If we seriously want to understand hearing loss, we have to understand both the physical side, which makes hearing progressively more difficult, and the psychological side, which includes the lesser-known emotional responses to the loss of hearing. In conjunction, 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. Even though nearly all instances of hearing loss are physically treatable, only around 20% of individuals who would benefit from hearing aids use them. And even among those 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 possibility for better hearing and the wide-spread reluctance to attain 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 people generally 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 noted 5 stages of grief that everyone coping with loss seems to pass through (in surprisingly consistent ways), although not everyone does so in the same order or in the same time period.

Here are the stages:

1. Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferable reality.
2. Anger – the individual acknowledges the loss but becomes angry that it has happened to them.
3. Bargaining – the individual reacts to the feeling of helplessness by seeking to regain control through bargaining.
4. Depression – comprehending the weight of the loss, the individual becomes saddened at the hopelessness of the predicament.
5. Acceptance – in the final stage, the individual accepts the situation and presents 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 reaching the last stage of acceptance — hence the discrepancy between the opportunity for better hearing and the low numbers of people who actually seek help, or that otherwise hold off 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. Seeing that hearing loss develops slowly as time passes, it can be very difficult to detect. People also tend to compensate 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 might hear those with hearing loss assert that other people mumbles, as if the problem 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 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 coping 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 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 presumption that there is no hope for treatment. They may persist 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 use them, that means 80% of those with hearing loss never get to the final stage of acceptance (or they’ve arived at the acceptance stage but for other reasons decide not to act). In the acceptance stage, people acknowledge their hearing loss but take action to correct it, to the best of their ability.

This is the one positive side to hearing loss: in contrast to other kinds 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 frustration 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 improve it, and rediscovered the pleasures of sound.

Which group will you join?