Stages In Adjusting To Blindness


Stages In Adjusting To Blindness

      "I'm blind and I know I have a challenge to face. But, I feel lucky I didn't die,” said Jerry. He was talking to a therapist, explaining how he felt. This was his sixth visit since his release from the hospital; the car accident that had caused his blindness had happened two months ago. The therapist had just asked, again, how he felt about losing his sight. Jerry thought he knew why this guy was hitting on this question, even so he was starting to get irritated with it.

     The therapist tried a new tack. "In the past, have you ever experienced a significant loss? Like the death of someone close to you?"

     Okay. Jerry thought, he'd go down this path. "There was my grandpa; my dad's dad."

     "Tell me about that," the therapist prompted.

     Jerry sat back in his chair, expelled his breath, trying not to sound frustrated. After all, he knew this guy was trying to help him. "My grandpa and I were close. I was the only grandkid that had red hair like him. And he and I really hit it off … you know, he'd bring me special little gifts, take me places with him. And one day I was expecting him to come over and he didn't show. I could tell my parents were hiding something. When other people started showing up, they told me."

     "What did they tell you?"

     "That grandpa wasn't coming, not any more. He got sick and the angels took him to heaven."

     "How did you feel about that?”

     Jerry took his time to think through how he would phrase his answer. He wanted to be as honest as he could. But suspecting it might not be enough for this guy. "Well … I was only five. Sad, I guess. I mean, I'm sure my parents did their best to break the news to me, and you know help me with it."

     "You were pretty young. Do you remember anything more?"

     "Well …" Jerry felt he had to say more and went with what he recalled was big about that whole thing, back when he was so small, "I missed him. We had fun together."

     The therapist tried again. "Anything else happen more recent?"

     "No, not really," Jerry said and he thought it was about time he addressed what he was feeling about this line of questioning the therapist was taking. "Look, I know you want me to tell you that I'm sad or pissed-off because of what has happened to me. But what I feel is that it could have been worse, the car could have killed me instead of just blinding me!" That had come out with more heat then expected and he wasn't sure he cared.

     "Jerry, I haven't been confrontational with you yet, but I think you know what I'm probing for here. I've yet to see you as you say, sad or pissed-off about losing your sight. And frankly, that has me concerned. so yeah I'm wondering why you aren't showing any of these things. And understand, it's natural to feel these emotions."

     "Well, I don't feel that way. It's not like I am dealing with a death, just the opposite, I'm grateful to be alive. And I don't know what I can do to convince you that it is the truth," Jerry said.

     The therapist was silent for a moment, thinking. "Well, I hear you. I just think you are not letting loose. My job is to help you make this change that has been forced upon you. I'm not picking on you, I'm treating you like an average guy and the average guy feels something when they lose something as significant as their eye sight. And you're right, it is like adjusting to a death, there are stages to work through; denial, anger, bargaining, acceptance. So again, getting emotional right now is okay, you work through it and it passes and you do go on with your life. But carry any amount of these unresolved stages along with you and it can get in your way, prevent you from the level of success you rightfully can achieve."


e-mail responses to

**1. Interesting. On the one hand, Jerry's in denial. That's natural, and it'll go away on its own. He should feel a tragic loss--the world is set up so that sight is the primary sense, and anything else is going to seem a pale substitute.

On the other hand, one has to wonder whether the shrink would have equated losing an arm to the death of a family member. This sounds like a bit of pressure from the "better dead than blind," camp. After the therapist convinces Jerry that that's how he should feel, the next step will be to adjust Jerry so that he becomes what the sighted think the blind should be, based on how he should see himself according to a sighted perspective. Sinister.

The truth is that Jerry can rely on no one but himself to rebuild himself as the best blind person he can be. His shrink cannot understand it, and can only help him deal with the immediate aspects of posttraumatic behavior. After that, he's on his own, and there will be no accurate measure of his self-esteem, but that which he finds for himself.

Mark BurningHalk

**2. I was blinded 37 years ago in an auto accident. I remember being afraid to ride in a car, but my best friend took me for a hair raising ride and - problem solved. Like your story's character, I recall being matter of fact about the whole thing. The kid sitting next to me in the car was DOA, so I too was glad to be alive. I figured then and know for sure now, that God had a plan for me.

Charles Hackney

**3. I love your new provoker for two reasons. Firstly, I am a clinical psychologist, and secondly, I am totally blind. From a therapist's perspective, I am embarrassed by the poor technique by the therapist. My goodness, there has been a lot of attention given to therapy in the media with the HBO show "In treatment." It would have been exciting for the show to have the therapist to have a blind patient. What I think isn't good is when people have experiences like this person who are lead or encouraged to "feel" things they just don't feel. I can strongly identify with the blind person in this story because I think all of my life people have been trying to tell me how I feel about my own situation. How much sence does that make? If people want to know how people feel or what they think, just ask. Adjustment to blindness is a journey for that one person. It is not a linier process easily predicted by a theory, but one of experiencing, living, learning, and loving. From a psychologist's perspective, I do understand the therapist's probing because he wants to help. The best way to help is to gently nurture so that someone can naturally grow. Sometimes they go
"overboard" with wanting to help. they aren't helping, but just embarrassing, angering, and ignoring what the patient has said. Many times people just need someone to be there and to accept them for where they are. I don't think this therapist accepts where this person is at psychologically in their adjustment to blindness. And guess what? The patient knows that he isn't being accepted and even tries to give the "right" answers.

When I first went blind, I had no idea that it was going to be as hard as it turned out. I was a young child who continued to do fun things, play with friends, and watch TV. If a therapist or my parents would have said, "no, you feel sad, you are not happy." That would have been ridiculous and would have damaged my natural progression through adjustment. Sometimes people make blind people feel sorry for themselves or helpless because of their insensitive probing or questioning. If there are people that are reading this who are therapists, I'm encouraging you to have your own therapy or psychoanalysis to understand your own feelings and thoughts about blindness before you work with anyone who is blind. I really think this provoker shows how other people need to be able to adjust to blindness as well. It is not just a process that involves the blind person, but society as well. I actually wrote my dissertation on
"interpersonal perspectives on self-concept development in blind adolescents." In short what that means is that parents, teachers, therapists, and other sighted people have to be aware of their own sadness and their own fears and their own problems with blindness. All of the people around us also have to "adjust to blindness" and their adjustment impacts our adjustment. Adjustment to blindness is not an interpsychic experience I N T E R Psychic), but an intrapsychic experience (i n t r a psychic). Intrapsychic experiences involve not just the blind person but everyone else as well.

