‘Hearing Loss’ Category
» posted on Wednesday, February 23rd, 2011 at 9:26 pm by Bobbi
The 6 Stages of Adjustment to Hearing Loss of the Nerve Type
Of the many problems and conditions that can affect the human body, hearing loss of the nerve type is one of the least detectable and the most communicationally segregating and psychologically devastating.
Segregating because it fractures and warps the ability to communicate effectively if one cannot speechread and/or is not assertive enough to speak up and tell others s/he has this impairment.
Devastating because it changes present relationships, places a barrier on new relationships and often strips the individual of his/her dignity, pride and independence.
It is not easily and/or readily recognized as blindness or mobility impairments. It only becomes noticeable to self and others when the individual tries to communicate or to understand a speaker and the words sound garbled.
An individual with a moderate to profound hearing loss of the nerve type may have no difficulties getting where s/he is going but once s/he arrives at his/her destination, the problem begins. His/her problem goes completely unnoticed by others.
Unnoticed for 2 major reasons:
It is not easily detectable by others, and
The individual is not about to admit s/he has hearing loss of the nerve type to others and chance a negative reaction. People don’t have any problem admitting they can’t see and they have no difficulties wearing glasses. The interesting thing I have personally witnessed are those who wear hearing aids will not change their battery in front of other people. Instead they go to the bathroom to do that. While those who wear glasses have no problems whatsoever removing their glasses, holding them up to a light and cleaning them, then putting them back on right wherever they may be.
Why is it so difficult for us to admit we have a hearing loss?
I can provide 4 reasons based on my students answer to that question. The following are the most frequent reasons. And, every individual who has developed hearing impairment of the nerve type can relate to one or all these reasons or a combination of them. In this paper we are talking only about those who have NERVE impairment.
1. The person who has acquired hearing impairment yet continues to hide the problem may be exposing his own pre-biased deep seated feelings about deafness. Unknowingly, by “covering up” the problem… he is keeping the stigma attached. S/he’s ashamed of having this problem or feels ashamed. That feeling is based solely on what s/he has heard others say about it and/or what reactions they have demonstrated. Like anything else if it’s hidden away, and brought out into the open it will create negative reactions. After thousands of years of this vicious cycle of defeat it is still playing its old game of “cover up.”
At one time I collected antique books of any title. One day a friend gave me a book wrapped up beautifully with a nice bow for my birthday. It was well worn hard back copy published in 1648. What a treasure! The title: Deaf and Dumb. And, I think you already know what it talks about. That was in the mid 1600 yet in 2011, although we’ve advanced in technology the social attitudes are still way behind. I don’t think we’ll ever see a book that is titled: Blind and Dumb.
What’s interesting here are similar words by Helen Keller who had both deafness of the nerve type and blindness. This was her statement:
“I have both deafness and blindness and of the two deafness is the worst because it has to do with communication and without communication we have nothing. With blindness I do not see thing’s but with deafness it separates me from others.”
2. Those of us who have had normal hearing and developed a hearing impairment later in life are accustomed to helping others less fortunate; and this may make it difficult to accept anything less than perfect in ourselves. Whereas, we were once in a position to help others, we are now in the position “to be helped”. That, in itself, is the difference between independence and dependence. America is not only youth-oriented but good-health oriented; and, we all want to be a part of that. This attitude has been reinforced by the audio visual media even more so in the latter few years than ever before in history.
3. We have noticed how others treat those who have hearing loss and we don’t like what we see. (This one was the most frequently mentioned)
4. That leads us to believe that people are not very understanding about this problem and even if we admitted it they soon forget and we are back to zero again.
If we, who have hearing loss of the nerve type cannot accept and understand this disability, we cannot possibly expect others to comprehend it. Maybe the answer is within our own attitude and how we viewed hearing impairment in others. In order to get past this problem we need to ask ourselves some questions and the answer will roll to the front of our mental cupboard. The following are some questions and you can ask yourself other questions as well to get to the bottom of why we are so sensitive about our impairment.
Before I developed hearing loss…..
1. how did I view others who had hearing impairment?
2. what did I do to help others who had this impairment?
3. how did I repeat a statement when that someone didn’t hear it the first time said?
4. how many times did I laugh at a joke being told and then told my friend who had hearing impairment and missed the punch line … “He just told a joke.”
5. how much time did I spend with an older individual who couldn’t keep up with the conversation at the Holiday family dinner table?
You don’t have to share your answers with me. The purpose of these questions is to help you find how caring you were with those around you who had hearing impairment. If you find you were not as caring as you’d like someone to be to you, forgive yourself right now because you can’t change something that happened years ago. But you can change what you would do now and in the future. That’s the key. Don’t look back. That’s what we call “learning” and seeing things from a different light.
