The human story is one of growth and discovery. New foraging grounds, new tools, new methods of cultivation, new iPhones. Humans have thus put a premium on knowledge of how to expand their abilities and empower themselves. Likewise, we have long held those who claim to have that knowledge in awed reverence. Figures like mystics, shamen, sages, or village elders populate the popular conscience as early possessors and purveyors of this knowledge. However, as my academic readers surely know, specialization is key. The work of expanding human function has been sifted and separated into three distinct fields: academy, church, and clinic with all empirical pursuit of increased human function being confined to the latter.
One of the clearest examples of creeping medicalization is our collective inability to conceive of para-medical research, activities, and functions as anything but medical. There is nothing inherently medicinal about occupational, art, music, dance, and other therapies; nor is biotech, which can be medical in application, inherently medical in function. However, these ability-expanding pursuits—pursuits that can be called abiligogy, guidance that shapes ability over an individual’s life course (as opposed to pedagogy, a pursuit of ability-expansion directed exclusively at juveniles)—are largely subject to medicalization in their approach, ethics, and standards of care and success. In many cases, this medicalization extends to the physical spaces in which research is undertaken and ability-enhancing services rendered. Thus highlighting the ways in which, like Noah, these professions have been swallowed by the institutional medical whale.
A more subtle but no less illustrative example can be found in the scouting rooms of major professional sports. Those of you who have read Michael Lewis’s Moneyball or seen the Aaron Sorkin adaptation will recall the crusty old scouts—those who could ‘just feel’ if a player had the right tools—gathered around a table left flummoxed by statistical innovation. The old grouches, certainly practiced eyes at ability identification, were replaced by ever more sophisticated statistical analysis. This analysis demanded every larger datasets and ever more fine-grained inputs, including on player movement, musculature, and injury probability. This evolution culminates in medicalization. Today it is almost impossible to get your foot into the scouting room, let alone a seat at the table, without a degree in kinesiology—which is… you got it, a medical discipline.
This medicalization of the expansion of ability shames those it is meant to help, shackles those who practice ability-expansion professionally, and slows our collective journey to a brighter, fairer, expanded future.
In the case of recipients of abiligogy, those most impacted by the medicalization of, frankly put, damn near everything, this trend can have profound consequences. When those with chronic conditions, crips, and others who can benefit from ability-enhancing services (Maslow, among others, would argue that we all stand to benefit from therapy in one form or another) are treated as a patient within a medicalized framework there is an implied defect, a damage to be corrected. This is backward.
Treating people as broken trains them to think of themselves that way. This can have profound consequences for the individual. These effects range from low self-esteem to a profound and isolating sense of otherness. The damage done by this implied defect and othering has been treated ad nauseum in media ranging from books and scholarship to The Breakfast Club and all points on the gradation have one thing in common:they prevent the actualization of or actively destroy ability. We must view therapies as positive and progress-oriented, as ability-expanding.
The medicalized framework also impacts abiligogs. Abiligogy is a practice of promotion, not prevention. It promotes wellbeing, new skills, the expansion of self and one’s capabilities. Medicine, while at times capable of producing similar results, speaks the language of coercion and often plays the conservative game of prevention. “Don’t project you voice while sitting or you will develop polyps. Don’t listen to your composition at more that 70% volume or you’ll damage your hearing.” When we free abiligogs from this coercive atmosphere and ethos of prevention we can focus on the actualization of an individual’s potential and talents. While it is true that this may occasionally involve coercion—the institution at which I am pursuing a Ph.D. has the threat of academic consequences up to and including exclusion from my academic community in its quiver—these are employed in the pursuit of growth and are therefore part of the expansion of the human endeavor of discovery, community, and wellbeing.
Further, ethics rules that make sense in a medical context can hinder growth and shackle abiligogs when applied outside of a strictly medical setting. This is not to say that medical professionals shouldn’t follow ethics rules or that the ethics rules should be selectively applied. Rather, this phenomenon necessitates the recognition of abiligogy as a distinct professional practice in which professionals can apply their skills and training in a non-medical setting.