Dr. Andre Watson Philadelphia, PA,

**4. Since I've always been blind, I can't speak to this provoker from personal experience. But, I do have an opinion.

Several years ago, my neighbor lost most of his sight after two surgeries; one for a detached retina, and the other for a cataract. He has lived next-door since 1972, so has had many years to observe Jerry and me, in our daily lives and learn of our attitude toward blindness.

After Bill lost his sight, his transition seemed amazingly smooth. I'm sure he had, and probably still has, some times of feeling badly or sorry for himself. But, these are infrequent. Bill wanted to learn Braille, right away; he did that. He went to a rehab center for blindness skills training and then to learn to use a computer. I taught him to use a cane, and he uses it, regularly, around the neighborhood. He did all this as an older person...late 60s and early 70s.

I relayed that story to say that I'm sure there are stages of acceptance and grieving for the vision loss. But, I also believe that much of the transition time can be overcome by having a good attitude toward blindness and then taking the steps to learn the necessary skills.

It seems that this counselor was so focused on what he learned the consequences of blindness should be that he didn't see that his client had already come to terms with the biggest part of becoming blind...his attitude. Now, the client was ready to move on, and the counselor was still trying to get him to follow the prescribed stages, which he learned about in some textbook.

Cindy Handel Willow street, PA

**5. I should say right up front that I was born visually impaired so have not experienced exactly what this person is going through.

My initial reaction while reading the latest thought provoker is that this client should be looking for a new therapist. I was quite disturbed by the way the therapist assumed that this person would experience grief in exactly the same way as another individual.

Grief is as individual as the people who experience it. Someone else might experience the stages of anger, denial, etc. that the therapist eluded to in his discussion, but others might not. Who are we to judge whether this person has grieved "appropriately" to his loss of vision?

In addition, was the client required to see a mental health professional by someone in the medical or rehabilitation field? If so, I feel that there needs to be some education taking place in the medical and rehabilitation fields. Counseling and therapy do have their benefits, but it is my belief that the client should choose whether to seek out these resources or not. I have discovered from personal experience that if one is pushed into therapy, the client is miserable and doesn't see why he or she has to even be there.

If the client was in therapy by his own choice, the therapist should be listening to the client's thoughts and feelings, not pushing his own agenda. It seems that the therapist has one goal, and only one goal. That goal is to show the client that he must go through the prescribed stages of grief in a prescribed order.

As a future rehabilitation teacher, I see the value of the grief stages, but I do not feel it is my role to judge what stage of grief the client is in. I do feel as a rehab professional that it will be my job to assist the client to accept his or her vision loss, but it isn't up to me whether the client utilizes what I teach once his or her services are complete. I can show the value of various techniques, but ultimately, it's the client's choice whether he or she utilizes everything he or she has learned in rehab.

Alexis Read
Graduate Student in Blindness and Low Vision Studies
Western Michigan University

**6. I'm a retired therapist. And I think your fictional therapist is stupid. And uneducated about trauma. And missing the first tenet of therapists, expressed as 'Begin where the client is! " In the scenario, the client didn't seek out therapy, he isn't feeling pain--yet. With a trauma, the first coping skill is cognitive. Feelings come later. So our "helpful" therapist is actually undermining his client's defenses. And the client is in the middle of that great river, de-nial. And that's ok.

Hey man;, lighten up, stop telling him how he ought to feel. And for Pete's sake, get him a new therapist in three months, when he's had some living under his belt.

Anita Cohn, LISW

**7. The problem here is that counselors can be a little too "professional." The therapist sounds like he's trying to force a "textbook response." This is the worst way to go about it, because he is not treating Jerry like an individual. Some people adjust more readily than others.

Take these three real-life examples.

Fanny Crosby said flatly, "If perfect earthly sight were offered to me this instant, I would not accept it." She adjusted to blindness rather well.

Rebecca Veeck was asked if she accepted it. She said, "You accept it, but you never really accept it." So Veeck didn't like it, but was resigned to it.

Anne Sullivan, who was Helen Keller's famous tutor, never accepted blindness. She had lost her sight as a child. At age 15, her sight was restored by an operation, but remained tenuous. Sullivan knew that her eyes would weaken over time, and they did. (The stress of being Keller's caretaker didn't help.) As Sullivan got older, her sight began to fail again, and she was extremely bitter about it. She went to her grave blind and angry.

As for Jerry, who knows what his reaction might be, if the counselor would just back off?

David Lafleche

**8. I'm a blind therapist, in private practice and teaching for a long time. My problem with the therapist in this scenario is that he is treating Jerry “like an average guy …” Were I supervising this therapist, I might suggest that he listen more to his client, and treat this person as the individual he is. At present, he is clearly more in touch with feelings of gratitude for being alive than he is with his loss. Perhaps as he goes through more of his life now as a blind person, he may begin to experience some of the differences between being sighted before the accident and now being blind, and this may lead him to the grief and anger that the therapist is expecting him to feel. Perhaps not—it remains to unfold. Also, it is important to recognize that the stages” listed denial, anger, bargaining, depression, acceptance do not occur sequentially for most people. Rather, people tend to move back and forth among them.

Karen Rose, MFT

**9. As far as you missed last month, at least for me, this one is dead on. I was 11 when I lost most of my usable vision, and I did not work through those issues at the time. There were good reasons: I was relieved that there would be no further surgery; I was extremely lucky in being able to deal with blindness operationally -- skills training, education, and ultimately employment quickly and effectively, but I didn't work through just how pissed off I was at the whole world. Again, I was very lucky to manage that anger better as the years went by, but had I any suggestions for my parents, who moved heaven and earth to make me independent and successful, it would be that maybe we all should have taken a little more time to work through what happened to all of us. I just think back then it never occurred to us that such a thing was important.

