From Disabled Students to Disabled Brains: The Medicalizing Power of Rhetorical Images in the Israeli Learning Disabilities Field

Abstract

The neurocentric worldview that identifies the essence of the human being with the material brain has become a central paradigm in current academic discourse. Israeli researchers also seek to understand educational principles and processes via neuroscientific models. On this background, the article uncovers the central role that visual brain images play in the learning-disabilities field in Israel. It examines the place brain images have in the professional imagination of didactic-diagnosticians as well as their influence on the diagnosticians' clinical attitudes. It relies on two theoretical fields: sociology and anthropology of the body and sociology of neuromedical knowledge. The research consists of three methodologies: ethnographic observations, in-depth interviews, and rhetorical analysis of visual and verbal texts. It uncovers the various rhetorical and ideological functions of brain images in the field. It also charts the repertoire of rhetorical devices which are utilized to strengthen the neuroreducionist messages contained in the images.

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Correspondence to Ofer Katchergin.

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Endnotes

Endnotes

  • 1 The Case-Book of Sherlock Holmes (Arthur Conan Doyle).

  • 2 The term neurocentrism refers to a world view in which human experience, behavior and occurrences can be effectively and comprehensively explained through enlisting insights from the neurosciences (Lilienfeld and Satel 2013). According to this world view brain research is more "scientific" than psychological or sociological research (and definitely more so than philosophical studies) relating to human thinking, motivations, feelings and actions. For this reason, the neurocentric world view was subjected to much criticism about the diminishing and even nullification of the importance accorded to psychological, environmental and cultural explanations and factors.

  • 3 The term neuroreductionism refers to the discursive and cognitive mechanisms that reduce the human subject to a mass of neurons (Martin 2004). Processes of reducing human existence to purely neurological activities simultaneously reflect and reinforce the neurocentric world view that is developing in contemporary culture. A well-known literary expression of this reduction is expressed by the famous detective Sherlock Holmes quoted in the epigraph of this article in which he states that he is only a brain and that his other body parts are but appendages.

  • 4 On integrating several techniques of data collection and analysis (including interviews, texts and even material objects) into ethnographic observational research, see Sabar Ben Yehoshua 2001.

  • 5 This special profession of 'didactic-diagnosis' needs further explanation. Interestingly, the very concept of 'didactic diagnosis' is unique to Israel (Sharoni 2013). It was coined by the Israeli 'founding fathers' of the learning disabilities field during the late 60' (Sharoni ibid.; Katchergin 2009). It related to a process of identification and mapping of children's learning strategies and behavior in various 'basic skills' relating to reading and writing. This process was supposed to be a unique expertise which should have been studied from the aforementioned new learning disabilities experts. Since the mid 60' 'didactic diagnosis' was taught as a new profession in private institutions by a relatively small group of experts whose main scientific and academic influence was the concurrent burgeoning learning disabilities field in the U.S.A (Katchergin ibid.). A nation-wide process of academizing the 'didactic diagnosis' profession has begun only in the late 90'. Since then, and especially during the first decade of the 21 century, 'Didactic diagnosis' departments have been concurrently established almost in all the universities and educational academic college in Israel. In the last decade various academic professions (mainly educational psychologists) vie with didactic-diagnosticians for the learning disabled clientele. At the heart of the inter-professional conflict lies the claim of each profession that its body of knowledge is the most suitable in relation to an adequate diagnosis of learning disabilities (Katchergin ibid.).

  • 6 The research is inspired by the 'ethnography of images' method (Dumit 2004, 10) even though in this case my intention was to focus only on the rhetorical play of brain images in the conferences and the various ways these images were interpreted by the diagnosticians (and not on following the entire 'biography' or 'social life' of these images from their scientific production onwards).

    Regarding the rhetorical analysis: the article maps rhetorical devices that are deployed by conference presenters and interviewees (sometimes there is an ovelap). Still, it should be noted that the interviewees were already rhetorically primed to accept a neuroreductive view of learning disabilities before attending the conferences. This may explain their seemingly simplisistic and naïve compliance to the presenters claims and acceptance of brain images reductive interpretations at face value. That is, there is a larger rhetoric at work in this persuasion than is suggested in a mere listing of rhetorical devices deployed in the presentations themselves. Indeed, the entire neuroscientific discourse exemplifies a rhetorical movement that transforms the metaphoric spaces psychic interiority or into the literal space of the physiological brain (Thornton 2011, 152). It is through a broader rhetorical framework through which scientific research is interpreted and made sense of in relation to culture (Thornton 2011, 160-161).

  • 7 These include Tel Aviv University, Haifa University, Bar-Ilan University, the Jerusalem College, Beit Berl College, Levinsky College, Kibbutz Seminar College, and Shaarei Zedek Hospital.

