Article Highlight: Vol. 41, Issue 1, “‘I Don’t Have Time for an Emotional Life’: Marginalization, Dependency and Melancholic Suspension in Disability”

This week on the blog we are highlighting Brian Watermeyer’s article “I Don’t Have Time for an Emotional Life”: Marginalization, Dependency and Melancholic Suspension in Disability. Watermeyer provides an introduction to key aspects of the social and economic marginalization of the disability minority experienced globally. He then explores and compares the complex debates surrounding materialist and psychological approaches and accounts of racism and disablism, particularly with reference to the place of grief and loss in disability discourse. Finally, Watermeyer considers how Cheng’s engagement with racial melancholia may help illuminate how disability inequality, like that of race, may remain a stubborn reality.

Watermeyer begins by discussing some theoretical orientations of social inequality. In the discipline of disability studies, it is a historical materialist (Marxian) approach which has dominated, with particular attention to psychological aspects of disability oppression. Disablism can be defined as discrimination based on physical, sensory, cognitive, or psychiatric impairment. Combined with critical and liberatory theory of racial inequalities, Watermeyer states it is reasonable to assume that living in the face of discrimination and marginalization will create feelings of grief, withdrawal, and suffering, as harms are sustained at both the physical and psychological levels.

In her book, The Melancholy of Race: Psychoanalysis, Assimilation and Hidden Grief, Ann Cheng (2000) presents a psychological model of racial inequality with loss at its center. For Cheng, racial inequality persists within the United States because it forbids grief. The larger, societal demand for every individual to strive for an ideal cultural whiteness continually pulls individuals away from an emotional center, creating ambivalence, a lack of self-empathy, and distortions of ideology.

Building off of Cheng’s argument, Watermeyer discusses the shared characteristics of racism and disablism. Prejudice and stigma are the ever-present companions of structural inequalities for both forms of disparity. Disabled people, especially those in low income countries, are the most vulnerable of the vulnerable, as most societies are designed with only the needs of the non-disabled majority in mind. There are formidable barriers to housing, transportation, and freedom of movement, as well as exclusion or segregation in education and other public accommodations.

Additionally, Watermeyer states the cultural embeddedness of making sense of disability via a “medical model” has reinforced the marginal position of disabled people. In this institutional view, social disadvantage is understood as a simple consequence of bodily difference or dysfunction, portraying disabled people as “damaged invalids” who are unable to contribute in community life. This view negates any consideration of discrimination’s role in inequality.

While the historical materialist view recognizes the role of biomedicine in justifying the marginalization of disabled people, it is the quantifiable, visible reality of exclusion from the workplace, and other “barriers to participation,” as its primary focus. Yet Watermeyer recognizes the analysis of oppression should not just be in the public, institutional spheres, but should also include private domains. Social exhaustion and scarcity have a psychological component, and it is important to understand the ways in which ongoing assaults on identity limit the imaging of different social organization.

For Watermeyer, there are several problems with describing feelings of damage and tragedy as arising from both congenital and adventitious impairment, with little or no attention to structural or contextual factors. This viewpoint positions impairment of the body as the central disadvantage faced by disabled people, ignoring injustices such as discrimination and rejection. Further, attaching narratives of tragedy to disabled people has been loudly rejected by the international disability movement. According to Kleinman, Das, and Lock (1997), if there is loss or grief in the lives of disabled people, it has to do with social suffering, not bodily “flaws.”

While discussing oppression and melancholia, Watermeyer describes an encounter with “J,” a male psychotherapy client living with tetraplegia (paralysis of the lower limbs and partial paralysis of the upper). A South African man in his mid-twenties, J lived a life of profound structural exclusion, unemployment, physical dependency, a poor social network, and imprisonment in his mother’s residence by poverty and poor public transportation. In his limited engagements with the world, indications that he was “broken” were commonplace.

When questioned about his emotional experience of these circumstances, J’s reply was, “I don’t have time for an emotional life.” At the subjective level, being trapped in an immovable system of structural exclusion meant being equally controlled by an “emotional economy,” with its own rules on what could be felt, loved, hated, or hoped for. In J’s life, these constraints appeared to limit emotional freedom as definitively as unreachable buses limited his movement. Emotional care, guilt, and limited space were the constant followers of his physical dependency, transferring feelings of sadness, frustration, or rage to unconsciousness. Simply, “not having time for an emotional life” meant not having the resources to overcome prohibitions on feelings and expressions of grief.

