Meditations on a Bullet: Violently Injured Young Men Discuss Masculinity, Disability and Blame

Violently-acquired spinal cord injury (VASCI) has recently emerged as a significant disability category. Identity formation following such a serious injury is important for psychosocial recovery. However, research examining individuals with VASCI is largely limited to epidemiological work prior to the injury and rehabilitation outcomes following the injury. This article details the results from a qualitative study to understand how young men with violently-acquired spinal cord injuries integrate the injury into their sense of self, as well as how the disability interacts with other aspects (e.g., racial/ethnic, gender, etc.) of their identity. Eleven men in this study were all former or current gang members, paralyzed because of their activities. Throughout the interviews four major themes emerged: environmental effects, making sense of the injury, living life on a split-screen, and challenges to masculinity. For the men in this study, the negative associations between disability and dependency affected their ability to integrate their injury positively into their identity.

When identities collide: masculinity,disability and race

This study is part of a larger project that examined the impact of violently acquired spinal cord injuries (VASCI) on identity among racial and ethnic minority men living in a major American metropolis. Like other individuals who sustain a disabling injury, individuals with a VASCI often struggle with the consequences of the injury vis‐à‐vis redefining their identities and their role in society. For the men in this study the negative association between disability and dependency affected the integration of the injury into their sense of self. The injury and resulting disability violated social understandings of what it means to be a man in their environments. The men noted the injury’s impact on their sense of safety, sexual encounters, body image and choice of intimate partners. Their social context shaped what it meant to be a man, played a role in their injuries and increased the challenges inherent in a life‐changing event.     

Men, sport, and spinal cord injury: an analysis of metaphors and narrative types

This article draws upon life history data from a small group of men who have experienced spinal cord injury (SCI) through playing the sport of rugby union football and now define themselves as disabled. The salient and most common metaphors used by the men in telling their stories post SCI, and the manner in which this is shaped by three narrative types, is focused upon in detail. The implications of this dynamic process for their identity reconstruction as disabled men are considered.     

Images of self and spinal cord injury: exploring drawing as a visual method in disability research

This article describes the use of drawings in a research project aimed at understanding the personal experience of spinal cord injury. The article briefly reviews the use of visual methods in disability research, and then describes the specific procedures used to elicit and analyze two sets of drawings: ‘draw your self’ and ‘draw how you see spinal cord injury in your mind’. The drawings were a small but essential part of a larger study focused on the community integration and participation of adults (n = 160) with spinal cord injury. Despite the challenges posed by this method for research participants with paralysis, the drawings provided unique insight into the personal meanings of spinal cord injury and how this injury is understood and represented to others. Using examples of participants' own drawings, we show how elicited drawings are a useful adjunct to traditional interview methods in studies of disability.     

The Caring Wife: The Experience of Caring for a Severely Disabled Husband in the Community

Modern medicine has dramatically increased the chances of survival following major trauma such as a severe head injury or high level injury to the spinal cord. Greater numbers of seriously disabled people are thus returning to live in the community. This article examines the situation of the wife who assumes a caring role following the onset of severe disability in her husband. The study examines community care for people with traumatic disabilities and the social expectations of women's role in the provision of that care. Reference is made to the British situation although similar experiences are shared by women in other developed countries. As health care and social service professionals seek to serve the needs of their physically disabled client it is recommended that they view also the needs of their other client-the carer.     

'Working at Disability': a qualitative study of the meaning of health and disability for women with physical impairments

Seven women with cerebral palsy and one woman with a spinal cord injury were interviewed about the meaning of health and disability in their lives. The most compelling feature of their narratives was the pressure to define their health by able-bodied standards. These women 'worked at' fitting their bodies and experiences into the limited societal understanding of a body. Paradoxically, the women seemed to come to a deeper personal understanding of disability and themselves through this work. The women's stories of health, impairment and disability, as told in the interviews, blended into rich chapters of their life stories.     

Men,spinal cord injury,memories and the narrative performance of pain

This article draws upon data generated from life history interviews with a small group of men who had experienced spinal cord injury (SCI) through playing sport and defined themselves as disabled. By focusing on the initial acute phase of rehabilitation following SCI their autobiographical memories of pain are explored in relation to the narratives constructed by the participants some years after the event had taken place. Attention is given to the themes of unspeakable pain, naming pain, welcomed pain, hidden pain and locked in pain. The analysis highlights the contextual nature of this phenomenon and the narrative resources that are drawn upon by individuals to give meaning to pain over time.     

Fatness as a disability: questions of personal and group identity

Both fat people and disabled people share common barriers to full societal participation and acceptance. While there has been a substantial amount of literature relating to these two groups as separate entities, there is a lack of contemporary research that investigates the relationship between fat and disability identity formation. The purpose of this qualitative study was to engage in a dialogue with fat individuals and explore the construction of their identities – whether or not they identified with having a disability and, if so, whether or not they viewed their fatness as a disability. Interviews with a sample size of seven participants who self‐identified as ‘fat’ revealed an unwillingness to adopt a disability identity based on their fatness.     

