Internalised
ableism.
Needing support can become associated with weakness, productivity with worth, and the body with a problem to be overcome. None of that is chosen — it’s absorbed, gradually, from culture, medicine, and sometimes from well-meaning therapy itself.
Messages that get absorbed
A disabled person may gradually take on cultural messages such as:
- Needing help means weakness
- Productivity determines worth
- Dependency means failure
- The disabled body is a problem
- Success means overcoming disability
- Anger makes the person difficult
- Grief means they haven’t accepted their disability
- They should be grateful, and stay positive
- They should inspire other people
- They should make disability emotionally comfortable for non-disabled people
Needing support can become associated with weakness, productivity with worth, and the body with “a problem to be overcome.”
What the therapeutic task isn’t
It isn’t compulsory positivity. Working with internalised ableism in therapy may involve mourning, anger, self-compassion, identity reconstruction, challenging internalised messages, reclaiming ambition, and developing a relationship with limitation that is neither denial nor surrender.
Ableism inside psychotherapy itself
Psychotherapy is not culturally neutral. Therapists may carry unexamined assumptions about health, independence, movement, normal development, sexuality, productivity, employment, self-sufficiency, eye contact, energy, body awareness, autonomy, recovery, and what “progress” looks like.
If these assumptions remain invisible, the disabled client can become responsible for educating the therapist while simultaneously receiving therapy. Research on visibly disabled psychotherapists identifies concrete forms this takes: infantilisation, exclusion, internalised stigma, unconscious bias, and strained therapeutic dynamics — while also showing that disabled therapists bring particular insight, authenticity and relational knowledge into practice.