Internalized ableism

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Internalized ableism is a phenomenon where disabled individuals absorb and enact negative beliefs and prejudiced values about disability that are prevalent in society.[1] Internalized ableism is a form of discrimination against oneself and others with disabilities, rooted in the view that disability is a source of shame, should be concealed, or warrants refusal of support or accessibility.[2] This internal conflict can stem from continuous exposure to negative social attitudes and a lack of adequate support for disabled people's needs, which contributes to a cycle of rejecting their identity to align with ableist "norms." Ableism encompasses more than just ignorance around disability leading to negative attitudes towards disabled people; it also includes unrealistic ideals of perfection and ingrained beliefs about bodies, promoting the idea that disability is inherently negative or unwanted.[3]

## History

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This concept of internalized ableism has historical roots that can be traced back to societal structures that prioritize able-bodied norms and often marginalize or stigmatize those who do not conform. As societal awareness of disability rights has grown, particularly since the rise of the disability rights movement in the 1970s, there has been increasing recognition of internalized ableism as a significant barrier to the well-being and self-esteem of individuals with disabilities.[4] Research into internalized ableism has been informed by broader theories in psychology and social justice, which emphasize the internalization of societal values by marginalized groups.[4]

## Origins

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Internalized ableism begins early, with societal perceptions often framing having a disabled child as a tragedy.[5] In a study, participants reported encounters where doctors emphasized impairments over potential, contributing to feelings of vulnerability and exclusion.[5] Despite parental efforts to counter stereotypes, inadequate expectations persisted, hindering the development of disabled children.[5] Intersectional biases compounded these experiences, with factors such as gender and social status exacerbating feelings of otherness. The pervasive tragedy discourse continued to shape participants' sense of self throughout adolescence and adulthood, with some explicitly identifying internalized ableism as a significant barrier to their well-being.[5]

## Campbell's framework

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Fiona Kumari Campbell, Disability Studies Researcher and Theorist

Fiona K. Campbell outlines two components of internalized ableism: distancing oneself from the disabled community and the emulation of ableist norms. These "tactics of dispersal" can hinder the formation of a shared identity among disabled individuals, weakening what otherwise could provide a sense of unity, and intensifying feelings of isolation. Emulating ableist norms, or "passing," often serves as a survival mechanism for people with disabilities, but can lead to a denial of one's true identity and reinforce the internalization of ableist attitudes.[6][1] Campbell's work emphasizes the harm that can emerge when a minority group is forced to adopt an identity that does not resonate with them or their internal values. Another author, Sara Ahmed, echoes Campbell's sentiments, writing that anyone who does not fit within a societal norm, whether due to race, disability, or gender, they are forced to settle within the current culture or defend themselves against criticism by adopting characteristics that are deemed more "normal."[7]

## As a form of oppression

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Internalized ableism is a form of internalized oppression.[8] Internalized ableism arises in response to external oppression, where individuals may develop negative feelings towards themselves and others in their group, often attributing blame to themselves.[9] Traditionally, internalized oppression is framed as a static, psychological issue rather than a dynamic issue that is derived from systemic consequences of generations of marginalization.[10] Internalized oppression occurs when individuals in marginalized groups undervalue themselves, perpetuating this mindset through generations and socialization.[11] Internalized oppression in turn leads to normalized exclusion, which is the acceptance or normalization of practices, policies, or behaviors that systematically exclude or marginalize certain individuals or groups within a society. Although internalized oppression is not always conscious, it can deeply affect how people see themselves and others within their group. This can lead to internal conflicts within the group and the perpetuation of microaggressions, which are subtle forms of discrimination.

