VI (visually impared) people who find their way about independently in a strange environment display spatial mobility. Incidents frequently instill apprehension into those affected. Here I show how the VI can rid themselves of that fear which guarantees them a victory over that apprehension.

Apprehension, freedom and spatial mobility

by Dr. Arne Harder;1)
translated by Hans Cohn

Apprehension

Conduct and experience in situations of apprehension and fear

A stone age man who is even afraid of harmless snakes suddenly encounters a giant snake during his search for food. He stiffens up from fright. Quietly crouched down, he hears the snake looking for him. Soon afterwards it rustles behind him in the grass. Now the apprehension lends him wings! At record speed he rushes off. The longer he stays, the more he becomes master of the situation. Soon he twists and turns, impeding the snake’s pursuit. Eventually he turns round and sees the monster a mere 50 paces behind him raise its headThereupon he takes his sling and a flat stone, takes careful aim and catches its head. Seconds later he steps on the snake lying in its last convulsions, guts it expertly and with its skin and flesh returns home. Today he is the greatest, for he has saved his clan from famine and himself from the fetters of his apprehension.

"Angst", the German term for apprehension, is derived from the Latin Word: "angustia", meaning closeness, trouble. Man's first angst-releasing situation, according to Freud,2) occurs at birth, when the baby pushes through the mother's narrow womb into the unknown.

Signs of apprehension and fear

Apprehension, fear and spatial mobility

Example

Years ago I had a job interview with the Protestant church in Magdeburg. I went by myself, although this took me through difficult and unknown terrain. "What impression does it make", I thought, "if I apply for a job as psychologist and turn up helpless and with a guide?" I marched off, concentrating on the way ahead. My thoughts were with the interview.

Suddenly a cyclist racingly appeared immediately ahead of me. My cane hit the bicycle, the person sitting on it cursed, as I unfroze from my fright and jumped to the side.

A little later, I was not sure Whether I had taken the right road. I could hear building noise. Perhaps I had to cross a building site. I needed certainty. In front of me I heard steps. I rushed forward and cried: "Is this Wiedemann street?" and "where does it lead from here?" The lady whose steps I had heard was frightened. She stopped a moment before walking on without speaking. What did I care for rules of comportment? I screamed the questions after her. "Not in this tone", she said and added, "I don't know." Now apprehension made me helpless. There was nobody within earshot. "But you can find out and read sreet names. I have to be at a job interview in the Kirchgasse in 15 minutes", I yammered. "That's your problem", she replied, "if you don't know your way and are in a hurry." She walked on and left a completely disorientated Arne standing.

Apprehension-evoking situations in the built environment

All people face problems of this kind. But the world is arranged as a "world for sighted".3) Most people find only a few apprehension triggers in the built environment, and with the expectations of society they are also Au Fait.

The situation is different for the VI, especially the recently blinded and elderly. Situations which were easily mastered earlier have become seemingly unscalable hurdles. The experience of being obsessed by apprehension and to appear helpless in public one wants, of course, to avoid. The "“egg of Columbus" many people have discovered for themselves: many have given up independent mobility in the built environment. To this possibility I would like to juxtapose several alternatives.

Methods of overcoming apprehension

To this end I introduce the approach which is used in cognitive behaviour therapy for apprehension-related troubles. I am referring here to Willi Butollo.4)

  1. Take it seriously: Apprehension must always be taken seriously, even when we know that it is ridiculous.
  2. Acceptance of the demand: One must face the situations evoking apprehension and learn to endure the apprehension. That is a Herculean task for those afflicted with apprehension!
  3. Transformation to fear: many unsuccessful attempts of dealing with causes in theory and practice may be required, before the apprehension is eventually kept within bounds, before it is turned into fear which can be controlled and tested for its reality contents.

Complicating the work with VI people, must be added the fact that they frequently require strategies different from those of the sighted. The problem is frequently: getting to know and practising new strategies. The expense may frighten some, but it may be the only means by which the apprehension can be overcome and the resulting freedom experienced.

Experiencing freedom

Expectation of freedom and individual freedom

How free we feel ourselves to be depends on the number of alternatives available in the particular situation in which we find ourselves: the more there are, the more freedom we will experience.

