Part 4 in a series of articles by Margaret E. Cleary, M.S., R.N., CVRT, based on principles from Thomas J. Carroll’s book Blindness.

Loss of the Visual Perception of the Pleasurable

a group of white men gathered in an art gallery - two of them have guide dogs

Carroll’s Concept: There is loss of the visual perception of a personally pleasing or lovable object. It might be a work of art, a smile on a loved one’s face, a new car, a running horse, one’s face in the mirror, or a beautiful person.

People with visual impairment loses direct sense pleasure which comes at times in the presence of color, form, or movement.

This pleasure concerns not simply natural emotional reactions, but associated emotions from earliest memories. A vacuum may ensue.

Cleary’s Observation: The pleasurable aspects of exercise may be diminished in an individual with diabetes. The world around cannot be experienced in the same way as before. Multiple tasks may be overwhelming or considered dangerous. Fun friends may avoid people with visual impairment, fearing responsibility. Finances may limit pleasurable activities.

Restoring the Visual Perception of the Pleasurable

Carroll’s Concept: People with visual impairment learn that pleasure occurs from encountering objects that denote ownership, affection, goodness, beauty, dearness by association, excellence in design or construction, sexual qualities, familiarity, and newness. Thus, seeing is only one aspect for providing pleasure.

Cleary’s Observation: In maintaining a well-balanced meal plan, people with diabetes and visual impairment cope with boredom, loss of appetite, disinterest, dependency and glycemic imbalance. Learning adaptive cooking skills, using new equipment, experimenting with recipes, and having a shopping plan restores the pleasure of once again providing foods of interest.

My Reflections: Challenged to create satisfying meals, Kevin C. enrolled in a culinary arts program. What a relief it was to find adaptive equipment that could make his cooking fun and productive when his vision diminished! These helpful adaptive items included a Foreman grill, slow cooker, Hot-Shot beverage maker, personal coffee maker, flame retardant mitt, talking timer, audible cooking thermometer, and lock and drain pot, to name a few. Many more are available through sources of specialty products.

Loss of the Visual Perception of the Beautiful

Carroll’s Concept: This is the loss of the visual embrace of the beautiful object, the drinking in of the beautiful, the visual embrace of the aesthetic. Colors, forms, shapes, and materials always impress. For those who are particularly alive to the beauty of objects, the pain can be nearly intolerable. For a person with visual impairment to stand in the presence of a delicately or majestically beautiful object and not be able to contemplate it causes untold frustration. Another’s words of explanation seldom fill the void. To lose the ability to be refreshed with new and wondrous objects may deaden the spirit.

Cleary’s Observation: People with diabetes may be so concerned with the tasks of diabetes self-managing that there never seems to be time for awareness of beauty. Not only is vision affected, but so also may be the other senses that awaken beautiful thoughts, touch, taste, hearing, smell, and those of movement.

Restoring the Visual Perception of the Beautiful

Carroll’s Concept: By substituting auditory perception to its highest level, the person with visual impairment awakens awareness of the beauty of such sounds as the whirring of a motor, a ticking clock, singing bird, familiar voice, and pleasing music. Visual images can be recalled and combined to bring to mind new pictures through “videation.”

Cleary’s Observation: People with diabetes and visual impairment may need to turn to activities that were not considered beautiful, but that can bring a sense of enjoyment to life. Technology helps with personal digital recorders, radio reading services, audio players and Talking Books, podcasts, and accessible computers and music systems. These help people connect with the joy and beauty of good music, literature, and diabetes self-care advances.

My Reflections: As previously mentioned, somewhere below the level of consciousness, sounds, smells, tastes and feels coming in can be taught to appropriate a visual image, thus forming a visualized background to daily life. Thomas J. Carroll and his artist colleague, Robert Amendola, developed a sensory development course around videation and spatial orientation that adds not only beauty, but safety. VisionAware offers information about this important topic of sensory development.

I had the privilege of learning under blindfold about how people with diabetes can protect themselves from injury. Mr. Amendola taught that we can create very realistic scenes in our heads based on information that we receive from things we hear or feel or understand in other ways. (One patient describes this experience in Mirage in the Desert.)