## Examples

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Internalized ableism manifests in various ways among disabled individuals, significantly impacting their mental and social well-being. Disabled individuals may subconsciously adopt ableist norms that devalue their disabilities and themselves, leading to self-devaluation where they view themselves and others with disabilities negatively.[8] Social withdrawal is another manifestation, where individuals may isolate themselves from society due to feelings of inadequacy or fear of discrimination, thereby reducing their interactions and support networks crucial for their well-being. Additionally, some individuals may overcompensate by pushing themselves to overcome or hide their disabilities, which can lead to exhaustion, burnout, and physical harm. There is also often a rejection of disability identity, where individuals avoid associating with other disabled people and distance themselves from their disability identity to not be identified with disability.[8]

## Impact

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### Health

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Social Determinants of Health

Internalized ableism can have effects on individuals' mental and physical health. It can lead to self-blame, low self-esteem, anxiety, depression, and social isolation.[12] Internalized oppression may contribute to negative mental health outcomes such as anxiety, depression, and feelings of inferiority. In a minority stress model constructed by Ilan Meyer, individuals with intersectional identities facing oppression experienced heightened stress from managing both external stigma and internal feelings of inferiority and rejection, which negatively affected their mental health.[13] Research has shown that internalized stigma in mental illness is linked to lower levels of hope, self-esteem, and social support, and higher symptom severity.[14] Similarly, research has found that disabled individuals face oppression in counseling, experiencing biases, stereotyping, and a lack of understanding from counselors, all of which hinder their self-perception.[15] Disabled people may feel pressure to be independent or to conform to societal standards of "normalcy," exacerbating the stigma and challenges they face. The medical establishment's pathologization of disability further entrenches these issues, with the pathology paradigm reinforcing the notion that disabled individuals must aspire to able-bodied standards. Social determinants of health and power dynamics further shape the experiences and identities of disabled young people, as external shame is reinforced and internalized.[8]

Additionally, shame is a significant aspect of internalized ableism, and affects the health and well-being of individuals with disabilities.[16] This feeling of shame arises from feelings of alienation and defeat, influencing behavior and interactions with the world.[17] Shame is closely associated with anxiety and depressive symptoms, triggered by perceptions of inferior treatment or threats to identity integrity.[18][19] "Core shame identity," characterized by a pervasive fear of exposure as deficient and flawed, perpetuates feelings of unworthiness and disconnection.[20] This internalization of shame within the personality can exacerbate depression and social withdrawal.[18] Overcoming internalized shame requires acceptance and support from others.[20] Peer acceptance, open sharing of feelings, and nurturing relationships can alleviate shame, fostering emotional well-being and empowerment within the disabled community. Strategies to overcome internalized shame associated with disabilities include participation in peer support groups, seeking therapy, engaging in education and advocacy, practicing self-care, learning assertiveness skills, fostering supportive relationships, and seeking peer mentorship.

### Social

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The emphasis placed by the dominant culture on ability and "normalcy" contributes to the perpetuation of internalized ableism, as it establishes unrealistic standards that affect both disabled and able-bodied individuals. Disabled individuals who require care or accommodations are often marginalized, reflecting a societal devaluation of their needs and humanity.[21] Resistance to internalized ableism involves recognizing and affirming the inherent worth of disabled individuals, fostering solidarity, and advocating for systemic changes that affirm disability as an aspect of human diversity.[22][23]  Examples of resisting internalized ableism include embracing one's disability identity, challenging stereotypes through activism and education, advocating for accessibility and accommodations, participating in supportive communities, and promoting dialogue about ableist language and behavior.[8] This resistance involves both individual actions, such as self-care and self-advocacy, and collective efforts to promote equality and inclusion for disabled individuals. Additionally, institutions systematically address internalized ableism by taking action such as promoting accessibility in public spaces, implementing inclusive hiring practices, and supporting legislation that protects the rights of disabled individuals.

## Affective solidarity

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The concept of "affective solidarity" underscores the transformative potential arising from the dissonance between one's self-perception and societal judgments.[24] This dissonance, encompassing emotions such as anger and shame, can spark a desire for justice and transformation. Despite challenges, including limited opportunities for collective identity among disabled individuals, solidarity within marginalized communities, as described, is a potent force in challenging internalized oppression.[25] The term "disability justice," originating from the Disability Justice Collective, emphasizes this intersectional framework prioritizing the needs of marginalized groups within the disability rights movement.[25] This approach recognizes the significance of care webs and solidarity among disabled and sick individuals, serving as a refuge for healing internalized oppression and ableism. Both individual empowerment and systemic change is important to combat internalized ableism.