More people today have hearing impairment than ever before in history and the teenagers are now being tested for hearing loss due to the musical radios they listen to all day long…directly into their eardrums and it’s louder than the cochlear can handle. Once the hair cells in the cochlear break…one will never hear that sound again….not even with a hearing aid/s. The aid amplifies sound…all sounds but technology has so greatly improved these last few years and I recommend anyone who has hearing impairment in both ear to wear 2 hearing aids. It is also a safety net so one can hear the noises around him/her an should be worn every time one drives a vehicle.
Elizabeth Kubler-Ross (1969) the author of Death and Dying, developed the 5 stages of dying. This development gave us a tremendous insight into the different emotional stages when an individual suffers a major loss. These stages apply equally well to any significant change in a person’s life. The stages developed by Kubler-Ross are as follows:
And, I have chosen to add one more stage for those who develop hearing impairment of the nerve type……stage 6. Rehabilitation
Like those who are faced with dying, those with progressive nerve loss face the same life threatening problems…..loneliness and rejection and the unknown. The difference between the person dying and the individual who has developed progressive nerve loss is the latter lives on but with a devastating disability.
The degree of reactions to the development of this problem is not necessarily in direct proportion to the degree of loss in hearing. However, the intensity of the reaction is directly related to several factors such as:
1. How much one needs and uses communication his/her daily life;
2. The attitude about self and others;
3. How others relate to them;
4. The ability to be flexible to the need and adaptable to change;
5. The ability to build a strong support system within the social circle s/he is accustomed to;
6. The tolerance level with self and others;
7. Length of time it takes one to admit to self that s/he has this problem;
8. Length of time it takes one to seek professional help;
9. The personal status level; and,
10. Personal communication skills.
Let’s take a look at my favorite American Humanistic Psychologist, Abraham Maslow’s hierachy of needs theory. (1970).
Maslow’s hierachy of needs demonstrates as the individual fulfills his /her needs on one level, s/he arrives at the next higher level. As Maslow’s chart below illustrates, the first 2 levels are the most basic in the human hierarchy chain of events!
Maslow’s Hierarchy of Needs
6. Desire to Know and Understand
5. Need For Self-Actualization
Self-mastery, desire to help others, ability to direct one’s own life, rich
Emotional experiences, a sense of meaning to one’s life.
4. Esteem Needs
Self-esteem, esteem of others, achievement, recognition, dignity,
Appreciation, self-confidence, mastery of oneself and one’s environment.
3. Belongingness and Love Needs
Love, affection, belongingness need for family, friends, group,
Clan, territorial imperative, and community.
2. Safety Needs
Security, stability, dependency, protection, freedom from fear,
anxiety, chaos, need for structure, order, limits, etc.
1. Physiological Needs
Homeostasis, specific hungers such as sex, food, water, air,
Shelter and general survival.
Adapted from Abraham Maslow, Motivation and Personality. (New York; Harper, 1970).
Although the needs on the levels 1 & 2 are necessary to survival they are not sufficient to maintain a satisfactory lifestyle and enable the individual to fit in with society especially if he is a product from a higher level.
I bring this information to your attention only so you can focus on the “why” an individual experiences panic and much difficulty upon acquiring moderate to profound hearing loss of the nerve type. How well one arrives on the higher levels has much to do with his/her ability to communicate with others. When the communication has been severed his/her very psychological well being is threatened and creates panic and sometime full blown panic. If the loss is sudden and severe such as over night or within a few weeks…it can be psychotraumatic!
Stress seems to affect people more profoundly if they feel powerless to control the situation. Thus, the reason more stress is involved for those whose hearing loss is sudden and severe. There is no time to develop a compensatory system. That’s why those who lose hearing in mid life of the nerve type have a difficult time as they are in their prime of life.
Some scientists such as Hans Selye appear to believe that some periodic doses of stress may have some lasting benefits. It may help an individual learn how to deal with the environment from a different perspective and help them find deep in their lowest gut something they didn’t know they had. And, as a result find the strength to survive.
People don’t just grieve over a loved one or a dear friend or favorite pet who has passed away, however, which is a major loss; they also grieve over losing a major sense and losing one’s hearing is an absolute major loss that most cannot possibly comprehend….until it happens. It can be a very painful experience. Looking at it from another standpoint, it can also be very rewarding….that is, if one can find themselves at that point.
I did. It became my life work. I loved teaching Psychology of Hearing, Solutions to Hearing Impairment Social Psychological Aspects and Speechreading which included teaching Body Language, Facial Expression. If I had my life to live over again, I’d teach the same thing.
I can remember when I was very young…4 years of age…I had no idea I couldn’t hear. I thought everyone else was just like me. When I played the gossip game with my friends, I learned the story always changed when it got to me. I solved that problem by being the one that starts the gossip game. No one was pointing their finger at me anymore. But I didn’t know it’s because I couldn’t hear a whisper. A whisper is very high pitch.
My mother was in the hospital most of the time from the time I was 4 to 7. She had cancer of the uterus. And, she wasn’t always feeling her best so she just thought I didn’t listen a times. She was not expected to live beyond 6 months and that was in 1945 but she lived to be 79 and passed away on Easter Sunday in 1994.
