In this article, the authors relate the life of Chris through narrative snapshots. Chris asked the authors to tell her story. They decided that it could be used to provide an insight into the different ways people with labels are confronted with professional practices and rituals.
Although Chris lived a “tough life,” her story is full of resilience and resistance. Chris will be kept in the authors' memory as a strong woman, a teacher, and a friend.
This story is written on the basis of a partnership between a woman who collected a lot of labels in her life and the first author of the article, Geert Van Hove. Chris took a lot of roles during her life: some of them were directly connected with labeling processes:
Child with “mental retardation,”
Child placed in a residential facility,
Young women with “mild mental retardation,”
Young wife of an older partner,
Mother of two kids,
Mother from whom childcare took away the kids,
Inmate in a psychiatric institution,
Client of a service of supported living, living in a small-group residence (four people),
Client of a service of supported living, living in a social apartment on her own,
Woman with physical impairment,
Resident of a home for the elderly.
In this article we juxtapose Geert's interpretations of Chris's story, based on his 18-year journey with her, against what the literature has to say about the lives of people with a disability. The other authors can be seen as the metaphor of a “Greek choir”: While writing this article—a process that took some years—Geert talked a lot about his plan to “tell the story” and all the doubts he had about doing so. Chris helped him build her story by giving him pictures and cards with notes. He brought the story into the courses of his coauthors; others helped him with the analysis and theoretical backgrounds. In particular, we focus on Chris as a woman and mother who struggles to maintain an intact sense of herself as a person with rights and responsibilities.
Recent attention given to the needs and wants of women with an intellectual disability and the inspiring books of Atkinson (2000), Priestley (2001), and Traustadottir and Johnson (2000) give us the support we need to start with a written report of this “journey.”
In 1986, when Geert met Chris, he was working as the coordinator of the service that offered support to her. The psychiatric hospital where she lived deinstitutionalized her to live on her own with the help of a supported living service. At that time she lived with the label mild intellectual disability combined with mental health problems.
Over the years, from 1986 until she passed away in 2004, Geert and Chris developed a close relationship. They learned to look beyond the labels applied to Chris. This was happening while they became partners in a mutual process of attempting to understand Chris's life story.
This article is written on the explicit request of Chris. “Tell my story” was one of her beloved sayings. A few months before she passed away, Chris expressed her commitment to telling her story:
Perhaps professionals giving support to young women who bear the label of intellectual disability can learn something from my story. If I had had good counsellors as a young woman, I might not have had to suffer the way I did. Because you know, Geert, if you go with the wrong men as a young woman, if they take your children away as a mother, if they lock you up in a psychiatric institution as a human being. … You go through hell without good support.
Patchwork of Key Incidents
“You study what is happening to others by understanding what is going on in yourself” (Frank 2000, p. 14).
The process of interpretation that Frank (2000) discusses can only be organized within the historical context of Geert's own life. In the life of Chris, Geert could discover a lot of parallels with his own life. Years ago, his grandmother was forced into a psychiatric institution with what we now label as postnatal depression. As a result of this, her children were taken away. After years she was released from the institution to pick up her life again. For Geert, telling Chris's story is a kind of “revenge” in line with the inheritance of his grandmother. Chris and Geert needed time to learn to know and trust each other. In their individual stories and mutual story, from a certain moment on, the power balance was reshaped in such a way that real dialogue and dialectics (read: role reversals) became possible (Peters, 2005). In such a new and uncertain construction of positions it was necessary to become hypersensitive to make sure that diversity and difference were understood without bringing them to alienation. We tried to respect differences without losing track of the world of women, mothers, and grandmothers. This kind of reflexivity was made easy because elements of life history as a biographical method (working with retrospective accounts) were combined with contemporaneous accounts based on participant observation and day-by-day contacts. Chris kept control of the whole process (Van Hove, 1999) because Geert and Chris met or phoned each other often to discuss the things they tried to find out and understand.
Table 1 represents the evolution of Geert's understanding of Chris vis-à-vis her life after deinstitutionalization, from 1986 onward, during which the two individuals learned from one another. During their time together, Chris and Geert interacted with more than 400 phone calls and more than 200 face-to-face visits.
Geert and Chris worked on a lot of research material together; for example, they coauthored a book chapter in Atkinson (2000) in which they used photos as the basic elements to build stories. They also produced a video about Chris and presented it at a conference about supported living within the Flemish speaking part of Belgium.
