The Capitalization Question: Not long ago, a reader asked us why we use the capitalized version of Deaf in our blog and website. This question brought us back to our thoughts last year, when we were in the middle of writing the text for the ASC website and debating the D/d issue. Opting to capitalize Deaf was not something we decided on a whim, nor was it a separatist type of move. We did it consciously, out of inclusion, out of practicality, and out of pride.

Deaf as an Inclusive Term: Far from viewing “Deaf” as a way of excluding people, we see the term as an inclusive one. To us, “Deaf” refers to any people who happen to be Deaf. It has nothing to do with having Deaf or hearing parents, or using ASL, SEE, spoken English, cued speech, or any other communication modality. Neither does it matter if one was mainstreamed, educated at a Deaf school, or homeschooled. Degree of hearing loss, being Deaf from birth or being late-Deafened, using a hearing aid or a cochlear implant – none of these, in our minds, precludes anyone from being Deaf.

Capitalizing Deaf parallels capitalizing African American, Jewish, Hispanic, and so on, with each of these capitalized designations referring to a group of people with their own culture and physical characteristics (i.e., skin color, bloodline, hearing status). All of these terms are inclusive. Some Jewish people may be observant Orthodox Jews, centering their lives around their religion, while others may simply identify as Jewish through their family lineage and never set foot in a temple. Some Jewish people speak Hebrew, while others don’t. Similarly, some Hispanic Americans may be fluent Spanish speakers, while others, perhaps third- or fourth-generation Hispanic Americans, may not be conversant in Spanish at all. Some may have dark brown skin, while others may have light brown skin, and still others might “pass” as Caucasian.

None of these differences function as exclusionary criteria. Jewish people are Jewish, African Americans are African American, and Deaf people are Deaf, no matter what individual differences might exist within these groups.

Deaf as a Practical Term: By using Deaf as an inclusive term, we are able to avoid the cumbersome use of a string of words describing different kinds of Deaf people. Which is easier reading?:

A) It’s important to know that being Deaf, deaf, hard of hearing, hearing impaired, Deaf-blind, or late-deafened itself is not a cause of depression.

Or

B) It’s important to know that being Deaf itself is not a cause of depression.

The practice of switching back and forth between Deaf and deaf, depending on the situation, is awkward and unnecessarily complicated. We don’t see jewish, african american, or latina being used to differentiate less-observant Jews, lighter-skinned African Americans, or non-Spanish speaking Latina people. It is simpler to reserve the use of “deaf” for when it is not referring specifically to people. For example: “She was deaf to his pleas”.

Of course, when distinctions need to be made between Deaf people (i.e., for research or assessment purposes), we understand the usefulness of terms like those mentioned above (i.e., hard of hearing, late-deafened, etc.). We also respect people’s choices in how they decide to describe themselves.

Deaf Pride: Why not just get rid of the big D and use “deaf” to refer to all people who are Deaf? We did consider doing this, but in the end, we felt it important to acknowledge that Deaf people are a unique group of people. In the same way that the J in Jewish is capitalized, the B in Black, and the L in Latina, we choose to capitalize the D in Deaf to reflect our pride in our community and culture.

Back to School: With September underway, Deaf students are once again heading back to schools and universities and once again, on the front burner, are concerns about Deaf education, student achievement scores, reading levels, and other related topics. It’s inevitable that comparisons will be made between Deaf students’ performances and those of their hearing peers.

Apples and Oranges: When an achievement “gap” between Deaf and hearing students is identified, panic ensues, fingers point, the ASL-versus-oralism-versus-cued-speech debate is inflamed, and people begin to wonder what is wrong with our Deaf students/teachers/schools/etc. Without a doubt, the Deaf education system, as is true of any education system, especially those serving minority students, has plenty of room for improvement. Comparing Deaf students to hearing students, however, is like comparing apples to oranges.

As Raychelle Harris wrote eloquently on the ongoing tendency to compare Deaf and hearing educational practices:

Why would we want Deaf schools, including Gallaudet University, to be the same as other hearing schools and universities? Our brains are wired differently, we use sign language, our experience is different. Why do we want to be like other universities? What’s wrong with being different? Why do we feel the need to conform to other university practices to validate our own practices at Gallaudet? This way of thinking: If they do this, then it’s ok for us to do this. If they don’t, then we cannot – is evidence of colonialism at its best. Our practices can and should be innovative, we have so much to teach the world. (reprinted with permission)

We agree. Yes, it’s a big hearing world out there, but who made hearing people’s language and culture the gold standard by which Deaf people’s performance must be measured? Why do some Deaf schools insist on following hearing schools’ curricula, relegating ASL and Deaf Studies classes to once-weekly occurrences? This quite clearly sends the message that anything Deaf-related is less important or valued than anything hearing-related. Schools should be meeting Deaf students’ needs, instead of trying to mold Deaf students to meet hearing people’s needs.

