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Insight Without Sight

Editor's Note: The following article is reprinted from Psychjourney, October 26, 2004.

During early college, I went for a consultation session with a local psychologist. When he asked me what I was majoring in, I told him I was studying psychology and that I wanted to be a counsellor. I thought he would be pleased that I planned to do what he did, and was hoping to hear all the reasons why he loved his job.

"Well," he said hesitantly. "Non-verbals are pretty important, and you can't see those. You could probably do okay, if you worked with a co-therapist."

His response surprised me. It had never occurred to me that my inability to see body language would be so important that it could keep me from being an effective therapist. I'd been legally blind since birth, and was used to relying on my sense of hearing to gather necessary information in a variety of situations. Counselling was supposed to be about listening and being compassionate, wasn't it?

Friends had always seemed especially comfortable sharing their difficulties with me. I had never felt disadvantaged or unsure of my connection with them simply because I couldn't see how they were sitting, what they were doing with their hands, etc. I could hear the quiver in someone's voice if they were crying. I could tell if a friend was angry or excited by how fast they were talking. Monotone speech alerted me to feelings of depression or hopelessness. Besides, didn't the classic psychoanalysts sit behind the client's couch so that client and counsellor could not see each other? I'd heard many reasons why Freud's theory was no longer considered valid, but that one had never come up.

I did not allow myself to become too discouraged by that psychologist's less than enthusiastic response to the idea of one day having me as a colleague. None of my psych professors, who were either Ph.D. psychologists or counsellors with masters degrees, seemed worried about my choice of majors. One of them even told me about a blind doctoral student he'd taught at another university, and how smart and capable that student had been.

When I began researching graduate programs, a friend put me in contact with a blind woman who was finishing her masters degree in counselling at a university I was interested in. This was the first time I'd been able to talk personally with another blind counsellor. I asked Lisa about things like taking notes, keeping track of time during sessions, handling the lack of non-verbal behaviours, and client reactions to her blindness and her guide dog. Her answers were encouraging. She assured me that such concerns were easily dealt with using some creativity and adaptive technology. She emphasized that what I had to offer was much greater than my visual limitations.

Though I did not attend the program Lisa was involved in, we have kept in touch over the last few years. She went on to pursue a doctorate in counselling. I was accepted into the only graduate program I applied to, and decided to specialize in marriage and family therapy. I was impressed by the respect and acceptance I immediately received from professors and classmates. The atmosphere was very collegial, and it seemed that all of us valued one another for our unique strengths and life experiences. I thrived in such an environment. Any adaptations or accommodations I needed were easily arranged with professors. Friends within the program were always willing to provide rides or help with more visual subjects, such as statistics. My guide dog helped me travel independently around campus, and a laptop with screen reading software allowed me to write papers, take notes in class, do internet research, participate in email discussion groups, and download syllabi and course materials. Most of my books were available on cassette from an organization that recorded textbooks for blind students. This was another indication to me that there were plenty of blind people working as counsellors. If there had not been a demand for such books, they would not have been recorded.

When I interviewed for my internship placement, my future supervisor asked me a lot of the same questions I had asked Lisa. I confidently responded, explaining how I could scan office paperwork into my computer so that I could fill it out, how I would set a clock to beep quietly ten minutes before the end of a session, and how Maggie would stay under my desk when clients were in the office. He offered me the position, and I readily accepted. Afterwards, he sent out requests on an email discussion list that he wished to contact other blind therapists working in college counselling centres. He spoke with several, who confirmed what I'd said, that blindness was really not a big deal, that adaptations were usually easily made, and that clients generally did not seem bothered by their lack of sight. He passed the contact information for several of these people along to me, and I had very helpful conversations with them myself. Once again, the confidence that I could do my job was bolstered by reassuring conversations with other blind counsellors who were successfully carrying out all the tasks I would be performing. They were honest about their difficulties, too. Though I was excited and optimistic, I did not forge ahead wearing rose coloured glasses, not that I could have seen the rosy color very well, even if I had been.

As I'd expected, my blindness was not much of a problem during the ten months I spent at the counselling center. I quickly learned my way to the office I used, the conference room, lounge area, etc. I also had someone show me how to work the camera I would use to videotape sessions for review in supervision. The office manager would spend about five minutes reading me information about new intakes or transfer clients, when necessary. Office staff would help my clients schedule appointments, and would read me the list of clients I would be seeing that day, or the next day. Since I had to sign the informed consent sheets that my clients signed, I simply signed one copy, which we xeroxed. I kept a stack of these in my office.

When I went to the waiting area to greet a client, I would speak their name, and then wait to hear the movement of them leaving their seat (putting down a magazine, picking up their book bag, etc.). I would then look in that direction, and extend my hand in greeting. This brief physical contact gave me a lot of useful information. A limp handshake communicates a different message than does a firm grasp. This was usually the only physical contact I would have with clients, except for a parting hug, if the client initiated it, at the time of termination.

That psychologist who once told me I would need a co-therapist got his wish in a way. My guide dog has proven to be an excellent co-therapist. She manifests the genuineness, unconditional positive regard, and non-judgmental acceptance that all counsellors strive to display. Many clients immediately zeroed in on Maggie. Their reactions were either very positive or neutral. I never had a client express fear of her. Some had left beloved pets behind when they came to the university, and told me how much they missed these non-human friends. Maggie proved to be an area of common ground to talk about while establishing initial rapport. If clients asked to interact with her, I would take off her harness to let her say hello, explaining how important it was that she know the difference between "work time" and "play time," and that she was not allowed to be petted or played with while wearing her harness. Maggie proved to be a calming presence for clients in crisis, as well, and interacting with her could almost be viewed as a "reward" for doing some hard and painful work in counselling. Her presence was appreciated by most colleagues, too, who often sought her out after difficult sessions, or a long day.

