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If we seriously want to understand hearing loss, we need to understand both the physical side, which makes hearing progressively challenging, 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 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 nearly 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 individuals who do seek help, it takes an average of 5 to 7 years before they arrange for a hearing test.

How can we explain the considerable discrepancy between the possibility for better hearing and the commonplace unwillingness to obtain it? The first step is to acknowledge 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 typically respond to losing something invaluable, which, thanks to the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand extremely well.

Elizabeth Kübler-Ross’ 5 stages of grief

Kübler-Ross noted 5 stages of grief that everyone dealing with loss appears to pass through (in remarkably consistent ways), although not everyone does so in the same order or in the same timeframe.

Here are the stages:

  1. Denial – the individual buffers the emotional shock by denying the loss and contemplating a false, preferred reality.
  2. Anger – the individual acknowledges 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 negotiating.
  4. Depression – comprehending 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 predicament and demonstrates 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 behavior.

Individuals 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 potential 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 most difficult to escape for those with loss of hearing. Seeing that hearing loss develops gradually over time, it can be very hard to detect. People also have the tendency 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 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 show itself as a form of projection. You may hear those with hearing loss assert that everybody 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 issue 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 different forms. For instance, 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 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 getting older, 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 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 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 arrived at the acceptance stage but for other reasons choose not to act). 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: as opposed to other types of loss, hearing loss is partially recoverable, making the acceptance stage much easier to reach. Thanks to major advances 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 difficulty 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 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 strengthen it, and rediscovered the joys of sound.

Which group will you join?