Adjusting to Blindness Literature Review

When contemplating vision loss, people imagine a debilitating, black void filled with isolation and loneliness. “Many people have an image of a person imprisoned by darkness—stumbling, falling, or groping around in the dark. They imagine a person who is totally inadequate and unable to take care of himself” (Schultz, p. 9). In fact, blindness is the most feared affliction, because sight is viewed as the most important sense (Wagner & Oliver, 1994). Hidden in the collective subconscious are the images of the blind beggar and the bumbling Mr. Magoo. After all, the typical person cannot comprehend life being meaningful without the ability to drive or the ability to appreciate aesthetic beauty. However, for the millions of people with vision loss, living with a visual impairment is nothing like sighted individuals perceive it.

Although blindness has existed since the beginning of recorded history, it only became a societal concern after World War II, when the hospitals were filled with blinded veterans. The strong, brave men, who had so valiantly fought for world peace and human rights, were now perceived as weak and helpless. It was at this time that the rehabilitation professionals began to analyze the issues of living without sight. Initial theory focused on the psychological death of the sighted individual and his rebirth as a blind man (Cholden, 1958). Further analysis examined the losses in psychological security, basic skills, communication, appreciation of all that is beautiful, financial and occupational status, and personality that result from blindness (Carroll, 1961). Common reactions to vision loss as observed by professionals include anger, resentment, shock, depression, and grief (Chevigny & Braverman, 1950; Cholden, 1958).

While acknowledging the impact of personality on adjustment, different reasons seemed to affect the status of people with visual impairment in society. Adjustment to blindness was felt to be impacted by beliefs and superstitions held by the culture and the individual (Wagner & Oliver, 1994). While many often perceived people who are visually impaired as helpless, resentful, bitter, and unhappy, some advocated that blindness itself does not create emotional disturbance. Instead, it is societal prejudices that cause emotional distress; many people who are blind concurred that the misconceptions others have about blindness, and not the loss of vision or the need for adaptive skills, is what causes anxiety (Cutsforth, 1951; Jernigan, 1969).

Further analysis of the impact that stereotypes have on the self concept revealed that people without vision often experience feelings of shame and inadequacy (Scott, 1969). Professionals in the field of blindness and visual impairment have suggested that attitudes of significant others (i.e. family and friends) have the most significant impact on the blind individual’s self-concept; families with positive attitudes help the blind person maintain a positive outlook (Lukoff, 1972; Versluys, 1980). It was also determined that the reactions of medical personnel have an impact on the adjustment process (Bauman & Yoder, 1966). Hence, there was a push for rehabilitation agencies to incorporate the effects of social attitudes into the service structure by validating the experiences of being blind in a sighted world, counseling and educating members of the support network, and lobbying and advocating for change in laws and attitudes (Hudson, 1994). Recent inquiries have focused on the following specific factors that affect adjusting to blindness: the age at which vision loss occurred, the degree of vision loss, and the coping strategies utilized (Bailey & Hall, 1990; Yeadon & Grayson, 1979).

Special considerations have finally been given to people with low vision. Having low vision has been likened to being neither fish nor fowl, neither sighted nor blind (Sacks, 1996). Therefore, specialized assessments and trainings have been conducted in the efficient and effective use of vision. It was also noted that preconceived notions of blindness and the individual’s personality before the loss of vision affected the coping process (Morrison et al., 1982). At long last, the following theories were synthesized into a life-long process of adjusting to the demands of life when someone is blind (Tuttle, 1984). This process is similar to the stages of mourning developed by Kubler-Ross (Truan & Trent, 1997). Furthermore, identity issues for learners with visual impairments from different minority and cultural groups have also been examined (Bau, 1999; Lopez-Justicia, Pichardo, Amezcua & Fernandez, 2001; Milian & Erin, 2001). In an attempt to foster adjustment to blindness, the role of support groups for parents (Nixon, 1988), seminars for people with visual impairments (Kronick, Kronick & Irwin, 1990), and intervention by the special education teacher (Tuttle, 1987) have also been explored.

