If we truly want to understand hearing loss, we have to understand both the physical side, which makes hearing progressively challenging, and the psychological side, which includes the lesser-known emotional responses to the loss of hearing. Jointly, the two sides of hearing loss can wreak havoc on a person’s quality of life, as the physical reality creates the loss and the psychological reality prevents people from treating it.
The numbers tell the story. Even though almost all cases of hearing loss are physically treatable, only about 20% of people who would benefit from hearing aids use them. And even among people who do seek help, it takes an average of 5 to 7 years before they schedule a hearing test.
How can we explain the immense discrepancy between the opportunity for better hearing and the commonplace reluctance to obtain 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 seemingly 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 detected 5 stages of grief that everyone dealing with loss appears to pass through (in surprisingly 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 contemplating a false, preferable 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 seeking to take back control through negotiating.
- Depression – comprehending the significance of the loss, the individual becomes saddened at the hopelessness of the situation.
- Acceptance – in the final stage, the individual accepts the circumstance and presents 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 arriving at the last 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 hold off many 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 develops gradually over time, it can be very hard to detect. People also tend to compensate for hearing loss by turning up the TV volume, for instance, or by forcing people to repeat themselves. Those with hearing loss can stay 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 may hear those with hearing loss assert that everyone else mumbles, as if the problem is with everyone else rather than with them. People persist in the anger stage until they realize that the issue is in fact with them, and not with others, at which point they may proceed on to the bargaining stage.
Bargaining is a form of intellectualization that can take various forms. For example, people with hearing loss might compare their condition to others by thinking, “My hearing has gotten much worse, but at least my health is good. I really shouldn’t complain, other people my age are coping with real problems.” You might 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 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 use 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 choose not to take action). In the acceptance stage, people acknowledge their hearing loss but take action to restore it, to the best of their ability.
This is the one positive side to hearing loss: distinct from other kinds of loss, hearing loss is partially recoverable, making the acceptance stage easier to reach. Thanks to major advances 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 — 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 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 enhance it, and rediscovered the pleasures of sound.
Which group will you join?