If we genuinely want to understand hearing loss, we need to understand both the physical side, which makes hearing progressively more difficult, and the psychological side, which includes the lesser-known emotional responses 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 creates the loss and the psychological reality prevents people from treating it.
The numbers tell the story. Although virtually all instances of hearing loss are physically treatable, only about 20% of people who would benefit from hearing aids make use of them. And even among people who do seek help, it takes an average of 5 to 7 years before they book a hearing test.
How can we explain the massive discrepancy between the possibility for better hearing and the wide-spread resistance to obtain it? The first step is to appreciate that hearing loss is in fact a “loss,” in the sense that something valuable has been taken away and is seemingly lost forever. The second step is to determine how individuals generally react to losing something invaluable, which, by way of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand exceptionally well.
Elizabeth Kübler-Ross’ 5 stages of grief
Kübler-Ross detected 5 stages of grief that everyone dealing with loss appears to pass through (in incredibly consistent ways), although not everyone does so in the same order or in the same amount of time.
Here are the stages:
- Denial – the individual buffers the emotional shock by denying the loss and contemplating a false, preferable reality.
- Anger – the individual recognizes 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 significance of the loss, the individual becomes saddened at the hopelessness of the circumstance.
- Acceptance – in the last stage, the individual accepts the circumstance and displays a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the recovering of control over emotions and actions.
Individuals with hearing loss progress through the stages at different rates, with some never reaching the last stage of acceptance — hence the discrepancy between the opportunity for better hearing and the low numbers of people who actually seek help, or that otherwise hold off several years before doing so.
Progressing through the stages of hearing loss
The first stage of grief is the trickiest to escape for those with hearing loss. Seeing that hearing loss advances gradually through the years, it can be very difficult to recognize. People also have the tendency to compensate for hearing loss by cranking up the TV volume, for example, or by forcing people to repeat themselves. Those with hearing loss can stay in the denial stage for 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 everyone else mumbles, as if the issue is with everyone else rather than with them. People persist in the anger stage until they recognize that the issue is in fact with them, and not with others, at which point they may move on to the bargaining stage.
Bargaining is a form of intellectualization that can take different forms. For instance, people with hearing loss might compare their condition to others by thinking, “My hearing has gotten a lot worse, but at least my health is good. I really shouldn’t complain, other people my age are coping with real 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 growing old, no big deal.”
After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may head into 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 surprisingly evasive. If only 20% of those who can benefit from hearing aids actually wear them, that means 80% of those with hearing loss never get to the final stage of acceptance (or they’ve arived at the acceptance stage but for other reasons decide not to act). 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: compared with other kinds of loss, hearing loss is partially recoverable, making the acceptance stage easier to reach. Thanks to major improvements in digital hearing aid technology, people can in fact strengthen their hearing enough to communicate and participate normally in daily activities — without the stress and difficulty of impaired hearing — enabling 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 stuck somewhere along the first four stages of grief — struggling to hear, damaging 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?