The Psychology of Hearing Loss

If we really want to understand hearing loss, we need to understand both the physical side, which makes hearing increasingly challenging, 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 quality of life, as the physical reality brings about the loss and the psychological reality prevents people from addressing it.

The numbers tell the tale. Even though nearly all cases of hearing loss are physically treatable, only around 20% of individuals 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 arrange for a hearing test.

How can we explain the enormous discrepancy between the potential for better hearing and the commonplace resistance to achieve it? The first step is to recognize that hearing loss is in fact a “loss,” in the sense that something invaluable has been taken away and is apparently lost forever. The second step is to find out how individuals typically 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 identified 5 stages of grief that everyone dealing with loss seems to go through (in remarkably consistent ways), although not everyone does so in the same order or in the same amount 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 reacts to the feeling of helplessness by seeking to take back control through negotiating.
4. Depression – comprehending the weight of the loss, the individual becomes saddened at the hopelessness of the situation.
5. Acceptance – in the last 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 actions.

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 potential for better hearing and the low numbers of people who actually seek help, or that otherwise wait many years before doing so.

Progressing through the stages of hearing loss

The first stage of grief is the hardest to escape for those with hearing loss. Seeing that hearing loss develops slowly 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 persist 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 realize that the problem 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 various 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 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 head into a stage of depression — under the mistaken assumption that there is no hope for treatment. They may remain 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 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 arived at the acceptance stage but for other reasons choose not to take action). In the acceptance stage, people recognize their hearing loss but take action to correct it, to the best of their ability.

This is the one positive side to hearing loss: unlike other forms of loss, hearing loss is partly recoverable, making the acceptance stage much easier to reach. Thanks to major improvements 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 — 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 strengthen it, and rediscovered the joys of sound.

Which group will you join?