If we truly 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 responses to the loss of hearing. In conjunction, 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 treating it.

The numbers tell the tale. Even though nearly all instances of hearing loss are physically treatable, only about 20% of people 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 a hearing test.

How can we explain the considerable discrepancy between the potential for better hearing and the widespread resistance to attain it? The first step is to appreciate that hearing loss is in fact a “loss,” in the sense that something valuable has been taken away and is apparently lost forever. The second step is to find out how individuals generally respond to losing something valuable, which, courtesy of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand exceptionally well.

Elizabeth Kübler-Ross’ 5 stages of grief

Kübler-Ross defined 5 stages of grief that everyone dealing with loss appears 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 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 reacts to the feeling of helplessness by trying to take back control through negotiating.
4. Depression – understanding the significance 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 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 actions.

Individuals with hearing loss progress through the stages at different rates, with some never getting to the last 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 many years before doing so.

Progressing through the stages of hearing loss

The first stage of grief is the trickiest to escape for those with hearing loss. Given that hearing loss develops slowly over the years, it can be very hard to detect. People also tend to compensate for hearing loss by cranking up the TV volume, for instance, or by forcing people to repeat themselves. Those with hearing loss can remain 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 reveal itself as a form of projection. You might hear those with hearing loss state that other people mumbles, as if the problem is with everyone else rather than with them. People persist in the anger stage until they realize 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 various forms. For instance, those with hearing loss might compare their condition to others by thinking, “My hearing has gotten a lot 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 growing old, 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 mistaken presumption that there is no hope for treatment. They may stay 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 shockingly elusive. 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 reached the acceptance stage but for other reasons choose not to act). In the acceptance stage, people recognize their hearing loss but take action to improve it, to the best of their ability.

This is the one positive side to hearing loss: unlike other kinds of loss, hearing loss is partially recoverable, making the acceptance stage much easier to reach. Thanks to major innovations in digital hearing aid technology, people can in fact strengthen 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 pleasures of sound.

Which group will you join?