[visionrehabtherapist] Re: Adjustment To Blindness Question
- From: Dina Rosenbaum <dina.rosenbaum@xxxxxxxxxxx>
- To: BJLejeune@xxxxxxxxxxxxxxxxxx, visionrehabtherapist@xxxxxxxxxxxxx
- Date: Fri, 30 Aug 2013 15:01:59 -0400
Hi All, The Carroll Center’s independent living program still centers
around the psycho-social adjustment to blindness thorough training,
counseling and peer relationships. You are right that sometimes the client
is not ready for this type of program and can’t imagine being in a program
for several months, but when they talk to others who have completed an
adjustment program they are more willing to try. There is great power in
finding consumers who once shared their concerns to help them accept this
type of rehabilitation. I am sharing this great article.
*From Balance for Blind Adults, Canada.*
*The Twenty Losses of Blindness*
In the years during and following World War II, Reverend Thomas Carroll
worked with blinded veterans to help them reintegrate into civilian
society. He developed a new mobility program, opened the first facility for
the newly blinded in the U.S., and went on to become an outspoken advocate
for the rights of the blind and vision impaired. In 1961, his book *Blindness:
What it is, What it does, and How to Live with it* was published. In the
first part of his book, “Analysis of What is Lost,” Carroll addresses the
social and psychological adjustments that accompany vision loss. Although
significant progress has been made in rehabilitation services and assistive
devices since Carroll’s time, his insights continue to be relevant today.
In the following, we provide an overview of the impacts of blindness that
Carroll identified. If you have recently experienced vision loss, you will
recognize common experiences in the adjustments described. If you have a
friend or loved one who has vision loss, Carroll’s work helps to understand
how blindness affects a person’s life.
------------------------------
*Basic Losses to Psychological Security*
1. Loss of physical integrity
Self-esteem is closely related to physical competence and appearance. When
individuals experience blindness, they may feel ‘broken’ or no longer
whole. When they were sighted, they may have had negative stereotypes of
blind people. They may now see themselves as outsiders and different from
those in the broader community.
2. Loss of confidence in the remaining senses
Vision is the dominant, integrating sense. Without it, one must learn to
trust the other senses. However, this does not occur automatically. People
often have the mistaken belief that blind people have extraordinary senses
of hearing and touch. This has been shown not to be true. It is actually
the result of increased concentration and training. There is no magic
compensation in the remaining senses. Vision is such a dominant sense that
the newly blinded do not find it at all easy to gather environmental
information from the remaining senses.
3. Loss of reality contact with the environment
Sight plays the primary role in maintaining orientation. When sight is
lost, individuals can lose a sense of where they are, and of who or what is
around them. Although sound can be helpful, it moves and echoes off objects
and is not as localizing or specific as vision. Objects may no longer be
where they were expected to be. A feeling of “separateness” and a sense of
isolation also occurs because the brain is receiving less stimulation.
4. Loss of visual background
Sighted individuals have a far-reaching experience with the environment.
Sight gives them an instantaneous sense of what is in the environment
beyond their immediate task. In the absence of vision, hearing can provide
some information, but only about people or objects emitting sound. Touch
reaches only as far as arm’s length. Also, peripheral vision can no longer
be relied on as a warning system. People and objects just suddenly appear
and it’s frightening. Newly blinded persons are in a visual vacuum, without
a palette of colour and movement around them.
5. Loss of light security
It is a mistake to equate blindness with darkness. The vast majority of
people who are legally blind have functional vision, and many others can
perceive light.
Equating blindness with darkness also has broader psychological
implications. Light is associated with goodness, truth and, in general,
positive characteristics. Darkness, on the other hand, is associated with
evil, despair, and ignorance. Light and darkness, therefore, have emotional
connotations for both sighted and blind people. According to Carroll, this
can result in barriers to full acceptance in the broader society.
Those who have been totally blind since birth—those relative few who have
never had light perception—must rely on the word of others who say they
live in darkness. Also, those who are experiencing a progressive loss of
vision often fear the final loss of sight as complete darkness.
------------------------------
*Loss in Basic Skills*
6. Loss of mobility
Significant loss of vision results in a loss of independence and in the
ability to negotiate the environment. Newly blinded persons may be afraid
to move around their homes on their own. They are without a sense of
freedom, security, and control in their environment and feel very dependent
on others.
7. Loss of techniques of daily living
The performance of daily tasks leads to repeated frustration. The result is
that the individual is constantly reminded that he or she is blind.
------------------------------
*Loss in Communication*
8. Loss of ease of written communication
With the onset of blindness, individuals lose their ease of access to
reading and writing. They are no longer able to deal with making lists,
keeping track of appointments, taking notes, or maintaining confidentiality
in correspondence. They can no longer see photographs and other graphic
illustrations. Newspapers and magazines become inaccessible, as do the
books they may have enjoyed reading to their children. The loss of written
communication also has detrimental effects on one’s profession.
9. Loss of ease of spoken communication
Gestures and facial expressions are important aspects of spoken
communication and are lost with the onset of blindness. It becomes harder
to interrupt in a conversation, to know who’s there, or to know when
someone may have walked away. Without visual cues, silences can be
difficult. An individual may feel he or she is expected to say something to
fill the silence. Public speakers also lose the ability to refer to their
notes.