Robert Shelton

**10. It is different when a child loses vision than it is for an adult. And worse, it is a nightmare when someone takes their sight on purpose with some kind of sharp instrument. As this happened to me at age five, you cannot even begin to understand the nightmare I was plunged into. I couldn't be left alone in the house for a long time. I did not want to be anywhere near the person who blinded me. I was scared and wet the bed often during that horrible year of 1960. My family never had any disabled members in their midst before, and my mother who was an immigrant from Eastern Europe, did not know where to go. Anyway, it took me a long time to get through things. As I got older, different things came along to make some things easier I go on and do the best I can with whatever tools I get my hands on.


**11. Yes, the therapist is correct in saying that not addressing the issues of being sad, angry, denying blindness, etc. can cause problems in accepting going blind and having a positive attitude about blindness. However, I feel that the therapist might be trying to get Jerry to feel feelings he doesn't have at present. If Jerry doesn't have those feelings of being sad, or denial, and Jerry's being honest with himself and to the therapist, then the therapist shouldn't be forcing him to feel feelings he doesn't feel. Just because the average person might feel sad, angry, or denial at going blind doesn't mean that everyone else feels the same way. This narrative reminded me of when a family therapist insisted that I feel as though I was to blame for my parents' divorce. I knew that I was not to blame for their divorce, but, like Jerry's therapist, the family therapist was determined to fix what wasn't broken.


**12. We can't know what other conversations the therapist and Jerry have had, but I wonder what would happen at this point if the therapist asked Jerry to describe his reactions to blindness before his accident; there might still be that level of denial, but Jerry would be able to admit some negative biases. Language gives so much of our feelings away, even when we think we're saying something neutral; syntax says it all. In lots of cultures, white is the symbol of death; in the more Euro-American tradition, black is. People think of death, darkness, black and blindness as a closely connected pattern. So, it's not surprising that a therapist might consider death, loss and grieving when asking a person to recall a time of loss and grief.

I don't work with too many adults who are blind, but I visit parents of blind children, and whenever a parent tells me they're "okay" with a child's vision loss, a red flag flies up and I start proceeding very slowly. While it's not my job to ask them specifically how they feel, I definitely want to know something about their attitudes. These will most definitely have much to do with the child's own attitudes and ultimately progress in school.

Some years back I read in a magazine a story of a blind man who had lost his vision after establishing a successful business. The writer had interviewed this man and learned some troubling things - at least to me they were troubling. The man said he no longer worked; he said his wife wouldn't let him help her in the house; he also said that when he lost his sight, his life "took it in stride." I wished at the time I could have met this poorly functioning couple who probably thought things were perfect. I have often wondered what the years after the story brought. I wanted to tell him to leave his wife for someone of greater compassion and sensibility, knowing, however, that he probably thought things were going just fine. Perhaps he wished to have a bigger role in family operations, but he wasn't demonstrating this.

The only thing that worries me about taking the approach the therapist in the story did, is that I know that people with chronic illness are counseled in grief management. Therapists want the patients to deal with a loss and learn to live with the loss. I would never want someone to confuse blindness with illness. This story certainly doesn't suggest anything so misconstrued - nothing of the kind. But illness is just one more negative concept people frequently couple with blindness.

I expect Jerry is a composite of many people, and I would be curious to know if and how a breakthrough comes for those who, have become blind as adults, learn to rage against their fate, and then move on to a higher level of understanding.

Kat Guam

**13. ADJUSTMENT TO BLINDNESS?? Date: April 7, 2008 In April 1966, I stood on deck of the USNS WALKER (AKA Love Boat From Hell) which was docked in Honolulu Harbor. As the ship shoved off, I watched the night lights of Honolulu Harbor as I had the premonition this would be my last vision of the United States of America. A bunch of us were on our way to the battlefields of Vietnam.

That premonition meant to me that I would die and be shipped back inside a body bag. Who would have guessed that premonition would come true!! But instead of returning via body bag, I returned as a totally blind Vietnam veteran!!

At Hines Blind Center at Hines, IL, several psychiatrist talked with me to make sure I wasn't crazy, depressed or otherwise a danger to myself or others. Our conversations were short and apparently I answered correctly as they did not have me return for further investigation.

Probably returning home as a totally blind guy would cause intense emotional problems. However, I anticipated returning inside the body bag but here I was still breathing and moving about. Being alive, although a blind guy, still beat returning dead and then buried to be forgotten. For reasons known only to God, I felt and behaved as a guy with a second chance at life. Just being alive was good enough for me!

Fortunately my return to society went well. I tried college as I recalled seeing blind people in college and I guessed that's where all blind people went. This time I decided to make an excellent go at education as I felt my back against the wall. It was graduation or bust for me. It was rough but I made it through graduate school with excellent grades to boot.

I learned that there is no such thing as common sense. Everything is learned.

I learned that what separated winners from losers was who did the homework. Before blindness, I would prefer a beating over doing homework. But this time I was determined not to graduate a big dummy.

My Master's Degree is in Vocational Rehabilitation Counseling. If you do elect to try higher education, make sure you choose something having marketable work skills!! Focus upon what you want to do in life and for which there is a market willing to pay your salary. Also remember, there are no short cuts in life. Believe me, I learned that the hard way. Also, learn how to use Spell Check, it will always make you look smarter than you might really be.

Michael Becker: Louisville, KY

**14. I think the guy shouldn't even be in counseling unless he actually has a problem. It sounds like he doesn't at that time. Somewhere later down the road he may have to grieve but why is he there when he's currently in a thankful state?

We all face deaths--and let's face it, this is a death--at different places. Some of us meet it head-on, like when I lost my baby. And some of us go months or years, like my friend who lost a baby a month before me but didn't grieve until a year later. You can't feel something that isn't there. When he gets out there and starts realizing the things that he can't do any more, or has to learn to do them differently, then he may finally be confronted with the loss. Right now he is thankful, a counsellor shouldn't be trying to drag him down into a place he's not ready to go.

Barbara Hammel

**15. Anyone who acquires a handicap later in life is thought by the psychologists to go through the same steps one goes through when mourning. However, like everyone else, people are people and not punched out of a cookie cutter. The shrink in this thought provoker was right if he wanted to treat his patient just like they said in the textbook but this individual didn't match that description. Acquiring a new handicap is not like a strep throat where you prescribe the anti-biotic and expect that the patient will be cured within a day. Handicaps are unique. People are unique. Consequently, with all the good intentions of the psychological community, not every person will match the textbook description.

