Hearing Loss and Grieving
By Margaret Robertson

It sounds like a bit of a gloomy topic, doesn’t it? At the outset, let me hasten to say that I am not about to recommend that we all go about with long faces, perpetually mourning our losses. But it is an important topic, and I believe it is one too often inadequately managed in dealing with hearing loss.

Not everyone of course is emotionally affected by hearing loss, but many people are, and how that is handled can be of critical importance to their well being and rehabilitation. Grief acknowledged and handled can free up our energies for positive problem–solving and getting on with our lives. Grief unacknowledged and buried can consume energy and show its face in denial, angry bitterness or ongoing depression.

Many of you will have heard of the Kubler-Ross model of grieving, originally developed to understand and assist the process of coming to terms with our own impending death or the death of a loved one. It describes a process whereby the grieving person goes through a variety of feelings of pain, denial, sadness and anger, before final acceptance of the changed reality is reached. Grieving takes time. There is no one right way to grieve. It is most important that the process not be rushed or suppressed and that that the full range of feelings be permitted expression.

Counsellors have found this model can be applied usefully to all kinds of losses. Encouraging people to unburden sadness or anger helps them get through and recover from crisis situations or setbacks. Bringing buried sadness or anger out in the open can relieve some types of depression very readily.

But what happens in rehabilitation for hearing loss? It is my observation that hearing impaired people are rarely encouraged to give expression to painful feelings about the many losses they are encountering - or anticipating - in losing their hearing. The rehabilitative focus for hearing loss is usually overwhelmingly practical, focusing on acquiring a hearing aid, developing skills in speech reading, learning hearing tactics, trying out assistive listening devices, etc. etc. Perhaps it is the urgency of finding ways to cope that can cause the need to grieve and reach some kind of psychological adjustment to be jumped over.

I suspect this accounts for some of the failures in rehabilitation. Unfortunately some hearing impaired people do retreat into bitter solitude. Some deny they have a problem hearing at all and blame a noisy world and people mumbling for their difficulties. Some do purchase hearing aids and then rarely use them. Some do lead sad, unnecessarily restricted, lonely lives. One author, Carmen, in a 1983 book, Positive Solutions to Hearing Loss examined this issue, linking the outcomes of a decision to acquire a hearing aid with the stages of the Kubler-Ross process the person is experiencing. He highlighted the risk, if anger or depression is still dominant, of transferring negative feelings about having a hearing loss to the aids. It might be better to wait until some adjustment and acceptance is achieved. That’s food for thought, isn’t it? I remember feeling unreasonably negative and critical about the first ‘Managing Hearing Loss’ course I attended as a young woman. Nowadays I can acknowledge it wasn’t the course I was negative about!

The need to grieve is perhaps more obvious in those of us whose loss of hearing has been a sudden shock. But it cannot be assumed that because a loss of hearing has been lifelong or progressive that it has been accompanied by progressive acceptance. Frozen states of sadness or anger can persist and interfere with adjustment. And painful shock can be precipitated in people with progressive hearing impairment by sudden confrontations with the accumulating losses. Experiences that trigger awareness of such issues as: the extent of withdrawal from previously valued activities, the vanished pleasure in favourite music or sounds, the necessary relinquishment of aspirations for the future, nostalgia for the old easy participation in casual conversations, can set off once more the need to grieve and come to terms with hearing impairment.

So, what are we going to do about it? For a start, let’s not be frightened of grieving. We are a bit too much of a ‘stiff upper lip’ culture I suspect. Grieving is a normal process for getting over setbacks in life. But it can take courage sometimes, particularly if we are frightened that if we let ourselves identify all the losses and experience all that pain we may never come out the other side. Some people get stuck in the angry stage of grief, perhaps instinctively preferring feeling powerful anger to powerless sadness. But there is plenty of evidence that grieving does lead to recovery and engagement with the new life after loss. Some people perhaps are discouraged by advice from those around them along the lines of not to ‘wallow’, but to ‘get on with life’. The irony in this is that it is by a bit of ‘wallowing’, if you like, i.e. identifying and giving vent to the painful stuff, that we do clear the decks and free ourselves up to indeed ‘get on with life’.

Don’t be rushed into premature decision-making about hearing aids, devices etc, if you sense that you do need some time to emotionally come to terms with hearing loss. In the best circumstances, the rehabilitative process will provide access to someone sensitive and skilled to help you do this. If it doesn’t and you feel that talking about it would help, seek out someone good to talk to. This could be a good friend or family member, a self -help group advisor, or maybe a professional counsellor. Some counsellors specialise in helping with grief and loss issues.

Here is a checklist of what to look for in a listener.

A good listener will give you:

• time and emotional space to talk

• acknowledge and affirm your feelings

• encourage you to express them

• not take over, or talk about their problems

• not be judgmental

• not get over-involved

• not catastrophise

• not rush into advice giving or problem-solving.

Be aware too that a spouse is often not the right person to choose. It is obviously hard for them to be sufficiently detached and it can overburden an intimate relationship to expect partners to act as therapists as well.

If you are in the business of giving help, perhaps volunteering to help others adjust to hearing loss, use that checklist to monitor how you go about the task of listening. It is all too easy as a well-intentioned helper to feel overwhelmed by someone else’s distress or anger. We try to make them ‘feel better’ by giving fulsome reassurances or by attempting to distract them with diversions or tales about our own experiences. We may feel the need to try to banish their distress by giving them lots of information or advice about how to fix their problems. But all that is unhelpful for someone who simply needs to work through the grieving process. It can convey the message that it is not appropriate for them to talk about their feelings. Just listen and communicate your understanding, and trust that the right time will come for information and advice when the person’s energies are ready to turn to problem solving.

And even after you have achieved a pretty good adjustment to hearing loss it is important to recognise episodes of grieving in yourself. It can be a great relief to identify those sad feelings after a disappointing experience as a spot of grieving, rather than start labelling them as depression or as evidence that you will never really come to terms with hearing loss. Often just the act of identifying them as such makes them easier to get through. And then do some problem solving to see what might be changed to improve on that disappointing experience. If you do suspect that you have some longstanding sadness or anger to deal with, it may be a good idea to seek some professional counselling.

Life with a hearing loss will always be challenging, throwing up disappointments and losses along the way. Sometimes the losses simply have to be accepted. But an enormous number can be tackled and remedied. Proper attention to grieving can help us accept the former and get to work on the latter. Let us do it well and ensure our energies are available and mobilised to build the satisfying and rewarding life with hearing loss that we all know is possible.

This article posted to this web site on 19 December 2003