Counsellor’s guide to the stages of sight loss grief

Our counsellor, Deborah, delivers counselling sessions to people living with sight loss across Greater Manchester, either face-to-face or over the telephone.

In this blog, Deborah discusses how much of the work she does is supporting issues connected to the grieving process and the various stages of grief. It is important to note that this is not a definitive guide, as each individual experiences grief in a different way.

Stages of grief

Primarily, working with blind and partially sighted clients is rooted in supporting the issues connected to bereavement and its stages of grief.

An experience of loss of any kind brings up similar feelings to those we can experience through the loss of a loved one – sight loss is no exception.

Here is an overview of the stages of grief that people with sight loss may experience; not all individuals will experience all of the stages, and may not pass through each one in a linear order.

Denial

This is when an individual is disbelieving that their sight will not improve, and that there is nothing more can be done medically, for example at the hospital or optician. They may have a sense of false hope, that in time they will be able to see better. It can present in many emotions such as shock, longing, disbelief, frustration and a paralysing state of waiting to recommence life once their sight returns or improves.

Statements such as “I feel like I want to clean my glasses’’ or “take out my eyes and wash them” or “if only I could just see a bit better” are clues that the individual is facing this mind set. They are likely to think that accepting it is a negative, and that giving in would send them into a depression.

The way forward, although not easy, is to question what the denial is doing for them in any positive sense. It is in fact preventing them from beginning to learn new ways of living and getting the help they need, and spoiling their present day.

It is a slow process, but once the individual realises it is actually doing them more harm than good, the change can be quite dramatic and lead to positive change in feelings and behaviour.

Helping the person to see they need to let go, and accept that this is where they are at and need to seize what they can, is an important process that counselling can help with.

Anger

The individual can be angry at the diagnosis, the consultant, family members, the universe, and often themselves for the reasons behind the sight loss.

The anger is often a distraction from dealing with the sight loss, and it is important to acknowledge the unfairness of the situation and listen to the reasons why the person is angry. It is important to work through the anger in order to move towards acceptance. Forgiveness is often the key here if nothing proactive can be done.

Depression

Depression is a common reaction to a diagnosis, or becomes deep-rooted at living with the ongoing frustrations that living with sight loss brings.

A cloud of despair around the reality of spending life in a dark or isolated place, which no one truly understands, and feeling a burden to family and friends. That life is so much more difficult and everything takes so much longer and hazards are everywhere.

The loss is so much greater than simply what can be seen. Self-esteem is the biggest casualty quite often, as the individual loses their sense of identity because they may lose their job, independence, driving licence, pastimes, capability, friends, relationships and need the support of others.

This can often result in the person feeling quite pathetic and a burden. Shame is also a huge emotion surrounding sight loss. Although it would seem hard to understand, it is very common for visually impaired individuals to feel ashamed and even embarrassed that they cannot see, and are terrified of showing themselves to appear foolish, often avoiding asking for help in an attempt to disguise their vulnerability.

Acceptance

This is where the person living with sight loss needs to aim to be in terms of their mental health.

A place where they can accept the level they are at and begin to function in a new way, in a new life. As with the death of a loved one, the individual needs to experience a new sense of self and acknowledge their grief for their loss and that it will never go away – but they will learn to live with it even though it is hard.

Visually impaired men and women can live contentedly once they begin to accept the situation and begin to live with it rather than fight it, hate it or be stuck in their anger or denial of it.

No one would argue that living with sight loss is at all easy, but until acceptance is reached life is much harder mentally and physically. This state of acceptance is fluid and there are days, weeks, months when the mind set fluctuates, especially as things change which are out of their control. A prognosis, a life changing event, a social change or simply a fall or breaking something can swing emotions back and forth, but the restoration of acceptance is key.