If I look for a job requiring qualifications society expects that I am able to travel independently. These expected attributes I call expectations of freedom. I experience Individual freedom in the particular situation in which I find myself.

If we are obsessed with apprehension there is no place for freedom. The greater the apprehension and the better we are able to overcome it, the more freedom we will experience.

Spatial mobility and freedom

With every journey we are able to undertake independently, we gain at least one further alternative. The greater the spatial mobility, the sooner are we able to meet the expectations of society. However, freedom is only to be gained withalternatives. Having to manage every journey independently, however difficult it is and however rotten I feelmakes me a slave to my expectations and those of others on me.

As Birgit Drolshagen maintains, apart from "doing it independently", the "purchase of assistance" and the request for support from friends, relatives etc. is still available to us. 5) Spatial mobility becomes freedom because I am able to walk the roads available to me independently, but do not have to.

Spatial mobility

The definition according to Emerson Foulke6)

According to Foulke, the mobile (blind) person is able to manage roads in the spatial environment, performing the journey:

Stress in traffic conditions can hardly be avoided – remember the sudden appearance of the bicycle. But Fridays at the main railway station in Cologne I find it often difficult because of the ambience and the many different sounds to obtain the information I need to get to where I need to be in time. Then I experience a lack of calm which can easily lead to the experience of apprehension.

Regarding the first four tasks I am in agreement with Foulke. But is grace really necessary for spatial mobility? Old people with restrictions of joints and muscles unable to use the cane elegantly would then never be mobile. They would have to think if they are better off staying at home. For Foulke means: if the style of walking looks clumsy and helpless blind people would reinforce the unfavorable impressions currently in circulation (l. c., p. 129).

Navigation and orientation, Landmark potential and preview

He/she who navigates well but orientates badly often loses his/her way but rarely gets bruised. He/she who orientates well but navigates badly arrives bruised, where he/she wants to be.

The landmark potential depends on the method of mastering the route. If one goes by car one hardly hears the sound which present themselves on the way. These are therefore hardly available to a car driver. For the blind pedestrian, however, they form some of the best landmark sources. Regarding preview, Barth and Foulke differentiate between two kinds: spatial preview e.g. by means of perception and perceptual preview, e.g. by means of previous experiences. Both go hand in hand.

Examples of spatial conception by blind people

How blind people arrive at spatial conceptions I will demonstrate by the example of the hearing net.10) According to MansfeldThe hearing net is the Noise ambience of a room or terrain. It consists of the typical sounds and the location of its typical appearance.

When I enter a strange room and hear the hum of a strange overhead projector, I first perceive the direction from which the hum comes. At the same time I can hear the reverberation from the wall and can estimate how big the room might be. The estimate could be wrong because other obstacles could break the reverberation. I must therefore walk through the room and perceive more and more sounds and echos from the walls and other obstacles. The more often I pass through the room and listen carefully, the more closely I "tie" the hearing net and the better I know which sounds I have to expect where and what restrictions the room presents. Thus a room concept is made up of perception and memories of earlier experienceswhich allows me constantly to judge my landmark potential. This spatial room scheme also helps me to store tactile impressions and smells.

Gradually the hearing net, perceptions and experiences lead to a spatial impression with which I can draw a map of the room from memory. The result is my cognitive map.11) But when I want to get to know a terrain in the street outside, then it quickly becomes difficult to form a cognitive map. Before I know what makes up the typical noise of a longer journey many walks may be necessary.

So another kind of route mastery must be found which is quicker and produces similar results. In my opinion this is the cognitive running label.12) I imagine this to be a list of instructions which follow from starting out to getting there. Apart from the spoken instructions, this programme contains supplementary spatial instructions. What, where and how to perceive what there is in space is detailed, particularly for important locations and stored in the memory.13)

General principles of spatial mobility for VI persons

More geographical than spatial orientation13)

Sighted people can often survey parts of a journey as a whole and orientate themselves spatially through their perception. According to Brambring this is called spatial orientation.

VI people lack that facility. They often have to plan short stretches to gain a piecemeal impression of the way ahead. According to Brambring this is called geographic orientation. VI people need more pre-informations about a new journey than the sighted. But it is these which are just not available to them.

