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Cognitive Disability: A Challenge to Moral Philosophy
September 18-20, 2008, Stony Brook Manhattan
401 Park Avenue South

The realities of cognitive disability pose a significant challenge to certain key conceptions philosophers have held. Philosophers have conceived of the mark of humanity as the possession of rational cognitive capacities. They have traditionally extended the mantles of equality, dignity, justice, responsibility, and moral fellowship to those with these abilities, whom they speak of as ‘persons.’ What then should we say about those with severe cognitive disabilities?  How should we treat these individuals and what sorts of entitlements can they claim?  Should we grant the arguments of some philosophers who want to parse our moral universe in ways that depend on degrees of cognitive capacity, not on being human? How do claims for the moral consideration of animals bear on the question? Is it morally acceptable to consign some human beings to the status of ‘non-persons’?  Philosophers have rarely faced these questions squarely and systematically.

Speakers include public intellectuals such as Michael Bérubé, Ian Hacking, Martha Nussbaum and Peter Singer. The conference will explore philosophical questions about three specific populations—people with autism, Alzheimer’s disease and those labeled ‘mentally retarded’ —and will raise ethical and foundational questions on regarding both theoretical and practical matters.

More here.

I thought of this in connection with visible facial difference (e.g., people with Moebius Syndome, facial disfigurement):

Rebecca writes:

Appearance distress and visible differences have been associated with a number of problems including depression and anxiety, low self-esteem and negative body image and interpersonal problems. However, not all individuals with a visible difference report a negative experience, some report the minor role it plays in their lives and its positive consequences.

This project is concerned with identifying factors associated with the ability to adjust to a visible difference. Demographic variables and the physical nature of the visible difference have been repeatedly found not to predict distress. However, it has been found that individuals who place greater importance on their appearance use strategies to cope with their visible difference that are maladaptive. Furthermore, individuals who have easy, recurring access to a negative schematic representation of their appearance are more likely to be poorly adjusted. What seems to play a crucial role in why some individuals lend more psychological importance to appearance is their interactions with others from an early age. Thus, the feelings of people around us, which as a child is mainly our family, are assimilated into a child’s perception of their visible difference, and subsequently affects their ability to cope.

For more, go here.

Moebius Syndrome and pain: neurophenomenology and the ‘lived experience of impairment’. 

Extended narrative first-person accounts of the pain-experience in male and female adults with Moebius with attention given to pain facial expression. 

My interest is in shared awareness of pain grounded in empathy, and the extent to which facial expression is a mechanism of empathy and second-person consciousness of pain. Given that the experience of pain as a form of human interaction is partly facial and thus mutually reinforcing, what happens to a person in pain closed permanently to pain facial conversation? Is his pain not more intense? Or, cognitive? How do Moebians typically perceive the link between pain and the threat of danger? Does facial paralysis modify the experience of pain by shaping the magnitude of pain and hence the magnitude of suffering?


In mutual gaze, we experience another person intimately

There is the experience between people that is described as ‘lost in conversation’. What is this like? Well, it occurs in normal social interactions, when people have conversations. There is an interchange of information and feeling, if you like, and a degree of cooperative effort (‘give and take’) between the conversationalists. When it works, ‘lost in conversation’ means effortless and natural conversation between people, when opinions and words circulate without impediment.

Of philosophic interest in this experience is the subjective absence of a sense of self (Cole, 2001). In the situation of being ‘lost in conversation’, I am, as Merleau-Ponty suggested, ‘in the facial expression of the other, as I feel him living in mine’ (Merleau-Ponty,1964). To have a conversation with another person, and to be lost in it, is to be drawn into a quality of relatedness to the other person, to his face and words, such that the other person is inclined to respond to me (think how a child perceives a smile as a smile). Attentional absence of oneself in conversation and social interaction may signal social competence (Leder, 1990).

Persons with facial difference may never experience this absence of a sense of self. A person with facial disfigurement may fear looking at another’s face for fear of what the other will think (Cole, 2001). Not fear of thought in the mind, but fear of thought clearly personified in the face of the other. In this situation, there is no mutual gaze between conversationalists, no sense of intimacy or empathy with the other. The result is that those with facial difference develop a fragile sense of self, which they are not prepared to risk – as we routinely do – in conversation or social interaction.  

The gaze of a person has the capacity to penetrate, to create a demand. This is the demand that I reveal myself to you. At the same time, the existence of facial difference creates an opacity between a person and the other who seeks to relate to him or her. This opacity of the face revealed in facial difference is the source of stigma associated with facial difference – because the face is always visible – and the recognition on the part of someone with facial difference that his or her face stands to the other as his does to me is the origin of shame.  

References

Cole, J. 2001. Empathy Needs a Face. Journal of Consciousness Studies, 8, No. 5-7, pp.51-68.

Leder, D. 1990. The Absent Body. Chicago: University of Chcago Press.

Merleau-Ponty, M. 1964. The Primacy of Perception. Evanston, IL: Northwestern University Press.

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