The Psychology of Hearing Loss

If we seriously 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 responses to the loss of hearing. In concert, the two sides of hearing loss can wreak havoc on a person’s quality of life, as the physical reality produces the loss and the psychological reality prevents people from dealing with it.

The statistics tell the tale. Although almost all cases of hearing loss are physically treatable, only around 20% of individuals who would benefit from hearing aids make use of them. And even among individuals who do seek help, it takes an average of 5 to 7 years before they schedule 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 invaluable has been taken away and is seemingly lost forever. The second step is to determine how people generally react to losing something valuable, which, by way 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 observed 5 stages of grief that everyone coping with loss appears to pass through (in incredibly consistent ways), although not everyone does so in the same order or in the same length of time.

Here are the stages:

1. Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferred reality.
2. Anger – the individual recognizes the loss but becomes angry that it has happened to them.
3. Bargaining – the individual responds to the feeling of helplessness by seeking to regain control through bargaining.
4. Depression – understanding the weight of the loss, the individual becomes saddened at the hopelessness of the circumstance.
5. Acceptance – in the final stage, the individual accepts the situation 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 actions.

Individuals with hearing loss progress through the stages at different rates, with some never arriving at 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 wait 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 loss of hearing. Because hearing loss develops gradually through the years, it can be very difficult to recognize. People also tend to make up for hearing loss by cranking up the TV volume, for example, or by forcing people to repeat themselves. Those with hearing loss can remain 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 may hear those with hearing loss declare that everybody else mumbles, as if the issue is with everyone else rather than with them. People persist in the anger stage until they realize that the problem 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 different forms. For instance, those with hearing loss might compare their condition to others by thinking, “My hearing has become much worse, but at least my health is good. I really shouldn’t complain, other people my age are dealing with real 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 growing 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 mistaken presumption that there is no hope for treatment. They may persist 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 surprisingly elusive. If only 20% of those who can benefit from hearing aids actually use them, that means 80% of those with hearing loss never reach the final stage of acceptance (or they’ve reached 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 partly recoverable, making the acceptance stage easier to reach. Thanks to major advancements 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 amplify it, and rediscovered the joys of sound.

Which group will you join?