Judith Bron NFB Writers' division Mailing list

**16. Having been in therapy myself, and having been a social worker, it was fairly predictable to me what the therapist's line of questioning might be, and the responses jerry gave. I have been blind since birth, so perhaps I didn't go through quite the stages Jerry might experience, and I think the therapist is certainly trying his best here. But I certainly went through stages of denial, saying that it wasn't a big deal that I was blind, just a nuisance, while in many ways acting totally differently. I also went through my rebellious stages of independence, refusing help, courteously if I could, angrily if courtesy didn't work. I have also heard that others, even those who were blind from birth or since they were young children, went through certain stages, from rebellious independence, to a more realistic sense of independence. I think there is nothing wrong whatsoever with talking with a competent therapist about these feelings, but I have a sense Jerry may not be ready yet. And that's okay. When he gets a little further along, when denial becomes harder and harder, I have no doubt he will reach out for the help he may need.

A big trauma in my life was being hit by a car while crossing a busy downtown street in August, 1985. At first, I practiced denial, big-time. Oh, I was grateful that my injury wasn't worse. I acted more concerned for the driver who hit me than myself, as they were carting me off to the emergency room. And of course, there was no question that I would get back out there and cross streets again, as soon as the stitches in my leg came out, no, correct that, before they came out. And I was never going to tell my parents, as my mom might try to overprotect me, which she certainly did when I told her. I didn't even want to tell friends, fearing that people might think I was trying to get people to feel sorry for me. But certain emotional realities came to bite me. I discovered in a few weeks that I really was angry, at my family, for clamoring that I should sue this driver, at the driver, at his insurance company for giving him insurance in the first place, and at myself for not getting over the fear of crossing busy streets. That took a long, long time and many, many street crossings before I could truthfully say that that fear was gone. So, while not meaning to sound too dramatic, I suspect Jerry will have a long period of emotional adjustment, but it will not do any good to rush him, sooner or later he will recognize that, and hopefully get the help he may need.

Nark Tardif

**17. I have to say that I was born prematurely, about three and a half months. I have never had time to adjust to blindness, as I was thrown into the mix without question, without asking, without time to think. My grandparents raised me, as my mom didn't want anything to do with a blind kid.

As I grew up and passed through the stages of nursery school and the early years at the Overbrook School for the Blind, my life was a series of bumps, bruises and everyday blindness occurrences. I grew up with sighted kids at the nursery school and blind kids at the Overbrook School. We played games, ate meals, got dressed, learned our lessons and went our separate ways.

The challenges to my life came later, after I'd left the sheltered grounds and lifestyle of Overbrook, of my grandparents' home. I attended public school from sixth grade on and went to Susquehanna University in Selinsgrove, Pennsylvania.

I knew I was different, but how different I wasn't sure. I was, however, expected, despite my difference, to attempt to take physical education classes, do my homework, and I got into my share of trouble with other youth and college mates. I even learned to work on automobiles, which was something that consumed a large amount of time in my youth and after college years. Learning that putting my hands on a car to put in a set of shocks, springs, adjust a carburetor, or just to wash and wax it, proved to bring me a lot of satisfaction that some other folks might get by playing basketball, reading
a book or going to a store to pick out clothes. But, the experiences all proved that sheltering one doesn't help in later life.

The only times I get angry is when my lack of sight gets in the way, because I can't get a driver's license. However, my ability to get around is enhanced by a wonderful Seeing Eye dog at present. I've had six so far and have loved every step I've taken.

My ability to deal with people doesn't have to do with having sight or not, it's just part of life. But, the frustration I feel is that some people are bitter about blindness because they feel that everyone owes them a living.

The gentleman in question says that he's lucky to be alive, and I side with him. Though he's blind, he has a second chance. And, although his sight was taken from him, he has his life and that's important.

michael Townsend

18. Jerry may have a loving, supporting, loyal family. His accident may have taken more lives and his sight may not seem as valuable as a life. He may be located in a community with excellent resources for blind people. Maybe he owned his own business and employment was not an issue. Maybe he has perfect hearing which makes blindness infinitely more bearable. Maybe he has highly developed orientation skills. Maybe he is already super-rich and retired. Maybe his cast of supporting characters does not desert him at the moment of blindness. Maybe he has a job that does not need eyes to handle. I can think of a lot of reasons why Jerry might appreciate being blind over being dead. I went from perfect health and fitness to suddenly blind, suddenly disabled, and suddenly ill in less than 3 seconds, from running a $50 billion campaign for the poorest people in America to nothing, from a blessed and wonderful life to...joblessness, homelessness, familylessness, and almost leglessness in a similar accident. My therapist would not let me express my anger, always directing it elsewhere. Despair immersed me after being dumped in a nursing home after rehabilitation, with little hope for the future. It was a very long way to the bottom. I spent years in physical therapy, etc., working out in swimming pools, etc. I think blind people who live alone have a particular cross to bear. Surrounded by family and loved ones, hope springs eternal. That did not happen for me and it does not happen for many. Blindness with hearing disability has been a long twilight struggle for social justice. I have been independent since I left the nursing home on July 4, 2000. I am a battle-hardened survivor of the "great war" for standing in a seeing world. Jerry's circumstances need to be explored before saying he has missed one of Krubler-Ross's stages of grief. Maybe. Maybe not. He might have a "vision" of another type. He might have seen Hell and having been rescued from its pits might appreciate an opportunity to reform his ways. He might be nutty as a fruitcake.

What restored me from despair to hope was the kicking in of my optic nerves in late August, 2000. The beauty in my eyes, the hope in my heart, the lifting of my despair gave me the fortitude to press on for years. In November, 2007, in Paradise Valley, Arizona, Sara O'Meara, a wondrous healer prayed for me and my eyes physically widened and each day something wondrous comes back. I still cannot see but man does not live on anger but on hope, not on himself but on others, not on mere survival but on thriving for success. Persons with sudden blindness, disability, or illness are called to show the indomitable spirit of mankind as each one strives for continuous perfection despite all obstacles. They are called to action, perseverance, courage, passion, strength, and commitment to independence. Maybe circumstances were such in Jerry's case that grief does not matter. It matters to me. It matters to most of us. He will grieve in his own way and in his own time. Despite the grief, he must push on towards excellence and independence, towards peace and happiness, towards community and the world. I hope he does not get angry and that blindness gets him a better job, a better education, a better life than the one he had. The issue of blindness is tied to the issue of liberty, and as Patrick Henry said so long ago: "give me liberty or give me death."

