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      Will psychology ever ‘join hands’ with disability studies? Opportunities and challenges in working towards structurally competent and disability-affirmative psychotherapy for energy limiting conditions

      research-article
        1 ,
      Medical Humanities
      BMJ Publishing Group
      disability, Health policy, psychotherapy, Ethics, Politics

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          Abstract

          Despite sustained efforts among critically informed scholars to integrate thinking from disability studies into psychology, the psy disciplines continue to largely neglect the lived experience of disabled people and overlook disability as a form of social inequity and valued culture. In this article, I make a renewed case for integrating thinking from disability studies into psy, in particular within the psychotherapy professions and in the case of ‘energy limiting conditions’, a grass-roots concept that includes clinically and socially marginalised chronic illness such as Long COVID. Drawing on my experience as a disabled practitioner, and situating this within extant literature on disability and psy, I take an autoethnographic approach to exploring opportunities and challenges in bridging the interdisciplinary divide. I argue that unacknowledged institutional ableism within psy reproduces and is reinforced by physical and attitudinal barriers for disabled practitioners and service users, engendering under-representation of disability in psychotherapy professions and lacunae in disability-affirmative conceptual resources. Additionally, I propose that hermeneutical lacunae are bolstered by documented defensive clinical practices pertaining to disability. After discussing a wealth of opportunities for integration offered by disability studies, and noting the institutional failure within psy to embrace disability-related demographic and epistemic diversity, I question whether ongoing epistemic and social exclusions within the psy disciplines constitute a case of ‘willful epistemic ableism’. Drawing on theorising vis-à-vis epistemic injustice and epistemologies of ignorance, I signal a form of systematic, actively maintained and structurally incentivised (motivated) non-knowing that results in collective failure among dominant groups to recognise established hermeneutical resources of the disabled community and allies. I conclude with suggestions of how this form of epistemic injustice might be mitigated.

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          Most cited references150

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          Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

          Ilan Meyer (2003)
          In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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            Conceptualizing Stigma

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              Epistemic Injustice

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                Author and article information

                Journal
                Med Humanit
                Med Humanit
                medhum
                medhum
                Medical Humanities
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1468-215X
                1473-4265
                June 2024
                24 June 2024
                : 50
                : 4
                : e012877
                Affiliations
                [1 ]departmentDepartment of Women's and Children's Health , Uppsala University , Uppsala, Sweden
                Author notes
                JoanneHunt, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; joanne.hunt@ 123456uu.se

                None declared.

                Author information
                http://orcid.org/0000-0003-3868-5765
                Article
                medhum-2023-012877
                10.1136/medhum-2023-012877
                11877048
                38914457
                24b99bbd-de6b-4c86-8ac3-1e0b5b0dc74a
                Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ Group.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

                History
                : 22 May 2024
                Categories
                Original Research

                disability,health policy,psychotherapy,ethics,politics
                disability, health policy, psychotherapy, ethics, politics

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