Women With Visible and Invisible Disabilities: Multiple Intersections, Multiple Issues, Multiple Therapies, edited by M. E. Banks and E. Kaschak. New York: Haworth Press, 2003.
Co-published as a special issue of the journal Women & Therapy (26 (1/2), 2003), Women With Visible and Invisible Disabilities contains papers in which the authors address therapeutic issues experienced by women with disabilities. Written primarily by and for therapists and clinicians, the collection also includes several authors or co-authors who identify as women with disabilities. The editors focus on the intersections of gender, race, ethnicity, social class, and disability. Contributors explore a wide range of issues, including increased risk factors experienced by women with disabilities, health/ wellness, social relationships and roles, sexuality, spirituality, identity, and employment.
The authors aim to address the relative lack of awareness of and research on the experiences of women with disabilities, including women of color, among therapists and clinicians. As Kemp and her colleagues write, “Disability is not a standard part of clinical training in diversity” (p. 161). By using “case” studies, interviews, surveys, first-person accounts, and inventories, authors seek to fill in some of the gaps in professional understandings of disability, which over-emphasize medical or deficit model understandings. Themes that run throughout the text are focused on the importance of understanding disability as an integral aspect of identity, developing cultural competence related to disability, and understanding how disability intertwines with other aspects of identity.
Particular contributors stress the need for clinicians to be conscious of ways that they may have internalized societal misperceptions or stereotypes about disability. Williams and Upadhyay, for example, discuss the importance of not invalidating a client's experiences, particularly those with less obvious disabilities. Nabors and Pettee also discuss the importance of “not assuming that a woman that has a disability is seeking treatment because of her disability” (p. 334, italics added). Many of the women interviewed share experiences of being patronized or pitied by therapists, who may lack professional or personal experience with disability. These insider perspectives prove to be the most valuable aspect of the text, which would be strengthened by a more sustained attention to the voices of women with disabilities themselves.
Despite the “dearth of research …on minority women's experience of health, illness and disability (Feldman & Tegart, p. 128), Women With Visible and Invisible Disabilities includes multiple chapters that are focused on the experiences of women with disabilities who are from racial minority groups (Nabors & Pettee; Yee, Nguyen, & Ha), including those living with HIV/AIDS (Feist-Price & Wright), arthritis (Feldman & Tegart), substance abuse (Beatty), and eating disorders (Bagley, Character, & Shelton). Several authors suggest the need for more relevant models for thinking about disability among minority communities, including collectivist models informed by black feminist theory (Feldman & Tesant) and womanist or feminist informed approaches to therapy (Nabors & Pettee). In their call for an alternative model, these authors critique both the medical and social model approaches for failing to capture the experiences and perspectives of women of color who have disabilities.
The authors of this special issue break a lot of new ground. Individual chapters in the text focus on the experiences of women who have sustained head injuries as a result of interpersonal violence (Ackerman & Banks), on the “invisible” harm caused by prostitution (Farley), the sexual rights of women with cognitive and other disabilities (Mona & Dotson; Stinson & Christian), and the particular difficulties of women with disabilities who wish to leave their partners (Olkin). Despite the way these and other chapters offer important insights into the range of perspectives and experiences of women with disabilities, many chapters in this collection fail to dislodge normative assumptions about disability being an individual pathology requiring a therapeutic treatment.
Although Poolin and Gouliquer, for example, attend to the historical and cultural construction of premenstrual syndrome (PMS), hysteria, and madness, too often authors in this collection portray the difficulties experienced by women with disabilities as solely a function of their impairment. In other words, women are left to “cope” with societal structures or attitudinal barriers they experience in their day-to-day lives rather than to critique, disrupt, or change them. Thus, although Banks and Kaschak set out to examine the social construction of disability, because of the therapeutic focus of the text, they often slip into more medical and individual approaches.
A strength of the collection lies in the attention given to the intersectional nature of disability with issues of gender, race, sexuality, and social class. It also includes a number of chapters authored or co-authored by women with disabilities, and one chapter is focused on the need for reasonable accommodations for students who are in clinical programs, internships, and practicums (Kemp, Chen, Erickson, & Friesen). Although the text touches on a wide range of visible and invisible disabilities, many of which are ignored in similar texts and anthologies, the editors did not include any chapters focused on women with developmental disabilities. Also, chapters are short and written in a very accessible style. Thus, although the text is an important contribution to our understanding of some of the clinical issues related to disability and gender, the authors aim to fill a range of gaps in clinician understandings and understandably focus more on breadth than on depth. Certainly, any one of the issues in the book warrants further study, but Banks and Kaschak have done a good job in opening the discussion.