Scott Wendell Bray, Ph.D., Ph.D. Candidate [

**19. After reading the TP I wanted to hit the counsellor over the head. I don't believe grief is something that can be gone through linearly and then it just disappears. This guy might be dealing with it at the moment, fine, well and good, leave him to it in my opinion. Let him do some rehab and monitor his progress, let him know that these are the stages you might go through so that if he does, he can seek help if he needs to, or acknowledge what is happening when it does. The counsellor character seems to be a bit naive and not very good in his line of work. Perhaps he is only new to the field…

From Penny from Australasia

**20. In this story Jerry had lost his sight in adulthood and for him it may have been like a death. He had lived a significant amount of time with sight, able to drive a car, walk freely in unfamiliar surroundings, take for granted the colors of everything around him. He had a car wreck and lost his sight and his life was altered. I'm sure he was grieving. I believe, however, that the therapist was trying to force the issue. Jerry might have had all kinds of feelings about his blindness, anger, frustration, fear and all the rest, but the therapist, in my opinion, should have allowed Jerry to have his emotions in his own way. If the therapist had said something like "gratitude for being alive is a good thing. Feeling good about being alive and being blind is valid. Just think about the possibility that not being able to see when you used
to see could make you angry?--if the therapist had said something like that maybe Jerry would have been able to look at the whole range of his emotions without being angry with the therapist. I think the therapist effectively closed all communication between Jerry and himself by trying to tell Jerry that he should be angry about his blindness and that gratitude for being alive was nothing but denial. I'm not saying Jerry wasn't in denial; I'm saying the therapist couldn't see that it might just be possible for Jerry to be grateful for his life lived with blindness.

Chris Coulter ACB-L listserve

**21. This provoker makes me "pissed off" because any therapist worth his salt should know that The Stages Of Blindness is only a yardstick. We aren't all automotons. We do not experience things in the same way or even at the same rate. This twit therapist is right to probe, but is wrong in his assumption that there is something wrong with Jerry. Jerry may indeed be feeling grateful to be alive. It may take Jerry months or a year or more to absorb his loss. He may not become angry at all. He may try to bargain he may not. He may grieve when he cannot drive or do something else. Jerry, the fictional newly blinded man, is or should be an individual. These stages are recognizable phases true, but they do not necessarily occur in order or in sequence.

I am upset by this provoker because it perpetuates the myth that human beings are cookie cutter individuals. There are myriad factors which affect one's grieving, for loss of sight or anything or anyone else.

Jerry may be far along the path of spirituality, making his loss something to be absorbed and assimilated with no fuss in light of where this guy is. He may have known a person who is blind, taking away the fear of the unknown. He may not confront his loss until much later. People are individuals. God breaks the mold every time He makes a human being, and then each human being's experience is different. Each human being's interpretation of his or her life's experience is predicated on previous experience, mental and spiritual and emotional growth. I repeat, any therapist worth his salt would do better to listen instead of to manipulate.

Ann K. Parsons ACB-L listserv

**22. What I see here is a demonstration of denial. This person is saying that the loss of his vision is not a big deal, but his or her visual loss is so new, that she or he has not had a chance to experience the loss of all of things that he or she used to do using her or his vision. The realization of these losses will occur over a period of time -- e.g. going in the garage and finding a bicycle that can no longer be ridden; the first ride in car and realizing he or she won't be driving anymore; not being able to view a sporting event, movie, or theatric performance; loss of the ability to play cards or board games visually -- the list goes on.

I think the counselor, might be jumping the gun a little with his line of reasoning with the consumer. That same line of reasoning might be more useful maybe six months down the road, after the person has a chance to experience various losses associated with his or her loss of vision loss.

**23. There are supposedly five stages of grief when dealing with catastrophic loss. In my fifty plus years of legal blindness, I have managed to combine the first four stages into one, which is what serves as my personality. My daily outlook is one of denial, anger, bargaining, and depression. The fifth stage, acceptance, may be somewhere in the distant future, but I think not. I know I should be grateful that my situation is not worse, but I still, "Rage, rage against the dying of the light."


Ross OandM listserv

**24. I think it must be remembered that everyone is different. Some people handle loss differently than others. When I meet people who are newly blinded or who have a newly blinded person in their family, I try to concentrate on giving answers on how that person can continue with their life. Demonstrating those alternative techniques I hope will make a difference.

Regards, Robert Jaquiss NFB Blindkids Mailing List

**25. I can kind of see where Jerry is coming from. My former roommate did lose most of his sight later in life, but not in a car accident. As a matter of fact I think he's losing more and more sight. He has indeed had to make a huge adjustment, and it's not been a walk in the park. I'd tell this therapist to just take his time with Jerry, and Jerry will eventually be able and willing to talk about things. I don't have any personal experience with this since I went blind at the ripe old age of 6 months. I guess you could say adjustment for me came right away, or when I was about a year old or something like that. The one area in which you could say I haven't really adjusted well is dealing with state-run services for people with disabilities, but that's a whole topic in and of itself. I can't recall exactly how my parents reacted when they found out I was blind, but I think they got over it pretty quickly. At the time I had no siblings. My brother and a sister are also blind, and my brother was adopted. I think our other family members had a pretty easy time adjusting to our blindness. However I think there's definitely a grieving process when anybody loses something, be it their sight, a loved one or otherwise. This grieving process can be as big or small as the grieving party or parties deem necessary. My next-door neighbors lost a son not long after my former roommate and I moved into this building, and I can tell you it has been and will no doubt continue to be a huge loss for them. Shortly after he died, I can remember going up to their apartment to attend the Shiva. Having never been to a Shiva before I wasn't really sure what to expect, but I knew there'd be a lot of grief and sorrow involved given the situation. There certainly was a lot of that. My roommate at the time and his mother were there, as were many other close friends and family members. The staff of this organization were very good about telling those of us who had never attended a Shiva exactly what to expect. Immediately following this young man's passing, we were told to more or less keep our distance and let the family deal with their loss in private. Over time, Jerry will regain the skills he had before his accident and he will learn to adjust to his blindness. This probably won't happen overnight, but eventually he will be back to work and doing the things he so loves. He'll probably need some adaptations, but that's par for the course. Hopefully, if he's lucky enough to live in a state with good VR services, they'll pay for the things he needs.