From the material gathered by Chris and Geert, we extract here key incidents (Emerson, 2004). Such incidents have to be seen as narrative snapshots, rich descriptions of things that happened in Chris's and Geert's lives. Bulmer (cited in Emerson, 2004, p. 458) calls working with key incidents retroduction. Retroduction refers to the process of moving back and forth between the stories and the theoretical concepts as used in disability studies in education. We are using key incidents because they are relevant to an emerging theoretical framework, and we will modify theoretical positions to fit our stories. In that sense, the narrative snapshots or key incidents have to be seen as more than just observations or events. We see them as “gifts,” at least to the extent they make it possible to converse about previously silenced topics and prepare us to deal more humanely with the diversity of human experiences (Ellis & Bochner, 1996, p. 25).
Reintroduction: Moving Back and Forth Between Narrative Snapshots, Geert's Interpretations, and Theoretical Viewpoints
In this section, we will triangulate narrative snapshots, personal interpretations, and theoretical viewpoints.
First Description of Chris's Situation: What Did the Files Say?
Chris was described in the files as “having mental retardation” and “a hysterical personality structure.” Starting from this point of view, we found in her medical files the different decisions that were made for Chris:
As a child with a label Chris was sent to special schools and institutions.
She received medication to treat her mental health problems.
Chris was not allowed to get psychotherapy because she was described as “not fluent enough in verbal contacts due to her ‘mental retardation’” (a prerequisite to receive psychotherapy).
She was put on a waiting list to get support from a project for supported living for people with intellectual disability.
Geert met Chris in a psychiatric ward that was used to treat women with “mental retardation” and mental health problems.
As a young, inexperienced support worker, Geert was impressed by her files—which he got to know in the first steps of an intake procedure. So, before he met Chris in person, her “reputation” was already nailed down. Geert was completely surprised when he met Chris for the first time: She looked like a friendly Flemish mother of a family. She asked questions about his life in parallel with the questions he asked her (e.g., Do you have children already? Are your parents still alive? In what kind of house do you live?). It has to be said that Geert was confused by the way Chris met him, because it did not correspond with her given reputation.
Chris and her situation were determined, medicalized, individualized, hystericized and eventually fixated (Allan, 1999, p. 57).
In this sense, Chris was othered, discriminated against, and put in a dependent position. An analysis of this snapshot results in a view that seems to state that Chris was forced to fulfill the roles that are related to the labels that were imposed on her. Following Bogdan and Taylor (1994), labels such as intellectual disability are seriously misleading. The term's scientific aura is deceptive in that it conceals subjective moral and cultural value judgments (p. 67).
Roles as a Practical Path Toward Talking about the Complexity of Chris's Identity
Once Chris was released from the psychiatric hospital, Chris and Geert discovered (together), through the richness of their meetings, the kind of caricatural image that care providers were making up about Chris.
At the start of his collaboration with Chris, Geert and his colleagues within the service of supported living initially confirmed the caricatures. They “allowed” her, after her release from the psychiatric center, to live in a halfway house with three other women (people she did not choose). The dominating view seemed to be that of the philosophy of the halfway house's support team: “Women of middle age with a cognitive impairment are better off living with a number of peers in a small group home situated in a central location in a quiet village with the required social control. … There, they find a perfect balance between participating in the controllable community on the one hand and the quiet atmosphere of that community on the other.”
Roberts and Donahue (1994) propose that by fulfilling different roles people represent a varied image of themselves. Looking at the various roles Chris played or was forced into is revealing. By continuously referring to the other roles she had already fulfilled in her life (and still wanted to fulfill), Chris claimed for herself different positions.
The position of a woman with sexual needs
After a period of residing in a psychiatric hospital, Chris started to live in a house with three other ladies. There, she tried to fight the caricature of being an “asexual human being.” She was very open about her sexuality as a single person. During a certain period she managed to get “sex books” to make sure that her fantasy was stimulated.
The team of professionals seemed more embarrassed to work with this topic than Chris was. Geert never learned in his training about the “normal” sexual desires of people with disabilities. Within the field of special education during that time, the focuses were more on sexual abuse and setting up programs to educate youngsters in an attempt to prevent aberrant behavior.
