rejoinder to scott by michael a. harvey

Fam Proc 23:216-221, 1984

REJOINDER TO SCOTT BY MICHAEL A. HARVEYThe response by Sam Scott to my article vividly illustrates the intense controversy that pervades and confounds the

practice of providing psychological services to Deaf persons. Its central issue is communication: how and to what extentcommunication occurs between Deaf and hearing persons.

As the reader will note, the controversy is often bitter and emotional, replete with "name calling" and misplaced sarcasm,as exemplified by Scott's title, "Will the Therapist Listen?"

In regard to communication, Scott apparently misunderstands and falsely states my first assumption to be "that unless therelatives of a deaf person know Sign Language, family communication will be faulty and in need of a translator." Scott thenstates his assumption to be that, regardless of how any given family communicates, "they do communicate very well." Thisis much too general and simplistic. My article was specifically in reference to "families in which there are hearing parentsand siblings and at least one Deaf child or adolescent whose primary and preferred mode of communication is AmericanSign Language (ASL)." In audiological terminology, this type of deafness usually means a severe to profound (at least 70dB), bilateral, congenital hearing loss with minimal residual hearing. These particular persons frequently become frustratedwhen relying exclusively on lipreading in order to communicate with several persons in a group, i.e., with their nuclearfamilies. It is also frustrating to their hearing siblings and hearing parents. For example, in 1974, over 100 English mothersof Deaf children were asked what they felt their greatest problem was; 76 per cent of them gave answers indicatingproblems that arose from difficulties in communicating. When asked what they felt was the greatest problem from thechild's point of view, 89 per cent replied that it was communication (6). Similar results have been obtained from studiesthroughout the United States, conducted after 1980 (5, 8, 9, 11).

Why does this occur? Assuming that everybody in this particular kind of family takes care to speak directly to the Deafperson, to talk slowly, to talk in order (never simultaneously with another person), to employ sufficient lighting, to makesure there is minimal background noise, and to indicate first the direction from which the words are being spoken, then, andonly then, is it linguistically possible clearly to lipread approximately 33 per cent of what is being spoken (10, 12).Furthermore, this percentage is the upper limit; it is a function of the phonological visibility of the English language and isin no way correlated with intelligence (13).

Yet, communication clearly happens in these families; information is exchanged, the Deaf sibling "picks up" on facialexpressions, body movements, daily behavior, and gestures. But it is not linguistically optimal. One must often resort toguesswork or to deducing from the context of a conversation exactly what is being talked about. As an example, I recentlyled a panel of Deaf siblings and their hearing parents. One Deaf male adolescent commented that "my parents and I havealways had surface discussions.... I save the deep discussion for my friends, like talking about feelings" (my emphasis). Hewas referring to linguistic communication issues, rather than to the normal adolescent individuation process. This siblingwas not labeling his intra-family communication as "faulty" per se; he simply wanted it to be more meaningful and personal.

My paper emphasized that it is common but "not always the case" that such families prohibit the use of Sign Language.Furthermore, as Scott correctly points out, the educators? the schools for the deaf? have promulgated the myth to parentsthat Sign Language would impede speech/ lipreading development and thus prevent their Deaf children from interacting inthe "hearing world." This is the oral philosophy; it prohibits Sign Language (or any behavior indicative of being differentfrom hearing persons), even when used as a supplement to lipreading and speech. Consider the following quotation by aprominent superintendent of an oral school:

We should hope and work for the day when there is no subculture of the deaf.... anything less than commitment tototal integration into a hearing society is a goal that cannot be acceptable to parents of deaf children. [2, pp. 524-25]

This parental attitude is not outdated, as Scott suggests, when one considers references after 1980 (1, 4, 8, 9, 14). It isimportant to note, however, that parents have appropriately relied on such professional opinions and have "followeddoctors' orders." They are certainly not viewed by this author as deserving of blame.

The method of "total communication," which Scott incorrectly defines as "Sign Language and oralism," has recentlygained in popularity. Total communication, as coined by Holcomb and Denton in 1965 means that

the Deaf child must be introduced early in life to a reliable receptive-expressive system of symbols which he is freeto learn to manipulate for himself and from which he can abstract meaning in the course of unrestricted interactionwith other persons. Total Communication includes the full spectrum of language modes: child-devised gestures, thelanguage of signs, speech, speechreading, fingerspelling, reading and writing.... and includes auditory stimulationand use of residual hearing. [3, p. 4]

Printed from The Family Process CD-ROM_______________________________________________________________________________________

