Faculty Spotlight

Language as an Enabler of Thought and Practice
Published: April 10, 2011

As you have undoubtedly realized the French have two words for language where English speakers only have one. Thus, to simplify, the French when talking about child development will speak of ‘langage’ and when they speak about learning a foreign language they will use the word ‘langue’.

As an English person one day I realised, due to the fact that in English we use one word for both ‘meanings’, that I had a tendency to see  ‘language’ as in child development  as being one example of languages rather than seeing a language  as being a kind of subset of what  the French call ‘langage’. Now this may be an entirely personal insight but it brings to mind that language can mould reality in unexpected ways.[1] In more sociological terms, language, and the categories it creates, produces different ‘taken for grantedness’ in different cultures. This is important because it can impact on how we deal with health and public health issues. What is more I feel it provides a preliminary, but important key, for the analysis of how institutions work in different sociocultural environments.  Language descriptions thus potentially offer a way of revealing what is underlying approaches in disability and public health policy.  Let me try and spell out more clearly what I mean. Let me pose you a question. Which do you prefer?

  1. people with disabilities
  2. disabled people
  3. people in a disability situation

Why? (At this point it might be best not to read any further before jotting your idea down on a piece of paper. )

The French equivalent would perhaps be:

  1. Personnes présentant une incapacité
  2. Personnes handicapées
  3. Personnes en situation de handicap

French professionals in my experience generally choose the third variant.  They reason, I would surmise, in the following way. First they find ‘disabled people’/ ‘personnes handicapées’ less acceptable than the other two since there is a tendency to identify the person with his or her disability. The person becomes the disability in some kind of way.  For similar reasons this is why the epithet “les handicapés” is used less and less.  French professionals would scrupulously avoid such reification. Secondly, even if the first variant is preferable, the fact we talk about people with disabilities does not sufficiently take on board the idea that  disability is the result of an interaction between the physical and sociocultural environment AND the person with his or her individual characteristics. And so consequently they opt for the third expression. This has the advantage of considering that a person’s degree of functioning or disability can vary according to situation, and furthermore certain situations are more important than others for different individuals. Now it is worth pointing out that this third possibility has come into use fairly recently. It comes from the Disability Creation Process[2] (DCP) framework conceptualised by Patrick Fougeyrollas and colleagues in Quebec, Canada. Before this came into vogue the preferred term in France was probably ‘personnes handicapées’, and in Euro-English was probably ‘people with disabilities’. Paradoxically the term ‘personnes en situation de handicap’ does not figure in the major French legislation of 11 Feb 2005. One reason for this can be found in the French Senate report where the senators explicitly state that changing the situation of an autistic child does not fundamentally modify that child’s autism…

With respect to the term ‘people with disabilities’ I was recently invited to a conference in Brussels and was most attentive to avoid using the term ‘disabled people’ and consequently talked of ‘people with disabilities’. Immediately following my presentation you can imagine my surprise when an English university lecturer started her presentation by saying “In Europe you use the term people withdisabilities, but as a British professional we speak of ‘disabled people’, because we believe it is society that disables people… “

So here we have the same term ‘disabled people’ which as a ‘Frenchified’ Brit  I had chosen to avoid, the British speaker, having been brought up on a diet of British social model thinking, chose to explicitly use, saying that ‘disability is not in the person: it is society that disables people’. Paradoxically we were using language differently to say very similar things!

Simple definitions and names can hide or reveal much. (Even if how people employ the names may need careful interpretation.) As Ian Hacking perspicaciously suggests ‘Names organise our thoughts’[3].

So what can we conclude from such a discussion? One possibility is: Language matters!  But the way we use it and interpret will very much depend on our culture. Yes that’s all very well, I hear you say, but the way you describe reality does not change it! In some kind of way both views would seem to be true!  But what is certain, even if one may consider that the way you describe something has no direct effect on that thing; descriptions can have impact on people through different mechanisms.

Here the distinction made by Ian Hacking between what he terms as ‘Indifferent kinds’ and ‘Interactive kinds’ is useful.[4] If I describe a table as being a cloud of protons, neutrons and electrons…, what ever the accuracy of this description, it has no effect on the nature of the table. Unless I am a trained karate expert my hand will not pass through that cloud! Ouch that hurt! The table is an indifferent kind. If however I describe a child as having learning disabilities I will potentially change their life for the better or the worse.  Thus in public health our descriptions and the terms we use do matter since they conceptualise and favour certain approaches which may feedback into the self-image and behaviour of those described.  Labelling and treating people as their labels imply, can have feedback effects and induce self-fulfilling prophesies in a similar way to the well known Pygmalion effect.  This is well borne out in Zola[5]’s work on disability where he shows that language can have an impact simply by the way it is used.  Thus Zola suggests that if you describe someone using the passive form as being ‘wheel-chair bound‘ or on the contrary in an active way as ‘getting about in a wheel chair’, your way of thinking about that person and probably treating that person may be very different. This also calls to mind the ‘Does he take sugar‘ phenomena well known in Britain. A person in a wheel chair being pushed by someone else is not addressed directly at the tea break, but his or her helper is.