The position of mother of two daughters
Chris's two daughters were taken away from her by the child welfare services. She describes herself as “a mother with a lot of stories about her struggle to keep her daughters with her.” In the moments when she speaks of this, she literally says that if she, in the past, had had the support that is available now through services of supported living and its structural agreement with regular child care, it would have been possible to have her daughters with her and to keep on living as a united family.
Geert learned to listen to this part of the story from the perspective of being a father. Being a parent was a topic he discussed with Chris. Talking about dreams parents have for their children and about the despair parents can feel if something is wrong with their children offered opportunities to built bridges to each other's lives.
The position of a grandmother
One day Geert's colleague from the United Kingdom, who was preparing a book about women with a label of learning disabilities, phoned and asked Geert if he knew women within their 50s who would be willing to share their story for her book. One of the persons Geert considered was Chris. She immediately agreed to participate but only on one condition: She wanted to position herself as a grandmother: “I don't think they will find a lot of women who were living in institutions and were dealing with care givers who can talk about how it is to be a grandmother. … [T]his is my chapter in the book.”
The fact that Chris took the role of being a grandmother brought Geert back to the story of his own grandmother who did not receive (years ago) the necessary support to keep her family together, and another bridge was built.
The position of a partner in discussions
Chris prepared a lot of her meetings with friends and professional support givers beforehand by writing out on paper what she wanted to discuss. When someone was expected to visit her, she took some time to think over the topics she wanted to discuss. On other occasions she wrote letters to people just before they visited her to ensure that her topics would be covered. Those letters or cards sometimes gave a mixed sense: on one hand, they helped Chris to clarify what she wanted to get into in the discussion; on the other hand, the people who received the cards saw them as a present. Being one of the people who got cards and letters from Chris, Geert learned the ins and outs of building a dialogue with someone with a label.
It was not until later that Geert and his colleagues understood Chris's reactions to be statements of “resistance” and “resilience” (Goodley, 2000; Roets & Goedgeluck, 2007). It is clear that the different roles imposed on Chris—as a woman aware of her sexual needs, as a mother of two daughters, as a grandmother, and as a discussion partner who is well prepared—are in direct contradiction with the image of “person with a disability” or “hysterical patient” created by social, economic, and political contexts (Traustadottir & Johnson, 2000, p. 17).
Despite the fact that she fulfilled her role as a group member many times after her stay at the psychiatric center and during her stay at the halfway house, Chris started to question or reject those fixated images. Foucault (quoted in Allan, 1999, p. 46) introduced these acts of resistance as “technologies of the self.” Chris fluidly negotiated and mediated her identity by alternating between a “disabled” identity given to her by professionals of the care system and the other roles she wanted or had to fulfill. Sometimes those acts looked like a kind of resistance (Goodley, 2000, p. 176)—for instance, her challenging request for sex books. Sometimes her acts created “an unstable space where limits are forced” (Foucault, quoted in Allan, p. 48), as when Chris played the role of a mother with a disability whose children had been taken away or the role of a grandmother in a book on women with intellectual disability. Sometimes she strategically blurred boundaries from the inside-out (Braidotti, 2004, perceives this as mimesis) without destroying bridges with the staff members. In other words, she continued to play the role of woman receiving support (with regular counseling moments), while at the same time she determined the agenda of those moments via her written preparations.
As a result of the processes described above, Chris was able to leave the halfway house organized by the service of supported living much sooner than “the programme” prescribed. In the process designed by the professionals, “clients” should stay at the halfway house for 18 months. Chris left the house after 7 months. She moved to her own flat with ambulant support.
Chris and Her Body
The fact that Chris was described, in the files, as having a hysterical personality structure prevented a “virgin start” for the first meetings with Geert and his colleagues. What to do about Chris's never-ending back problems, her difficulties walking on some days, her questions to be allowed to see a doctor?
In this way, Chris's body became part of a power game—between Chris, on the one hand, and the team of the halfway house (including Geert), on the other—in which many messages concerning her body were interpreted. For example, as taken from an old-fashioned special education perspective (see Skrtic, 1991), complaints of physical pain from individuals with a disability were often questioned with the following:
“impossible to establish objectively”
“being used here as a means to get extra attention?”
“being used here to escape a number of household tasks that she is required to do in the half-way-house in order to train or acquire skills?”
