There Is Always a Hidden Side to Impairment

Over the last decade or so, there has been a growing tension within the ‘disability community’ between those who define themselves as having hidden impairments, and those with visible impairments. People with hidden impairments are often frustrated at the lack of awareness people around them have for how they are feeling, and therefore they can have a level of jealousy for people with visible impairments, believing we have it ‘easier’.

People with visible and therefore often more significant impairments can wonder why people with hidden impairments are complaining, as they do not have the constant stigma since they have the ‘luxury’ of choosing who they disclose their impairment to.

While it may not be easy to heal this rift, I think it may help to dispel one myth and understand that every impairment has a hidden side, even if people with visible impairments do not realise it. In fact, in terms of diagnosis and treatment, as well as public perceptions, people with visible impairments may find it harder to have their hidden impairments or symptoms acknowledged and therefore managed. I was 34 before I finally had my lifelong mild bipolar diagnosed and so treated with medication. I am sure if I have not had cerebral palsy, my bipolar behaviour would have been more of a concern as I would have been closer to the norm.

Even impairments that are visible will have hidden symptoms that are not widely known or discussed, such as the need to manage continence with pads/nappies or other devices. A perfect example is that because people with spinal injuries can not often feel their legs, they do not have the sensation of pain that is the warning signs of ill health. This means they have to manually check their body on a regular basis for sores, cuts and so on. It also means they need to be careful when cooking or handling hot objects because they can burn themselves without realising it for hours, or even days, causing serious harm.

I would guess that if we were to explore in detail the lives of people with visible impairments, we would see a range of hidden issues that may shock or surprise people, including people with other impairments. But a lot of our impairment issues are a private matter, for only those who need to know about them, and I believe that they should remain a private matter. That said people who look ‘disabled’ get the metaphoric platinum card to services and the attention of the public, whether it is desired or not. We do not have to show off our symptoms for attention because we look disabled naturally and therefore often have a confident and stable identity.

People with hidden impairments often have the same need for services but because they do not look disabled, they do not always get the same treatment, although often fail to understand this is not always a bad thing. This invisibility creates a frustrated identity and often a need to ‘shout’ about their impairments to get the attention they feel they deserve in a manner that may not always be graceful or natural. While people with visible impairments do not need benefits to prove they are disabled in terms of identity, the benefit system is often an important component of their identity for people with hidden impairments, and so there may be a greater emotional need, as opposed to practical need, for disability benefits, and its labelling process. I believe this is one reason there has been such opposition to the welfare reforms.

I believe if people with hidden impairments and visible impairments could understand they often have more in common than they may realise, with symptoms like chronic fatigue, stress and pain, then new bridges and understandings could be built that creates harmony where there was conflict. It is harder than it looks but I do think greater awareness of all impairments by everyone, what I like to call ‘impairment literacy’, including an insight to the hidden side of many impairments, then disabled people may get on better more than they currently sometimes do.

from Simon Stevens


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