If we truly want to understand hearing loss, we need to understand both the physical side, which makes hearing increasingly difficult, and the psychological side, which includes the lesser-known emotional reactions to the loss of hearing. In concert, the two sides of hearing loss can wreak havoc on a person’s total well being, as the physical reality causes the loss and the psychological reality prevents people from addressing it.
The statistics tell the story. Although nearly all instances of hearing loss are physically treatable, only around 20% of people who would benefit from hearing aids use them. And even among individuals who do seek help, it takes an average of 5 to 7 years before they arrange a hearing test.
How can we explain the considerable discrepancy between the possibility for better hearing and the wide-spread unwillingness to attain it? The first step is to acknowledge that hearing loss is in fact a “loss,” in the sense that something valuable has been taken away and is apparently lost forever. The second step is to figure out how individuals generally react to losing something valuable, which, owing to the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand exceptionally well.
Elizabeth Kübler-Ross’ 5 stages of grief
Kübler-Ross noted 5 stages of grief that everyone dealing with loss seems to go through (in remarkably consistent ways), although not everyone does so in the same order or in the same length of time.
Here are the stages:
- Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferred reality.
- Anger – the individual acknowledges the loss but becomes angry that it has happened to them.
- Bargaining – the individual reacts to the feeling of helplessness by attempting to take back control through bargaining.
- Depression – understanding the weight of the loss, the individual becomes saddened at the hopelessness of the predicament.
- Acceptance – in the last stage, the individual accepts the circumstance and demonstrates a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the regaining of control over emotions and behavior.
People with hearing loss progress through the stages at different rates, with some never getting to the final stage of acceptance — hence the discrepancy between the possibility for better hearing and the low numbers of people who actually seek help, or that otherwise wait many years before doing so.
Progressing through the stages of hearing loss
The first stage of grief is the most challenging to escape for those with loss of hearing. Seeing that hearing loss advances gradually over time, it can be very hard to recognize. People also have the tendency to compensate for hearing loss by turning up the TV volume, for example, or by forcing people to repeat themselves. Those with hearing loss can persist in the denial stage for many years, saying things like “I can hear just fine” or “I hear what I want to.”
The next stage, the anger stage, can express itself as a form of projection. You might hear those with hearing loss state that other people mumbles, as if the problem is with everyone else rather than with them. People remain in the anger stage until they realize that the issue is in fact with them, and not with others, at which point they may progress on to the bargaining stage.
Bargaining is a form of intellectualization that can take different forms. For example, people with hearing loss might compare their condition to others by thinking, “My hearing has become a lot worse, but at least my health is good. I really shouldn’t complain, other people my age are dealing with genuine problems.” You may also find those with hearing loss devaluing their problem by thinking, “So I can’t hear as well as I used to. It’s just part of getting older, no big deal.”
After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may go through a stage of depression — under the false assumption that there is no hope for treatment. They may persist in the depression stage for a while until they realize that hearing loss can be treated, at which point they can enter the last stage: the acceptance stage.
The acceptance stage for hearing loss is shockingly evasive. If only 20% of those who can benefit from hearing aids actually wear them, that means 80% of those with hearing loss never reach the final stage of acceptance (or they’ve arived at the acceptance stage but for other reasons choose not to take action). In the acceptance stage, people recognize their hearing loss but take action to restore it, to the best of their ability.
This is the one positive side to hearing loss: unlike other types of loss, hearing loss is partly recoverable, making the acceptance stage easier to reach. Thanks to major innovations in digital hearing aid technology, people can in fact enhance their hearing enough to communicate and participate normally in daily activities — without the stress and frustration of impaired hearing — allowing them to reconnect to the people and activities that give their life the most value.
Which stage are you in?
In the case of hearing loss, following the crowd is going to get you into some trouble. While 80% of those with hearing loss are trapped somewhere along the first four stages of grief — struggling to hear, harming relationships, and making excuses — the other 20% have accepted their hearing loss, taken action to improve it, and rediscovered the joys of sound.
Which group will you join?