05-20-99 Vn.
Although the range of emotional issues
related to the damage caused by hearing impairment is far
too extensive to cover completely here, what follows
touches on the basics, and will hopefully convince the
reader of the need for study into the true impact hearing
loss inflicts on its victims.
Hearing loss has emotional variations
that add great complexity to the rehabilitation process.
In efforts to rehabilitate themselves, hard of hearing
people are often more reactive than proactive because
they do not clearly understand the effects of their loss.
Such reactions add further to the damage inflicted by
hearing impairment.
The same reactions add great complexity
to those who serve them. When hearing aids are rejected
by consumers, the dispensing profession would have us
believe vanity is the culprit. Yet many of those same
consumers readily adjust to wearing eyeglasses.
Rather than vanity, we should consider
the lack of education and unawareness of the value of
hearing and its impact on a positive lifestyle.
This powerful issue is often overlooked
by professionals who sell hearing aids. The eyeglass
industry has succeeded in convincing its public that good
vision is an important component to a quality life.
Providing the same degree of
satisfaction in the fitting of a hearing aid, though much
more complex, is the challenge to this industry.
While millions of people with varying
degrees of hearing impairment languish in despair,
denial, shame, and confusion about their condition, the
silent toll hearing impairment is taking on this country
is increasingly disconcerting.
Take, for example, the case of the
Exxon Valdez, the infamous oil spill--the worst in US
history. According to USA TODAY, "... the helmsman,
Robert Kagan, didn't understand the command ... he
hesitated." Kagan was portrayed by the defense
lawyers as being "hard of hearing and too timid to
obey orders because he was once yelled at too
sharply."
Hard of hearing people do not become
sensitized to society's insensitivity. Instead, they
react in ways that normal hearing people wouldn't
understand. Is it possible that a hearing aid could have
made a difference for the Valdez?
While Kagan's experience is one of the
most dramatic examples of the real cost of unaddressed
hearing loss, the silent toll it takes on the human
condition rarely receives the attention it warrants. The
notoriously reclusive Howard Hughes is a perfect example.
In correspondence, Katherine Hepburn
wrote, "Howard Hughes was a curious fellow. He had
guts and he had a really fine mind, but he was
deaf--quite seriously deaf" (note: early uses of the
word "deaf" included both the deaf and HOH) and, he was apparently incapable of saying, "Please speak up. I'm deaf" Thus, if he
was with more than one person, he was apt to miss most of
the conversation. This was tragic. But, he was absolutely
incapable of changing." Ms. Hepburn, in her
autobiography, "ME," goes on to say, "His
(Hughes') doctor, Lawrence Chaffin, was my doctor too. He
felt, as I do, that Howard's deafness finally did him in.
Howard had a serious airplane accident which caused him
unbearable pain. For the pain he was given morphine--and
Howard finally found this blank road more comfortable
than the endless life struggle. One cannot blame him, but
it was very sad. He was a remarkable man."
From the time Beethoven was 28, he was
burdened with a hearing loss he attempted to hide--and
struggled with a lifelong obsession with suicide. He
wrote his brother, "I was soon compelled to withdraw
myself to live a life alone. ... It was impossible for me
to say to people, 'Speak louder for I am deaf'." And
in another letter he said, "For two years I have
ceased to attend any social functions, just because it is
impossible for me to say to people, 'I am deaf'."
(The inability to admit hearing loss and request
assistance is suffered by many HOH people.)
Dr. James Jerger of the University of
Texas depicts a broader description of the problems
suffered by hard of hearing people: "The list of
problems which have been associated with hearing loss is
extensive. It includes: fatigue, irritability,
embarrassment, tension, stress, anxiety, depression,
negativism, avoidance of social activities, withdrawal
from personal relationships, rejection, danger to
personal safety, general health, loneliness,
dissatisfaction with life and unhappiness at work."
The experiences of elderly hard of
hearing people support Dr. Jerger's description. When
hearing impairment occurs at a later age, the loss is
particularly difficult to contend with. After a life-long
ability to communicate, the barriers imposed by hearing
loss sometimes appear insurmountable. Whereas with other
afflictions, people learn their range of limitations and
can prepare themselves as they must.
People tend to avoid situations where
they know they cannot function, which easily leads to
isolation. It is difficult to adjust to the self-imposed
isolation. Certain acoustic conditions may lend
themselves to good comprehension and enjoyment--even by
hard of hearing persons. In other situations, they may be
able to hear but only understand snatches of the
conversation. And still in other cases, they comprehend
little or nothing. Since it is often impossible to know
ahead of time how well they will be able to hear, those
who are reactive choose to stay at home, although they
may desperately wish to participate. Those hard of
hearing people who are proactive may continue trying, but
with ongoing frustration and disappointment.
