Page 9 - Cahier-Pratical- Low-Vision-De-2014.indd

3. The Psychological Factor Finally, we should note that these periods of reconstruction form The psychological state of a patient who is requesting a low vision part of therapeutic cycles in which the wishful thinking keeps coming aid cannot be dismissed. The shock of being told the diagnosis, back, always triggering the expectation of a miracle, the disappea- and especially of learning that the disease cannot be cured, leads rance of the problem or a cure, the vain hope of “seeing again as to psychological repercussions, with a characteristic path that before”, the dream of it all going away. This inner vision is used and Visual Impairment cannot be avoided. This must be recognised and respected by the developed when you can no longer have full confdence in incom- low vision professional, failing which, rehabilitation will not occur plete visual information. All representations of self and conceptuali- under the best conditions and will not give the expected results. sation are then more correct and based on a number of experiences. The Main Stages along the Psychological Path. A few typical reactions from the psychological stages gone through The “grieving process” following any loss is characterised by three after being told the diagnosis, gathered when vision aids are being phases. This psychological mechanism is a normal mechanism of proposed and tested: adaptation to a loss that cannot be alleviated. • No need for them because “I have injections”. a) Distress: this is the shock, the denial: “It cannot be pos- • Using a system, reading, ... will “damage what little sight sible...”, “I haven’t lost anything”, which occurs when the bad I have left”. news is given. • Not really needing the product, preferring to go without rather b) Depression: this is the disorganisation, the time when the per- than make the effort to learn how to use it. son confuses what they have lost with their very selves: “I’ve lost • Finding that the system is too diffcult to use: “I can’t read like everything...”, “I have no value any more...”. Their self-image is that.” called into question. • Loss of appearance, no longer being “like everyone else”. c) The Upward Turn: then comes the period for restructuring, • “Spending so much now...” reacting, adapting, and understanding the functional extent of • Secondary gains (visits, protection by relatives, etc.) the defciency and the resulting disadvantages and incapacities. The person reconstructs an image of their functional self and is ready to “make the best of it”. Practical Low Vision This path is normal, long and painful. Each person goes through the various stages at their own pace, depending on their past, their history and their personal resources as well as on the assistance and support that they receive. The issue for the patient is to re-invest as widely as possible in areas of established skills and perhaps explore other skills and interests that have not previously been developed much. The help to be provided is therefore functional and technical and falls entirely under the responsibility of the relevant professionals. The Importance of the Quality of the Interview. The interview with the visually impaired person provides several elements essential to their care. Firstly, by describing their loss, whether sudden or progressive, what they can still do and what they can no longer do, the patients give us an idea of what is most important to them and help us to define a plan for them. We also learn how they react to the onset of the impairment and the stage they are at in the grieving process. This time also allows the Low Vision Specialists to adopt the right professional attitude and find the proper way to communicate, to adapt themselves to the person and to provide the explanations, encouragement and support along the way to the best of their ability. Care should be taken to avoid being condescending or overprotecting and to treat the person as a responsible adult. It is important to take into account their experience, their previous professional and recreational activities, their intellectual level and their cognitive capacity. This allows us to make use of the mental structure, the fundamental process of categorisation in the acquisition of knowledge, the capacity for abstraction, the imaginary, access to mental pictures and any inner vision that helps compensate for a visual shortcoming. 9 Copyright © 2013 ESSILOR ACADEMY EUROPE, 13 rue Moreau, 75012 Paris, France - All rights reserved – Do not copy or distribute. Copyright © 2013 ESSILOR ACADEMY EUROPE, 13 rue Moreau, 75012 Paris, France - All rights reserved – Do not copy or distribute.