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The Medical Model of Disability identifies disability as being a individualised medical problem based on impairment, deficit and dysfunction.  This model depoliticises disability and extracts it from wider socio-economic, political and cultural contexts.  In this extraction from context the medical model means that performance environments, artistic content, performer identities are all at  odds with the specificities of disabled artists.

Theatres continue to exclude by virtue of their physical and sometimes geographical inaccessibility. Curricula of artists training courses promote standards that some with (or without) impairments will never reach.  Curricula content say nothings of the history of exclusion experienced by disabled people.  Artists are assessed in ways that celebrate achievement over contribution and  difference. And at the most ordinary level, disabled performers continue to be singled out for the specialised attention of specialness, are segregated from non-disabled peers through the presence of non-disabled adult supporters and remain unrepresented in images of schooling and educational attainment. There are three further consequences of the Medical Model on the involvement of disabled people in the performing arts.

Firstly, it generates a culture of dependency in which relationships between disabled and non-disabled people are often seen as a kind of master – servant relationship in which the masters – non-disabled people – may sometimes masquerade as servants and vica versa: in short, relationships which are not only defined by an imbalance of power and control but relationships where the locus of power is neither easily identifiable nor controllable.

In some examples we’ve seen, the ‘master’ is not necessarily the simultaneous presence of another human being on stage: it can be the disembodied presence of a plaintiff voice in a song or the digital imperative of a 4:4 rhythm generated by a computer programme: the performer becoming what you might call becoming, thanks to that old Grace Jones track, a slave to the rhythm.  The masters of the action on stage come in all shapes, sizes, sounds, pictures and media.

Secondly, the Medical Model generates the notion of a Hierarchy of Disability.  In this Hierarchy, disabled  people with hidden impairments such as dyslexia may be disinclined either to see themselves as disabled or, more dramatically, see themselves higher up a scale of social value due to their perceived lower degree of impairment.  It also leads to conversations which  uses the assessment of the degree of impairment as a means to assess the aesthetic quality of the work in question.  Here, we say things like ‘Wasn’t that work fantastic bearing in mind they are . . .’ where  the dot dot dots of the punctuation can be joined up by using such terms such as learning difficulty or deaf or blind.

The hierarchy of disability also leads to the possibility that the value of a piece of work can plunge rapidly – much like the share values on stock exchanges across the world at the moment –  if we learn that rather then being performed by a group of disabled people, it was performed by some people who weren’t disabled at all.  Hierarchy of disability means we are constantly assessing the degree of impairment: not the meaning of the work presented before us.

A third consequence of the power of the medical model can be detected in how audiences are encouraged to respond to the work before them.  The medical model leads to the phenomena of disabled people as being described as tragic but brave;  as having suffered with a particular physical or mental impairments;  and as people to be either pitied, patronised or demonised. The ‘ahhhh’ moment is a frequent manifestation of audiences and can be brought about by the falling cadence of a solitary accordion, the slow fading light of a follow spot or the isolation, centre stage, of a character who’s been presented with an external hostile world of attendant characters and impossible plot demands.

The techniques of isolation and segregation here are critical in establishing this kind of response from audiences who might find themselves whispering to their partner, There but for the Grace of God reflecting perhaps a sense that there is more at stake emotionally for certain audience members in this moment of performance by disabled people than there is in  performances by non-disabled people.  Perhaps the histories of conflict with the medical authorities, with the social services and with the wider, dominant  expressions of normality that disabled people and their families share means that the expression of audience responses to disabled performers is always likely to carry additional significance.

The medical model highlights the manipulative, emotional power of theatre and art, perhaps to the disservice of both performers and audience.

(Extract from The Puppet Question revisited: movements, models and manipulations – reflections on cultural leadership)