BBC News - A Point of View: Happiness and disability

Surveys reveal that people with disabilities consistently report a
good quality of life, says Tom Shakespeare. So why is it often assumed
they are unhappy?

Have you ever thought to yourself: "I'd rather be dead than disabled?"
It's not an unusual reflection. Disability, in everyday thought, is
associated with failure, with dependency and with not being able to do
things. We feel sorry for disabled people, because we imagine it must
be miserable to be disabled.

But in fact we're wrong. It's sometimes called the "disability
paradox". Surveys reveal people with disabilities consistently report
a quality of life as good as, or sometimes even better than, that of
non-disabled people.

Impairment usually makes little difference to quality of life.
Research shows, for example, that overall levels of life satisfaction
for people with spinal cord injury are not affected by their physical
ability.

Even the clinical facts of whether their spinal lesion is high or low,
complete or incomplete - all aspects that affect functioning - don't
seem to make much difference. Human flourishing is possible even if
you lack a major sense, like sight, or you can't walk, or you're
totally physically dependent on others.

So what's going on?

If you think about it for a moment, you realise that people born with
an impairment have nothing to which they can compare their current
existence. Someone lacking hearing or sight has never experienced
music or birdsong, visual art or a sublime landscape. Someone with an
intellectual disability may not consider themselves different at all.
Someone like me, born with restricted growth, has always been that
way. Even if life is sometimes hard, we are used to being the way we
are.

For people who become disabled, there's a typical trajectory. I can
say this from personal experience, having become paralysed in 2008.
Immediately after the onset of injury or disease, one can feel
profoundly depressed, and even contemplate suicide. Yet after a period
of time, people adapt to their new situation, re-evaluate their
attitude to the disability, and start making the most of it.
Sometimes, they are driven to greater achievements than before.
Remember those amazing Paralympic athletes...

Maybe you are sceptical about the subjective nature of quality-of-life
data. Bioethicists sometimes describe these self-reports in terms of
the "happy slave" concept, in other words, people think they are happy
because they do not know any better. Perhaps these cheerful people
with disabilities are deluding themselves. Or, perhaps they are
fooling others. Maybe in private they admit to misery, while in public
they put on a brave face. Either way, it's said these folk must be in
some kind of denial.

There is some positive correlation between seeing meaning in life and
being happy, says Pascale Harter, but studies suggest this is not a
necessary condition for happiness. Studies from all over the globe
collated by the World Happiness Database in Rotterdam have produced
some surprising findings about what makes people happy.

But these explanations are patronising, not to say insulting. More
importantly, they're wrong. Research in a field called hedonic
psychology has supported disabled people's self-reports of good
quality of life. Scientists such as Daniel Gilbert have done very
thorough testing of what people say and how they think. They've come
up with the concept of hedonic adaptation - which refers to the way in
which after trauma, quality of life eventually returns to
approximately what it was before the trauma struck. Amazing, eh?
Unfortunately this also happens in reverse - so, if you are lucky
enough to win the lottery, you'll feel like £10m for a year or two,
but then you'll go back to being as miserable or cheerful as you were
before your stroke of luck.

So if these self-reports are true, we will need to find better ways of
understanding the disability paradox.

To start with, we can offer more nuanced accounts of the psychological
processes that go on in the mind of a person with disability.
Adaptation means finding another way to do something. For example, the
paralysed person might wheel, rather than walk, to, places. Coping is
when people gradually re-define their expectations about functioning.
They decide that a stroll of half a mile is fine, whereas previously
they would only have been content with a 10-mile ramble. Accommodation
is when someone learns to value other things - they decide that rather
than going for walks in the country with friends, it's far more
important to be able to go to great restaurants with them. This
teaches us an important lesson - human beings are capable of adapting
to almost any situation, finding satisfaction in the smaller things
they can achieve, and deriving happiness from their relationships with
family and friends, even in the absence of other triumphs.

Our appraisal of life with impairment may have less to do with reality
than with fear and ignorance and prejudice. We wrongly assume that
difficulties for people result in misery for people.

Omar Sy and Francois Cluzet in a scene from the film Les Intouchables,
2011 Omar Sy and Francois Cluzet in a scene from the film Les
Intouchables, 2011
Even to the extent that impairments do entail suffering and
limitation, other factors in life can more than compensate for them.
Take the recent French box office sensation Les Intouchables, in which
the protagonist, Philippe has tetraplegia, but despite this, he is
able to have a good quality of life because he has money. Even people
who aren't lucky enough to be wealthy Parisian aristocrats can enjoy
the benefits of friendship or culture, despite the restrictions that
impairment places on them. By contrast, it is plain to see that
someone can have a fully functioning body or mind and yet lack the
social networks or the personality necessary for living a happy and
fulfilled existence.

This highlights the importance of the environment in determining the
happiness of disabled people. As in most areas of life, it's
structural factors that make the real difference. Participation, not
impairment is key. Do access barriers stop you going to school with
your friends? Do you have a job? Does society meet the extra costs of
having an impairment through a welfare system which is fair and
non-stigmatising? Do you face hostility and hate crime? Unfortunately,
in most of these respects the situation for disabled people has been
getting worse, not better, in recent years. According to the Centre
for Welfare Reform, this government's spending cuts have had a hugely
disproportionate impact on the lives of disabled people in poverty.

Girl with Downs' syndrome
In arguing that social barriers are more of a problem than the
impairment itself, I am not suggesting that fear is completely
irrational. For a start, disability is very diverse in ways that mean
we have to soften the claim that "disability is no tragedy". Some
illnesses and impairments undoubtedly involve greater degrees of
misery or suffering than the average human should have to endure. I'm
thinking of depression, for example, which biologist Lewis Wolpert
memorably labelled "malignant sadness". There are some nasty and
painful degenerative diseases. Impairments that involve considerable
pain, whether physical or mental, are obviously less compatible with a
good quality of life.

It's also true that in general, disabled people usually have fewer
choices than non-disabled people. Most societies still have limited
accessibility. Even in a barrier-free world, the disabled person is
more likely to rely on mechanical devices that periodically
malfunction, rendering the individual excluded or dependent. I have
been stranded thanks to a flat tyre on my wheelchair or a broken lift
numerous times. Most disabled people become inured to the frustrations
of inaccessibility or breakdown, but it certainly makes life less
predictable and less free than it is for the non-disabled.

But my point is that while disability is not simply an irrelevant
difference, like the colour of your skin, neither need it be a
tragedy.

And remember: Mere existence entails problems. Hamlet, listing reasons
why death is to be preferred, highlights "the thousand natural shocks
that flesh is heir to". To be born is to be vulnerable, to fall prey
to disease and suffering, and ultimately to die. Sometimes, the part
of life that is difficult brings other benefits, such as a sense of
perspective or true value that people who lead easier lives can miss
out on. If we always remembered this, perhaps we would turn out to be
more accepting of disability and less prejudiced against disabled
people.

Source:

http://www.bbc.com/news/magazine-27554754

-- 
With best regards,
Sanchit Katiyar.

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