by Angelina Veiga, Disability Psychotherapist


Disability organisations tend to promote the concepts of advocacy, self-choice and self-determination under the guise of a person-centred ethos and subscribing to the UN Declaration of Human Rights and the UN Convention on the Rights of People with Disabilities. However, in practice some organisations are not actualising what they promote. Instead, and increasingly we are faced with organisations operating in states of anxiety and crisis, where systemic despair envelops those being supported by the disability service. This creates an anxiety felt by all those within the system. The trauma of disability becomes further traumatising for those not adequately being contained at a psychic level due to increased anxiety in the organisation.

While it is acknowledged that many agencies are excelling at service delivery to enable people to live as independent and self-actualised lives as possible, it is this author’s experience that there also exist agencies who are unable to provide a thinking space for all levels of staff to reflect on the experience of a disabled organisation. A disabled organization is an organisation that finds themselves unable to think. They lose the ability to think about the effects of disability on people whom they support. This non-thinking state vibrates through and paralyses the organisation’s capacity to think and reflect. The organisation becomes traumatised.

In disabled organisations a culture develops that consists of crisis management and scapegoating. Dissociation in service provision develops. Management teams dissociate from the experience of lower-ranking staff, who in turn dissociate from the disabled people they are supporting.

Disability by its nature draws a projection of societal hate and fear; these states are projected onto the disabled person. In disabled organisations this is mirrored within staff teams and through organisational dynamics and modes of relating. Furthermore, a hierarchy of projected disability can exist amongst people with disabilities themselves.

The demand for organisational advocacy is infused by the hate of the advocate for challenging longstanding organisational culture and beliefs necessary for introducing change. The advocate must become creative and strategic in their approach to encourage, empower and influence thinking and unconscious belief systems to explore and implement lateral thinking among resistance by those who hold power, whether through organisational dynamics or employment contracts. The advocate finds themselves a lone voice and bearing witness to the projections of disabled thinking and non-thinking states that see the hate of disability seeking to find containment in the advocate. The system is not set up to support the advocate to complete the organisational tasks set. The advocate takes refuge in small victories and thinks about the internal world and experience of the person with disabilities.

Disabled organisations lose the ability to work relationally—i.e. to consider self with other (De Young 2003). They also lose the ability to mentalise (Fonagy, Gergely et al 2004). Human beings are essentially meaning making and relational beings that seek to understand relationary experiences. Disability can be experienced as continuous trauma that contains losses, abuses and the infringements of human rights. It is extremely painful to think about the losses and infringements that people are experiencing on a daily basis as they access services. These losses can include the loss of relationships, sexual lives, financial control, privacy and health, amongst others.

Organisations struggle to contain the anxiety inherent in the attempt to deliver a service with fewer resources. This is a real and traumatising reality in this current climate of cutbacks. These cutbacks result in reducing quality of life of those most vulnerable and those who are less able to advocate for themselves. The emotional and practical effects of these cutbacks are enormous.

Disability service provision calls for the examination of the emotional impact of the disability. Examination of impact of disability can occur in reflective meetings, where open and honest discussion of all aspects of work is encouraged. These types of meetings promote insight and lead to healthy organisational functioning (Hopper 2011). When agencies struggle to provide thinking spaces and contain the anxiety and pain of disability, there cannot be a culture of advocacy, self-determination or choice. The anxiety of the current financial experience for disability organisations moves managers away from thinking about the lived experience of disability to ‘managing the books’. There needs to be space for people to bear that which is most unthinkable—the pain of a life unlived and the pressures to exist against societal repulsion and financial constraints. Without thought, trauma paralyses the thinker; with thought there is some respite and a capacity to hope that things can be made better or at least survived.


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