Jake Joehl, Evanston, IL

**25. Why is the guy in therapy if he's just happy to be alive? Maybe the therapist was just trying to make sure Jerry got his money's worth. I suppose the therapist could have said, "You're fine. Come back if you ever have any problems," but he probably felt obligated to make sure Jerry really was fine before he didthat.

My opinion is that if Jerry didn't have any problems, he shouldn't blame the therapist for doing his job and probing for them. He should have just got up, said, "I'm fine," and went back to work.

John G. Heim ACB-L listserv

**26. My take on this Thought Provoker is that, as I'm sure you would understand, many of us don't deal with issues of loss the same way. The other thing is, in this one, Jerry likely doesn't know what to think of himself as a blind guy and he probably hasn't met anyone who is, so has little idea of what to expect from himself. Yesterday a lady wanted to give me some money--unsolicited, of course, and not accepted. I was waiting for a ride, am seeking other employment, and courteously, but honestly told her," I'm not a beggar." My wife, who is also blind, never gets these folks, but something like that happens to me at least quarterly and I'm not shabbily dressed, either. Just my thoughts on yours.

Have a great day. Chris Jones Tacoma WA

**27. So much of our individual behavior is controlled by our culture. And in America, many cultures exist side by side, even overlapping. But regardless of how much or how little of our feelings we show to the world, a major loss does impact our emotions. But in our work with older folks, we seldom talk about the stages of loss. We simply start working from where they are. Perhaps they are in deep denial, or in a funky depression. Wherever we find them is where we begin problem solving. Our goal is to help these older folks be as independent as possible. Or, we tell them, as independent as they want to be. When we are successful in finding ways for them to continue doing the things they want to, or need to do, we usually see a change in their outlook on life. A very few tell us that they have adjusted to blindness. But most folks tell us they are thankful for the help we gave them in order to use what little sight they still have. And at 80 or 90 years of age we don't kid ourselves into believing that we're going to change folks life-long attitudes. We count it as a success when they are back living meaningful lives.

Carl Jarvis ACB-L listserv

**28. The therapist must be fresh out of graduate school and must have had a grade point average of 4.0. Quick with a textbook approach, and the textbook must have been Father Carroll's more than 50-year-old theory of blindness. YIKES!

Seville Allan NFBtalk Mailing List

**29. When I was younger, adjustment to your blindness meant accepting the sighted world as it is, that is, don't ask for accommodations. Now that at least some accommodations for us are considered reasonable, the issue gets more complicated. I know I can never think of the word "adjustment" as meaning anything else but stay in your place, wherever that is. I was always visually impaired, so really there wasn't anything to adjust to, except public attitude. We all have to be comfortable with who we are, and that includes, for most people, having a less-than-privileged status. Rehab as we know it involves setting goals for ourselves and then finding a way to get there, or, perhaps, accepting that right now there isn't a way to get there. I have tried therapists, but most of them do try to fit me into some definition of appropriate behavior, or emotional state that they consider normal. Even their adjustment inventories have questions like "If you saw someone you didn't like, would you cross the street in order to avoid confronting him/her?" I've never found a blind therapist, but I'm pretty sure they have their agendas and stereotypes, just like everyone else. This thought provoker certainly illustrates the land mines we navigate on the way to self-actualization, or to not being dysfunctional, or some other state that I'm sure I'll recognize when I get there.

Abby Vincent ACB-L listserv

**30. I think that people's responses to the onset of blindness differ, depending on the individual situation and just how blindness occurs and the individual's personality structure. I know that in the work I do (I'm a social worker in the adoption field) there's a set of beliefs concerning how adoptees feel about being adopted and what kinds of issues must be dealt with. It's a kind of orthodoxy that a lot of professionals adhere to. The same kind of thing happens in the blindness field. There are general guidelines but it isn't helpful to impose them on every situation.

Miriam ACB-L listserv

**31. This problem I run into the sight people really do not understand us whom are blind. Some of us accept our blindness and other have major problem handling the blindness. Sometime they big problem is sight have problem real problem knowing where and when we need help. We still want our independence. One thing I run into many times is that when you eating anybody want to help you. I like to tell them would please kept your hand off of my plate and if I need assistance I ask for help. Yes, there are time when we need help but our pride get in the way and we refuse to ask for help. We all have our up and down days. But each person have there way of handling stress of blindness.

Dexter Terry

**32. Since I was little when I became blind, I don't know what it's like for someone who becomes blind later in life. From what I learned in psychology courses, the stages are not clear-cut. I would expect people to feel emotions like sadness or anger. But it may take some people longer than others to let their grief and frustration out. They may be too afraid to let these emotions come to the surface.

Mary Jo Partyka

**33. I lost my sight as the result of a brain injury sustained during the labor and delivery of my daughter. I experienced the anger, grief, confusion, bitterness, and displacement that many imagine. There was a definite death of self, not solely due to the cortical blindness but also because I lost the capacity to walk, talk, breathe independently and had to undergo extensive therapy to learn to do, literally, everything again. Initially, I wasn't even grateful to be alive because I felt that my survival was a burden on my family and a cruel act by God. Today, my perception is different. Mainly because of my exposure to individuals who acted as role models and happened to be blind. While many discount the stages, it is important to acknowledge that for some it is a profound loss. Not that the sense of loss is insurmountable, but, given the potential trauma response prompted by the life altering adjustment, it is important that we accept people exactly where they are in their life with blindness. If adjustment is an issue, help the individual acclimate. If this was an anticipated outcome and the individual has been comfortable with the life change, maybe assistance with acclimation is not necessary. Or, if the change has had no profound impact, then work with adjustment may not be as pertinent. In all mental health work it is important to approach individuals with unconditional positive regard, free of judgment and directives. So, assess where the person is in his/her process and work from there.