Total attention

VI people must undertake a journey with total attention. Four aspects of attention can be differentiated according to Plohmann et al.14)

  1. General attention: At any moment something unexpected can happen. Therefore we have to register everything wide awake.
  2. Directed attention: We must concentrate totally on the journey. Perhaps a nightingale starts singing wonderfully; we will have to ignore it.
  3. Divided attention: Apart from the orientation we have to watch the traffic.
  4. Long-term attention: if the journey is long we have to maintain our attention for a long time.

Of course, any journey requires all these aspects of attention from sighted people as well. But the same journey demands for more concentration from VI people, because they have To piece together the total conception from the different parps.

The freedom of dependence

All this cannot be accomplished if we are somewhere else with our thoughts or we are not well. Blind people who are head over heels in love or seriously ill should not undertake unfamiliar journeys unaccompanied. They should, however, benefit from the freedom of dependance.

Dealing with limits

General statements about VI people in Germany

The German Federation of the Blind and VI (DBSV) reckons that there are 155.000 blind and 600.000 VI people in the Federal Republic on the strength of those who receivd the blindness allowance in some Federal states in 1995, translated upwards for the whole country.15) The Federal Office for statistics gave the number as 81.000 totally blind in 2003.16)

Undisputed is the distribution of blindness: more than two thirds of blind people are over 65, a good third is over 80. Therefore age-related conditions, such as deafness, movement restrictions, consequences of stroke or dementia occur frequently. I have found no figures for the number and extent of these afflictions, neither for Germany, nor for any other country.

It is even harder to find out the degree of reduced spatial mobility blind people command or can probably acquire with proper tuition. It is common knowledge that VI people much less frequently than the sighted master the environment independently. The reward for renouncing independence — they have far fewer accidents than sighted people.17)

If one wants to find out, how mobile a blind person can probably become, one first of all needs information about their attentiveness, memory (particularly referring to the working memory) and, above all, their conceptual ability for retaining spatial information, And here there are as good as no tests which one could employ – above all, with elderly people. 18)

Methods of recognising and extending one's own ability

Mobility instruction

A blind person who enters a new environment should apply for mobility instruction from qualified instructors. If the mobility lessons can be financed, will depend upon the regularities of the country where the VI person is living in. Those who attend to mobility instructions will learn, whether blind or with residual vision, how to move in space independently and safely.

Particularly important is mobility instruction for people who have recently lost their sight or part of it. Whether blind or partially sighted, they will learn how to get about safely in the environment. At the same time they learn how to use the white cane and other mobility aids correctly.

Psychotherapy

Sometimes apprehension makes it impossible to tolerate the thought of exposing oneself independently to the built environment. Others are already managing some journeys by themselves, but notice the apprehension hinders them much more than the fear of the situation justifies. But constantly to expose oneself to traffic with shaking knees is something that not even a VI person has to endure!

Here a course of psychotherapy from a confident practitioner will usually result in improvement. Of course, psychotherapists are hardly likely to be familiar with mobility problems of blind people. The patient will, therefore, have to take the initiative in seeing to it that psychotherapist and mobility instructor collaborate, if necessary.

Practice makes perfect

Only when the newly acquired skills and knowledge are frequently used will the mobility clearly improve and the apprehension be reduced. One should therefore venture out as often as possible, even in unfamiliar surroundings.

I recommend the same procedures to those who are unable, for financial or other reasons, to access mobility instructions. They should start by getting a long cane and practise in their own home. If they use it correctly: the cane should be held well forward, so that it makes contact with the obstacle rather than their body. When confidence is gained and safety ensured, one should venture out in the company of a sighted friend or relative who should be ready to step in To prevent accidents.

However, it must be stressed that the VI person should do their most to arrange some expert instructions. A qualified instructor is essential, not only in teaching the correct technique of long-cane use, but also in the choice of the most suitable cane for a particular client, not forgetting the tip of the cane which will depend on whether the client prefers to keep the cane permanently in contact with the ground or pick it up between steps.

