Psychologically Speaking: Do you hear what I hear?

Hearing loss can impact on socialization, communication, relationships and one's self-esteem.

By DR. BATYA L. LUDMAN
hearing 88 (photo credit: )
hearing 88
(photo credit: )
I grew up with a mom who became moderately hard of hearing after contracting an infection at 18. Throughout our lifetime together, I "sensed" when she couldn't hear, often acted as her ears and attempted to protect her from those less kind individuals who had no patience for her inability to hear, without even being aware of my given role until I was much older. In later years my dad became hard of hearing as a result of occupational noise, and we had to adapt to two parents with impaired hearing. Hearing loss doesn't just affect adults but may affect children as well. It can be quite obvious, but it can also be so subtle as to go undetected for months or even years. It can be temporary or permanent, mild or profound, progressive or stable. The effects of hearing loss can be far-reaching and from an early age can impact on socialization, communication, relationships and one's self-esteem. Sadly, many a doctor has made light of it, suggesting for example, in an older patient, that the problems are an inevitable part of aging. While that may be a cause, there are other causes as well. I've had many a young patient who presented with behavioral problems and low frustration tolerance when part of their problem was actually a hearing loss. I've also seen families who are quite angry at a family member for the wrong reason, and that reason is a hearing impairment. Last week, I sat in my daughter's dance class and experienced the pain of music being far too loud, and then drove in the car in which family members had the volume turned up way too high. Here are just a few (among many other) signs of hearing loss: Delayed or lack of sounds, speech or response to noise in an infant or young child. Not quite answering the question being asked, giving inappropriate answers or misunderstanding directions. Difficulty distinguishing two words that may sound alike, such at "cap" and "cat," or mispronouncing words such as "vacroom" for "vacuum." Inattentiveness, low frustration, acting out. Turning the television or radio up too loud, shouting, or turning one's ear in the direction of sounds. Asking people to repeat words or sentences, asking them to talk louder or finding that they have to watch your face closely in an attempt to understand. Missing high-pitched sounds. Saying "what" a lot, especially if the person is in another room. Avoiding social situations because the noise level is too great and they may feel uncomfortable. Here are just a few things you can do to enhance communication, reduce misunderstandings and decrease frustration: Start by encouraging the person to check out his hearing. While he may not have trouble with the actual volume so he can hear, he may have trouble with the sounds being muffled and therefore he doesn't understand what was said. These are two different things. There are different kinds of hearing loss. Some can be helped with a hearing aid; others cannot. Make sure you have the hearing impaired person's attention before starting to speak. Face them. They often do more lip reading than you are aware of. Call them by name or touch them gently on the shoulder to let them know they are being addressed. Stand fairly close but not so close as to be intrusive. Speak clearly and slowly. Put breaks in between sentences so that you give them time to understand and or ask questions. This is especially helpful for someone as they get older and may need more time to process what is being said. Reword a sentence if what was said isn't understood. Repetition is often not helpful but saying something in a different way often is. Double reference things when possible. Say for example, "Chana, the woman you met at the grocery store yesterday" as a way to make it easier to understand what is being said in context. Don't speak loudly or shout. While this is often tempting, it often just makes things worse. It's also quite embarrassing to the person who doesn't hear. Remember, most people with a hearing loss are of normal intelligence. They simply can't hear well. Don't talk down to them, walk away in mid-sentence or treat them as if they can't make decisions. They simply don't hear well. Make sure that your hand is not over your mouth, you're not chewing gum or food and that your lips and face can actually be seen. Facial expressions may be more important than you think. Try and choose a setting that is small, quiet and intimate. Too much background noise can serve as a distraction and make it impossible to hear. Reduce noise by turning off the dishwasher, air conditioner, music and other competing noise or move to a quieter spot if it makes it easier to be heard. Make sure you and they are both understood. Ask them if they heard you in a way that suggests that it is important to you to both understand them and be understood. Let them know when you are switching topics so they can be included in the social flow of a general conversation. In a large setting, let the hearing impaired person choose the best spot for him. Some may prefer the middle of a table; others may prefer to be close to a family member, a speaker, etc. Encourage only one person to talk at a time as it becomes impossible to hear with lots of cross talk. If it is something important and you are not sure if you were understood, write it down. This is especially true with directions or a message from someone. Recognize that people with a hearing loss may feel a profound sense of loss. While initially there may be denial, as time goes on and the hearing loss becomes more severe, one may eventually have to acknowledge that he may need help in the form of a hearing aid or other device. This in itself may result in frustration, depression and a sense of lowered self-esteem. People can feel angry, left out and quite lonely. They may isolate themselves, act as if they don't care or become apprehensive and anxious. Going to the movies, out with a crowd or even watching television may be difficult, if not impossible. Relationships may be tested when poor communication leads to increased conflict, and often one or both spouses may feel unloved or ignored. Family members may also feel frustrated and unheard, and find themselves lacking patience and understanding. Everyone has adjustments to make. Having grown up with family members with varying degrees of hearing issues has also had its very funny moments. Receiving totally scrambled messages, watching family members say the wrong thing at the wrong time and living in a "loud" household has resulted in all of us having an unusual sense of humor and a greater appreciation of how easy it is to put one's foot in one's mouth without even being aware of it. It also makes one appreciate how important one's hearing is and not simply take it for granted. Next time you are in a room where the volume is too loud, protect your ears. Remember, we have two ears and only one mouth. Or, as another popular saying on the Internet would have it, listen and silent both have the same letters. Perhaps that's a sign that we all need to listen just a bit more and attempt to communicate a bit better - with those who hear well and those who don't. The writer is a licensed clinical psychologist in private practice in Ra'anana. ludman@netvision.net.il