## Overcoming

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Resistance to internalized ableism hinges on access to safer spaces, characterized by solidarity and support. These spaces, often fluid in nature, are deemed "safer" rather than "safe," as they can swiftly become unsafe due to various factors such as access issues, ableism, micro-aggressions, or violence.[5] In a study, participants expressed the relief of letting go of their defensive walls on rare occasions, highlighting the constant vigilance required to navigate ableist encounters.[5]

Family support plays a pivotal role in resisting internalized ableism, with some experiencing empowerment and advocacy from relatives.[5] However, not all families provide such support, as seen in instances of belittlement and ableist aggression. The importance of supportive environments extends beyond the family, as exemplified by positive experiences in summer camps for disabled individuals.[5]

Access to spaces where disabled individuals feel welcomed, understood, and supported is crucial for fostering solidarity and resisting internalized ableism.[5] Peer support and shared experiences contribute to a sense of belonging and empowerment, ultimately countering internalized ableism and facilitating healing.[5]

## Criticism and controversies

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Protest against victim-blaming in Alberta, Canada

Some critics question the concept's oversimplification of the relationship between individual experiences and societal structures.[8] The idea that internalized ableism solely attributes to negative feelings and beliefs may overlook external factors like discrimination and systemic barriers. Additionally, there's debate on whether internalized ableism adequately represents the diversity of disabled experiences and cultural perspectives.[8] Critics also raise concerns about the effectiveness of addressing internalized ableism through individual-focused approaches. They suggest that efforts should also target systemic inequalities and promote social inclusion rather than solely focusing on changing individual attitudes. Moreover, there's worry that interventions may inadvertently reinforce stereotypes or stigmatize certain disability experiences. Furthermore, there's discussion about unintended consequences, such as potential victim-blaming and overlooking intersections between disability and other forms of oppression like racism or sexism.[8]

## See Also

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* Epistemic injustice
* Anosognosia

