Technorati href="http://www.technorProfile Thinking Nurse: Tregaskis - Constructions Of Disability - Book Review

Thinking Nurse

This blog will reflect my interests in learning disabilities, nursing, nursing theory, philosophy and politics and my general interests in the arts and literature. (Nursing is an art as well as a science!) Philosophy and nursing have been intrinsically linked since the days of Socrates, his mother was a midwife, and taught him everything he knew!

Wednesday, January 12, 2005

Tregaskis - Constructions Of Disability - Book Review

Claire Tregaskis - Constructions of Disability: Researching the Interface between Disabled and Non-Disabled People, Routledge 2004.

It is rare that I get so excited about a piece of research, but here is one that I found thought provoking, inspiring and challenging. It is an interesting and innovative book that I feel should be read particularly by learning disability nurses, other professionals who work with disabled people, and also by anyone interested in disability or sport and leisure.

I have previously pointed out the interstitial nature of nurses' work - occupying the 'grey areas' the places that no other profession seems to go. One of these interstitial loci, is at the interface between disabled and non-disabled people. When two (or more!) world views collide there is inevitably conflict, and stress and also the opportunity for creativity and synthesis, this book is the example of such creativity and synthesis.

Nurses and other professions interested in the issues that arise when confronting issues of 'integration', or 'community presence and participation' will find this book speaks directly to their questions.

Tregaskis has produced a brilliant piece of qualitative and experiential research. She spent months as a researcher and participant in a leisure centre, looking at ways that disabled and non-disabled people interacted, drawing enormously on her own personal experience and impressions. The beauty of qualitative research is that it addresses the worlds of feelings and human meanings as much as it does the world of hard fact. Tregaskis has lived in and described these worlds in a way that opens them up to the reader, a chance for horizons to meet and for knowledge and meaning to be exchanged.

Tregaskis explores the various identities she assumed, and had thrust upon her at the centre in a groundbreaking way. This use of multiple identities allows her to "reflect as fully as possible the complexity of my fieldwork identities and relationships" (p8) In one chapter (p121 - 127) she directly confronts her own role as an oppressor in certain contexts within the centre, with an impressive level of honesty and introspection that would be a good example for nurses in their own reflection on practice, nurses also finding themselves as agents and colluders in the interstitial spaces between oppressor and oppressed. In a situation where Freire would argue that to fail to take a stand alongside the powerless is to side with the powerful, nurses need to pay heed to Socrates' injunction to 'know thyself'.

Practitioners with an interest in Learning Disability will be particularly interested in the ways that people with learning disabilities were included, and excluded in the centre, particularly by the experience of people in segregated groups organised by professional carers, with the chilling "supposed need for surveillance of disabled people by disability service staff' (p115) that typified the participation of a number of centre users. Her writing on the experience of people with learning disabilities is a direct challenge to all practitioners in this field to look at how their practice impacts on the lives of the people we are meant to be 'empowering'.

While Tregaskis is strongly influenced by the Social Model, she has gone well beyond the 'simple binary oppositions' that cruder versions of this model advocate, she is interested in finding points of common interest between people with disabilities and non-disabled people, as a basis for forming 'alliances for change' (p91).

She explores the way sport, and her presence in the centre offered her "a time and space in which I could reclaim and celebrate my body" (p95) She explores the idea of 'the communicative body', the notion that "our bodies are a key emotional outlet through which we can begin to make connection between our experiences" (p100).

Tregaskis has a great deal of expertise through her experience as a countryside access officer, explaining that access is about far more than doors, ramps and toilets, and suggests a multiplicity of ways that sports centres, and other institutions can be made more accessible to people with disabilities, that should be studied by anyone who wants to accomplish more than token gestures toward accessibility and inclusion.

The book is also interesting for it's critique of Wolfensbergers' theories of 'normalisation' and 'social role valorisation', she challenges the implicit value judgement contained in Wolfensbergers' conservatism corollary that "disabled people should do all they can to fit in with the mainstream and avoid doing anything that would draw attention to their difference" (p98)

She also points out that although she, as a well-educated researcher, and the centre manager (a black man) both had very valued social roles, they still both experienced discrimination and oppression.

Her conclusion is that "true inclusion will only be achieved when as a society we begin to systematically build all social provision around the premise of the equal valuing of difference." She advocates that "we challenge the assumption that impairment automatically results in devalued social status. Instead we need to follow the lead of the disabled peoples' movement in encouraging more disabled people to acknowledge and celebrate their own difference from the norm." (p152)

One question for discussion arising from this book is whether we as Learning Disability Nurses can/should/do encourage our clients to 'acknowledge and celebrate their difference from the norm', and what are the consequences for us and our clients of taking such a position? This blog seems as good a place for such a discussion as any, so I invite readers, whether they are nurses, disabled people or simply interested parties to make their contribution to the discussion here.

I would be very interested in any comments on this issue, and hope that this excellent book launches a discussion which helps us all clarify our ideas and hone our practice.

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