Summary

Mobility training for blind and VI people is at least as important as driving lessons for the sighted. The struggle for spatial mobility is hard. Hardly any VI person will achieve complete independence. Thus a VI person will have to come to terms with some degree of lacking spatial independence. But the struggle for the individual maximum of spatial mobility will generally bring its own reward. Spatial mobility is a human right. It provides us with the experience of freedom.

Everyone should recognise the importance of acquiring a maximum of spatial mobility that his personal prerequisites permit. Society should feel in duty bound to provide the means for every member requiring training to access it.

Footnotes and references

  1. This paper was delivered on 6 10 2007 at St. John's Church, Düsseldorf (FRG) as part of an information seminar organised by the blind and Vi welfare of the Protestant Church in the Rhineland. The {original} text including videos demonstrating the atmosphere at Cologne main railway station is available on the web at:
    http://www.med.uni-magdeburg.de/~harder/angst.
  2. Freud, S. (1999). Hemmung, Symptom und Angst (inhibition, symptom and apprehension). In: Anna Freud (Hg.). Sigmund Freud, gesammelte Werke chronologisch geordnet, Bd. 14 Werke aus den Jahren 1925-1931 (113-205). Frankfurt a. M.: Fischer.
  3. Burlingham, D. (1981). Blind in a world for the sighted. Journal of clinical psychology and psychotherapy, 29, pp. 315-329.
  4. Butollo, W. (1993). Die Angst ist eine Kraft (The apprehension is a force). 5. Auflage, Pieper: München.
  5. Drolshagen, B. (2007). Und ich mache es doch — Selbstbestimmung trotz Hilfebedarfs im Alter. (And I can do it nevertheless: Self-determination despite the need of help in old age). Horus 69 (3) S. 110-113.
  6. Foulke, E. (1983). Spatial ability and the limits of sensory systems. In: H. L. Pick & L. Acredolo (eds). Spatial orientation: Theory, research and application (pp. 125-141). New York: Academic Press.
  7. Petrie, B., Johnson, V. V., Strothotte, Th., Fritz, s., Michel, r. & Raab, a. (1996). MOBIC: Designing a travel aid for blind and elderly people. Journal of navigation, 49, pp. 45-52.
  8. Brabyn, J. A. (1982). New developments in mobility and orientation aids for the blind. Transactions of biomedical engineering, BME-29, pp. 285-289.
  9. Barth, J. L. & Foulke, E. (1979). Preview: A neglected variable in orientation and mobility. Journal of visual impairment and blindness, 73, pp 41-48.
  10. Mansfeld, f. (1940). Die Verdunklung und die Blinden (Darkness and the blind) Arch. f. d. ges. Psychologie Bd. 107, S. 411-436.
  11. Downs, R. M. & Stea, W. (1978). Maps in Mind. London: Accademic Press.
  12. Harder, A. (1993). Zur Aneignung von Wegen: ein Feldversuch mit geburtsblinden Menschen (on mastery of paths: field experiment with congenitally blind persons). unpublished dissertation, University of Giessen.
  13. Brambring, M. (1982). Language and geographic orientation for the blind. In: R. J. Jarvella (ed.). Speech, place, and action (pp. 203-216) Chichester: Wiley.
  14. Plohmann, A. M., Kappos, L., Ammann, W., Thordai, A., Wittwer, A., Huber, S., Bellaiche, N. & Lechner-Scott, J. (1998). Computer-assisted re-training of attentional impairment in patients with multiple sclerosis. Journal of Neurology, Neuro-surgery and Psychiatry, 64, pp. 455-462.
  15. http://www.dbsv.org.infothek.statistik.html (inquiry, May 2006).
  16. Telephonic inquiry at the Federal Office for Statistics: May 2006.
  17. Brambring, M. & Schneider, W. (1986). Lokomotion und Verkehrsverhalten bei sehgeschädigten Personen. (locomotion and traffic management of visually impaired persons). Rehabilitation, 25, S. 74-79.
  18. Harder, A. (2007). Blindengerechte Tests: Problemstellung und Perspektiven (inclusive tests for blind persons: problems and perspectives).
    http://www.med.uni-magdeburg.de/~harder/bltests (enquiry: September, 2007).

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