The value of employment for people living with spinal cord injury in Norway

The purpose of this article is to examine the value of employment for people living with spinal cord injury in Norway. The main focus in the 31 interviews dealt with general perceptions of integration and participation. The value of employment was a major theme, primarily described by the participants in terms of personal and social identity in interaction with others, as a hegemonic social norm and a sense of moral obligation to contribute to society. The value of meaningful regular jobs – in contrast to government projects jobs or routine jobs – was emphasized.     

IDENTITY DILEMMAS OF CHRONICALLY ILL MEN

Chronic illness frequently comes to men suddenly with immediate intensity, severity, and uncertainty. Because men contract more serious and life-threatening chronic illnesses than women, experiencing illness causes men different identity dilemmas. This paper explores men's identity dilemmas by studying how men experience chronic illnesses and by looking at how assumptions about masculinity affected their identity. The paper explores four major processes: (1) awakening to death after a lifethreatening crisis, (2) accommodating to uncertainty as men realize that the crisis has lasting consequences for their lives, (3) defining illness and disability and (4) preserving self to maintain a sense of coherence while experiencing loss and change. The data are derived from forty in-depth formal interviews of twenty men, informal interviews with these men, and an extensive collection of published and unpublished personal accounts. The data were analyzed through the strategies of grounded theory.     

Adjustment to disability

This article will focus on the biopsychosocial challenges encountered when an individual is disabled at an early age as well as when an individual acquires a disability later in life. Two case examples will focus on the adaptations/life choices that are necessary to adequately meet psycho/social/developmental needs and enhance individual self esteem. The case of Rita, a woman who lost her hearing at age two, highlights the importance of integrating a biopsychosocial approach to understand the multiple challenges and adaptations of individuals who are disabled at an early age. Laureen, a woman who acquired a spinal cord injury during her late teen years, described her struggles as a young adult adapting to a physical disability. Both cases highlight the importance of integrating an ecological/systems framework focusing on a biopsychosocial perspective, emphasizing the interrelationship between biological, psychological, social, technological, cultural and political factors.     

ANTICIPATORY AND ACTUALIZED IDENTITIES: A Cultural Analysis of the Transition from AIDS Disability to Work

Throughout the course of their lives, many people living with HIV/AIDS have prematurely retired onto AIDS disability. A new trend, however, has swept across the nation. Where once people were getting sick, leaving work, and embracing inevitable death, now, with advances in medical technology, many people with HIV/AIDS are renewing their lease on life and discovering a desire to go back to work. To learn how gay men's identities are impacted as they transition from AIDS disability back to the labor market, I conducted three months of fieldwork at an employment placement agency in San Francisco. During fieldwork I distributed informal questionnaires to 120 gay men and then formally interviewed 10 additional gay men who had either transitioned or were considering transitioning from AIDS disability back to work. Analyses reveal that cultural, structural, and medical contradictions typify the return to work. As gay men experience and live through these contradictions, their identities split into anticipatory and actualized components. By facilitating a reassessment of meanings and values, anticipatory identities cognitively and emotionally prepare individuals as they brave the road back to work. This version of identity represents a romanticized confluence of worker (role) identity, gay (status/master) identity, and overall sense of self (self-concept). Personal experiences with stigma, shame, and discrimination along with complexities of the workplace and medical services, however, prevent the maturation of anticipatory identities when seeking reemployment. This results in loosely coupled and situationally informed actualized identities . The relationship between these two identities suggests that many people living with HIV/AIDS—and indeed others who experience stressful life transitions—face complex choices between quality-of-life issues and the ability to survive according to external cultural and structural constraints.     

‘Trial by fire’: forms of impairment disclosure and implications for disability identity

This article examines the ways in which people living with non-apparent impairments, sometimes called ‘invisible disabilities,’ choose to disclose their impairments to friends, colleagues, and supervisors. Drawing on life-history narratives conducted with 12 men and women who acquired non-apparent impairment through accident, injury, or illness, this analysis demonstrates that people who have acquired non-apparent impairment use three primary forms of disclosure – confessional, pragmatic, and validating – serving as mechanisms by which individuals internalize the stigma associated with disability, pragmatically acquire accommodations, or resist and challenge ableist views. This analysis shows the ways that disclosure more broadly, and these forms specifically, play important roles in developing and negotiating disability identity.     

桑兰：梦想在延续

1998年7月21日,在美国参加第四届友好运动会的中国女子体操队队员桑兰在赛前练习中颈椎受重伤,胸部以下瘫痪。在遭受如此重大的变故后,当时仅17岁的桑兰表现出难得的坚毅。她说:"我对自己有信心,我永远不会放弃希望。"10年来,桑兰用她的勇气延续着自己的梦想,坚持治疗、在北大求学、担任北京申奥大使、主持奥运电视节目、当选北京奥运会火炬手……她充满力量的笑容总能给人希望!     