Copyright © 1999 Family Process.1

Scott refers to the paper's stance as condescending, apparently because of the article's emphasis on therapeuticintervention strategy. This illustrates another misunderstanding of the intent of the article: "Family Therapy with DeafPersons: The Systemic Utilization of an Interpreter." Its objective is to describe how to utilize an interpreterpsychologically, given specific kinds of treatment considerations for specific kinds of families that are experiencing specifickinds of problems that necessitate family treatment. In this case, the presence of an intepreter is often perceived as symbolicof their Deaf child. One may explain this phenomenon as stimulus generalization or transference. The interpreter, affiliatedwith Deaf culture and competent in Sign Language, is most similar to their Deaf child; he or she also represents preciselywhat these particular parents have been taught by the school system to deny and avoid. Consider a clinical example of onemother who, in this case, requested with ambivalence that the therapist sign and that the family use an interpreter intreatment. During one session, as the interpreter began to sign, she commented, "You know? I just realized that my[18-year-old] son is Deaf!" and reported feeling relieved. Realistically perceiving him in this manner enabled both of themto enjoy a much happier and productive relationship.

In contrast, families that continue to deny the implications of deafness are clearly in pain; day to day family life is oftentinged with feelings of frustration and being overwhelmed. Such parents are frequently shocked, when interacting with theeducational system, to find out that "my 19-year-old Deaf child is reading at only the fourth grade level." (That is theaverage reading level of Deaf adults in this country [14]). Given communication barriers that limit incidental learning andgiven this extremely low level of reading achievement, it becomes apparent that Scott's suggestion that the average Deafchild "learns as many people do without being taught" is erroneous and misleading.

Scott's interpretation of how an interpreter can modify the balance of power in the family? "just through sheer numbers,a therapist and an interpreter and a child who sign are more powerful than two parents who do not"? suggests thiscomplicated and subtle process to be a simple game of "tug of war." It is not. By the therapist demonstrating empathy witheach family member, eliciting his or her strengths, and skillfully shifting coalitions, he or she can facilitate accomplishingthe goal of this process, which is to help families resolve the pain that necessitated treatment. To resolve pain oftennecessitates changing behavior. Given what family therapists have learned about cybernetic processes such as homeostasis,it should come as no surprise that change is often difficult and happens slowly.

In regard to persistent parental perceptions of helplessness, I have received several phone calls from parents who do notwant their 25-year-old Deaf "child" to own a car and drive, or who report that "my daughter is immature because she neverunderstands my directions." An interpreter enables the Deaf child to communicate clearly and succinctly with his or herparents ("deep communication"); repeated demonstrations of effective communication of thoughts and feelings enhances theDeaf person's status in the family. To label these parents' behavior toward maintaining homeostasis (perceiving their childas helpless) as incompetent or callous would be incorrect and condescending; to correctly label it as indicative of fear ofchange, fear of the future, or fear of "letting go" is to pave the way for an "open family system" and consequent familygrowth and happiness.

The correct definition of an interpreter is important in the field of deafness. Scott's description of an interpreter as one"who signs" and the implication that "a trusted friend" or "family member" can interpret is an extremely serious professionalmisconception. The Registry of Interpreters for the Deaf (RID), a national evaluation system established in 1964, hasclearly distinguished interpreting from signing(15). A fully certified interpreter (CSC) is one who has obtained anextremely high level of proficiency with at least two different types of Sign Language? Signed English and American SignLanguage; who is able to accurately interpret/transliterate back and forth between these two languages and spoken English;and who has taken additional course work in audiology, cross-cultural issues, linguistics, and ethical considerations. Asigner is simply one who can sign at varying levels of proficiency. Because many counselors have naïvely utilized signers asopposed to interpreters in treatment, R.I.D. has established stringent certification requirements so that what Scott terms"muddling up communication" will not occur. "A trusted friend" or "member of the family" may be qualified to sign butcertainly not to interpret. Scott's assertion is akin to stating that anyone who has taken one undergraduate counseling courseis qualified to do psychotherapy.

It further seems psychologically unreasonable to expect that a family member would accurately interpret what the Deafmember is signing. On the contrary, as with hearing families, the level of distortion and misinterpretation would beexpected to be in accordance with the explicit/implicit rules of communication between the parent and the Deaf child and toincrease in direct proportion to the level of conflict between them. I am reminded of an incident in which a Deaf male wasreceiving a psychiatric evaluation, with his father serving as interpreter. After a while, it became puzzling to the psychiatristthat the Deaf son would seem to sign for several minutes, whereas his father voiced only brief sentences. When asked aboutthis, the father replied, "Oh, don't worry, doc? most of what he was saying was gibberish."

In addition, Scott does not appear to understand the role of an interpreter. He states that "language is a complicatedbusiness and the addition of a person who interprets has a potential for muddling up communication." This is precisely whyan interpreter is required! An interpreter has had extensive and specialized training in "demuddling" communication at alinguistic level.1 Scott also states that "the interpreter can be more beneficial to the therapist in establishing and shiftingcoalitions...." Not only is this antithetical to the role of interpreters, but it clearly violates their code of ethics (15).