Maggie was also my way of letting clients know, without having to make it a main topic of conversation, that I was blind. The different appearance of my eyes, and my inability to make true eye contact were further clues to my lack of sight. Most clients seemed to quickly accept my blindness. They observed my professional appearance and demeanour and saw that I was comfortable in my surroundings, and quickly realized that I knew how to do my job. In fact, several commented that they felt more comfortable knowing I could not see them. Other blind counsellors had told me this often happened. I sensed that, for some, my lack of sight communicated that I knew how it felt to be seen as "different." I think some clients believed I must know what it was like to face challenges in life. Others were glad I couldn't see what they physically looked like. This could be because of lo self-esteem, body image issues, or a simple wish to remain as anonymous as possible. If I needed to know something about their appearance, I simply asked.

I received a lot of auditory clues about clients' non-verbal behaviours. For example, I could tell one client talked a lot with her hands because I could hear the clinking of several bracelets. I could also pick up on the swishing of clothing in those who tended to fidget a lot. One client spent an entire session fastening and unfastening a Velcro strap on her backpack while she talked. Others often looked up, down, or around the office. I could tell this by the sound of where their voice was coming from. Distracted clients trailed off a lot while speaking. Depressed clients often spoke in monotones. Couples would make comments to each other, such as "Move your chair closer," or "Your hands are cold."

Occasionally, I felt that I was missing something by not catching someone's body language. Sometimes, while watching a taped session, a supervisor would comment on something they'd noticed that I could not have known. Rarely was this information vital, however. The few times colleagues commented to me about a client's appearance, it was to relate something striking, such as multiple piercings or blue hair. On one occasion, a member of our office staff came back to my office to tell me how handsome my last client had been. I believe I would have found all of these things distracting, and may have used the information, consciously or unconsciously, to make judgments about these clients. I was once surprised when, upon reaching my office, the client introduced me to his girlfriend. I had nearly closed the door on her, not realizing he had brought someone with him. This was a pleasant surprise, however, as I'd been encouraging him to do so.

After completing my degree, I decided it was once again time to seek out colleagues who were blind and working as therapists. I had some job-hunting questions that I wanted to talk about. In addition to the contacts I'd made previously, I found out about a mentoring project available through a national organization that provided a variety of services to blind people. Using this system, searches could be performed to find contacts in certain professions. I spent a great deal of time emailing those I located through this service. The American Psychological Association also had a mentoring network for psychologists with disabilities, which I contacted. I also did web searches for news articles about other blind counsellors, thinking I might share these with potential employers at the time of the interview to support some of the things I said about how I would perform job tasks.

At some point during this quest, I finally decided to start an email discussion list for those who were blind and involved in the helping professions. I had benefited from being involved in a number of such lists with other counsellors. Usually, list members had no idea I was blind, as it was not relevant to discussions and I felt no need to announce it for its own sake. I had also often received support and information from being involved in discussion lists for blind students and guide dog users. I felt a need to combine the benefits of both, however. Finding other blind therapists always seemed to involve a lot of research, and I wanted to bring as many as possible together in a central virtual location. For this reason, I created blind-counsellors@topica.com.

I spent a lot of time publicizing it to psychology, counselling, and social work related lists, and to magazines of interest to blind people. The list grew to over forty members in the first month of its existence. As I'd hoped, the membership was diverse, as was the dialogue. Shortly after creating the list, I was contacted by a writer from Counselling Today. She wanted to do an article about me, and the list I'd created, for an upcoming issue. I couldn't believe so much interest was being generated.

The list is quite diverse. Educational backgrounds range from current undergraduates to PhDs. There are blind people on the list who work in all sorts of counselling settings, from crisis centres to elementary schools. Some work with other people who are blind or disabled in another way, while others do not. Some lead groups. Others work with families, teenagers or the elderly. There are list members who supervise interns, teach classes as adjunct faculty, and lead workshops and seminars. Some counsellors on the list go to clients' homes while others have private practices. Members work in hospitals, mental health centres, schools, urban areas and rural communities. Some take notes and keep track of time using braille and braille watches. Others have offices full of the most up-to-date technology. Some of us use guide dogs, while others prefer canes. Some have had great experiences with graduate school professors, employers and supervisors. Unfortunately, many can tell horror stories about the misconceptions they have faced from within the helping professions. I am not the only one who has been discouraged from entering the field. Some list members have difficulties because they are required to use computer programs that are not very accessible.

What unites us is that all of us are legally blind, and all of us are involved in the helping professions. List members are able to network, ask questions of one another, share information, and find support. We can do all this without having to arrange for transportation, scan printed materials, or have the help of a sighted reader. Using adaptive technology, list members can easily read and respond to messages. I wish such a list had been around when I was an undergraduate student with questions and concerns. I am always thrilled when students join the list. Through this email list, I can, both directly and indirectly, provide them with the support and encouragement they will need to be successful in the counselling profession.

Carmella Broome is a graduate of the Counsellor Education program at the University of South Carolina. Her area of specialization is marriage and family counselling/therapy. Carmella obtained initial licensure as a Professional Counsellor and Marriage and Family Therapist in 2005 and now works with adolescents, individual adults, couples and families at a private counselling agency in South Carolina. She can be reached at: cdbroome@worldnet.att.net

Comments

Excellent, informative article, beautifully written. I'm a novelist and my current novel involves a blind therapist, though not blind from birth. The information you provided here will be very helpful to me.

Thank you.

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