The tough part about working with those are Intellectually Disabled is abiding by their natural, human rights. The problem isn’t so much observing these, but it’s understanding what they want in the first place.
In a previous post I wrote about the challenges of working with a non-verbal, intellectually-disable client.
In Australia, the rights of all disable people are protected; this has come about because there have been many cases of horrid and systematic abuses to the most vulnerable sections of the community — those who have not had the capacity to speak up. Even children have the ability to tell someone about abuse they may experience and tell others who is doing it.
There is funding available to disabled people to access services like Occupational Therapists, Behavioural Psychologists, Speech Therapists, and so on; there is even funding to pay for Disability Support Workers (DSW) to help them build capacity and live as independently as possible.
Living with dignity involves being able to choose the path of your own life. I see it with my disable clients all the time that they are being ‘asked’ to do something or participate in an activity because their parents/guardians want them to, or because a professional has suggested it to “build capacity to have an enriched, fulfilling life”.
It’s really obvious to me that my client doesn’t want to do something I’ve been directed to take him to. He shuts down, stops engaging with me, and his behaviour becomes quite challenging and unmanageable.
The problem is, he can’t communicate to me what he does want to do; because he hasn’t learned to communicate for 29 years, trying to understand what he wants is near impossible.
Like today for example. He was able to indicate NO when I suggested his usual Monday morning activity. Awesome!
The problem was that’s where the communication ended. I put forward some other suggestions, and got neither YES or NO. So what do I do?
I want his consent to assist him so he can enjoy his day. Maybe he just wants to stay home and chill... I don’t know however, as he seems to be unable to be clear.
It got me thinking about the whole issue of consent. It’s been a hot topic for a couple of years, as we come to understand that a lack of consent either way may not actually be consent. This has been what has fuelled the #metoo movement.
I’ve seen the issue of consent as a minefield in the medical/health industry. Some medical professionals use fear (usually of pain or death) as a way to gain consent to procedures or treatments that the patient is not 100% sure about.
I was involved in some education around consent issues in the local Tantra/Conscious Sexuality a few years back (now there is a field where there are huge issues) and the thing we used to teach was that:
Yes = Yes
No = No
Not sure/undecided/maybe = No
You’d be surprised how many Tantra teachers, gurus, and ‘sexuality practitioners’ get that horribly wrong!
The issue I’ve noticed in both the medical and sexuality fields is the notion of manufactured consent. Noam Chomsky has co-written an excellent book on it.
The idea is simply that you create a frame around what you want people to consent to by constructing a narrative where the alternative appears so undesirable that there really is no other choice.
Imagine a doctor saying to you, “take this drug or you’re going to die!” What would you do? Or worse, the threat was made on your children....!! This is how the vaccination debate has deteriorated, with both sides using such methods to push parents into consenting with their views.
Manufactured consent is everywhere. It’s the way salespeople ‘convince’ you to buy their product/service. Persuasion techniques using methods of Ericksonian Hypnosis and NLP are regularly taught to salespeople, life coaches, business executives, Public Relations seminars, and utilised by politicians, mass media, and corporate spin doctors.
Coming back to the problem with my client, I consider whether my suggestions to him are to benefit him, or me.
While I don’t him to be out in the community feeling anxious, the reality is I also don’t want to be in that position. But I have the capacity to manage my own emotional states well enough to remain grounded and calm in a situation when my client is unable to.
I do have to think preventatively, and consider what we can do that is going to be “enriching and fulfilling” but is not going to add to his inability to deal with even the simplest of life’s normal challenges.
I can’t pretend to know what’s going on in his head; but at least I can try my best.
Photo courtesy of Philipp Wüthrich on Unsplash