Lay people seldom understand that
hearing loss is often unbalanced. For example, a person
might hear low tones but not be able to hear high tones
well. In conversation, such a person won't be able
to hear complete words clearly, and thus, must
subconsciously piece the communication together. And
often, it's the wrong message.
An example: The sound of "S"
in a word is of a high tone. A person who doesn't
hear high tones well may interpret "best" or
"nest" as "bet" or "net."
The result is that the conversation goes askew, because
the words don't connect to other things that are being
talked about. Asking for someone to speak louder often
doesn't resolve the problem because it is a tone
deficiency. With added amplification, all tones are
amplified, preventing comprehension. The perplexed hard
of hearing person is left trying to maintain a position
of understanding, yet pondering "what's wrong
with me"?
It is vital that hard of hearing people
learn to readily ask for repeats when they don't
understand--and that they shed their inhibition about
telling others about the hearing loss. Instead, hard of
hearing people should ask people to help. A little
"bluffing" might be okay in certain group
situations, but sometimes it will be necessary to ask
people to repeat and to speak louder. Myriad assistive
devices are available to give the hard of hearing person
a communication boost. Learning about these devices can
make a world of difference.See
details at Assistive Listening Devices.
A major continuing problem is that too
often people do not recognize their hearing is
deteriorating. While they can hear many sounds, they lose
the ability to hear those tones that allow comprehension
of the spoken word. At this point, many blame the
"mumblers," as they continue to avoid
rehabilitation via hearing tests and hearing aids. Years
are often lost in this unnecessary avoidance mode. This
is a serious mistake.
Hard of hearing people may hear all the
words of a joke but yet not comprehend the nuance or
secondary meaning of the words, and therefore do not get
the joke. It is this inability to get the full message
that adds stress, exhausting hard of hearing people to
the point that they want to flee the situation. The
stress, however, does not stop with the exit but may
continue for hours causing some to turn to tranquilizers
or alcohol.
People with normal hearing can be
spoken to and understand what was said in the presence of
other sounds. Hard of hearing people often can't do
that. Even when doing simple tasks, hard of hearing
people must stop in order to concentrate on what is being
said. The result is more stress. By itself, that is a
minor problem. But people who are hard of hearing must be
always alert to when conversation may or may not be
taking place--particularly when background sounds exist.
For example in a restaurant, though
nothing might be being said, hard of hearing people must
focus their concentration on lip-reading and hearing in
anticipation of conversation, never knowing where it may
come from--the waiter behind them, the someone at the
table next to them, or their dinner companion.. This is
the reason that such people may prefer to eat alone so
that they may do so in a relaxed way without being
perched on the edge, diligently watching and waiting.
Following a typical conversation,
normal hearing participants generally retain a fairly
good idea of the basic information that was exchanged, be
it names or whatever. The hard of hearing person usually
has been so focused on trying to understand the
conversation that awareness of the complexity of the
events discussed suffers, and memory of the conversation
is badly limited.
Edna Levine in her classic, "The
Psychology of Deafness," tells of an otologist
examining a patient who wrote on the patient's card,
"progressive deafness," adding that "the
record might more accurately read, 'Diagnosis:
fear'." Fear of failure, fear of ridicule, fear of
people, fear of new situations, chance encounters, sudden
noises, imagined sounds; fear of being slighted, avoided,
made conspicuous �these are but a handful of the
fears that haunt the waking and even the sleeping hours
of the sufferer of progressive deafness. Small wonder
that, at best, he tends to live in an atmosphere of
despondency and suspicion. Small wonder that, at worst,
he may not particularly want to live at all."
While the foregoing summarizes the
condition for many hard of hearing people, other hard of
hearing people appear to suffer less stress. The apparent
reason is that they have accepted the loss and live
within the restrictions it creates. This is true of many
seniors who refuse to wear a hearing aid. Others may have
resources (money, prestige, beauty, etc.) which diminish
the effects of their being hard of hearing.
However, people who are able to handle
their hearing loss have often reaped the benefits of an
early education on the value of hearing, of the effects
of being hard of hearing, of how to buy and what to
expect from a hearing aid and other helpful devices.
Does hearing loss cause or contribute
to depression? An in-depth study of the relationship
between hearing loss, stress, and depression would
provide insight into the depression experienced by so
many elderly who also suffer hearing loss.
It has been noted that in a decline of
hearing capability from hoh into profound or deaf state,
that in this (not being able to hear) a dramatic relief
occurs in that the person no longer feels an internal
obligation to try to hear, to try to sort out the words,
and from that, in time, moves into other less frustrating
modes of communication.
In summary; dissemination of
information of the deterring emotional damage/effects (of
being hard of hearing) by professionals and consumers,
could facilitate rehabilitation by promoting earlier
testing as well as obtaining, adjusting to, and accepting
counseling in the hearing aid fitting process.
