The last time you posted something like this, I fretted for a whole day, trying to figure out how to respond. I found I could not do so without a mindkillxplosion at how offensive it is

Of course suggestions to make radical changes can offend.

Here I have basically two choices: (A) Don't try to address the issue on a deep level (B) Say "I see this triggers your pattern of learned helplessness". "It needs a certain amount of pain for a person to decide that their suffering is enough and that they stop to suffer."

Unfortunately text isn't a good medium for doing (B) and even Skype isn't.

In your specific case being blind also adds additional issues that don't exist for most people.

expresses bafflement that you don't just move to a nice city like theirs

"Expressing bafflement" isn't a good description of what I'm doing when I'm asking for "Why do you do X?". I ask that question because I feel that the other person benefits from answering the question and getting clear about "why they do X". If you actually make a decision that it's for you the right choice to stay where you are at the moment, you feel more agentship.