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More thoughts on empowerment.

The invitation to write this response to Emener's paper on empowerment came as something of a surprise. "I haven't written anything on empowerment" says I, "Why me?" After a quick review of my publication list I realized that I've not written on much of anything else; I just hadn't used the word "empowerment" very often. Obviously, others were paying more attention than I was.

The Burnt-out Administrator (1980) ended with a section headed "Reassessing Power". It differentiated push power from pull power, and power over others from power over oneself. The following year, The Psychology of Disability (1981) began a chapter titled "Legislating: The Long Arm of the Law" with these words.

"The last chapter... 'Transcending: Disability as Growth Experience' suggested that benefits accrue when individuals can let go of personal power strivings. This chapter emphasizes the psychological benefits of belonging to a group with a solid, political power base. The apparent conflict is resolved only by apprehending the developmental and multifaceted nature of the coping process. Law-making is a basic power approach designed to give freedom and equity to groups of people. Transcendence of power needs and approaches, as discussed in the previous chapter, is an individual's step toward liberation of a different kind. It becomes more attainable, it seems, after individuals have experienced the sense of being powerful in ways meaningful to them. Thus, while the previous chapter pointed out that excessive preoccupation with power may interfere with reaching the highest levels of self-actualization, this chapter unabashedly recounts the psychological values of having sufficient political influence to protect one's fundamental, self-evident, inalienable rights."

The Dream's Not Enough (1981), a film, and Women and Employment (1982), a monograph, were about empowering women with disabilities to chew their way out of a trap with two locks-- stereotypical careers for women that were also stereotypical careers for people with disabilities. This territory of empowering women to move into non-traditional employment has been so well worked by others during the eighties that no further word of explanation is needed.

In Psychological Aspects of Rehabilitation Engineering (1983a) I tried to clarify why people with disabilities sometimes reject assistive devices ordered by professionals, in the hope of increasing providers' respect for consumers' choices. The pivotal issue is the degree to which a device promotes accomplishment of life tasks which the consumer sees as important. To illustrate:

"If the client lives, s/he is motivated. When professionals declare clients, patients, students, etc. 'unmotivated,' what they mean is "They're not motivated to play my game my way."When I rejected hand rims on my first wheelchair, many professionals would have taken that as evidence that I was unmotivated. Nothing could have been further from the truth. I had thought it all out and reached what seemed the best decision in view of my specific life goal at that time--getting a goodman: no hand rims because a) they would add to the distracting clutter of the wheelchair and I wanted people, especially men, to see me, and b) they would suggest that I could propel my own chair, which would interfere with the serene, helpless, graceful image I intended to project. Like a fox is crazy was I unmotivated."

That may sound neurotic as hell now, but it was highly adaptive in 1951. And it was my decision, based on my perception of the important tasks in my life. My family and the professionals who served us bit their tongues, let me learn by my own mistakes if that was how it had to be, and did not disempower me by over-riding my judgement in order to protect me. Their faith and patience were rewarded. Once I accomplished the task of getting a good man, and my chosen life task became "get a good JOB", I was instantly motivated to go for any devices that might help reach it, regardless of their effects on my appearance.

In 1983 I prepared a Rehab Brief (Vol. VI, No. 7) titled "The Results of Helping: Empowerment or Helplessness?" It summarized work done by Brickman, Coates, and others at the University of Wisconsin, showing that certain helping models may render help recipients more helpless than before. Four models were studied, each defined in terms of the locus of responsibility for causing and solving problems: you are responsible for neither in the "medical" model, for both in the "moral" model, for the cause but not the solution in the "enlightenment" model, and for the solution but not the cause in the "compensatory" model. While noting that models holding individuals responsible for solutions (moral and compensatory) may cause fewer engendered-helplessness problems, the researchers did not promote one model over the others. They concluded that helpers may help most by helping people sort what they can control from what they cannot. It seems worth noting that what the authors called the "moral" model might now be called the "holistic or holotropic health" model.

Families with Disabilities: A Mutual Adjustment Process (1983b) stressed the importance of expecting people with disabilities to meet their responsibilities to family members who may be handicapped by their disabilities as much or more than they. It doesn't take mental gymnastics to discern that responsibility is empowering, whereas being relieved of it is disempowering. Brickman, Coates, et al., cited earlier, saw this in their study of the medical model.

In Evaluation from the Client's Point of View (1984a) I described a "consulting model" of rehabilitation service opposed to a "boss model" where a powerful authority tells a powerless subordinate what to do. My consulting model is close in spirit to Emener's empowerment model, as both oppose the decision-making imbalance still endemic to medical practice. In the context of evaluation, the major points were: a) it is the client, not the professional, who most needs to know the results of any tests, to aid lifelong decision making; and b) many tests cannot be interpreted without the client's input. That is, what are called "interpretations" of test profiles are only tentative hypotheses which must be validated by the client. "Information is power" and "turn the power over to the people" were the main themes of that presentation. In a more general context, I urged readers to operate, not like managers, but like consultants who empower managers to make good decisions long after they (temporarily hired experts) are gone from the scene.