  • 8 Medicalization means the conversion of life circumstances and social and human phenomena into medical situations through applying definitions and concepts originating in medical discourse to ever-increasing spheres of life (Conrad 1975; Conrad 2007).

  • 9 For a historical analysis of medicalization trends in American education, see Cohen 1983; Petrina 2006.

  • 10 On the sacrosanct status of the brain and its position as a central cult object in the discourse of experts and in everyday popular culture, see Thornton 2011. Present-day images of the brain imply that brain imaging can, in practice, reveal not only neurochemical patterns but also the spiritual essence of being human and deep-rooted truths about the nature of man (ibid.). Conceptualizations of the brain as a sanctified metaphysical object are not new. On historical attempts to locate the soul or other metaphysical entities in the brain, see Zimmer 2004.

  • 11 Some of the diagnosticians were immediately able to produce the photocopies or diagrams of the brain which mostly originated from the conferences or even from American professional literature. Furthermore, visual representations of the brain (even if they tended to be primitive simulations) are interspersed in the canonical texts of Israeli researchers such as Rahmani (1981), Simpson (1985), Darin (1984) or renowned scholars such as Engel-Eldar (2004). These texts were familiar to most of the interviewees and constituted part of the basic professional literature in their homes or offices.

  • 12 In this excerpt there is use of the figure of speech, Hypocatastasis.

  • 13 In the jargon of didactic diagnosticians they repeatedly used "orientation metaphors." In the above passage disabilities are to be found (or hidden) inside the brain. Metaphors like these fit in with the general reductionist strategy – characteristic of the expert discourse -- according to which learning disabilities are a matter of neurology and should be studied as such.

  • 14 According to Latour and Woolgar (1986) Scientific knowledge is embedded in procedures of inscription, that is the rendering of what is contested and not-yet-fixed immutable or possible to circulate in various codified material forms (brain images in this case). Such inscriptions are the outcome of the effective alignment of organization and technology (ibid.). Latour (1990) elaborates on the persuasive power of visual and verbal inscriptions. They are argued to possess many rhetorical advantages: they are mobile, immutable, recombinable and are perceived to be built on many facts. The material mediations of the brain images are generated in scientific labs and circulate in various scientific and social fields. The current article demonstrates how these images have persuasive force in the didactic diagnosis professional field (that is outside the strictly scientific arena of the neuroscientist lab). More on inscriptions and inscription tools, see Latour and Woolgar 1986; Latour 1990.

  • 15 This is a particularly interesting fact, for, it must be recalled that didactic diagnosticians are, by professional and academic training, products of the faculties of education and teaching departments, and not of medical schools, biological or neuropsychological departments (Katchergin 2014). In this sense, their preference (in the days to come, of course) for finding and developing of biological solutions constitutes another occurrence of processes of medicalization and neuroreductionism of the educational space.

  • 16 Among the most recycled representations were those published in studies by Dehaene, Paulesu, and Sousa.

  • 17 Indeed the logic of ipsedixitism was embedded in the entire 'initiation rites' structure of the conferences.

  • 18 These dramatic steps of including the audience of diagnosticians in the act of interpretation of the visual representations, as well as pinning the educational body to which they subscribed to the neurological body of knowledge give credence to Goffman's argument that social actors are inclined to attempt to give the impression that they are closer to their audience than they really are (Goffman 1959). In developing the dramaturgical model for analyzing everyday life, he adopted various theatrical strategies for attempting to give the impression of proximity to the audience (ibid.). In this sense the dramatic expressions described contribute to the strategies Goffman supported.

  • 19 It was found that there was a distinct difference in the rhetorical devices deployed by the presenters and the interviewees. This leads to the hypothesis that the presenters and interviewees use different rhetorical devices to achieve different goals. While the presenters attempt to imbue their neurocentric framework into the minds of their listeners, the already convinced interviewees try to use their acquired neurocentric knowledge in order to rationalize their professional practices and demonstrate their expertise.

  • 20 On the historical positive stereotyping of the category of learning disability and of the learning disabled (see Katchergin 2012).

  • 21 An example of the contribution of the neuro sciences to the field of education in Israel can be seen in Kutik-Friedgut et al. (2014). Based on brain imaging that examined cognitive and linguistic skills related to acquisition of reading and writing, study materials were developed that exercise those skills in order to allow the learners to acquire the skills more rapidly, more effectively and more enjoyably (ibid.).

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Katchergin, O. From Disabled Students to Disabled Brains: The Medicalizing Power of Rhetorical Images in the Israeli Learning Disabilities Field. J Med Humanit 38, 267–285 (2017). https://doi.org/10.1007/s10912-016-9425-1

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Keywords

  • Brain imaging
  • Medicalization
  • Sociology of neuromedical knowledge
  • Neurocentrism
  • Critical rhetorical analysis
  • Critical discourse analysis
  • Social construction of learning disabilities