Adjustment to dis/ableism, affect and agency in clinical settings: a provocation?
Presented at the online symposia in Spain on 2nd October, 2025.
To cite this work: Sanmiquel-Molinero, Laura (2025). Adjustment to dis/ableism, affect and agency in clinical settings: a provocation? In Goodley, D., Halsey, R., Scully, J., Singh, S., Titchkosky, T. and Wong, M.E. (Editors). The Disability Matters Scholarship Collection. Sheffield: 爆料TV.
Laura Sanmiquel-Molinero is a Juan de la Cierva post-doctoral research fellow at the Department of Social Psychology of Universitat Aut貌noma de Barcelona (Spain). Her research focuses on the dialogue between Critical Disability Studies and traditional approaches to disability in Psychology, Sociology and Anthropology from an intersectional perspective. She has also participated in a research project on disability and sexual and reproductive rights funded by the Spanish Ministry of Science. She has authored several journal articles regarding dis/ableism and its intersections.
For the video recording of this presentation, please see the online symposia page.
As a disabled woman and a psychologist, I had always been obsessed with the mantra: 鈥測ou have to adjust to your disability鈥, repeated both within psychology and in my everyday environment. What did it actually mean? How was a subject supposed to speak, act and feel in order to be considered well-adjusted to their disability? Since discovering Critical Disability Studies, I was able to give a new meaning to the question: what role did ableism and disablism play in this 鈥済ood adjustment鈥? Could it be that a well-adjusted disabled person was in fact a person well-adjusted to dis/ableism? In what ways did this process of adjustment take place through affect? What affects did ableism and disablism prescribe and proscribe for disabled (and non-disabled) body-subjects?
In order to try to answer some of these questions, some years ago I decided to carry out a narrative-ethnographic study (Sanmiquel-Molinero, 2023) in what struck me as a production line of 鈥渨ell-adjusted disabled people鈥: a neurorehabilitation hospital. To take on this task, I found invaluable support in the work of academics such as Dan Goodley, Kirsty Liddiard, Katherine Runswick-Cole, Rebecca Lawthom, Donna Reeve and Carol Thomas. Over the past twenty-five years, all of them have worked to reclaim affect as an indispensable analytical (and political) category for Critical Disability Studies.
I will now outline how their concepts of 鈥榓ffective disablism, emotional labour and 鈥榓gency as affect鈥 have influenced my work. The notion of 鈥榓ffective disablism鈥 helps us account for all those emotional impacts that disabled people experience on a daily basis, insofar as we are constantly told that 鈥榳e are out of place in the world鈥. This can take multiple forms: a supposedly 鈥榳ell-meaning鈥 comment on how inspiring we are for not having committed suicide despite 鈥榦ur situation鈥, or the architectural barrier at the train station that, according to the authorities, there are 鈥榮till no resources to remove鈥欌 What was expected of a body newly inducted into the disability club in the face of such situations? Early on in my ethnography it became clear that the answer was none other than emotional work.
The concept of emotional work allows us to name all those emotional performances that the 鈥榙emanding non-disabled public鈥, as Goodley (2017) would put it, requires us to enact in response to affective disablism. Forget about telling off lovers of inspiration porn, forget about proclaiming that we have a right to travel on public transport without constantly putting ourselves at risk. As became clear in the hospital鈥檚 psychology sessions I participated in, the best response to such grievances seemed to be to 鈥榣ook the other way鈥. There began to emerge what it meant to be well-adjusted to a disability in affective terms: nothing other than appearing unaffected by dis/ableism. But it was not enough simply to declare, chest out, 鈥榯hat kind of thing doesn鈥檛 affect me鈥. The true good adjustment lay in claiming 鈥榯hose things don鈥檛 affect you鈥 while allowing them to affect you in ways that reproduce dis/ableism.
And this brings us to the third concept from Critical Disability Studies that has most influenced my work: thinking of affect not as mere emotion, but in relation to agency. From the Spinozist conception proposed by Goodley et al. (2017), agency is the ability to affect and be affected by one鈥檚 human and non-human environment. If being well-adjusted to disability means appearing unaffected by dis/ableism while acting according to its normative demands, then good adjustment to disability leaves us ill-equipped to affect these systems of oppression.
When I first communicated these results to the neurorehabilitation hospital some years ago, the response was not what I expected: while some psychologists there supported me, others were negatively affected by my explanations, which they considered biased 鈥 surely the product of my own traumas with disability 鈥 and hurtful, insofar as they implied an attack on their daily practice. At the same time as my work as a researcher had affected them, my own ability to affect 鈥榯he field鈥 was also altered. As Liddiard (2013) explains, I was forced to undertake significant emotional work to keep myself afloat during fieldwork: I had been hurtful, but I was also hurt. The doors of the observation spaces I had worked so hard to open began to close, literally or symbolically. Fortunately, I was supported by colleagues such as Andrea Garc铆a-Santesmases, who helped me navigate the situation, and my virtual research stay at iHuman with Kirsty Liddiard and Dan Goodley also helped me
All of this led me to connect two concepts often understood as opposites: agency 鈥 as the ability to affect and be affected 鈥 and vulnerability 鈥 as the susceptibility to be wounded by the environment. In what ways could the lens provided by Critical Disability Studies, which had been so healing for me as a disabled woman, also leave deep wounds in professional spaces? Had that wounding been counterproductive, insofar as it not only affected me emotionally but also prevented me from significantly affecting the hospital鈥檚 dynamics in ways that counter dis/ableism?
A few months after completing my doctoral research, one of the professionals at that hospital put me in contact with Javier Monforte, who is the one who invited me to be here today, as he felt that 鈥榳e spoke a similar language鈥. Together, we are beginning to reflect on these questions, since we are concerned with the challenge of bringing Critical Disability Studies into clinical settings, which are increasingly keen to incorporate a social perspective but still reluctant to address dis/ableism and affect. We do not yet have definitive answers. We are confident, however, that sharing this presentation with you today will stimulate us in building one.
References:
Goodley, D. (2017). Disability studies: An interdisciplinary introduction. SAGE.
Goodley, D., Liddiard, K., & Runswick-Cole, K. (2017). Feeling disability: Theories of affect and critical disability studies. Disability & Society, 33(2), 197鈥217.
Liddiard, K. (2013). Reflections on the Process of Researching Disabled People鈥檚 Sexual Lives. Sociological Research Online, 18(3), 10.
Sanmiquel Molinero, L. (2023). El ajuste a la discapacidad como espacio-tiempo liminal: Un an谩lisis desde los estudios cr铆ticos de la discapacidad [PhD Thesis, Universidad Aut貌noma de Barcelona]. Department of Social Psychology.
iHuman
How we understand being 鈥榟uman鈥 differs between disciplines and has changed radically over time. We are living in an age marked by rapid growth in knowledge about the human body and brain, and new technologies with the potential to change them.