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 reactions to the loss of hearing. Together, the two sides of hearing loss can wreak havoc on a person’s quality of life, as the physical reality brings about the loss and the psychological reality prevents people from dealing with it.
The numbers tell the story. Although nearly all cases of hearing loss are physically treatable, only about 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 potential for better hearing and the wide-spread reluctance to achieve it? The first step is to recognize 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 very well.
Elizabeth Kübler-Ross’ 5 stages of grief
Kübler-Ross observed 5 stages of grief that everyone coping with loss seems to go through (in remarkably consistent ways), although not everyone does so in the same order or in the same timeframe.
Here are the stages:
- Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferred reality.
- Anger – the individual recognizes the loss but becomes angry that it has happened to them.
- Bargaining – the individual responds to the feeling of helplessness by seeking to regain control through negotiating.
- Depression – understanding the weight of the loss, the individual becomes saddened at the hopelessness of the circumstance.
- Acceptance – in the final stage, the individual accepts the situation and exhibits 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 actions.
Individuals with hearing loss progress through the stages at different rates, with some never getting to the final stage of acceptance — hence the gap between the opportunity for better hearing and the low numbers of people who actually seek help, or that otherwise hold off a number of years before doing so.
Progressing through the stages of hearing loss
The first stage of grief is the trickiest to escape for those with loss of hearing. Considering that hearing loss advances gradually through the years, it can be very difficult to detect. People also tend 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 reveal itself as a form of projection. You might hear those with hearing loss claim that everyone else mumbles, as if the issue is with everyone else rather than with them. People remain in the anger stage until they recognize that the problem 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 various 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 dealing with real problems.” You may also come across 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 aging, no big deal.”
After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may enter a stage of depression — under the false assumption that there is no hope for treatment. They may remain in the depression stage for a while until they recognize 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 arrived at the acceptance stage but for other reasons decide not to take action). In the acceptance stage, people recognize their hearing loss but take action to improve it, to the best of their ability.
This is the one positive side to hearing loss: unlike other types of loss, hearing loss is partially recoverable, making the acceptance stage much easier to reach. Thanks to major innovations in digital hearing aid technology, people can in fact improve their hearing enough to communicate and participate normally in daily activities — without the stress and frustration of impaired hearing — permitting 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 strengthen it, and rediscovered the pleasures of sound.
Which group will you join?