As a result of stereotypes, folklore, and fear surrounding blindness, it has been important to realistically examine the effects of vision loss on the individual in order to facilitate the development of successful coping strategies. Although initial interventions focused on personal qualities of the individual, it was not long before the impact of societal attitudes on the person with a visual impairment was realized. Thus, it was necessary to synthesize the psychological and sociological models of adjustment. Once a cohesive model of adjustment was developed, it then had to be applied to a variety of groups encompassing the entire spectrum of vision loss: those who were born blind, those who lost their vision after early childhood, those who have no vision, those who have some vision, those who have additional exceptionalities, and those whose only disability is blindness. Due to the diverse composition of this group, continued research and application is needed.

References

Bailey, I.L., & Hall, A. (1990). Visual impairment: An overview. New York: American Foundation for the Blind.

Bau, A.M. (1999). Providing culturally competent services to visually impaired persons. Journal of Visual Impairment & Blindness, 93, 291-297.

Bauman, M.K., & Yoder, N.M. (1966). Adjustment to blindness—Reviewed. Springfield, IL: Charles C. Thomas.

Carroll, T.J. (1961). Blindness: What it is, what it does and how to live with it. Boston: Little Brown.

Chevigny, H., & Braverman, S. (1950). The adjustment of the blind. New Haven, CT: Yale University Press.

Cholden, L.S. (1958). A psychiatrist works with blindness: Selected papers. New York: American Foundation for the Blind.

Cutsforth, T.D. (1951). The blind in school and society: A psychological study (rev. ed.). New York: American Foundation for the Blind.

Hudson, D. (1994). Causes of emotional and psychological reactions to adventitious blindness. Journal of Visual Impairment & Blindness, 88, 498-503.

Jernigan, K. (1969). Blindness: Concepts and misconceptions. Baltimore: National Federation of the Blind.

Kronick, B., Kronick, S., & Irwin, J. (1990). Living with blindness seminars. Journal of Visual Impairment & Blindness, 95, 150-160.

Lopez-Justicia, M.D., Pichardo, M.C., Amezcua, J.A., & Fernandez, E. (2001). Journal of Visual Impairment & Blindness, 95, 150-160.

Lukoff, I.F. (1972). Attitutudes toward blind persons. In attitudes toward blind persons (pp. 1-13). New York: American Foundation for the Blind.

Milian, M., & Erin, J.N. (2001). Diversity and visual impairment: The influence of race, gender, religion, and ethnicity on the individual. New York: American Foundation for the Blind.

Morrison, M., Cellura, C., Conti, B., Gasperini, J.D., Press, R., Robinson, T., Rosen, S., & Schumacher, N. (1982). The first steps. Palo Alto, CA: Penninsula Center for the Blind.

Nixon, H.L. (1988). Reassessing support groups for parents of visually impaired children. Journal of Visual Impairment & Blindness, 82, 271-278.

Sacks, S.Z. (1996). Psychological and social implications of low vision. In A.L. Corn & A.J. Koenig (Eds.) Foundations of low vision: Clinical and functional perspectives (pp. 26-42). New York: American Foundation for the Blind.

Scott, R.A. (1969). The making of blind men. New York: Russell Sage Foundation. Schultz, P.J. (1980). How does it feel to be blind?: The psychodynamics of visual impairment. Van-Nuys, CA: Muse-Ed Company.

Truan, M.B., & Trent, S.D. (1997). Impact of adolescents’ adjustment to progressive vision loss on Braille reading skills: Case studies. Journal of Visual Impairment & Blindness, 91, 301-308.

Tuttle, D.W. (1984). Self-esteem and adjusting with blindness: The process of responding to life’s demands. Springfield, IL: C. Thomas.

Tuttle, D.W. (1987). The role of the special education teacher-counselor in meeting students’ self-esteem needs. Journal of Visual Impairment & Blindness, 81, 156-161.

Versluys, H.P. (1980). Physical rehabilitation and family dynamics. Rehabilitation Literature, 41, 58-65.

Wagner-Lampi, A., & Oliver, G.W. (1994). Folklore of blindness. Journal of Visual Impairment & Blindness, 88, 267-276.

Yeadon, A., & Grayson, D. (1979). Living with impaired vision: An introduction. New York: American Foundation for the Blind.