## References

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1. ^ a b Campbell FK (2009). "Disability Harms: Exploring Internalized Ableism". In Marshall CA (ed.). Disabilities: insights from across fields and around the world. Praeger perspectives. Westport, Conn: Praeger. pp. 19–34\. ISBN 978-0-313-34604-0. OCLC 261177632.
2. ^ Campbell FK (2009). Contours of Ableism: The Production of Disability and Abledness. London: Palgrave Macmillan UK. doi:10.1057/9780230245181. ISBN 978-1-349-36790-0.
3. ^ Campbell FK (2019-04-03). "Precision ableism: a studies in ableism approach to developing histories of disability and abledment". Rethinking History. 23 (2): 138–156\. doi:10.1080/13642529.2019.1607475. ISSN 1364-2529.
4. ^ a b Brinkman AH, Rea-Sandin G, Lund EM, Fitzpatrick OM, Gusman MS, Boness CL, et al. (Scholars for Elevating Equity and Diversity (SEED)) (2023). "Shifting the discourse on disability: Moving to an inclusive, intersectional focus". The American Journal of Orthopsychiatry. 93 (1): 50–62\. doi:10.1037/ort0000653. PMC 9951269. PMID 36265035.
5. ^ a b c d e f g h i j David EJ (19 December 2013). Internalized Oppression: The Psychology of Marginalized Groups. Springer Publishing Company. ISBN 978-0-8261-9925-6.
6. ^ Campbell FA (2008). "Exploring internalized ableism using critical race theory". Disability & Society. 23 (2): 151–162\. doi:10.1080/09687590701841190. hdl:10072/21024. ISSN 0968-7599.
7. ^ Ahmed S (2017). Living a feminist life. Duke University Press Books. ISBN 978-0-8223-6304-0.
8. ^ a b c d e f g h Jóhannsdóttir Á, Egilson SÞ, Haraldsdóttir F (February 2022). "Implications of internalised ableism for the health and wellbeing of disabled young people". Sociology of Health & Illness. 44 (2): 360–376\. doi:10.1111/1467-9566.13425. PMC 9304167. PMID 35034362.
9. ^ Rosenwasser P (21 May 2002). "Exploring internalized oppression and healing strategies". New Directions for Adult and Continuing Education. 2002 (94): 53–62\. doi:10.1002/ace.59. ISSN 1052-2891.
10. ^ Tappan MB (2006). "Refraining Internalized Oppression and Internalized Domination: From the Psychological to the Sociocultural". Teachers College Record: The Voice of Scholarship in Education. 108 (10): 2115–2144\. doi:10.1177/016146810610801006. ISSN 0161-4681.
11. ^ David EJ, Derthick AO (2013). "What Is Internalized Oppression, and So What?". Internalized Oppression. New York, NY: Springer Publishing Company. doi:10.1891/9780826199263.0001. ISBN 978-0-8261-9925-6.
12. ^ David EJ (9 December 2013). Internalized Oppression: The Psychology of Marginalized Groups. Springer Publishing Company. ISBN 978-0-8261-9925-6.
13. ^ Meyer IH (2003). "Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations : Conceptual Issues and Research Evidence". Psychological Bulletin. 129 (5): 674–697\. doi:10.1037/0033-2909.129.5.674. PMC 2072932. PMID 12956539.
14. ^ Livingston JD, Boyd JE (December 2010). "Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis". Social Science & Medicine. 71 (12): 2150–2161\. doi:10.1016/j.socscimed.2010.09.030. PMID 21051128.
15. ^ Reeve D (June 2000). "Oppression Within the Counselling Room". Disability & Society. 15 (4): 669–682\. doi:10.1080/09687590050058242. ISSN 0968-7599.
16. ^ Velotti P, Garofalo C, Bottazzi F, Caretti V (February 2017). "Faces of Shame: Implications for Self-Esteem, Emotion Regulation, Aggression, and Well-Being". The Journal of Psychology. 151 (2): 171–184\. doi:10.1080/00223980.2016.1248809. PMID 27858531.
17. ^ Slobodin O (May 2019). "Between the eye and the gaze: Maternal shame in the novel We Need to Talk about Kevin". Feminism & Psychology. 29 (2): 214–230\. doi:10.1177/0959353518783785. ISSN 0959-3535.
18. ^ a b Giordano S (October 2018). "Understanding the emotion of shame in transgender individuals - some insight from Kafka". Life Sciences, Society and Policy. 14 (1): 23. doi:10.1186/s40504-018-0085-y. PMC 6389160. PMID 30270405.
19. ^ Goldberg C (1991). Understanding Shame. J. Aronson. ISBN 978-0-87668-541-9.
20. ^ a b Ashley P (25 June 2020). Shame-Informed Therapy: Treatment Strategies to Overcome Core Shame and Reconstruct the Authentic Self. PESI, Incorporated. ISBN 978-1-68373-281-5.
21. ^ Ahmad A (June 2019). "Living a feminist life". Contemporary Political Theory. 18 (2): 125–128\. doi:10.1057/s41296-018-0199-2. ISSN 1476-9336.
22. ^ Banks ME, Gover MS, Kendall E, Marshall CA, eds. (1997). Extraordinary bodies: Figuring physical disability in American culture and literature. Columbia University Press.
23. ^ Thomas C (1999). Female Forms: Experiencing and Understanding Disability. Open University Press. ISBN 978-0-335-19693-7.
24. ^ Hemmings C (August 2012). "Affective solidarity: Feminist reflexivity and political transformation". Feminist Theory. 13 (2): 147–161\. doi:10.1177/1464700112442643. ISSN 1464-7001.
25. ^ a b Piepzna-Samarasinha LL (2018). Care work: dreaming disability justice. Vancouver: Arsenal Pulp Press. ISBN 978-1-55152-738-3. OCLC 1022794053.