We live in a period in which the body is idealized and objectified to a high degree. Implied in any idealization of the body is the rejection of some kinds of bodies or some aspects of bodily life (Wendell, 1996, p. 85). In such ways the social welfare system inflicted guilt and stigma around Chris, her body, and her experience of pain and suffering (Wendell, 1996, p. 105).
Physical suffering was only one of the means whereby the social welfare system objectified Chris on a physical level. Chris felt humiliated when she had to wear second-hand clothes. Her social situation as a divorced woman on welfare was strongly determined by the financial space in which she was allowed, for instance, to buy clothes. As a result, she regularly accepted the offers of second-hand clothes from people in the neighborhood. Many times, it was clear that despite Chris's initial gratitude and happiness, she also felt humiliation: For example, she said to Geert during a walk around the market, “Do you think it's fun never to be able to buy the clothes I like?”
Being with her on that market square, Geert for the first time became personally involved in the intersection of social class (read: poverty) and impairment. This is an example of the total interwovenness of the social model of disability and more personal experiences and identity. On one hand, the social model analysis shows that people with a label of mild intellectual disability often face parallel problems (here, more specifically, the budget problems) with people who are labeled as socially deprived or poor (Booth and Booth, 1998; Emerson Graham, & Hatton, 2006).
At the microlevel, on the other hand, Chris can be seen as a woman with a lot of subjective contributions who rediscovers her womanhood and also wants to manifest this by taking care of the way she looks. This is reminiscent of Susan Gabel's description of her experiences with mental illness: “When I conceptualize my experiences with depression as body experiences, … I'm using my body as a site of my imagination, as a means of constructing images of myself” (Gabel, 1999, p. 41).
Chris, in one of the many discussions on how bad she felt about “looking like a patient,” showed that she intuitively understood the centrality of the body to the social experience of disability when she said the following, “I don't want to look like a patient of the Psychiatric Centre anymore. I want to have my hair done, buy clothes. … You never know, Geert, I might find a man yet.”
Going back to the story of his grandmother, Geert knew that she found another man after being released from the institution; they lived happily as a couple for more than 30 years.
From Stigma to Opportunities
Consistent with Chris's resilient nature, she often turned stigma into an opportunity, as in the next snapshot. However strange it may sound, Chris's physical complaints also allowed her to meet new people who were important to her. For instance, she developed a special relationship with her general practitioner (GP)—whom she described as “the first doctor who really believes me.” The doctor took Chris's complaints seriously, finally establishing that she had an extreme form of osteoporosis. This was such a revelation to Chris that she started to see her GP as a friend. She was very proud that she was allowed to call him by his first name when they were alone. The doctor took his position as a confidant very seriously and expressed this, for example, by bringing Chris books on a regular basis, knowing that she liked to read.
Geert received a lot of phone calls from the GP in the beginning. However, by diverting the doctor to a real dialogue with Chris, he managed to create a space where Chris could speak, with a specialist who was willing to listen, about pain and her turbulent body.
It is interesting to see how Chris perfectly controlled and used the act of “transgression” introduced by Foucault (quoted in Allan, 1999, p. 46–48). The body and the pain that eventually proved so decisive and limiting in Chris's life suddenly opened up opportunities to meet people. At the same time, expressions of friendship between Chris and her doctor (such as calling each other by their first names) were limited to the private sphere and exchanged for formal titles (Dr., Ms.) at public moments. For those who transgress, as Chris and her doctor were doing in this example, Otherness lies ahead in new forms of subjectivity. It allows individuals to shape their own identities (Boyne, quoted in Allan, 1999, p. 48) while simultaneously obeying enough social norms to avoid serious trouble.
Chris recognized the tension between the reality of life as a person with a disability and society's assumptions and representations about people with a disability. For example, Chris wanted to discuss the fact that it is not true that all people with a disability who live on their own become very sad and lonely. She had pictures that included her 60th birthday party. The pictures showed two ladies who worked as volunteers; they drove Chris to the hospital she needed to go to every month (the relationship became more than that between “a taxi driver and a tourist”—e.g., they sent each other cards on Christmas and birthdays). Another visitor in the pictures was one of the neighbors who lived on the same floor as Chris; she visited the birthday party to show off her grandchild (the fact that she brought her little one showed that she agreed on Chris's status as a grandmother). Two other visitors worked as volunteers in hobby clubs and in the local library. Chris had, for a few years, a very busy weekly schedule that included going to a lot of clubs (a knitting club, a club where they played a variety of card games). She was one of the proud members when the hobby club had its yearly exhibition that showed its members' works. She was a regular visitor of the library (odd for someone with the label of mental retardation), and it happened that she learned to know the librarian who helped her look for, as Chris said, “books women like to read.”