That same year, I studied Yugoslavian Self Management in Rehabilitation (1984b). Descriptions in the literature sounded so empowering that I hoped for ideas to help our rehabilitation organizations. However, centuries of domination seemed to have made Yugoslavians so wary of the corrupting possibilities of power that they had forgotten it also enables. To prevent abuse, no one was granted enough power to get anything done. I should have waited; barely a year later, Yugoslavian newspapers were admitting openly that Tito's grand idea wasn't working.

On the subject of "who has the power", when asked to provide a Commentary on a monograph titled Independent Living and Attendant Care in Sweden (Ratzka, 1986), I minced few words.

"Swedish cluster housing sounds like you pay for the physical help you get by turning over to the municipality the control of your life-- even if you're fully capable of doing all the social-management decision making that needs to be done. The devil offered Faust a better deal."

An invited reaction to newly formulated ethical canons for rehabilitation counselors was titled Fighting Another's Battles: When Is It Helpful? Professional? Ethical? (1987a). The canon stating that counselors should do advocacy seemed overly protective, compared with an emphasis on their responsibility to teach--empower--clients to advocate for themselves.

An invited address on Quality of Life (1987b) formulated definitions barring anyone from judging another's "quality of life". Members of society may judge the value of each other's lives--to illustrate, many people say Einstein's life was more valuable than their own. And we assign values to lifestyles regardless of who is "wearing" them, ourselves or others. I simply reserve the term "quality" to apply to the subjective qualitative experience, and no one can assess that but the subject.

The foregoing passages on empowerment are easy to characterize as such and place in a rehabilitation context. Another set is more difficult to explain. If the kinds of empowerment discussed above could be labelled "political" and "psycho-social" or "psychological", then the remaining ones might be seen as adding a "psycho-spiritual" dimension.

A local Humanist Club invited me to address its members on the topic "What It's Like to Be Disabled". The group had no prior knowledge of disability issues, and the soul search I conducted in order to give them something authentic led to a speech titled Mortal: Why Me, Lord? God: Why Not? (1984c). The writing process drew me into realms of consideration that were alien and surprising to me at the time, at least on a conscious level. In retrospect, it began a new way of understanding, expressing, and trying to help others understand and express "empowerment". It also triggered recognition that writing--the process--is part of the research effort, not just something to do after the findings are recorded. This required a belief shift, toward paying as much honor to the science conducted in "the laboratory within" as to that conducted in ordinary laboratories. That belief shift has proved to be the most empowering change of all.

Empowerment at the level of the individual personality includes such examples as: having an ingrained disposition of expecting your ideas to be respected; being deeply fascinated by some phenomenon or subject matter; or discovering that you can make mistakes and nothing terrible will result. In short, anything construed as being motivating can be construed also as empowering. Motivation is power. Intellect is the steering wheel and desire is the motor. Having your motive power available, not immobilized by fear of being ignored, ridiculed, or struck dead, is vastly empowering. This kind of empowerment is largely something our parents do for us, through the genes that help determine our energy levels and other physiological aspects of functioning, and through early experiences that reward powerfulness or discourage it. If our parents did us wrong--usually unknowingly--sometimes our friends or professionals can help us gain empowerment later on.

An address to the National Recreation Therapy Association (1989a) urged members of the audience to use the books, audio-taped lectures, and videotaped interviews of mythologist Joseph Campbell to help clients put painful experiences into spiritual contexts. The purpose is to mine beneath surface appearances of being victimized by unfairness or outright evil to deeper perceptions wherein suffering takes on meaning within a larger religionphilosophical context. Campbell spent a long lifetime gathering data from virtually all cultures, sifting through writings and artifactual evidence of sacred beliefs to arrive at the cross-cultural commonalities. One can thus be sure of covering the known ways of looking at pain and suffering and share them with clients without proselyting them toward a particular belief system.

That year I also wrote an essay titled "I have this body; what am I supposed to do with it?" for a training guide accompanying a counseling videotape on maximizing attractiveness (1989b). I began with an explicit acknowledgement of the connection between attractiveness and empowerment.

"Research has provided supportive evidence for folk wisdom about the power of attractiveness. The better looking you are, the greater are your chances for success and happiness in your personal life, your social life, your love life, and your work life."

The essay then wound its way through all five senses--how to look better, sound better, feel better, taste better, and smell better. It ended with a hint about a sixth sense, a section headed "What you Intuit: Love Isn't Blind, It Sees through Cherished Lies."

