As we go through our daily lives we come across people of all ages and all walks of life. Almost every scheduled patient at our office has some degree of hearing loss, but detecting it and quantifying it are only the first steps. However, depending on what level of acceptance the individual is in, the next step is not always clear. Some people are ready to move forward with treatment and some are not. It took me a while to understand, but people do really go through a process of acceptance that is very similar to the grief process.
In her book “On Death and Dying” (1969), Elisabeth Kubler-Ross, psychiatrist, first identified the five stages of grief that terminally-ill people go through as being: denial, anger, bargaining, depression and acceptance. It is also possible to apply these stages of grief to other life-changing experiences of pain or loss such as traumatic events like divorce, illness, loss of limb, or more specifically for our purposes the impairment of one of our five senses, our hearing.
Certainly, any degree of hearing loss can have a negative impact on one’s life. It can affect one’s ability to not only communicate with loved ones, clients, or co-workers, but also their ability to hear their favorite sounds, such as music, birds singing, children’s laughter, etc. Coping with this loss is definitely a process. Not everyone will respond in the same way. A person may not necessarily be in only one stage of the process at a time.
Pretty much universally, the first stage is denial. We often hear patients say, “I can hear fine, it’s just that everyone mumbles. I hear what I want to hear.” Blaming others instead of accepting ownership of the condition is very common. Very often, the person is not ready to move forward until they have reached a state of acceptance. From years of experience, it appears to be a good idea to move someone who is in the denial stage more slowly into the process of finding a hearing solution.
Denial is often replaced with anger over time. This is usually the point when one asks “Why me?” It is not uncommon for individuals to lash out at loved ones, and even toward the professionals who are trying to help them.
After the person has stopped denying the fact of being hard of hearing, and after the anger has subsided, they may move on to the bargaining stage. Bargaining either with themselves, with others, or with God for the possible return of their hearing. Sometimes this turmoil translates into postponing the inevitable, with statements being made such as “I’ll get my hearing tested if it gets any worse.”
Upon the realization that denial, anger, and bargaining have not worked, the individual often will reach the realization that nothing thus far has worked (i.e., that the inability to hear is real and it’s permanent). All excuses have been exhausted. They are no longer able to deny the hearing loss. The manner in which they express depression may be through feelings of sadness, loneliness, or despair. Isolation, in the form of withdrawal from conversations, activities, or people in general may then arise.
Most people will eventually come to terms with their hearing loss as they reach the final stage of acceptance and ask “What can I do to hear better? What are my treatment options?”
Each person is different in how long this transition from denial to acceptance will take. It is only when the patient realizes that unlike in the case of death, something CAN be done to improve their quality of life, will he or she be ready to seek out help and move forward. Our audiologists stand ready and willing to help!