Julia Shalkovskaya, interview. Continued

We continue our conversation with Julia Shalkovskaya about psychology and the peculiarities of psychologist work with inclusive patients and their families.

Julia, please tell me, what are the particularities of providing psychological help to a family where, for example, a child has started to lose their sight? Does the work of a psychologist in such a case differ from cases when a child has been born blind?

The main difference is that, when a child who has just been born cannot see, there is, roughly speaking, no need to work with them directly. Everything can be handled by the parents who would have already learned about their kid’s condition from a doctor or maybe they themselves have noticed that the child cannot see and realized that something needs to be done about it. The basic needs of an infant, such as sleep, safety, food, and maternal affection, which we mentioned in the previous interview, are met by the parents in the same way as in the case of a seeing child. The psychologist would mostly interact with the parents in this case, i.e. the mom and dad if it’s a full family, or with just one parent otherwise. They might only need to work with the child at a later stage.

Cut-In: Psychologists work with the main members of the family, its pillars, and the child

At the earliest stage, a psychologist usually works with the mother, as she is usually the one who covers the child’s basic needs. Work can also be done with the father because it is the same family, and he often experiences the same emotions as the mother. Only when the child begins to realize themselves, the psychologist starters to work with them. Usually, children begin to realize themselves (begins to mentally separate themselves from their parents) from about one year old.

In the case when a child loses their sight at the age of 5-6 or older, working with them represents is an entirely different matter, as it constitutes a significant change in life, which would difficult to survive alone. In this case, psychologists primarily work with the child, as they experience this change as a personal tragedy.

For such a case, it becomes necessary to work with the child as an individual, to develop their self-esteem and formulate a new concept of their future life and a perception of their own “self,” which, of course, would change dramatically. It is important to explain and clearly demonstrate to the child that the fact that they have lost some or all of their sight does not make them worse or less complete than others. A child with inclusion, in this case, is a person just the same as everyone else, they simply lost the ability to see.

When does a psychologist start working with the parents of such a child?

At the same time as they start working with the child themselves, because it can be difficult for parents to cope with what has happened. Their beloved son or daughter, the light of their life, has suddenly lost the ability to see. Parents may discover this change, for example, when the child keeps running into things, and then mom and dad might yell at them: “Can’t you see where you’re going?!” And the child really cannot see that well. It is no longer as easy for them to perform familiar activities that used to be easy with full vision.

This is the first thing that parents and other family members have to deal with. A psychologist has to explain that it is now necessary to activate the parent’s “GPS” to help the child and teach them how to cope with ordinary activities such as cleaning, setting the table, or performing other tasks by prompting and guiding rather than doing everything for them. “Reach your hand out,” “take a step to your left,” or “the chair is behind you.” In other words, help their child develop new skills to interact with the outside world.

What is the most important thing when working with someone who has recently lost their sight?

As I have already mentioned, it is necessary to work on the child’s perception of themselves, helping them find their place in these new circumstances. The psychologist’s task is to activate the compensation mechanism, which helps the child to find their place within the new reality.

Literary creativity, development of mathematical abilities, or modeling can act as compensation, as it promotes imagination and the transition of tactile sensations to a new level. For example, the hands of someone who cannot see can feel the material better when modeling than those who can. This ability to “see” with one’s hands compensates for the lack of sight. In general, compensation is a kind of defense mechanism to restore normal interaction with life after a difficult period of experiencing trauma.

So one of the psychologist’s tasks is to awaken this compensation mechanism in a person with inclusion?

Yes, this is one of the psychologist’s main tasks, one of the goals towards which we, psychologists, work in such cases.

First, we see the blind child as a human being, no matter whether their life activities have become limited or not. If they are depressed, then, as we discussed in the previous interview, we need to work with grief, as what has happened is bound to invoke it. Once all the stages — i.e. anger, denial, bargaining, depression, and acceptance — have been passed, we begin working with the patient’s compensatory mechanisms.

Of course, there are cases when a person decides to do nothing and go with the flow. A psychologist cannot provide help if a person is unwilling to help themselves. But if there is a desire to remain active, to start or continue to do something, then the psychologist’s work can bear tangible fruit.

Cut-In: A psychologist’s work is guided by their client’s wishes

A psychologist’s work is guided by their client’s wishes. Do they want to do sports? Well, let us see what can be done and how it may work. Perhaps they like the IT sphere? Okay, let us work on fitting in there. Special tests for professional orientation and abilities, such as those conducted at school, can also help.

In the process of such work, a person’s main traits are revealed. Do they like working with other people? If yes, then one solution may work for them, and if not — then other options can be explored. Some do not like computers, and prefer to take care of plants. Maybe the person is fixated on the spiritual and philosophical, so the can try to write articles or make other content in that field.

