[Social-sciences-list] Self-disclosing blindness as part of a therapeutic relationship

[Kaiti Shelton]

Hi all,

I am in my undergrad for music therapy and am working on a Alzheimers
and dementia unit at an assisted living facility for my practicum this
semester.  The last time I worked with  this population I was under
the mistaken impression that I should not disclose my blindness for
several reasons.  I thought that it would turn the focus onto me in
the sessions rather than the residents-a common problem for first-time
practicum students who really want to take a client-centered and
humanistic approach, and as they have memory problems I thought if I
disclosed once I'd have to disclose all the time which would cause the
first problem in the first place.  This time my supervisor disagreed
with the last supervisor I had and said I should absolutely disclose
this information with the residents even if they don't remember it or
have trouble grasping it.  At best it will strengthen the therapeutic
relationship between the residents and I, and at the least it will
give me practice for when I'm in the working world and will need to
share this all the time.

I would typically describe myself as someone who is comfortable with
my blindness.  I'm a good self-advocate and have no problems asking
for help in stores and other places I travel to independently.  I'll
ask classmates to read what's on the board if a professor forgets to
say something that tells me what it is, and I'm even working on a
project with another blind student to organize a student org for
disability awareness on campus.  However, self-disclosure with my
residents has been challenging and I'm trying to understand why.  I've
been seeking supervision from my professor because I feel like this is
something in me that I need to get to the bottom of for the future.
While my supervisor and I agree that it isn't adversely effecting my
work in the sessions (I had a great one with the residents last week
and self-disclosed), it does seem to be concern for possible
countertransference in the future though I am keeping it in check now.

I've heard several theories from my supervisor which could all make
some sense either on a conscious or unconscious level.  His main
theory is that I really don't feel understood by others I'm around on
a daily basis so I'm afraid to be purposefully vulnerable when in a
position of leadership.  The other theory is that I am just concerned
about being vulnerable in a leadership role as a therapist without
reference to external factors and the problem is contained to therapy
situations.

I've been trying to process this for a good chunk of the semester now,
and feel like I need to find some answers soon because I'll be working
with vulnerable populations in Jamaica this summer and in a psych
facility for duel-diagnosis patients this time next year.  It doesn't
really make sense to me why I'm so sensitive about self-disclosing in
this context.  It doesn't make sense to me that I can walk up to a
random store clerk to ask a question or get some help but I have
trouble talking to those who cognitively don't have the processing
power to judge harshly or even remember the disclosure for very long.
If anything I would think this was the safest place to disclose if I
were uncomfortable with blindness.  Some of the sharper residents may
recognize it on their own from time to time as they've made comments
which lead me to believe that, but that doesn't bother me either.  I
had one lady remember to remind me of her name for the first few weeks
on her own every session before I could ask her myself, and once I
learned her voice well enough and started referring to her in the
sessions she said, "You've got it," and stopped prompting her name.  I
genuinely appreciated that little bit of help, but it just seemed like
she was sharp enough to pick up on why it took me longer to learn
names than my co-leader.  If I appreciate that and don't feel awkward
about it then why is self-disclosing so difficult?

I want to get to the point where this isn't an issue.  My goal is to
work in a hospital with children who are dealing with chronic
illnesses or who may have acquired disabilities.  I want to use my
blindness as an advantage in the relationship between me and my
clients so that it might help them see their own disability doesn't
have to hinder them.  In order to do this, though, in the most
effective way for all involved, I'm going to have to master the art of
self-disclosure.  I do have an easy time doing this around kids, and
have even thought of ways to self-disclose for the future in ways
which don't set my blindness and the disability or medical condition
the child is in the hospital for apart.  I've come up with possible
ways I can use my own blindness as a point of empathy for the child
while being sensitive to the specific things they're going
through-even if they are seemingly unrelated.  Some points are the
same, like I was in the hospital a lot when I was young and feared
treatments, nurses, needles, etc, but I'm interested in helping kids
learn to cope with chronic conditions after leaving the hospital as
well, and part of that will also involve self-disclosing and being
there for the family members.  If this is an issue specific to adults
in some way, then I'll definitely want to fix this problem soon.

It is worth mentioning that I am already in contact with a music
therapist who is blind and I have reached out to her for her thoughts
on the matter as well (though I have not heard back from her yet).  My
supervisor thinks it would be a good idea to talk to her as well as to
other people who may have experienced this as therapists, but he
doesn't seem to know what else to tell me beyond what he has already
said.  I've had two separate supervision meetings with him about this
now and he has advised me to just continue to research and talk to
people who may be able to help me process.

Any thoughts or suggestions would be appreciated,
-- 
Kaiti