Comparison, Othering, and Surveillance: Foucauldian Discourse Analysis of Peer Support in Visual Impairment Rehabilitation Services in South Africa.

Purpose: Peer support has been identified as an important aspect of rehabilitation for visually impaired adults. However, there is a limited exploration in rehabilitation studies literature of the identity-related impact of these interventions, both at an individual and collective level. Through attending to the discourses on blindness, well-being, and social inclusion that circulate in organization cultures, this article considers the role that peer support plays in forming "blind communities" with particular characteristics, and what these communities might model about life with blindness, both to newly blind persons and to society. Research Method: Foucauldian discourse analysis was conducted on semi-structured interviews with 18 visual impairment rehabilitation service users and eight rehabilitation practitioners at four organizations providing services in the Western Cape, South Africa. Results: Formal peer support is lacking in the sampled organizations, suggesting that relational aspects are not a priority in rehabilitation practice. The formal and informal peer support that does exist in these services is shadowed by largely negative sociocultural beliefs about blindness. Participants described a culture of comparison, othering, and surveillance within which, the article suggests, they are unable to explore and embrace authentic and positive blind identities. This has implications for both individual and collective empowerment. Conclusions: Greater attention must be paid to both rehabilitation practitioner training and the design and implementation of rehabilitation services to the identity-level impact of rehabilitation. This is essential to develop services that promote individual and collective empowerment and that respond to the multilayered practical, social, and psychoemotional needs of blind adults. Impact and Implications: Applying a critical disability studies lens to rehabilitation studies and practice brings to light the ways in which sociocultural beliefs about blindness influence the operation and focus of peer support interventions. A culture of comparison and othering in group rehabilitation services is a barrier to the formation of empowered communities of blind persons where diverse, authentic, and positive blind identities can be developed and embraced. Against a backdrop of largely negative ideas about blindness, peer support tends to encourage practical and emotional coping in a way that establishes a moral imperative that prohibits the healthy expression of complex emotions. There is a need for the development of rehabilitation practitioner training which focuses on the identity-level impact of undergoing a rehabilitative process for newly blind people. [ABSTRACT FROM AUTHOR]