"You were born with crummy hair? Face? Body? Fine. Let's do the best we can with all of them; and then turn to a more potent matter--the attractiveness of our personalities. Hopefully, we'll also have time to work on what some people believe you can take with you--spiritual beauty, the kind that glows from your innermost core and radiates out."

Interpersonal interactions in groups, organizations, societies, or the entire globe cause the complexity of understanding what empowers whom to increase dizzyingly. A personal confrontation with this arose while preparing a panel presentation on The Right to Die: Whose Decision Is It? (1990a). A crucial factor in the controversy about who has the power to say "when" manifests both as an aspect of social philosophy and as an individual personality trait--the urge to seek freedom versus the urge to seek protection. American social philosophy tries to guarantee both liberty for all and protection of the vulnerable. This can't be done fully, since freedoms collide with each other and protections collide with freedoms. Difficulties arise when personalities are strongly driven toward freedom versus protection, and they assume everyone else is or should be driven in the same direction.

Through literature search and networking I discovered that I am far more willing to risk certain protections in order to keep certain freedoms than are many of my disabled-advocate colleagues. Most are against right-to-die measures which could erode protection against decision makers with "the-disabled-would-be-better-off-dead" mentalities. They are working hard to protect--empower--us against excessive societal readiness to eliminate severe disability the Nazi way. However, from the viewpoint of someone who deeply understands Patrick Henry's anguished cry, despite benign motivations, their efforts potentially block the freedom to say "when" on the ultimate issue in life--which is disempowering.

There is good news behind the confusion of single acts being both empowering and disempowering for the same people. Neither side is "right"; the health of our system resides in the dynamic tension that gives balance between the libertarian and protectionist extremes. If either side ever wins, we're in trouble. Awareness of this empowers one to rise above the unending debate and see that it is more than okay to be at a standoff; it is vital. By further understanding that the key is individual personality differences, not an absolute moral imperative, the energy drained into proving one side right and the other wrong can be used in honest negotiating toward equity between differing preferences.

An address to the American Congress of Rehabilitation Medicine (1990b) jumped and rolled onto the battlefield of who-has-the-power? in the delivery of health-care services. Suffice it to say that provider-power was distributed equitably among the usual allied-health and rehabilitation professionals plus naturopaths, Chinese herbalists, Native American shamans, Christian Science practitioners, and practitioners coming to be classified under the rubic "energy medicine"--e.g., acupuncturists and Aryuvedic practitioners. (Actually, all but allopathic medicine --which seems stuck on matter, not energy--may eventually be classified there.) On the balance of power between consumers of health-care services and providers, I spoke for the "consultant" rather than "boss" model and let it go at that.

An article titled "Transcending Catastrophe: Psycho-spiritual Aspects of Rehabilitation" (in press) observes that interest in mundane versus spiritual power follows a developmental sequence.

"Building a philosophy of life in which having a disability has meaning at a metaphysical level will not be the first order of business during most people's initial rehabilitation.... When I got it that I was to be a permanent quadriplegic, I had no inclination to contemplate my purpose here on planet earth, the impact of quadriplegia on fulfilling it, or the acquisition of spiritual power. All I wanted then was to acquire enough ordinary interpersonal and economic power to reasonably assure my physical and psychological survival. Only when I felt 'home safe' on those scores did I begin to pay attention when philosophical topics were mentioned."

Philosophical topics are about the only ones that interest me anymore. The book I am presently writing bears the working title "Personality and Catastrophe: Partners in the Dance". Clearly, it is not just about coping with the physical and psycho-social worlds described in The Psychology of Disability a decade ago. It acknowledges a world beyond that accessible to the five senses, a world of spirit or pure energy or Divine Consciousness. In the metaphor of religion, it is equally about the soul, and how the soul uses personalities as instruments for perfected expression, and how that often works best when personalities master catastrophic losses, pain, and suffering.

This wide array of issues relating to empowerment suggests the importance of mutual empowerment in decision making at all levels and in all specialties of rehabilitation. It is probably obvious to everyone that policy setters need to empower managers to empower service providers to empower clients. Today's mail brought what appears to be a handout from a workshop to help top managers select and develop middle managers who can be counted on to empower their subordinates. It is a summary diagram of the "principles of empowerment." There is no information permitting me to give credit to the creator, but it is so suitable for rehabilitation organizations--applying to all levels from the client to the chief agency decision maker--that I will accept the magic of its timely appearance and describe it nonetheless. Picture a pyramid. It is divided into seven layers--from its wide-based bottom to its apex. The bottom and largest layer is marked "Courage". One step up is "Trust." Above these, in order, are "Responsibility," "Integrity/Commitment," "Authenticity/Self-expression," "Communication," "Autonomy," and finally, at the apex, "Contribution or Service."

