Pluralistic Counselling for Sight Loss
Dr Mhairi Thurston, Senior Lecturer in Counselling at Abertay University
I am a blind pluralistic counselling academic with an irrational fear of writing. That blank page and the deafening voice of my inner critic, telling me no one is interested in what I have to say and that other people are so much more eloquent writers than I ever will be. Words don’t flow easily and a lot of the time they don’t flow at all. Each sentence is edited and re-edited… and re- edited, sometimes before being scrapped altogether. Being invited to write a blog is about as scary as it gets for me. I say this by way of introduction (and perhaps by way of defense, so that you won’t judge my writing as harshly as I will).
Pluralistic counselling for sight loss
I wasn’t always blind. The process of losing my sight was (and still is) ridiculously difficult. I have been lucky because I have retained a small amount of residual vision, that has allowed me to engage with printed materials. I have been told I don’t ‘look blind’. But now my residual sight is deteriorating and I have to adapt to new ways of ‘reading’ and new ways of functioning in my world. When I was first diagnosed with this incurable sight condition, I was pregnant with my third daughter. I liken it to a nuclear bomb being dropped into my life. I stopped working, so I had to move to a smaller house, I stopped driving and I had three children under five. The world, as I knew it, had imploded, along with my hopes and dreams, and I became deeply depressed. At the time, there was little acknowledgement and support for the psychological impact of sight loss. When, four years later, I trained to become a Pluralistic counsellor at Abertay University, I was able to make sense of my own inner world from a multiplicity of psychological perspectives. That was an important part of my own journey towards making sense of and adapting to my sight condition.
My subsequent research career has focused on understanding the social and emotional impact of acquired sight loss. My main idea was to understand the impact of sight loss and then to develop a relevant model of counselling from a pluralistic perspective. To be honest, initially a part of me wondered whether counselling could actually help someone adjust to a future life that they didn’t choose and didn’t want. I held on to an insider bias.
My first research project found that “going blind” could be understood as a process. This had implications for the kind of help that was needed at each stage of the process. Then, through a series of systematic case study research projects, I began to understand what clients with sight loss found helpful about counselling.
I developed a tentative therapeutic task list from the research findings, which formed a sort of ‘counselling menu’ for clients with sight loss:
- Telling the story of what’s happened (having time and space to clarify thoughts)
- Feeling heard and understood (feeling that someone understands the impact of sight loss)
- Expressing difficult emotions (fear, anxiety, low mood)
- Exploring identity (integrating sight loss with sense of self as a whole and letting people see me as a blind person)
- Examining and challenging negative self -concepts (not being hard on myself)
- Exploring the possibility of a future without sight (planning for future strategies, living in the present)
- Making the most of support and cultural resources (groups, relationships, meditation etc)
- Fostering self -acceptance (self -care and compassion)
- Recognising skills and achievements (collecting positive evidence)
- Developing agency (reinforcing empowerment, feeling less vulnerable
The idea was that the counsellor might tentatively offer these to the client as potential areas for exploration if the client felt any of them resonated with their own experience of sight loss. This exploration could be done using a range of methods drawn from a range of approaches, depending on the client’s preference. For example, for task 6 (‘Exploring the possibility of a future without sight’) sometimes fear of the future can feel overwhelming to a person and can rob them of an appreciation of the present and things that they can still enjoy doing. Mindfulness or relaxation techniques could be offered to allay feelings of panic about the future by grounding the client in the present moment, if they thought that would be useful to them. The client might want to explore some of the difficult emotions associated with fear of the future and this could be done though emotional focusing or through creative methods such as drama or art as well as through talking. Some kind of exploration using CBT coping strategies could also be helpful and the client might be encouraged to gather evidence of the changes they have already coped with and the strategies they have employed to foster their sense of empowerment.
The pluralistic framework opened up the possibility of working collaboratively with the client using a range of different methods and interventions from all modalities.
In 2018, Amanda Hawkins (RNIB) and I designed a short course for qualified counsellors based on these Pluralistic ideas. We wanted to help counsellors from all modalities understand the practical and psychological issues associated with sight loss and to help them gain confidence and skill working with this client group. The Pluralistic framework was an ideal theoretical positioning for this. The two- day CPD course, accredited by Vision UK, has run in London, Edinburgh and Dublin. More dates and venues will be advertised when Covid-19 restrictions ease.
This has been a whistle- stop tour of ten years of academia and over twenty years of blindness. It has also been my first and possibly only attempt, at blogging. Just for the record, I now believe that good counselling can change lives. Especially lives affected by sight loss. Now to work on my fear of writing……..