10. Loss of informational progress
Fewer forms of information are readily and naturally available. This makes
it difficult to keep up with what’s going on in the world at large, in the
community, or among friends. It’s also more difficult to keep up with
current hair styles and fashion. Individuals may find their world becoming
smaller.
------------------------------
*Losses in Appreciation*
11. Loss of the visual perception of the pleasurable
Loss of vision means losing the ability to access objects you found
visually pleasing. This also includes looking in the mirror or seeing how a
new outfit looks. Does the food “look good” to eat? Singles bars just
aren’t the same! You can no longer see the faces of your family.
12. Loss of visual perception of the beautiful
This is a significant loss for those who once enjoyed the visual
arts—museums, art galleries or a scenic walk in nature. It can be
frustrating to try to imagine while someone else tries to describe
something beautiful.
------------------------------
*Losses Concerning Occupation and Financial Status*
13. Loss of recreation
Recreation, whether physical or intellectual, is vital to stress
management. Perhaps the individual used to play basketball with friends or
took art classes. Even informal recreation activities like sitting down
with a good book or playing the piano using sheet music are gone.
14. Loss of career, vocational goal, job opportunity
Many who experience blindness are seniors who have already retired. Others
may have careers they can return to with minor adjustments. For many
working age adults, however, this is an important loss. The reality is that
personal identity is very much tied to work. A favourite question at
parties is “What kind of work do you do?” This is an uncomfortable question
for someone who has recently experienced a loss of vision. At the same
time, it is telling when the question isn’t asked at all because of the
lack of expectation often associated with blindness.
Work also fills a lot of time in people’s lives. There is a large void of
time, intellectual stimulation, social contact and sense of accomplishment
when work is taken away.
15. Loss of financial security
Having to quit work or leave for retraining results in a loss of financial
security. A major role in the family changes if the person with vision loss
is a caregiver or breadwinner.
Expenses may also increase as a result of medical issues and those
associated with living with a disability. Taxi costs may increase,
bargain-hunting is much more difficult, and dry-cleaning bills may
increase.
------------------------------
*Resulting Losses to the Whole Personality*
16. Loss of personal independence
People in the general public may believe the stereotype of the “helpless
blind man” and reduce their expectations of the person’s independence.
The person with vision loss may struggle between the desire to remain
independent and hold onto the freedom it allows and the desire to remain
dependent in order to take advantage of the protection it provides. A major
part of independence is knowing when to ask for help. People with “giving
personalities” have a more difficult time accepting help.
17. Loss of social adequacy
This loss tends to come from the lack of expectation of others who are
trying to be kind and sympathetic. In their former sighted lives, people
experiencing a loss of vision may have felt pity for those who were blind.
This perception can carry over into their newly blind identity. Blindness
may also result in a separation from society at large. Either the
individual is seen as helpless or as possessing superpowers of hearing or
memory. In either case, a feeling of social inadequacy may result.
18. Loss of obscurity
This involves the feeling that you’re always “noticed” by others. People
who experience blindness lose their privacy. They are noticed and may
become public figures merely because of their blindness. They may not want
this attention but don’t always have a choice. They become “the blind
graduate”, “the blind lawyer” or “the blind dad of the first grader”.
19. Loss of self-esteem
There are two aspects to self-esteem—the objective, based upon a realistic
sense of our accomplishments, talents and contributions, and the subjective
sense based on our feelings about ourselves.
When blindness occurs, it is no longer possible for one’s “former self” to
exist due to some or all of the losses above. People experiencing vision
loss may alter their expectations of making contributions in the future and
be affected by how they are perceived by others.
20. Loss of total personality organization
A wide range of psychosocial problems can manifest themselves as a result
of vision loss. The individual’s total personality experiences an onslaught
of blows. How she or he reacts depends in part on personality and on
individual strengths and weaknesses. Inevitably there is a significant
shock to the system.
------------------------------
The challenge is to put the pieces back together to move forward with a
fulfilling life. BALANCE for Blind Adults supports people who are blind or
visually impaired in overcoming feelings of loss by building skills and
strategies for independent
living<http://www.balancefba.org/services/services.html>.
Learn more about Reverend Thomas
Carroll<http://www.carroll.org/about/our-founder>.
To access Carroll’s book, visit www.carroll.org/the-carroll-store/books/
--------------------- Original Message -----
*From:* Susan-Marie <susanmarie9@xxxxxxxxxxxxx>
*To:* visionrehabtherapist@xxxxxxxxxxxxx
*Sent:* Friday, August 23, 2013 9:44 AM
*Subject:* [visionrehabtherapist] Adjustment To Blindness Question
Hi Everyone!
Sorry for more questions out of left field. Can any of you tell me your
opinions regarding services for clients/consumers making the psychological
and emotional transition from being sighted to life as a partially-sighted
or blind person? I am aware of the mini-adjustments, (many lasting about 5
days and varying from state to state), but can any of you give your
opinions about how you feel the transition is being addressed in general?
Also, have you ever felt that the individual is not quite ready for
services because he/she may be struggling with adjustments to the new
lifestyle? If I am not clear in what I'm asking, please let me know.
Also, please feel free to answer me off-list. Thanks so much in advance
for your responses and have a great weekend!
Best,
Susan-Marie
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