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Sound Writing

Subsection 6.2.3 Language Toward Neurological and Physical Inclusivity

What is considered an illness or disability has changed throughout history and also varies between cultural contexts. Disability has also been stigmatized and wielded as a form of social control; a student member of the National Alliance on Mental Illness (NAMI) gave the examples of both drapetomania, an illness that white psychologists hypothesized as the cause for Black slaves to want to run away from enslavement in the 19th century, and hysteria, which was used as a form of social control for women. Today, both of these illnesses are considered pseudoscience and understood to be part of a long history of scientific racism, and sexism respectively.
Despite the progress that has been made, disabilities and illnesses continue to be stigmatized, and the way we write about them has the power to break down or perpetuate stereotypes that directly affect the lives of people with these conditions. Additionally, many terms carry historical baggage that we, as writers, aren’t always aware of; for instance, while in the early twentieth century people classified as “idiots” were subject to forced sterilization, we now use the word casually. By learning the history behind the words we use and choosing to write respectfully about people with mental and physical disabilities we help create a culture that rejects ableism.

Student Perspective 6.2.6. Cultural Context of Mental Health and Illness.

This is why I’m always saying research those cultural contexts, you know, because with mental illness and mental health, the way in which we talk about it is all a form of social control.
―Member of NAMI
University of Puget Sound
May 2018
Mental health and mental illness are frequently mistaken as synonyms; however, mental health refers to a person’s mental well-being—including their emotions, thoughts, feelings, and the ability to overcome challenging situations—while mental illnesses are disorders affecting the way one thinks, feels, behaves, or interacts with the world. Just as it is possible to have poor physical health (e.g. a broken arm) without having a physical illness, so too do many people experience poor mental health without having a mental illness. People may fall anywhere on the mental health and mental illness spectrums: for example, someone with a chronic mental illness such as OCD may have good mental health. Sometimes mental health concerns that go untreated can develop into mental illnesses, such as anxiety or depression. Additionally, where each of us falls on the health and illness spectrums is always changing, and we will all experience poor health at some point in our life.
In fact, one way of thinking about disability is that any time we spend able-bodied is really time spent “temporarily able-bodied” since we will all experience disability in our lifetimes. Despite the widespread incidence of disability, disabilities are stigmatized in many cultures, and people with disabilities are discriminated against in both overt ways (such as the eugenics movement) and covert ways (such as buildings that lack wheelchair access and/or Braille translations). A student member of NAMI described how mental illnesses are also sometimes regarded as less legitimate than physical illnesses because they are less visible, giving the example that people are more likely to consider it a sign of weakness to take medication for a mental illness than for a physical illness; just as you would not tell someone with diabetes that they should learn to stop depending on their insulin medication, so, too, would you not consider that someone with a mental illness should eventually grow out of taking their medication.

Student Perspective 6.2.7. Intersections of Mental Illness and Health.

Constantly considering the ways in which mental health and mental illness intersect with a lot of other identities is really important. They don’t exist in isolation from other people’s identities, They really intersect with your sexual orientation, your gender identity, your race, your socioeconomic background. . .you can’t really write about mental health and mental illness in isolation of all of those factors that are brought into it.
―Member of NAMI
University of Puget Sound
May 2018
As you write about mental and physical illnesses, be conscious of how they intersect with other aspects of identity. For example, as a member of the University of Puget Sound NAMI club points out, a woman with a mental illness is more likely to be written about as weak and emotional, while men with mental illness tend to be portrayed as violent and angry. These depictions perpetuate false stereotypes of both mental illness and gender. Additionally, the way physical and mental illnesses are conceptualized, diagnosed, and treated varies between different cultures, and factors such as immigration, racial discrimination, and expensive healthcare and medication make access to treatment inaccessible for many people. When writing about illnesses, health, and disability, avoid making broad generalizations, since people’s bodily experiences are dependent on a plethora of other aspects of their identities. Additionally, because of this diversity, the experience of a mental illness for one person is often not the same as for another, and a treatment that works for one person will not necessarily work for another. For more on the importance of writing with specificity, see Subsection 6.2.1 on intersectionality.
While it is impossible to foresee and prevent every knowledge gap, using people-first language can be a way to combat ableism by acknowledging the common humanity of all individuals rather than referring to certain individuals only by their disability or handicap. To learn more about whether to use people-first language, review Section 6.1. The use of ableist words and phrases remains common in both written and spoken communication. Check out the example below for a list of words to avoid as well as words that you can choose to use instead to write and think more equitably. Please consider these terms as an introduction to an ongoing conversation rather than a comprehensive guide, and continue to foster your awareness by continuing to learn and ask questions!

Example 6.2.8. Frequently used Ableist Phrases and Alternatives.

Here are a few common ableist words and phrases along with alternative ways that you can refer to people respectfully:
crazy, confined to a wheelchair, defective, dumb, feebleminded, handicapped, idiotic, insane, invalid, lame, lunatic, manic, mental, moron, retard, psycho, psychotic, schizo, short-bus, spaz, simpleton, stupid, special/special needs, unbalanced, unstable
neuroatypical/neurovariant/neurodivergent, with a/an (physical, mobility, intellectual, cognitive) disability, blind/low-vision, deaf/hard of hearing, uses a wheelchair/cane/walker/crutches, with a chronic health condition
List 6.2.9. Strategies for Writing with Neurological and Physical Inclusivity in Mind
  • Only refer to disabilities if they are relevant to what you’re writing.
    For example, referencing a wheelchair in a sentence like “A man in a wheelchair let me borrow his pen” is unnecessary and ableist. However, relevantly referencing disabilities can be important: “My friend, who uses a wheelchair, was late to class because of limited accessibility on campus.” (This rule is true for other minoritized identities as well.)
  • When writing about people with disabilities, it can be useful to put the person first.
    For example, by saying “a person with disabilities” rather than “a disabled person,” and “they are a person with schizophrenia” or “they have a diagnosis of schizophrenia” not “they are a schizophrenic.” While this is a good rule-of-thumb, it is not always appropriate. Read Section 6.1 to learn about the importance of listening to people’s preferences to make this decision.
  • Use “disabled” as an adjective, not as a noun.
    Just as you wouldn’t refer to transgender people as “transgenders,” so, too, would you not refer to people with disabilities as “the disabled.”
  • Know that a disability is a condition, whereas a handicap is a constraint.
    Someone can have a disability, such as congenital blindness, but someone cannot “have” a handicap—rather, their environment (lack of Braille on signs, for example) handicaps them.
  • Recognize that cultural identity can be connected with disability, but that they are not the same thing.
    For instance, one can be deaf (that is, have the physical condition of not being able to hear), and one can be part of the Deaf community (people who communicate in sign and who identify culturally as Deaf—including deaf people but also people who are close to deaf people, such as hearing children of deaf parents). Being deaf doesn’t necessarily mean being Deaf, and vice versa.
  • Do not use terms like “normal” or “healthy” when referring to people without disabilities.
    Some people also object to the phrase “able-bodied.” Instead, use the term “people without disabilities.”
  • Do not write about people with disabilities (or other marginalized people) in terms of overly heroic or tragic narratives, as this reinforces existing stereotypes and emphasizes the “otherness” of someone with a disability.
  • Use this same set of guidelines regardless of whether the disability in question is visible or invisible.
Please consider this section as a starting point rather than a comprehensive guide, and please continue to grow your awareness in your life and education outside this book! Look for courses in Disability Studies and educational resources offered by your school’s office of accessibility and accommodation