Mary Chappell NFB Human Services Mailing List

**35. Very well stated Mary. The old "Meet the client where he / she is" comes to mind.

Julie Russell, LCSW New Orleans NFB Human Services Mailing List

**36. I mostly get pissed off when I can't immediately come up with an acceptable work around or alternative to a sighted solution. What I define as acceptable has varied greatly over the years as I learned new alternative techniques, created my own, or just become more comfortable with my capabilities and limitations as an individual.

I was a kid when I went blind and mostly didn't give a fig about the blindness at the time. I was far more interested in my baby sister, playing with other kids and getting on with my life.


**37. Well, I work as a licensed counselor and supervise other counselors. This therapist made a very common mistake that many counselors make: rushing a client. He is very correct that grief over loss of something does happen in stages. However, loss of a physical something is in ways different than loss of a person or pet. But it is not necessary nor important to compare the losses nor is it helpful to either the client or the therapeutic process to do so. What is important to do is understand that each of us experiences grief in a very real and individual way. While it is certainly true that this therapist understands the stages of grief, what the therapist is not understanding yet is, this man is not at the same point in his emotional realization that the therapist thinks he should be. There can be many reasons for this. Maybe he is still in the denial phase and it sounds like he is. He might stay there for a long time, actually, which is truly okay. No one has the right to knock someone out of that phase of grief and to do so can cause irreversible harm, actually. When Jerry faces a good hard blow with reality, i.e. learns that he cannot be an airplane Pilot or a gravedigger because he is blind and he always wanted to do that, he will understand wholeheartedly the impact that blindness has on his life; or, when Jerry faces the reality of discrimination because he is blind, or, when Jerry falls in love and she tells him that she wants nothing to do with him because he is blind. Then, he will understand. Right now, Jerry is feeling happy and grateful to be alive from a horrible car crash and blindness is a blessing. The therapist needs to enter Jerry's world, help Jerry figure out how he can deal with what he has where he is, build the skills he has and deal with Jerry's life where Jerry is. And deal with the therapist's own issues over blindness.

I get extremely frustrated with counselors who cannot enter clients' worlds where the client is. That is the only way one is going to effectively work with a client. It makes no difference how I think or what I think another person should be doing; it is their world and I have no right and no business to control it or decide they should or should not be in another place. Believe me, I have been to some very interesting places with them for some rather long times. Sometimes, they come over to our world, sometimes they choose to remain in their own world and it is always okay. And you know what? Sometimes, I'd rather be in their world than reality, too. But trying to force someone into your own place as a therapist is just totally uncaring and harmful to a client; they will move to a healthier place when they are willing, ready and able and all the therapist does when they attempt to force it is either push them into a more harmful place, or push them away altogether.

Jessie ACB-L listserv

**38. I don't believe everyone goes through the adjustment to vision loss in the same manner. A friend discovered she was losing vision due to retinitis Pigmentosa. She was in her twenties, a single parent of two small children, a six year old boy and a four month old infant. She got herself accepted into a program in Arkansas because she felt that if she didn't tackle the problem of learning blindness skills as quickly as possible she might be at risk to lose her children. She didn't take time for self pity, grief, anger or despair. In her mind there wasn't time for all that. She plunged in full tilt and wanted to be done as quickly as possible, setting herself a goal of six months to master the skills she would need. She went back to college and eventually got a teaching credential and was hired to teach in our local high school. She was shocked when someone at the Arkansas program told her that the staff thought she was at risk of a breakdown because she didn't seem to be allowing herself to grieve. They kept expecting to discover she had attempted suicide. I think a lot of how people deal with blindness depends on the type of person they are. I was only a child of eight when the lights went out, and at first was sad an maybe even a bit angry. It lasted about a week though since small children get bored with sitting in corners feeling sorry for themselves. At least I did and I was soon out climbing trees, running and being a child again. Sure, we may all experience those moments of frustration, embarrassment or even depression when something others take for granted is out of our reach. One person may mourn that she will never see the face of her child while another takes joy in holding her baby , and recognizes her child's voice in a babble of children. Is the cup half full or half empty. For me, I don't waste time regretting what I lack but focus on all the things I have. No one has it all, so should I dwell on what I lack? I don't think so. My world is full of tastes, textures, and many small and precious things of joy.

DeAnna QuietWater MO

**39. I have some real concerns about a therapist who believes that every client must follow along through designated series of steps. Most therapists realize that everyone has different ways of dealing with difficulties, and no way is particularly better than any other. As a special education teacher until my vision loss was too significant, I once said to a friend in a wheelchair that if one had taught special education, that person always knew someone who was worse off. Her reply to me was, "you don't have to be Pollyanna about everything." We laughed about that, and I recently used that line on her. but, it is true, most of us know someone that we regard as worse off. I don't see that as wrong, it's just true. We all have different ways of accepting difficulties, and we all have reasons for that acceptance.

Janet Coleman

**40. I actually liked this TP. I may not have liked the therapist, but when we're writing fiction it seems to me we have to include characters that we ourselves wouldn’t like. Else what's the point of reading? There's no conflict. Anyway, having said that, this brings to mind the experiences of a friend of mine. She was my first English prof at the community college I attended for the first two years of my undergraduate career. There were a few times that she had to cancel class because of illness. For the better part of five or six years she had these bouts, and she would tell me of them whenever we would meet or talk on the phone. Well, lo and behold, after misdiagnosing her with lupus, it turned out that she had multiple sclerosis. Mind you, this person is by her very nature a rather funny woman who laughs a lot, plus she's really smart. When confronted with something, she usually gets to the nub of the issue. I wish I could have been a fly on the wall while the doctors were talking to her. I guess their faces were the usual shade of grim as they told her what this meant, the possibility of being in a wheelchair, etc., ad nauseam. Well, her only reaction was, Well, can I work?" Not what the docs were expecting, apparently.