The birthday party convinced Geert and the other professional support givers that Chris was not lonely at all. The fact was they tried to convince her that she had to—although she was fighting with serious back problems—“integrate herself.” The professionals tried to motivate her to go more outside “to meet people.” Chris showed that she had the capacities to direct her own circle of support and friends to her apartment.
This key incident provides an entry to introduce the concept of culture, particularly “care culture,” and its oppressive tendency to impose professional values on recipients of “care” to an oppressive degree (Roets & Goetgeluck, 2007). Chris actively resisted the culture of care surrounding her. Together with Corker and French (1999), we recognize here a good example of how discourses of disability are underpinned by the concept of normality and the assumption that people with disability want to achieve this normality. The images associated with normality in our example are related to the fact that a “normal” person must integrate in society by getting out, not by being alone in his or her home. This was laid down in statements like “integrate yourself” and was perceived by others to be something “that is good for Chris.” Language and linguistic conventions play a very important role in the sometimes perverse care culture (Linton, 1998; Roets & Van Hove, 2003). We use the term perverse because the care culture always succeeds in incorporating new concepts—like integration—and using them as advertising signs for what often remain old or traditional practices.
In contrast, Chris's resistance to the culture of care took the form of some scholarly work. She wanted to help create a piece of culture, for instance, collaborating on a book by women with an intellectual disability, in which she took on the role of grandmother. Chris also spoke at a number of congresses, explaining her various life stages.
Together with Gill (1995), we see here that disability culture can become visible by the “piecing together of our history.” For example, the work of Dorothy Atkinson and her colleagues in the Learning Disability History Project taught us that people with an intellectual disability can be extremely good sources of information to map a piece of collective and individual history and make it useful.
Although Chris was a client of a service of supported living, there were always some topics she really wanted to keep to herself: her medical condition, her children, and her grandchildren. These choices gave her a lot of stress and conflicts. For example, there was the time she found out that one of her new professional assistants was making telephone calls behind her back with her general practitioner. She became very angry (the professional told her that she made the phone calls because she was very worried about Chris's physical condition). Chris held the position that her body was her own and that no professional could take over that power. She also fought to keep her position as mother/grandmother: For example, she had conflicts with her professional assistants about the money she was putting aside to give to her daughters and their children. The professionals were troubled that Chris was pulling the money from her food budget as it was scheduled in her budget scheme; they complained about the fact that Chris was not able to make priorities.
For Geert, these incidents were pivotal learning experiences. It was then he learned to switch from “defectology” to making bridges between his and Chris's lives. This switch was made easier because Chris showed she had perfect control living in different worlds.
Finally, Chris can be considered a typical example to illustrate that people with labels can be seen as being(s) who are in-between, in flux, in-the-making, changing, playing with certain social expectations and making use of their “nomadic potentiality” living in-between worlds (Braidotti, 2004, p. 61). In this sense, culture is being actively constructed by a dynamic relationship between social actors and social norms. Nomadic subjectivity is about the simultaneity of complex and multilayered identities. The nomadic subject is a myth, or a political fiction, that allows us to think through and move across established categories and levels of experience. The nomad stands for the relinquishing and deconstruction of any sense of fixed identity. The nomadic is akin to what Foucault (1977) called countermemory; it is a form of resisting assimilation into dominant ways of representing the self.
Geert went through a personal crisis because of a divorce. Chris heard about it through his colleagues and called him with the message that, for friends, she was always there: She told him, “I know how difficult the first months on your own can be … if you need someone to talk to you can always rely on me.”
Despite labels, positions can be reversed. In real Freirian (1971/2005) style, Chris taught Geert what “learning and living in dialogue” (Freire, 2000, p. 87) actually means. Geert was no longer her professional assistant. Instead, he became a younger man with family problems who was offered assistance by a wise friend with experience about divorce.
