I’m a Speech and Language Therapist.
Once, when I was still an undergraduate student and in Japan with Semester at Sea, a gentleman on a train asked me what I intended to do for a profession.
“Speech and Language Pathologist.”
He puzzled over that final word. “Pah…thaw…loh…gist,” and he pulled out a dictionary. (This story is pure non-fiction. Really. Yes, I met a kind gentleman on a train in Kobe who asked me what I wanted to do with my life, became confused at the word “pathologist,” and pulled out the perfectly appropriate dictionary for his momentary conundrum with me.)
I think he would have needed that dictionary for “conundrum” too….but that’s beside the point. He read something approximating, “…a scientist who studies the causes and effects of diseases, especially one who examines laboratory samples of body tissue for diagnostic or forensic purposes.”
Immediately, I countered, “Nononono! Um…speech and language therapist. I’ll help children who have trouble speaking.”
“Ahhhhh!”
That little cross-cultural moment for a 22-year-old foreshadowed the 43-year-old man who sits writing this post today.
Therapist. Supporter. Specialist. Service professional. Technician. Helper. Mack Daddy of Communicative Awesomeness. Anything…but…pathologist.
We speech/language pathologists are trained in a classic western medical model. Which is? If I could boil it down, I’d say it’s this:
You are broken and I will fix you.
As such, we need control. Rigid, specific, multifaceted, all-encompassing control. However, the only way to get even near that kind of control is to remove a person from that person’s authentic environment…where multiple factors; many unknown, immeasurable, and uncontrollable; can be mitigated. Then, we selectively choose “in” only those people whose trickier factors do not clash with our rules, controls, and standardization. And, we systematically exclude those who are not ultimately compliant in the manners we demand.
So, we do our therapies on a select group of individuals in completely inauthentic environments, with so many controls that a target behavior is destined to change in some way. But we, by definition, ignore all other factors and pretend that the microscopic change of one behavior in a laboratory setting will then re-integrate into the whole, back in the real world. We expect, to use professional jargon for a moment, maintenance and carry-over. Meaning, a person will maintain the things learned in the clinical environment and carry them over to other places and people and across various moods/states.
We claim to target these extensions of our direct therapy by giving very explicit homework to families and educators. We tell them what they must change their aberrant behavior to help fix their children and we rarely authentically ask for their input and suggestions; we treat families and educators as if they are not very important, let alone critical factors in the functioning of the individuals with whom they spend the most time.
Of course, if change doesn’t happen in the real world it’s their fault. The child’s and/or the parents’ and/or the teachers’ and/or somebody else’s. Not ours. The others didn’t do what we said to do right. We’re off the hook. And we parade out our successes while decrying others’ failures.
We, as human behavioral scientists and technicians, are loathe to relinquish the control of the absurdly inauthentic. We generally do not enter the worlds of the individuals with whom we work to learn about real behavior within the messy milieus of everyday life. We ignore the myriad factors contributing to one “undesired” behavior or another; and we refuse to admit that not only do we not know everything…we likely know nearer to nothing than we’d ever admit.
Indeed, as long as we’re locked in a sterile room with our clipboards, standardized procedures, manuals, advanced degrees, and the implicit belief that we are tinkers, or perhaps gods of a sort who can deem a person broken then claim the power to fix…we do know damn near nothing.
-G
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