the counsellor-client power imbalance, as well as challenging much of contemporary counsellor practice (McLeod, 1998). For the first time ever in a Donna Reeve Oppression within the counselling room 10 counselling text book, I found disability included within one of the principles of a ‘general’ counselling approach; this principle of the ‘user-friendly’ approach
4. Understands that users cannot be treated as though they were identical.
Class, gender, sexual orientation, power, age, disability, ethnic origin, religion and socio-cultural background are some of the more obvious differences which need to be taken into consideration if successful therapy is to be undertaken. (McLeod, 1998: 259).
Therefore, I believe that these newer counselling approaches potentially have much to offer disabled people, as well as other oppressed and disadvantaged groups within society. Drawing much from transcultural counselling there is significant emphasis on counsellors being trained in areas which recognise the totality of human experience political, social and historical contexts, in addition to the psychological aspects. As a result I would expect counsellors using these principles when working with disabled people to have an understanding of the historical, material and cultural contributions which have created the condition of disability, and the ways in which this form of social oppression is maintained within our society. These social counselling approaches encourage the counsellor to treat the client as a unique human being, free from labels such as female, gay or disabled.
Whilst these social approaches to counselling are evolving I think that it is vitally important for disability, as socially created oppression, rather than individual tragedy, to be represented and included from the outset. In that way, these new counselling approaches are more likely to meet the needs of disabled people, rather than leaving it to other professionals to make assumptions on our behalf. There are very few counselling agencies who are adopting these innovative ways of counselling (McLeod, 1998), and these approaches are relatively new and untested. However, I would hope that the recognition of the dangers of oppression in a counselling relationship together with an emphasis on the social and political reality of all clients, disabled or not, offers a productive way forward for counselling generally.
It is not clear to me at this time whether disabled people will be best served by another monolithic counselling approach addressing the specific concerns of disabled people, or by one of the new emerging social approaches to counselling with their holistic view of clients as human beings. However, I do believe that the issue of disability as social oppression does need to be represented within counselling theories, now and not later. Otherwise, oppression within the counselling room will often continue, preventing disabled people from gaining benefit from counselling in the same way that non-disabled people do.
Conclusions It has been recognised that disabled people need access to a counselling service which meets their perceived needs (Oliver, 1995). I have looked at the nature of the counsellor–client relationship to examine whether the counselling which disabled [start page 18] people receive is an empowering or oppressive experience. Counsellors, like the rest of society, are repeatedly bombarded by negative images and stereotypes of disabled people. Although counsellors readily acknowledge the importance of race and gender issues within the counselling room, I believe that the absence of DET from counselling courses together with the relatively small numbers of disabled people going through counsellor training, means that counsellors have little opportunity to look at their own unresolved prejudices and negative attitudes about disabled people. As a result, some counsellors can further oppress their disabled Donna Reeve Oppression within the counselling room 11 clients within the counselling room and counselling fails to be an empowering experience for the disabled client. DET is urgently needed for all counsellors; I would also like to see more disabled people becoming counsellors, and then on to become supervisors and tutors, challenging the system from the inside.
Whilst Lenny (1993) advocates the use of the person-centred approach for counselling disabled people I have argued that I do not think that this approach, even with DET, goes far enough in helping disabled people develop self-empowerment and a positive sense of identity. I believe that counsellors working with disabled people need to use a counselling approach that recognises the risk of oppression within the counselling relationship and therefore works to remove it. I have suggested two possible directions that could be taken to develop this approach. The first idea builds firmly on the principles of transcultural counselling which has oppression at its root, and suggests the creation of a new counselling approach - disability counselling
- which has the social model of disability as a cornerstone. Counsellors working from this perspective would recognise the social constructions of disability. They could empower disabled clients by helping them move away from self-blame for being excluded and to develop a positive sense of identity by challenging their internalised oppression. Finally, I have considered some of the new counselling approaches which operate on a social and political level, rather than a psychological level, such as the ‘user-friendly’ approach. Using one of these newer approaches counsellors working with disabled clients would appreciate the political, social and historical context of what it means to be disabled and would be better able to help the client achieve the counselling goals of emancipation and empowerment.
© Donna Reeve Editor’s note This paper was originally published in Disability and Society (2000),15 (4): 669-82, and is reproduced with kind permission of that journal. It is reprinted REFERENCES
d’Ardenne, P and Mahtani, A (1989) Transcultural Counselling in Action. London:
BAC (1996) Recognition of Counsellor Training Courses. Rugby: British Association for Counselling.
BAC (1998) Invitation to Membership. Rugby: British Association for Counselling.
Barnes, C (1991) Disabled People in Britain and Discrimination: A Case for AntiDiscrimination Legislation. London: Hurst and Co. and BCODP.
Begum, N (1996) General practitioners’ role in shaping disabled women’s lives. In
Barnes, C and Mercer, G (eds) Exploring the Divide: Illness and Disability. Leeds:
Brearley, G and Birchley, P (1994) Counselling in Disability and Illness. London:
Bury, M (1997) Health and Illness in a Changing Society. London: Routledge.
Chaplin, J (1988) Feminist Counselling in Action. London: Sage.
Corker, M (1995) Counselling - The Deaf Challenge. London: Jessica Kingsley.
Corker, M (1996) Deaf Transitions: Images and Origins of Deaf Families, Deaf Communities and Deaf Identities. London: Jessica Kingsley.
Corker, M (1998) Deaf and Disabled, or Deafness Disabled?. Buckingham: Open University Press.
Crow, L (1996) Including all of our lives: renewing the social model of disability. In
Morris, J (ed) Encounters With Strangers: Feminism and Disability. London:
Donna Reeve Oppression within the counselling room 12 DN (1999) Caught by the act. Disability Now, April, 10.
Finkelstein, V and French, S (1993) Towards a psychology of disability. In Swain, J, Finkelstein, V, French, F and Oliver, M (eds) Disabling Barriers - Enabling Environments. London: Sage and Open University Press.
French, S (1994) The disabled role. In S French (ed) On Equal Terms: Working with Disabled People. Oxford: Butterman-Heinemann.
Keith, L (1996) Encounters with strangers: the public’s responses to disabled women
and how this affects our sense of self. In Morris, J (ed) Encounters With Strangers:
Feminism and Disability. London: Women’s Press.
Lago, C and Thompson, J (1996) Race, Culture and Counselling. Buckingham: Open University Press.
Lenny, J (1993) Do disabled people need counselling?. In Swain, J, Finkelstein, V,
French, S and Oliver, M (eds) Disabling Barriers - Enabling Environments. London:
Sage and Open University Press.
Lewis, J (1999) A case for specialist counselling. PRG News & Views (BAC), 8: 13start page 19] Lonsdale, S (1990) Women and Disability: The Experience of Physical Disability Among Women. Basingstoke: Macmillan.
Masson, J (1992) Against Therapy. London: HarperCollins.
Mckenzie, A (1992) Counselling for people disabled through injury. In Social Care Research Findings, No. 19. York: Joseph Rowntree Foundation.