Chris's story can be read in different ways. Although labels are linked to people like Chris on the basis of IQ tests, we viewed her as an “intelligent” woman with many strengths: She was good at telling stories; she had a lot of friends; she was good at understanding people; she was good at communicating; and she was good at focusing inward on feelings and dreams.
Interacting in dialogue—from a Freirian (1971/2005) perspective—yields a number of insights that, for a long time, risked remaining hidden behind Chris's labels. The labels provided explanations that too easily perceived Chris as the cause of all her problems. If we dare to use a social interpretations lead analysis (Gabel, 2005) of Chris's life, it brings us to the following results:
Chris needed to be understood from the perspective of the social context within which she found herself
At many times of her life, Chris (as an orphan, divorced woman, patient in a psychiatric clinic) literally felt impoverished. At the end of her life, too, when her physical dependence forced her to leave her beloved apartment and move to a home for the elderly, this feeling became more marked. She only had 40 euros of pocket money per month. Because of this budget situation, she had to limit her calls to her daughters. She felt terrible about this and apologized to Geert for the fact that he always had to call her instead of the other way around. She also only read second-hand books, which she was given, and she could no longer afford a new dress every season. When her glasses broke, she could not have them repaired immediately and felt ashamed that the temple of her glasses had to be repaired with improvisation.
In other words, we have to support people with disabilities to discover/interpret their situations making use of different lenses. This exercise can only be understood by people who do not suffer from “professional thought disorder” (Allan, personal communication, based on Lowson, 1994). Geert has shown that he needed a lot of experiences with Chris to find a way to get rid of rigidly held (so-called professional) beliefs.
Chris needs to be understood as someone who struggled continuously to maintain control over her life
Living with a label meant a life-long struggle with the question: “Who controls my life?” (Danforth, 2001; Treece, Gregory, Ayres, & Mendis, 1999). Up to her last day, Chris was extremely sensitive to structures that threatened to influence or even take over the manner in which she lived. Thus, at the end of her life, she complained once more about the limitations she experienced at the home for the elderly. For example, all of the residents of the home took a bath once a week, whereas at home, Chris used to shower every day.
Her fighting spirit emerged even at other times. We learned to see and respect Chris's decision to take regularly the position of “freedom fighter” as a way to resist control over her privacy (Gabel & Peters, 2004). Chris helped Geert and others to learn to negotiate, to leave their old positions, to learn to live with open meanings.
Chris needs to be understood in the context of the existential questions that all people must face
Like many people, she was in pain at the end of her life: “I do not have one single day without pain,” she said. This prevented her from doing certain things (for instance, she had to leave a prayer meeting early). At the end of her life, she also thought a lot about death. She knew that her physical condition could only worsen, that she would become more and more dependent and isolated. Within the period when Chris became more and more dependent (physically), she started to think about a last will. She asked Geert to type it for her to ensure that
Her daughters wouldn't inherit any problems after she died (Chris was anxious that the two young women would need to pay the bills of her funeral);
The “right priest” would do the service;
She had enough money to pay for her funeral.
This brings us to the question concerning the truth of narratives (Riessman, 2002). At many times in her life, Chris was not taken seriously because, as a woman with a label, she was believed to be telling stories and was viewed as irrational or hysterical. Yet, by attaching value to what Chris said about her life, we were enabled to see Chris as one of our teachers.
From her position as a teacher, Chris helped us to blur the boundaries between “them” and “us.” By learning about what we share, we learn to overcome “ableism” (Gabel, 2005, p. 3–4) that promotes an unequal treatment of people with a disability like Chris because of assumed differences.
We are extremely grateful to Chris, who became one of our most important teachers in the field of disability studies. This article was prepared thanks to a Visiting Fellowship of Geert Van Hove at National Louis University in Chicago.
Editor-in-Charge: David Helm
Geert Van Hove (e-mail Geert.VanHove@UGent.be), Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium; Susan L. Gabel, National-Louis University in Chicago; Elisabeth De Schauwer, Ghent University, Ghent, Belgium; Kathleen Mortier, Ghent University, Ghent, Belgium; Jos Van Loon, Ghent University, Ghent, Belgium; Gerrit Loots, Free University of Brussels, Brussels, Belgium; Patrick Devlieger, University of Leuven in Belgium; Griet Roets, Ghent University, Ghent, Belgium; and Lien Claes, Ghent University, Ghent, Belgium.