2016 – Post-truth

As we reach the end of the year, it’s time for a round up. And what better way to round up in writing than to look at how our language has developed this year. “Post-truth” has been named as the word of the year for 2016 by Oxford Dictionaries. It is an adjective defined as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.” At the end of 2016, there is a feeling of exhaustion at the phenomenon of post-truth, that the forming of public opinion should somehow be more predictable than the phrase implies. But the fact that the word has been formed is indicative of a wider trend that is worth exploring, and how it relates to our understanding of ourselves as individuals grappling with long term health conditions in society bears examination. I wonder if we can expand the definition beyond its popular use in political confines and start to see this as indicative of a trend that also has positive potential.

Post-truth is a collective phenomenon in which the individual cedes authority to the community. The definition of it by the OED above is in-fact woolly. Post-truth should surely be a noun and not an adjective. Does it refer to the circumstances above, or to the reporting of them? Who defines the objective facts? In the recent political events, one can see that fake news is part of the counter to the objective facts. But in ordinary circumstances, who defines objectivity?

I am thinking of how post-truth applies to health. I’m particularly thinking of this in relation to long term health conditions. And the move from thinking of oneself as an individual to being one of a community. When you apply this to health, and think of long term health conditions as not being the preserve or the problem of the individual, but of the individual in society, the thing that springs to my mind is the highly successful propagation of the concept of the social model of disability, promoted by committed disability campaigners since the 60’s and now an accepted part of the discourse. What the social model of disability does is to place the individual in community and to say that the problem of disability is not the preserve of the individual, it is that of society when it does not make the adaptations necessary to give that person full access to society. It is not the person in a wheelchair who has the problem, it is the architect who fails to include a ramp in the design.

The social model of disability is akin in some ways to a holistic view of health, but it goes further. To view a condition holistically is still to view the condition as belonging to the individual, albeit the individual in all the strands of their life and not just in relation to their illness. To view a condition socially is to examine the individual holistically in society. It is my view that the social model is extending its reach, and I very much hope it does, to a range of long term conditions. But the one that it will start with is the Cinderella of disabilities, the Jonny Come Lately to the disability fold, and one to which special adaptations to the disability model need to be made. It will extend first to mental health.

If the wheelchair owner is disabled by the gatekeeper who is the architect, or the bus driver who doesn’t have a ramp, or the library that doesn’t have a lift, the mental health service user is disabled by stigma. Stigma is the bug bear of mental health, and after 20 years campaigning in the field I am disappointed to still be talking about it. Stigma is preceded by observation. And there are plenty of observers of mental health, and people who judge and exclude and stigmatise on that basis. But none of that judgement and exclusion is possible without counting one observation as ‘objective’ and the other, that of the person with the disability – or the mental health condition – as emotional or irrational. The observers are the psychiatrist, the insurer, the GP, the employer, and many others. They observe, they keep the record.

But if we are to enable a social model of disability as applying to other long term conditions, and particularly mental health, it is post-truth that, ironically, will provide a positive direction. Post-truth is emotional truth. Post-truth takes us away from the medical model and into a reality where there is no expert, where many voices have authority, and where the voice of experience in terms of the individual with the condition, is privileged to the same extent, if not more, than that of the medical expert.

I look forward to personal health records. I look forward to adding my voice to the ledger that is held on me. I look forward to counting on my authority and expecting and demanding that society counts on it too. I think that post-truth is an important trend and I look forward to seeing how the emotional truth of things that count can go forward from here. Politically, post-truth is a sink hole, it pulls the rug under one’s feet. But positively, we’ll go forward from here, and maybe the word of 2016 will form an important part of our future as we look forward to embracing diversity proactively together.

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