Well, she went on to work a few more years. She reached retirement age, so now I guess she's not working anymore, but other things defined her aside from her multiple sclerosis. The woman she thought was her mother died one day, and my friend was then charged with the responsibility of what to do with her house. She later found some papers revealing that she’d been adopted, and she found her birth mother, whom she discovered was very similar to her in personality. She also made a small fortune in investing in the ‘90s. She got divorced and married again, her daughters got married, and she now has grandchildren. In short, the only thing that differentiates her from so-called “normal” people (I use this term advisedly and loosely) is that she is now, to whatever degree, disabled.

Our protagonist in this story may, as others have pointed out, grieve over the loss of his sight, but he may never do so. He may never have to. I m no therapist, but it seems to me that a therapist's responsibility is to actually listen to the client and ask questions concerning what the client is telling him, not to prescribe how the client should feel. You either feel something or you don't; it's not someone else's responsibility to tell you how to feel.

john coveleski

**41. It's difficult for me to relate to a sudden loss of vision because mine took place over a period of many years. My guess is that , in Jerry's case, since it has been only two months since the accident, he hasn't realized the finality of the loss. When realization occurs, he will probably suffer the same emotions that others who have lost vision have felt. Jerry is thankful that he didn't lose his life, and that is understandable. However, the many emotional stages of anger, frustration and wondering why me, are bound to happen and hopefully he will come to terms with them and that is when the therapist will be able to help him.

Pat Wagner Portage Michigan

**42. In my line of judgment of this case, I feel that Jerry has not had enough time to feel the full loss of his sight. It takes more time to come to full realization of such a loss. Jerry has not enough time to experience the challenges he will be confronted with as he lives his life. Also, the therapist shows himself as lacking with knowledge, as well as experience to deal with Jerry's loss of sight. Jerry should seek out a more experience therapist. And it's quite possible that Jerry may not feel angry yet, or even later in life. I personally haven't felt anger for my fairly recent loss of sight! Jerry's sharing of his feelings of disliking the therapist line of questioning and pressure to come up with emotions of feeling a loss, as to compare with a loss of life is more evidence that the therapist is in experience. Jerry shows that he is quite aware of his loss of sight, and yet see's it as a blessing that he is still alive! Jerry should be counseling the therapist! Anyway, Jerry will do just fine in living his life. Should the issue of anger come to surface, than Jerry can always deal with it at that time.

Sincerely, Jack E. Mindrup

**43. I agree. All the therapist can or should really do is to share his concernsin "I" messages and express his opinion that such feelings may surface later on or in different ways and be harder to deal with. He could also say that grieving the loss of sight in no way takes away from gratefulness to be alive. It can be a both... and... response not an either/or. Mostly, though, I agree with accepting where the client is and letting him know counseling is available should he experience more negative feelings later on. There wasn't much said about the support system this guy has or his plans for learning to adjust to blindness as far as skills. Maybe the counselor could be asking him about how he plans to deal with the reality now that he is out of the hospital and still alive but different. The therapist could ask him about his concerns about how his life will be different, how he will remain independent, or how others are responding to his situation. I also wonder if he works and if the job is one he could continue doing with accommodations or if that will have to change. I wonder how he'll handle not driving and the numerous daily tasks he'll have to approach somewhat differently. That may be when the frustration or depression sets in. At present, he is just thankful to be alive and not in worse shape. That's understandable as an early response.

I was born prematurely and have ROP from the interventions used to keep me alive. When I first started college, someone asked me if I was mad at the doctors for doing things to me that resulted in my blindness. I said no, that they were trying to keep me alive. I feel blessed that I didn't have to deal with multiple disabilities or cognitive impairments. My situation could have been much worse. Still, there are days when needing help or taking longer to do things or something else blindness related really annoys me and makes me feel more limited than my sighted peers. That's just honest and in no way takes away from how grateful I am that blindness is my only physical limitation. Again, both. and…

Carmella Broome, Ed.S., LPC, LMFT/I Crossroads Counseling Center

Lexington SCNFB human Service Mailing List

**44. Hmm I don't see how this is going through stages 'in adjustment to blindness,' but it shows how some people still think blindness is a full loss of a life and/or not living at all. Hmm what else here? The inner thoughts Jerry showed where one: who sounds like he already 'adjusted' to his blindness, and they the doctor was just forcing the same dumb question at him as if he didn't think Jerry would 'EVER ADJUST' to his blindness. Hmm that's all I got.

Sean Moore

**45. I can understand those thoughts. I however did not feel lucky for awhile, I think. I lost most of my sight when I was 40, and right now I am thankful for still having some usable sight. They say there are 7 stages of grief and I don't think I went through all of them, but I am now at a place that I have accepted my blindness. I do however, still have some bad days when I am mad and wish I could see, but over all I am doing well. I think the guy is in denial and it will hit him at a later date when he goes to do something and he can't.


**46. Jerry should have been asked whether or not he wanted to see a therapist. The best thing for him would be a training center where he could learn blindness skills and interact with and get to know positive blind people. I wish that the sighted professionals would keep their mouths shut and listen to the blind. They always think they know best. They don't because they're not blind. Jerry is glad he is alive, as well he should be. God spared his life, and maybe he wants to be involved in a good church where he can deal with his life on a spiritual level as well.

Linda Mentink

**47. I really did not expect to add comments but here I go:

Stages In Adjusting To Blindness

It has been just 9 years since diagnosed with Retinitis Pigmentosa. Since it has been a slow process of losing my field of vision, there was time to adjust. The therapist should have asked what his skills and passions were before losing eyesight. Then ask how he can alter the current situation so these can continue in his life.

Maybe thinking of these things can do three things:

1. Realize that things will need to be evaluated and feelings may arise from frustration.

2. Pull himself together and explore (even be thrilled) to continue those positive aspects of who he was and who he is. This is the healing phase.

3. Learn that driving is out, asking others for help is in. That it is Okay to experience and share these feelings through forums and group expression like Thought Provoker. However, the therapist needs to be aware of these outlets.

I have felt an empty part of me despite the ability to be constructive and semi independent. Wanting to give by volunteering for a cause, a cause has not been strong enough yet. There is always a desire to join a charity group that networks with each other and their skills for a vision related cause. This does not mean writing a check or standing around at VisionWalk from FFB. These are feelings that reach the surface over time. The therapist should make this part of the sessions as well.

Phyllis Slater