Silk purses and sows' ears: the social and clinical exclusion of people with intellectual disabilities

摘要

This paper examines society's unconscious refusal to welcome people with intellectual disabilities from the margins of society, with particular focus on a specific manifestation of this enactment of social exclusion by the psychotherapy profession. I form connections between a societal disavowal of the human rights of people with intellectual disabilities and the psychotherapy world's paranoid fears of inviting the socially and cognitively excluded into its consulting rooms. Through an examination of the notion of social exclusion and cognitive deficit being mutually sustaining phenomena, I explore the detaching of people with intellectual disabilities from social relations and institutions, using as my main example the relative failure of contemporary psychotherapy in its various forms to include this patient group in its range of possible beneficiaries. Using various aspects of intersubjective, object relational and organisational perspectives, I consider the improbability of people with mild, moderate and severe intellectual disabilities reaching the apex of our globalised western society, and the various social ruptures that conspire to deny those with cognitive deficits a place at the social, economic, political and psychological table. I compare some literary representations of intellectual disability with more contemporary televisual portrayals, and consider the possibility of social inclusion through a rejection of a social model of disability that creates an artificial boundary between the ‘disabled’ and the ‘non-disabled’.