An external element or an internal process?

An exogenous conception reminds us of perceptions of the disability as accident, related to the action of an extrinsic element. Where does it come from? From nature or biology? From the social environment, the life-style or culture? From a pathogenic family? In the latter case, the mother is often the one suspected. She is the one in the wrong, it is her fault and maybe she wanted the child she brought into the world to be that way. The flawed assumptions attributing autism (whose aetiology has yet to be revealed) to a pathology in the mother-child bond come to mind. Perhaps a form of vengeance is the cause? A sorcerer, a genie, a spirit, a demon, God, or simply fate? Perceptions of the disability as a curse correspond to this conception.

Conversely, where an endogenous conception comes into play, the disability shifts to the side of the person affected. It comes from within, being an intrinsic process. Whence notions of dispositions or predispositions, of genetic heritage or heredity, of terrain and nature, constitution, temperament, or "internal environment", as in Claude Bernard's expression (1865), for whom stability of the internal environment predominated as clearly being the sine que non precondition for life being maintained. Interpretations of disability as a punishment are rooted in this conception: it is thought of as the consequence of what the individual or the social group have themselves caused, either unconsciously or deliberately, by negligence, excess, or transgression. If one looks to the Christian tradition, for the Hebrews of the Old Testament, the afflictions of the "impotent folk", the "blind, halt and withered" were handed down by God, who, thus, punished Man's lack of faith. Such is the story of Job and his many trials.

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