Adjustment to Disability

Abstract

This article will focus on the biopsychosocial challenges encountered when an individual is disabled at an early age as well as when an individual acquires a disability later in life. Two case examples will focus on the adaptations/life choices that are necessary to adequately meet psycho/social/developmental needs and enhance individual self esteem. The case of Rita, a woman who lost her hearing at age two, highlights the importance of integrating a biopsychosocial approach to understand the multiple challenges and adaptations of individuals who are disabled at an early age. Laureen, a woman who acquired a spinal cord injury during her late teen years, described her struggles as a young adult adapting to a physical disability. Both cases highlight the importance of integrating an ecological/systems framework focusing on a biopsychosocial perspective, emphasizing the interrelationship between biological, psychological, social, technological, cultural and political factors.     

How do men with paraplegia choose activities in the light of striving for optimal participation? A qualitative study,based on a phenomenological–hermeneutical method

The objective of this study was to explore the experiences of men with paraplegia with regard to how they choose activities. The study involved a qualitative research design, based on a phenomenological–hermeneutical method. The findings revealed that the activities participants were choosing could be on a continuum between the individual’s self and the influence from their environment. On this continuum, the choice to perform activities was influenced by two mediating factors: the individual’s activities performed during their life-history, and their activity challenges for the future. We conclude that choosing activities is an individually constructed internal process of negotiation. Feelings of resignation and revolt appear in combination with feelings of justice and injustice when balance is not found. This knowledge provides a better understanding of the impact of spinal cord injury, sheds light on the development of distress after spinal cord injury and sheds new light on individuals’ feelings of participation.     

Spinal Cord Injury

ABSTRACT

This article provides an overview of spinal cord injury (SCI) that is useful and informative for social workers and other health care professionals who work with this population. Social workers new to the specialty of spinal cord injury must expand their knowledge base of this chronic injury. Social workers contribute to the rehabilitation process through assessment, education, and discharge planning. This article also may be used to inform persons with spinal cord injury and their families and to encourage them to engage in dialogue about SCI in the earliest stages of treatment and rehabilitation.     

From the Freak Show to the Living Room: Cultural Representations of Dwarfism and Obesity1

This article examines how cultural representations of deviant bodies vary based on historically informed narratives of bodily stigma. Using content analysis of 40 episodes of reality television programming, I contrast cultural representations of dwarfism and obesity. Over time, dwarfism became constructed as an identity project with the aim of bodily acceptance, whereas obesity became regarded as a body project with the goal of body transformation through weight loss. The mostly positive historical characterizations of dwarfs allowed them to easily adopt the tenets of the disability rights movement as they evolved from freak show performances to television as an educational platform. They have adopted a social model of disability, positive social identity, self‐acceptance, and full social participation. By contrast, the past and contemporary representations of obesity have been overwhelmingly negative. Obese freak show performers were openly mocked, and classifying obesity as a disability has not yet gained traction as a civil rights movement. Instead, obesity is viewed through the lens of individual responsibility and limits of social participation are emphasized. Body modification through weight loss constructs an identity based on self‐change. Generally, this article suggests that cultural representations as de‐stigmatization projects are enabled or constrained by historical factors and the nature of the bodily stigma.     

When elevators were for pianos: an oral history account of the civilian experience of using wheelchairs in Canadian society. The first twenty-five years: 1945-1970

In 1945 Canadian World War II veterans with spinal cord injury were among the first Canadians to have access to medical rehabilitation programs, the Everest and Jennings folding, self-propelled wheelchair and automobiles with hand-controls. A previous paper, Going back to Civvy Street (Tremblay, 1996) described how the veteran pioneers used these new opportunities to return to full participation in civilian life. Drawing on oral history and archival research, this paper examines the experiences of Canadian civilians with spinal cord injury as they tried to follow the veterans' example. It discusses the strategies these pioneers used to overcome obstacles, such as stairs and curbs, as well as providing examples of their experiences in finding housing, education and employment. The paper reviews the responses individuals received from their fellow citizens and highlights the limited recognition of architectural barriers in an era when elevators were for pianos!     

Sexual Orientation Bias Experiences and Service Needs of Gay,Lesbian, Bisexual,Transgendered, and Two-Spirited American Indians

Summary

Employing both quantitative and qualitative methodologies, this study examined: sexual orientation bias experiences among American Indians (AIs) who were gay, lesbian, bisexual, transgend-ered, or two-spirited (GLBTT-S); service provider attitudes toward AI GLBTT-S; and service barriers and needs with respect to AI GLBTT-S at one AI community-based organization. Among the 14 AI GLBTT-S surveyed, the percentages reporting various bias-related experiences were comparable or greater to those reported for non-AI GLBTT-S in other studies (e.g., 36% had been physically assaulted because of their sexual orientation). The 22 service providers surveyed revealed generally low levels of heterosexism, which was inversely related to contact and comfort with AI GLBTT-S as well as understanding of AI GLBTT-S terms. Data from 8 focus groups (7 with service providers and 1 with AI two-spirited men) yielded four main themes related to problems and barriers to service utilization for AI GLBTT-S (i.e., invisibility, discrimination, trauma, and identity) as well as ideas for community-based program planning with this population.