Perhaps just as importantly, if you have no word to describe something, i.e. it is impossible to single out in any clear and precise manner that thing, then it is impossible to ask meaningful questions about it. Naming is the first step to conceptualising and thus being able to act upon the named.  In the words of Nancy Krieger[6]If you don’t ask, you don’t know and if you don’t know you can’t ask.” This has obvious relevance to the evaluation of such difficult and culturally sensitive issues such as discrimination and racism. But there is an opposite side to the coin. If you reify through language this can fix reality and create realities thereby lending credence to unscientific concepts such as race. Public health professionals are constantly juggling with similar dilemma. If they wish to improve the lives of a group they necessarily are obliged to label them, but in so doing may stigmatise them. On the other hand if they decline to clearly define problems or the individuals with the problem then much suffering can pass unnoticed and evaluation of policies becomes impossible.

Perhaps this dilemma finds its roots in the very idea of recognition. As Vincent Descombes explains the idea of recognition is fundamentally ambiguous. Recognition is ambiguous since non-recognition can be seen as a tolerance or on the contrary a lack and reciprocally recognition can be viewed as a highlighting or a stigmatization [7].

This is especially relevant in the case of disability or minority populations since if on the individual level one attempts to measure this thing we call ‘recognition’ we obviously must be very clear about how we define this.  In many ways the best recognition involves ‘Functioning ordinarily without receiving special attention’ Van de Ven et al. (2005)[8]. But this is very different from the equally necessary taking care of or paying special attention to people. The first arguably has a more inclusive feel about it. In our work on disability we are interested in looking at how to evaluate inclusive policies. It is not sufficient to open rights to people. This corresponds to equality of opportunity. But it is also necessary to consider to what extent people in the real world take up those rights and what return they receive from society. We wish to evaluate  inclusive disability policy, but this could be applied to all public policy,  by looking at the interactions between what the State offers, the people concerned within that society and how the reaction of society and its institutions disables or enables people to flourish in different situations.[9] Disabled people fundamentally possessing similar problems and aspirations to all people. Thus it is a matter of principle for us to adopt general theories rather than consider disabled people as an exceptional case which need different treatment.

To get back to our related language theme, if we accept Ian Hacking’s idea  “Names organise our thoughts this implies that the very names we use to describe phenomena structure our way of thinking about that phenomena.  It is thus salient to contemplate a) whether the description of people as being in a ‘disability situation’ is more accurate and less reifying than other ways of speaking. b) perhaps more importantly, since the terminology is based on an interactive paradigm compatible with the scientific model of the aforementioned (DCP) or the World Health Organisation (ICF) ‘International Classification of Functioning Health and Disability’ (2001), does our practice reflect that description or not ?

As a final note I could have started this piece by looking at the French word “expérience”. This is often the translation for two potentially very different and rich concepts In English: experience and experiment.  The other day I was thinking – Experiments to produce evidence must be reproducible. Yes… But is experience reproducible?  And is not one of the cannons of evidence upon which practice is based connected to reproducibility?  But there hangs another public health related tale…

Dr. Sherlaw, a lecturer  in anthropology of health and disability at EHESP, was born and raised in Yorkshire (UK). He studied Pharmacology at Kings College London and went on to receive an MSc in Information Science at the City University in London. In the early 90s, he joined EHESP as a Public Health Librarian where he dealt with social exclusion and disability matters. While indexing journals, books and dissertations, Dr. Sherlaw couldn’t help but notice the substantial differences in the way children with an intellectual disability were being categorized, educated and cared for in France and Britain. This encounter led him to do  a master’s degree in social and human sciences where he carried out a comparison of social representations in France and Britain in connection with the care and education of children and adolescents with learning disabilities. Following this degree, he received a phd in information and communication science from Nantes University. Dr. Sherlaw plays table tennis, chess, enjoys cooking and is a great fan of the Scottish Highlands.

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One comment

  • I do support the fact that words used to address is very important as it is mentioned in the article and what I think is that in the big forum most of the times the words become more important than the feel it carries which should not be that way.

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