Of course, it happens that certain paths become inaccessible, such as, for example, driving cars, but one can always find a new occupation and learn a new profession. Moreover, the search for compensation may reveal new abilities that the person did not even suspect they had.

A child may turn out to be a natural IT specialist, a hacker savant. I know a deaf girl who is an amazing dancer. She hears nothing but drum rhythms, and that is more than enough for her. So that is her compensation, and the main thing is to have drum rhythms in the music, and then she can dance like it is her God-given talent.

Is it important to do what one finds interesting?

It is very important to do things that you will actually enjoy.

We are not robots who do our job by vacuuming the entire apartment and then return to the recharge station, able to repeat the same process every day. Humans are multitaskers: we may like to sing, draw, sculpt, be passionate about math, physics, history, and geography. Therefore, it is important for a psychologist to suggest different activities, something new that may arouse interest and satisfaction.

Do you like sports? Great, go to the gym. You might become a great athlete, like, for example, Leonid Jabotinsky. If at first you do not succeed, then do not sweat it — just try and try again. Of course, it is great when we succeed right away, but that does not always happen, so keep trying, analyze your progress, and draw conclusions when necessary.

Cut-In: It is very important to do what you like

Many who are not limited in their activities change professions and start doing something that really inspires them by choice. At the age of 17, when you want to spend time with friends and do not seriously think about your choice of profession, it is difficult to make up your mind. Often we are influenced by our parents’ and others’ advice, go to study as, for example, a seamstress, and then find that our true passion lies with the art of baking. It happens that, having studied accounting, a person then goes on to become a talented mechanic, enjoying more success they would have found otherwise, even if simply because there is less competition in the motor repairs market these days.

It is necessary to find one’s path, one’s own direction, and this becomes easier with the help of a qualified psychologist.

Can we say then that a psychologist in such a situation is the engine, setting a person with inclusion into motion?

I would not say an engine, but rather a cane that blind people use to learn to walk again. A psychologist points out the direction to get out of the situation the person finds themselves in, guiding them until they get out of said predicament. For those without legs, a psychologist is more like wheels that guide their movement.

In short, a psychologist is like the “wise mentor” archetype character from classical storytelling, helping the protagonist, i.e. their client, find their footing and setting them up for future challenges and adventures.

Julia, and what happens if, as a result of all this, the psychologist’s help is either hindered or even halted altogether?

It depends on the stage at which the psychologist’s help is interrupted. For example, someone who has lost their sight will have a hard time without a psychologist’s help at an early stage, because it is the most difficult. So much stress piles up that it is difficult to bear on one’s own. The person risks exhausting all their resources: both moral and physical. These will need to be replenished, and that is only possible by working with a psychologist, in which case the psychologist will act as a power generator.

Once again: not everything and not always works out at first, and certainly not everyone can cope by themselves. You may need the help of a psychologist who will pick you up, for example, support your hand when you, as a blind person, pour tea into a cup or put cat food into your pet’s bowl.

We, psychologists, work to help you find your way in such situations. For example, how to pour water into a pot, how to go to the store using landmarks on the way there and back, how to start walking with a cane, and much more. How to ask others for help, how not to be afraid to do so, etc.

Cut-In: Not everything and not always succeeds the first time around

If you fail today, you will succeed tomorrow or the day after that, but you will definitely succeed. It is important to keep going, unafraid of making mistakes and trying your best. For example, if someone who cannot see needs to iron their curtains, they might burn the fabric the first time they do it, but then everything will get better and ironing become easier with each subsequent attempt.

What about if you need to leave your city or even country? What are the subtleties of working with such a situation?

We live in a world of smartphones and messengers: WhatsApp, Viber, Telegram, and others all help to stay in touch with your psychologist, allowing you to receive support anywhere you go. Of course, it will be more difficult for the psychologist and his client to work things out, because offline work is always more efficient. Working offline, a psychologist can show you how to walk to a store or, as I mentioned before, support your hand when you are pouring yourself a cup of water. But we still work online, whether you are in France or Germany, sometimes — with the help of local volunteers. The essence of our work remains the same: to help, guide, explain, and support the people who have found themselves in a difficult situation. Volunteers may not be able to do all the work for the patient, but they can still explain, guide, and help with paperwork or at least take the client to the place where said paperwork needs to be processed.

What else is important to understand about psychologist help?

A psychologist is not a 24/7 caregiver, that is simply not their function. A psychologist guides, supports, offers council, and may help you get through depression. However, it warrants reiteration, that a psychologist does not become their client’s employee.