Thursday, December 24, 2015

Restraint for Safety vs Restraint for Punishment (And Freddie DeBoer)

I wrote a piece for Pacific Standard that many people seem to have read (it was their most popular story on the site for 5 days or so. I gather that must mean something) on the systematic abuse of disabled children by teachers and other staff in schools and institutions across America. In the piece, I took three reports by three separate groups - Pro Public, the Center for Public Integrity, and the Disability Law Center of Massachusetts - and discussed the common pattern: restraint and seclusion being used to punish students for basic non-compliance.

For regular readers of this blog, you'll know this is the kind of thing I coordinate under the phrase the "cult of compliance" (search the tags for many more posts).

A few days ago, the well-known writer Freddie DeBoer responded on Twitter by asking me to read a piece he wrote that criticized the Pro Publica essay as "sensationalist and damaging." He calls it "Difficult Problems After the Death of Nuance." In the essay, DeBoer describes his experience as a caregiver in an public school with a segregated section for children with emotional disabilities, experiences that included restraint. With children who are likely to harm themselves or others, he asked, what are you supposed to do?

This is an entirely reasonable question. There are many situations in which restraint is a reasonable and appropriate response to specific behaviors. For example - if a child is about to run into the street, you should hold them. If a child, as DeBoer describes, is trying to throw a chair at your head or another student's head, you should stop them. These things happen.

But what the experts (for example Positive Behavior Interventions & Supports or Trauma Informed Practices) tell us is that such behavior have an instigating point, a cause, and that the correct response to such behaviors is to investigate those causes and try to work at the root issues, rather than try and solve the problem by treating the symptoms, the acting out in some way, with force. There is no amount of force that can make someone less disabled. All you end up doing is intensifying trauma.

Many IEPs (Individualized Education Plans) and similar documents contain provisions about the use of restraint. They are ideally crafted in collaboration with parents, other caregivers, as especially as possible the disabled person themselves. Restraint and seclusion may be necessary, but only as a holding action while you work on root issues.

In the cases I discuss, however, restraint and seclusion are being used to punish and to force compliance. Again and again, we see staff and teachers - who are surely under great pressure themselves, and drastically under-resourced - resort to fear, pain, and isolation to teach disabled students that if they act as themselves, in non-typical ways, they will suffer for it. People strapped to beds for throwing food, thrown into a closet with the lights off for not following orders, given electric shocks. That's the abuse. That's the practice we need to stop. That's the cult of compliance.

So overall, my response to DeBoer's entirely reasonable question is this: Restraint may be part of a safety plan, but it's not a teaching tool. It doesn't really change behaviors. Moreover, there are usually positive ways to change behaviors, but they take time, resources, and creativity. I think the restraint as safety vs restraint as punishment is a useful dialectic along which to assess a given situation.

Now a brief aside: I'm a little nervous about responding to Freddie DeBoer because my introduction to him was really through his back and forth with Angus Johnston (@studentactivism), who once wrote: "It’s become clear that Freddie is the kind of person who says “Give me an answer!” when he means “Admit that there are no answers!”

He has asked me for an answer, and I've given him one above, and my brief interaction on Twitter suggests he's open to the dialectic I propose. Again, I think he asks a useful question, and I'm pleased he sought me out.

The problem with his essay is this "death of nuance" framing. DeBoer believes that reactions to this type of outrage journalism, "Demonstrate the ways in which the world of sharing and likes and shallow understanding destroys nuance and creates a bogus conception of a black-and-white world."

He is furthermore:
Reminded of a few sad realities: that American liberalism culture is now synonymous with a juvenile Manicheanism that imagines some perfect world we could achieve if people just weren’t so selfish and evil; that getting showily, publicly angry about problems is more popular than actually attempting to solve them; that there is no issue of such emotional and moral complexity that many people can’t reduce it to a black-and-white caricature; and that we have created a media which has made its financial best interest inextricable from destroying depth, nuance, and complexity. I genuinely don’t know if people believe in difficult choices and intractable problems anymore.
I hope DeBoer doesn't really believe this. I suspect it's rhetorical rather than, as he says, "genuine." It's a way for him to continue his long-running diatribes against PC culture and kids these days, which is fine. I'm not going to get into it, except for these two points:

First, it's ahistorical. Getting outraged about outrageous things is normal. The press has always published outraged journalism intended to evoke sympathy, rage, donations, voting, direct action, and, most of all, more sales of media products. Before there were media products to sell, the sharing of outrage traveled through different kinds of information culture, but travel they did. Speed, scale, and means have changed. Local outrages can become national or international in ways never before likely (consider police abuses). Outrage can feed on itself in new ways too, because we can communicate our upset more effectively and quickly. But getting outraged about outrageous things is an appropriate and rational response.

Second, DeBoer here draws his meta conclusion about the "death of nuance" based on lack of knowledge of both disability and disability-related pedagogy. His lived experiences matter, but he confesses that these were confusing times for him in his life. When he writes, "Mental illness is powerful and terrible and that’s the world we live in," he places himself in a casually ableist epistemology that informs everything else he writes (I fear he rejects the concept of ableism, but that's a bigger conversation).

What's powerful and terrible is when people with psychiatric disabilities are denied the resources they need, and when stigma and fear make it harder for people with such conditions to come out as disabled, to ask for help, and so self-treat and self-medicate.

What's powerful and terrible are the intersections of mental-illness-stigma with racism and poverty. Marginalizing forces multiply dangerously. It's not a coincidence that the people in these institutions of the sort DeBoer describes tend to be poor and non-white. The nuanced liberal response to such conditions is not to decry outrage, but to identify root cultural, social, economic, and political causes and get to work.

With that said, I'm going to get back to work.

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