Selective Respect: It is acceptable and even considered exotic for a hearing British professional working in America, to speak with a British accent and write using British spellings such as “recognise” or “colour”. Why, then, is it a travesty for a Deaf person to speak with a Deaf accent or write English with second-language accent? Why are British people’s accents are more respected than those of Deaf people? Some people might argue that British people use “proper” English, but if that is the case, who decided that the American versions of “recognize” and “color” are acceptable, and not examples of “bad English”? Deaf people, and even other minorities such as African Americans, are quick to be criticized when our English is accented.

Meaningless Scores: In the same way that a psychological assessment score for a Deaf person can mean something very different than what it means for a hearing person, so do SAT scores and other achievement scores mean different things for Deaf students than they do for hearing students. More and more hearing universities give little weight to SAT scores these days, anyway, recognizing that they are poor predictors of achievement. It is unfair to look at Deaf and hearing scores side by side and come to the conclusion that Deaf students are less intelligent or less educated than hearing students. The types of questions and the cultural biases inherent in many testing instruments mean that they are not even measuring what they are supposedly measuring.

Tiptoeing Around the Topic: Without a doubt, one of the most sensitive issues in the Deaf community today is the role of hearing professionals who work closely with Deaf people. Bringing up this topic is a little bit like walking on eggshells. No matter your intentions – to open a dialogue, to encourage introspection, to understand motivation behind behaviors – you’re bound to hurt some people’s feelings, offend others, or even be misinterpreted as a militant separatist. Treading carefully with this in mind, we take a look at collaboration issues between Deaf and hearing professionals, and the philosophical implications behind them.

The Forensic Psychologist and the Deaf Psychologist: Not long ago, a hearing colleague who specializes in forensic psychology, and who does not sign or know much about Deaf culture, said something that struck us. He complained to Candace that another Deaf psychologist confronted him about his work evaluating Deaf people, and told him point blank that he was not qualified to conduct psychological assessments on Deaf people for the aforementioned reasons. His response was tinged with anger and defensiveness. He replied that the Deaf psychologist did not know as much as he did about forensic psychology, even though she had had some training, and that she was therefore not qualified to do a forensic assessment on a Deaf person.

In this case, who is more qualified to do a forensic psychological evaluation on a Deaf person? The hearing psychologist implied that knowledge of forensic psychology was more important. The Deaf psychologist countered that cultural knowledge and ability to communicate with the client, in addition to specialized training in psychological issues related to Deaf people, was more important. Who was right? Obviously, in this case, since neither psychologist was an expert in both areas, some kind of collaboration between the two experts was called for.

What we would like to point out, though, is the attitude of the hearing psychologist – that knowledge of forensic psychology is a more important factor than understanding anything about Deaf people as a cultural and linguistic minority group. Unfortunately, this type of attitude is widespread among hearing professionals. When they do collaborate with Deaf professionals in this type of situation, it is often the hearing professional who takes most of the credit for the work. This suggests that the hearing professional’s knowledge and expertise is more valued than the Deaf professional’s knowledge and expertise, even though neither could do the forensic psychological evaluation on the Deaf client without the other’s assistance.

In a collaborative effort such as this, the Deaf professional should be in the front, with the hearing professional being available as a consultant, sharing specialized knowledge and allowing the Deaf professional to grow and become an expert in the same area. Many hearing people are privileged in the sense that they have relatively easier access to learning and developing certain professional skills, in a world that can be oppressive to Deaf people. They have far more job opportunities than do Deaf people, making it feasible for them to specialize in areas such as forensic psychology. A Deaf professional, in contrast, might not as easily specialize in such an area simply because there are not as many job opportunities available in that narrow field.

The Tenured Hearing “Helper”: Another common attitude held by hearing (and some Deaf) professionals is that Deaf professionals “need them”. We were once told by a Deaf professor that it was good news that a hearing person got a position as a professor at Gallaudet, because this hearing person could help Deaf people get jobs in that particular department in the future. This is Gallaudet we are talking about, not some anonymous hearing-centered institution that may know nothing about Deaf people and may indeed need hearing allies to educate its people about Deaf professionals. Are Deaf professionals really so pathetic that we can’t get anywhere, even at Gallaudet, without hearing people’s intervention?