What may not be as obvious is that empowerment is not a one-way flow. Gary Zukav's 1989 bestseller The Seat of the Soul helps to explain this by distinguishing "external" from "authentic" power.

"The power to control the environment, and those within it, is power over what can be felt, smelled, tasted, heard or seen. This type of power is external...(it) can be acquired or lost... One person's gain... is perceived as another person's loss. The result of seeing power as external is violence and destruction. All of our institutions--social, economic, and political --reflect our understanding of power as external... The ability to control concentrated in the hands of a few people. To protect workers...we have created unions. To protect consumers, we have created bureaucracies... Anything we fear to attractive body, an agile a symbol of external power. What we fear is our vulnerability... After millennia of brutality to one another... it is now clear that the insecurity which underlies the perception of power as external cannot be healed by the accumulation of external power.

"Our deeper understanding leads us to another kind of power...that loves life in every form...that does not judge what it encounters, a power that perceives meaning and purpose in the smallest details upon the Earth. This is authentic power. When we align our thoughts, emotions, and actions with the highest part of ourselves, we are filled with enthusiasm, purpose, and meaning...Authentic power cannot be...hoarded. An authentically empowered person is incapable of making anyone or anything a victim...No understanding of evolution is adequate that does not have at its core that we are on a journey toward authentic power, and that authentic empowerment is the goal of our evolutionary process and the purpose of our being."

I would not try to dissuade my colleagues from continuing to deal with what Zukav calls "external power," but I do hope to persuade a few that attention to what he calls "authentic power" is also important to do.


[Institute for Information Studies, 1981,

The Dream's Not Enough: Profiles of

Successful Women with Disabilities. A

vocational counseling film and user resource guides, Institute for Information Studies: Falls Church, VA. PSI International, 1983, The Results of Helping: Empowerment or Helplessness? Rehab Brief, Vol. VI No. 7. Ratzka, A., 1986, Independent Living and Attendant Care in Sweden: A Consumer Perspective. (Commentary, page 65.) World Rehabilitation Fund: New York. Vash, C., 1980, The Burnt-out Administrator. Springer: New York. Vash, C., 1981a, The Psychology of Disability. Springer: New York. Vash, C., 1982, Women and Employment. In Perlman, L. and Arneson, K. (eds.), Women and Rehabilitation of Disabled Persons: A Report of the Sixth Annual Mary E. Switzer Memorial Seminar. National Rehabilitation Association: Alexandria, VA. Vash, C., 1983a, Psychological aspects of rehabilitation engineering. In Redden, M. and Stern, V. (eds.), Technology for Independent Living II. American Association for the Advancement of Science: Washington D.C. Vash, C., 1983b, Families with Disabilities: A Mutual Adjustment Process. Invited address, conference on The Disabled Person in the Family Setting. The Institute for Rehabilitation Research: Houston. TX. Vash, C. 1984a, Evaluation from the client's point of view. In Fuhrer, M. and Halpern, A. (eds), Functional Assessment in Rehabilitation, Brookes: Baltimore. Vash, C., 1984b, Yugoslavian Self Management in Rehabilitation. World Rehabilitation Fund: New York. Vash, C., 1984c, Mortal: Why Me, Lord? God: Why Not? Address to Humanist Club, Long Beach, CA. Vash, C., 1987a, Fighting another's battles: when is it helpful? professional? ethical? Journal of Applied Rehabilitation Counseling, Vol. 18, No. 4. Vash, C., 1987b, Quality of Life Issues Affecting People with Disabilities. Invited address, Second Annual National Education Forum, Bloomington, IL. Vash, C., 1989a, Recreation Therapy in the 1990s and Beyond. Keynote address, National Recreation Therapy Annual Meeting, San Antonio, TX. Vash, C., 1989b, I have this body; what am I supposed to do with it? In Looking Specially Good, Human Interaction Research Institute: Los Angeles. Vash, C., 1990a, The Right to Die: Whose Decision Is It? Panel Presentation, American Congress of Rehabilitation Medicine, Phoenix, AZ. Vash, C., 1990b, New Venues, New Allies, New Ways. Fortieth Coulter Lecture, American Congress of Rehabilitation, Phoenix, AZ. Archives of Physical Medicine and Rehabilitation, Vol. 71, no. 13. Zukav, G., 1989, The Seat of the Soul. Simon and Schuster: New York.]
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Title Annotation:Empowerment for People with Disabilities; response to William G. Emener 57 Journal of Rehabilitation 7, 1991
Author:Vash, Carolyn L.
Publication:The Journal of Rehabilitation
Date:Oct 1, 1991
Previous Article:Living with disability in Guatemala.
Next Article:Empowerment: a rejoinder to Vash's and Hahn's reactions.

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