Take, for instance, the role of psychotherapists in PhD candidates’ lives. As I’m sure many of you are aware, pursuing a Ph.D. can be grueling work. Not only do candidates have to identify gaps in the literature and come up with original research to address them but they must also contend with the calendar. Working to get well-written, fully-researched, unimpeachable arguments in front of reviewers often on tight deadlines is, in a word, stressful. The process necessitates long hours, finicky editing, and seemingly endless rewrites. It can feel a lot like repeatedly banging your head against the wall—in fact, some of my colleagues assure me that head-banging is actually part of their process.
No responsible psychotherapist would, could, or should, recommend engaging in frustrating work with insufficient rest. In fact, any psychotherapist who recommended my weeks of sleepless nights of reading and writing in the run-up to presenting my thesis proposal should probably be stripped of their license. However, that doesn’t mean the pursuit of a Ph.D. is ill-advised, nor does it mean that it is a process that has no room for professionals with training in psychology and psychotherapy. Quite the contrary. Doctoral studies are inherently ability-enhancing. Being put through the academic wringer is a necessary part of that growth. Ph.D. candidates stand to benefit from the advice and guidance of professionals with training in psychotherapy as they navigate that process. Yet, psychotherapists cannot recommend that their patients submit themselves to what occasionally feels like some sort of cosmic punishment doled out by the god of compound sentences. The solution, create a new class of professionals, psycho-abiligogs, free from the constraints of medicalization to—work in tandem with medical psychotherapy where this therapy is necessary—to act as guides in the process of ability formation.
Nothing has crystalized this for me more clearly that the head-banging frustration of the last two years. Hearing no time and time again from my supervisor was a good thing. Writing, rewriting, and re-rewriting was a good thing. Regardless of how excited I would have been had I got a green light following my mini viva, whatever bitter irritation I would have been spared, that stress and anguish, that hard-nosed abiligogy got me where I am now. And here is a much better place than where I was and where I was headed.
When freed from the constraints of creeping medicalization abiligogy can be transformative for those who receive it. I am fortunate enough to have first-hand experience in this domain; recently, following my mother’s passing I felt adrift, as if I were floating in space, silent and silenced. The loss seemed to me to be beyond the bounds of what could be endured. How does a person get over such a profound sense of emptiness and injustice—therapy, the knee-jerk response, had never healed my problems in the past; not the trauma of ostracization, nor of needles, nor of misprescribed medications that left me a husk of myself.
However, perhaps for lack of a better plan, I turned to my therapist, Dr. Chris. He reframed the question for me turning the struggle back to normal life into a question of ability. He told me to channel the wisdom my mother left me with. To pick myself up and fins strength and inspiration in her example. To remember, even though it may be difficult I have been in other situations in which my well-being has depended on my ability to acquire a new skill. Co-existing with loss and dealing with death is the hardest form of that, but it isn’t new.
Dr. Chris exemplified what abilogogy is and why it works. Where orthodox views of therapy medicine focus on healing, on the fixing of brokenness, on the remediation of damage centering ability, and engaging in abiligogy reframes the relationship of professional and patient focusing on growth, not damage.
In my case, I came to truly understand that we learn to live with ourselves as new beings post-trauma. There is no fixing, one can’t fix death and loss. There is understanding and growth. We develop and hone the skill of coexisting with trauma, of continuing to eat, sleep, breath, and think in a landscape that is forever changed by absence. That is abiligogy.
This trend clearly begs a response. My proposal is an evolution, a baby bird springing forth from the nest—a leap of independence without straying too far from home. Though it is likely impossible and certainly undesirable to completely sever abiligogy from medicine, abiligogy must be recognized as a separate pursuit which, while enjoying some overlap with medicine, is distinct from it. When we view interventions as learning experiences we expand ability.