The practice of family therapy in general is a complicated business. The therapist must authentically "be with" andaccommodate to each individual person in the room: respect each person's model of reality and elicit, without distortion,why each person has come into treatment. The therapist must master specific techniques and, in the context of authenticrespect, join the family in eliciting their assets and strengths and in finding solutions to their problems. Finally, the therapistmust be able to achieve a "metaposition" in order to observe all of the participants in the therapeutic interactions, to makesense out of the "gestalt." The suble art of doing family therapy was not elucidated on the presumption that the readers ofthis journal have achieved a certain level of competence as family therapists. I have described elsewhere (7) the process bywhich many family therapists learn these skills.

Specifically, with regard to treating families in which there is a Deaf member, four points become evident: 1. Since doing effective therapy is complicated and requires concentration, it is impossible to do therapy and be

concerned at the same time with accurate interpretation or transliteration of at least two different sign languagesystems and spoken English. Interpreting is also complicated and requires concentration. Simultaneously providingtherapy while interpreting will cause both to suffer.

2. It is vital for the therapist to respect each person's model of the world, both that of the Deaf and of hearing persons.Thus, if ASL is the Deaf person's primary and preferred mode of communication, it is my practice to sign in ASLwithout the use of voice (while the interpreter interprets in spoken English for the hearing members of the family)and to use spoken English to communicate with the hearing members of the family (while the interpreter interprets inASL for the Deaf member).2 The interpreter also interprets all intrafamily communication for the Deaf and hearingpersons.

3. In order to work with families in which there is a Deaf member, the clinician must be a competently trained familytherapist and be knowledgeable about deafness.

4. Delineating specific treatment considerations and techniques for families with specific kinds of problems certainlyneed not, and should not, imply negativism, lack of respect, or condescension.

Scott's list of words like "enjoy, love, friendly, joke, laughter" clearly connote family. But, if the therapist is not able tointegrate what these words represent with how to help families solve the problems that brought them into therapy, theybecome empty words that sound good but are devoid of substance.

REFERENCES

1. Chess, S. and Fernandez, P., The Handicapped Child in School: Behavior and Management, New York,Bruner/Mazel, 1981.

2. Connor, L. E., (1972) "That the Deaf May Hear and Speak," The Volta Review, 74, 518-527. 3. Denton, D. M., "The Philosophy of Total Communication," Brit. Deaf News, 1976. 4. Freeman, R., Malkins, S. and Hastings, J., (1975) "Psychosocial Problems of Deaf Children and Their Families: A

Comparative Study," Am. Ann. Deaf, 120, 391-405. 5. Greenberg, M. T., (1980) "Hearing Families with Deaf Children: Stress and Functioning Related to

Communication Method," Am. Annals Deaf, 125, 1063-1071. 6. Gregory, S., The Deaf Child and His Family, Halsted, N.Y., Allen and Unwin, 1976. 7. Harvey, M. A., (1980) "On Becoming a Family Therapist: The First Three Years," Int. J. Fam. Ther., 2, 263-274. 8. Hoffmeister, R. J., "Deaf Families: A Functional Perspective,"in K. Thurman (ed.), Handicapped Families:

Research and New Perspectives, New York, Academic Press, in press. 9. Hoffmeister, R. J. and Shettle, C., "Results of a Family Sign Language Intervention Program, Paper presented at

the 50th meeting of Convention of American Instructors of the Deaf, Rochester, New York, 1981. 10. Jeffers, J. and Borley, M., Speechreading (Lipreading), Springfield, Ill., Charles C. Thomas, 1964. 11. Levine, E. S., Ecology of Deafness, New York, Columbia University Press, 1983. 12. Luey, M. S., (1980) "Between Worlds: The Problem of Deafened Adults," Social Work Health Care, 5, 253-264. 13. Mindel, E. and Vernon, M., They Grow in Silence, Silver Spring, Md., National Association of the Deaf, 1971. 14. Moores, D., Educating the Deaf: Psychology, Principles and Practices, Boston, Houghton-Mifflin, 1982. 15. Moores, D., Registry of Interpreters for the Deaf, Code of Ethics, Silver Spring, Md., 1976.

Manuscript received September 16, 1983; Accepted September 16, 1983.

1Incidentally, it seems inconsistent for Scott to assert both that "language is a complicated business" and that these families"communicate very well" without Sign Language. He cannot have it both ways.

2This is because it is impossible to sign in ASL while speaking in English. They are two completely different languages.



rejoinder to scott by michael a. harvey

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