If we seriously want to understand hearing loss, we have 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. Jointly, the two sides of hearing loss can wreak havoc on a person’s total well being, as the physical reality produces the loss and the psychological reality prevents people from treating it.
The statistics tell the story. While almost all instances of hearing loss are physically treatable, only around 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 arrange a hearing test.
How can we explain the enormous discrepancy between the opportunity for better hearing and the widespread hesitancy to achieve 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 figure out how people typically react to losing something invaluable, which, courtesy of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand very well.
Elizabeth Kübler-Ross’ 5 stages of grief
Kübler-Ross identified 5 stages of grief that everyone coping with loss seems to go through (in surprisingly consistent ways), although not everyone does so in the same order or in the same period 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 recognizes the loss but becomes angry that it has happened to them.
- Bargaining – the individual responds 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 final stage, the individual accepts the predicament and exhibits a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the restoring 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 a number of years before doing so.
Progressing through the stages of hearing loss
The first stage of grief is the most difficult to escape for those with hearing loss. Seeing that hearing loss advances gradually as time passes, it can be very hard to recognize. People also have the tendency to make up for hearing loss by cranking up the TV volume, for instance, or by forcing people to repeat themselves. Those with hearing loss can remain 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 manifest itself as a form of projection. You might hear those with hearing loss state that other people mumbles, as if the issue 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 move on to the bargaining stage.
Bargaining is a form of intellectualization that can take different forms. For example, those 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 might 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 go into a stage of depression — under the false assumption that there is no hope for treatment. They may stay in the depression stage for a period of time 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 elusive. 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 reached the acceptance stage but for other reasons decide not to take action). In the acceptance stage, people acknowledge their hearing loss but take action to improve it, to the best of their ability.
This is the one positive side to hearing loss: distinct from other types of loss, hearing loss is partly 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 engage normally in daily activities — without the stress and difficulty of impaired hearing — empowering 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 enhance it, and rediscovered the joys of sound.
Which group will you join?