Melancholic systems deal with difference by maintaining existing racialized and discriminatory structures. This disjuncture produces a detrimental position involving both alienation from one’s emotional self, and experiences in the social world which repeatedly point to one’s failure to assume the ideals which secure real belonging. Watermeyer states that dominant culture presents disabled people with a paradox: while reaffirming the message that the disabled figure is dismal and broken, the world demands that he or she not grieve, as this would be a submission to the passivity, pessimism, and invalid status that pervade the disabled stereotype. As in the case of race, the ruling is “prove to me that you are not what I know you to be.”

Watermeyer’s perspective reframes lives of disabled people as basic to the universal human condition. The stereotype which attaches loss simplistically to impairment is rejected, and replaced by a more nuanced picture of struggle relating to discrimination, structural exclusion, pain, fatigue, and the host of everyday miseries that punctuate any human life.

References Cited:

Cheng, Ann A. (2000) The Melancholy of Race: Psychoanalysis, Assimilation, and Hidden Grief. Berkley: Oxford University Press.

Kleinman, A., V. Das, and M. Lock. (1997) Social Suffering. Berkeley: University of California Press.

Article Highlight: Vol 40 Issue 4, Media Representations of Opioid Misuse


The December 2016 issue of Culture, Medicine & Psychiatry is now available here. In this series of article highlights, we will explore publications included in the latest issue. This week, we present a highlight on Julie Netherland and Helena B. Hansen’s “The War on Drugs That Wasn’t: Wasted Whiteness, ‘Dirty Doctors,’ and Race in Media Coverage
of Prescription Opioid Misuse.” 
The article is accessible in full here.

The authors open their discussion by remarking that the media in the United States has increasingly honed in on heroin and opioid use and misuse by white individuals, particularly featuring stories like that of actor Philip Seymour Hoffman. However, throughout these articles, race is typically not mentioned in conjunction with white opioid users. At the same time, the media has historically depicted drug users as “black and brown,” and demonized these individuals as criminals whose drug use behaviors should be heavily policed.

Thus, the authors assert that there is a “narcotic apartheid” in the media, in which white drug users are insulated from the racist narratives that are attached to opioid misuse amongst non-white individuals. Coded language is typically used to delineate users by race: for instance, using “suburban” or “rural” to refer to white opioid users versus “urban” to indicate non-white users. Classist undertones also shape these narratives, as rural methamphetamine users are derided as ‘hillbillies’ who threaten the moralized order of “whiteness” as suburban and middle class. The type of drugs themselves have taken on racist and classist meanings, such that prescription drug misuse (often ascribed to wealthier, white individuals) is under-prosecuted compared to the use of methamphetamine (poorer, white individuals) and crack cocaine (people of color.)

Despite this, the authors state, it is the racist narrative that remains most prominent in media accounts. Through systematic coding and analysis, Netherland and Hansen found that middle-class white drug users are almost universally characterized in news stories as having “wasted” potential and being “victims” of a challenging climate of drug misuse. They also discovered that stories about drug misuse amongst people of color was not viewed as “newsworthy.” When it was reported, articles focused largely on arrests made or on convictions of drug-related crimes, or on the networks that linked drugs from black and Latina communities to white individuals in the suburbs. In the stories of white opioid users, the articles shifted blame away from the individuals, suggesting they did not ‘intend’ to become addicted. When discussing how to address white drug misuse, the articles most frequently turned to physicians’ prescription practices and the threat of over-prescription. Thus, the solution proposed entails greater regulation of prescription habits: again, beyond the level of the individual user.

Articles on opioid use amongst predominantly non-white, “urban” populations overwhelmingly suggested increased “criminal justice involvement” as the most appropriate response. These articles tended not to craft the stories of non-white opioid users as tragic or accidental. This centralized blame for addiction on non-white opioid users, whereas as noted before, white opioid users tended not to be blamed for their behavior. Further deepening these racist undertones was that the “dirty doctors” (those willing to prescribe opioids to predominantly white patients) reported on in the news were often themselves people of color or immigrants.

The authors conclude that characterizations of opioid news articles as “color-blind” due to the inclusion of stories on white users is misleading. While they agree that the representations of white opioid users demonstrates the impact of drug misuse across racial boundaries, there remains coded language that systematically disparages and marginalizes people of color who use these substances. Netherland and Hansen state that “in short, the problem of race and opioids cannot stop with expansion of access to treatment. Clinicians and health advocates have to address institutional racism, as reflected in media coverage of inner city heroin use versus the prescription opioid epidemic, if they want to dismantle racial exclusions in drug interventions” (page 680.)