If we really want to understand hearing loss, we need to understand both the physical side, which makes hearing progressively difficult, and the psychological side, which includes the lesser-known emotional responses to the loss of hearing. In concert, 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 treating it.

The statistics tell the story. Although almost all instances of hearing loss are physically treatable, only around 20% of people who would benefit from hearing aids use them. And even among individuals who do seek help, it takes an average of 5 to 7 years before they arrange a hearing test.

How can we explain the massive discrepancy between the potential for better hearing and the wide-spread hesitancy to attain it? The first step is to appreciate 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 determine how individuals typically 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 coping with loss seems to pass through (in surprisingly consistent ways), although not everyone does so in the same order or in the same length of time.

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 regain control through negotiating.
4. Depression – comprehending the significance of the loss, the individual becomes saddened at the hopelessness of the predicament.
5. Acceptance – in the final stage, the individual accepts the predicament and displays 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 behavior.

Individuals 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 possibility 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 hardest to escape for those with hearing loss. Considering that hearing loss advances gradually through the years, it can be very hard to recognize. People also have the tendency 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 remain in the denial stage for many years, saying things like “I can hear just fine” or “I hear what I want to.”

The next stage, the anger stage, can manifest itself as a form of projection. You might hear those with hearing loss state that other people mumbles, as if the issue is with everyone else rather than with them. People persist in the anger stage until they recognize that the issue 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 a lot worse, but at least my health is good. I really shouldn’t complain, other people my age are dealing with real problems.” You might also find 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 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 presumption 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 elusive. If only 20% of those who can benefit from hearing aids actually use them, that means 80% of those with hearing loss never reach the final stage of acceptance (or they’ve reached the acceptance stage but for other reasons decide not to act). 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 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 enhance their hearing enough to communicate and engage normally in daily activities — without the stress and frustration 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 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 amplify it, and rediscovered the joys of sound.

Which group will you join?