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This vignette illustrates how an individual with a complex pathology can present with a sight-threatening condition that appears to resist medical treatment in some measure if the psychological component is ignored. The case exemplifies the way in which therapeutic intervention can help in the recovery from a sight-threatening condition and from the underlying trauma associated with it.
It is recognised that people affected by sight-threatening conditions will understandably experience very strong and at times overwhelming feelings related to grief and loss. In this case, the possibility of sight loss created a severe reaction of panic and confusion, and disrupted cognitive functions. These problems were often compounded by symptoms including anger, disassociation, apathy, and depression.
This vignette showed how Bowlby's concepts of attachment and loss, and maternal deprivation, helped in the therapeutic alliance. The understanding of the client's internal working model was fundamental to the ongoing therapeutic process that allowed her to heal.