This brings to mind two possible definitions of hearing allies “helping” Deaf people. One option is for the hearing person to back off and not apply for a position that could be filled by a Deaf person. Another option is for the hearing person to go ahead and take the job, get tenured, spend 20 years in the position, and then “help” Deaf people by retiring and advocating for a Deaf person as a replacement, never mind the fact that by remaining in the position for 20 years, the hearing person has basically taken away an opportunity from a Deaf person.

To cite: McCullough, C.A., & Duchesneau, S.M. (2006, August 28). Walking on Eggshells: Deaf and Hearing in Consultation. ASC on the Couch. Retrieved (date retrieved), from http://www.ascdeaf.com/blog/?p=136.

The Big Book: Following up on this week’s earlier postings on labeling, today we thought we’d take a look at the DSM, the hefty 943-page widely used Diagnostic and Statistics Manual of Mental Disorders, published by the American Psychiatric Association. The DSM is used by mental health professionals as a diagnostic tool. Every mental disorder, from autism to depression to ADHD to schizophrenia to paranoid personality disorder, is defined according to how long and how intense a specific list of symptoms has been present. Take a look at this definition of Intermittent Explosive Disorder to get an idea of a diagnosis that has become a popular way of labeling people with road rage.

The Politics Behind the DSM: A little bit of background on the DSM. The first edition was published in 1952; the latest version came out in 2000. The first edition had only 50 diagnoses. Today’s DSM lists 374 diagnoses, more than seven times the original book. Does this mean cases of mental illness have grown in leaps and bounds over the past half century? Not exactly. The increase in the number of diagnoses is more reflective of insurance companies’ demands for very detailed and specific diagnoses. It is also related to the increasing availability of medications that can only be prescribed for certain clusters of symptoms, thus making it necessary to invent names for these symptoms.

Diagnoses end up in the DSM as a result of votes by a panel of psychiatrists. Of course, the panel reviews research, listens to recommendations from mental health experts, and spends lots of time discussing each diagnosis. In the end, though, a diagnosis gets into the DSM if it is the panel’s opinion, or value judgment, that it is actually a mental disorder. Consider the diagnosis of Homosexuality. For years, the DSM counted it as a mental disorder, in spite of the fact that there was no research to support this. Thanks to the efforts of gay and lesbian mental health professionals to educate the public about this, the Homosexuality diagnosis was finally voted out of DSM in 1973.

More and more people who work in the mental health field have been writing about how unfair and harmful DSM diagnoses can be. Women, for example, have been labeled with psychiatric disorders just for having normal mood swings because of changes in hormones related to childbirth or their periods. African Americans and other minorities, including Deaf people, have often been labeled as paranoid even though their fears and anger make a lot of sense due to the oppression they experience.

One Deaf Woman’s Misdiagnosis: If you are looking for a book for your summer reading list, here is one worth checking out. I Was #87, by Anne Bolander and Adair Renning is a story that makes us glad that more and more Deaf professionals work in the mental health field today, making it less likely that Deaf people will be misdiagnosed.

What’s in a label?: Labels are everywhere. We label people by gender, race, sexual orientation, body size, personality, politics, and so on. With every label comes an image, and with this image comes a prescribed set of behaviors. Girls should be polite and follow the rules; boys have lots of energy and sometimes can’t help their unruliness. People with bodies like runway models are beautiful; people with curves need to lose weight. If you cry a lot, you’re a wimp or overly emotional; if you hold back your feelings, you’re in control and rational.

Diagnostic Labels: In the mental health field, as everywhere, labels, or diagnoses, can be useful generalizations, but they can also be harmful stereotypes. Unlike medical diagnoses, psychiatric diagnoses are not as exact or objective, nor are they based on x-ray results or laboratory findings. Psychiatric diagnoses depend instead on clinicians’ interpretations of behaviors and feelings and quite often involve value judgments about what is “normal” and what is not.

Diagnoses may be helpful when they facilitate communication among clinicians and researchers or when they offer some guidelines about how to proceed with treatment. They can be harmful when they are stigmatizing or when they pathologize behaviors or temperaments that simply don’t fit into a culture’s definition of acceptable roles or behaviors, but are not necessarily mental disorders. Because insurance companies require diagnoses in order to cover therapy, our work as psychotherapists often means we are required to diagnose. Our focus in therapy, however, focuses not upon these diagnoses or labels, but on understanding clients’ issues and the possible impact of ineffective or oppressive societal, cultural, familial, or political systems on clients.