She had German measles when she carried me so I was destined to be deaf, blind, mentally retarded or any combination of those. As I got older and had high fevers from childhood diseases, chickenpox, measles, mumps, my hearing got worse. It was the high fever that caused the loss as per the diagnosis in later life. I didn’t know I couldn’t hear so I didn’t have a problem.
But I had an older brother and I took the attitude of anything he could do, I could do better or at least as good. He was 3 years older than me. I can remember he learned to spell the word, “people” and got loads of attention and praise from the family at a holiday dinner. I was watching that closely. And, I got that “aha” feeling. He was 7 and I was 4. I had a nickel saved in my drawer and I made a bee line for that nickel and off I went to buy a tablet. In those days you could buy a whole tablet for 5 cents. I already had a pencil that was about 3 ” long and I sharpened on the sidewalk.
Then off I went in search for a long word. Just any word would not do…it had to be a long word! Apparently, I was walking past a travel agency because across the entire window was a nice long word and I dropped to the hot cement sidewalk, spread out and copied letter by letter….C Z E C H O S L O V A K I A…..then, all the way back home I skipped and memorized that nice long word visualizing the attention and praise I would get for that…I was really going to outshine my brother. When I got home I was ready and I walked up to my mother and my Aunt Lucille and said, “I can spell a word, too.” My brother laughed and said, “what can you spell? Maybe “I” or “Me”….maybe “Cat” and he scrunched his nose up when he said, Cat. He was bent over laughing and holding his willy to keep from peeing his pants. And, my Aunt Lucille said, “What can you spell?” Now that was a hard question because I had no idea what I could spell. But I stuck to my guns. And I said, “I can spell a long word!” My mother said, “Ok, let’s hear it.” And, I started…. C Z E C H O S L O V A K I A. Then I smiled and waited for all the praise. But instead they all started laughing. I never forgot that. I was so hurt… I ran to my bedroom crying. I didn’t realize that no one knew what I spelled and I didn’t know either. But it wasn’t the last time I challenged my brother. I challenged him to the bottom of the hill on a bicycle. I got to the bottom before he did which was my goal, but I wasn’t on the bicycle when I got there! You win some and you lose some and sometimes it depends on how we look at it.
When I was 14 years of age we moved to El Monte ,California and that was the first year the school tested hearing. That was when I found out I had a moderate to severe loss. But, by that time I had developed some very strong compensatory skills. My grades were good…mostly A’s and B’s. By the time I was 18, when I got married, my hearing dropped to a severe to profound level. I dated my husband for a year and 9 months before getting married and my hearing loss was never discussed.
And, each time I had a baby it dropped some more. Anytime one goes into surgery and is given a spinal, or whatever medication they use to put you to sleep, your hearing may be directly affected. I had weak hair cells in my cochlear due to my mother’s German measles. I was very lucky nothing else was affected. After having 3 babies I became profoundly hearing impaired of the nerve type. And, based on my ENT it was more than likely a nerve loss from the very beginning. Most of my hearing loss was in the high pitch range so that means I couldn’t hear most or all of the consonants. Have you ever tried to read a book with all the consonants missing?
Let’s get back to grieving now…..It’s important to understand the process of grieving over hearing loss and to allow yourself the privilege of expressing and feeling the pain to yourself and others. Sometimes it is in the suffering that brings us to a climax where more understanding of ourselves and others take place. The true lesson in learning about empathy may be accomplished during this process. For it is within this personal experience where we reach deep down inside ourselves and tap natural reserves we never dreamed we had.
Not everyone travels through these stages in the exact same pattern; some people skip stages or get stuck in a stage for a long time and / or repeat stages. Each person travels through these stages at a different speed. But one thing every person who suffers a hearing loss has in common is s/he will find him/herself in one or more of these stages at one time or another prior to arriving at rehabilitation. When you understand these stages you can tell almost exactly where you, your family member or friend is in these stages.
Let’s talk about the different stages and let’s begin with Stage 1: Denial
A person enters this stage at about the time he has acquired a mild to moderate loss. If he/she has a sudden severe loss he will not enter this stage, instead he enters somewhere between stages 2 and 3. S/he moves at a faster speed and simply bypasses this stage. If the hearing loss is sudden and severe one may experience acute panic, suffer from anxiety and become nervous and frustrated when others don’t cooperate or forget you have a loss of hearing, and if you don’t find any immediate effective solutions.
Unlike those who have progressive hearing loss over a long period of time, this individual more than likely will seek help immediately. He has no time for denial of the problem or time to develop any sophisticated compensatory skills. S/he may admit s/he has hearing impairment to him/herself and others but it hurts deeply. S/he’s in mourning.
It hurts because s/he is being forced involuntarily to admit something is amiss about him/herself. S/he has found no options and not enough time to recover from the initial shock of the loss of a major sense. S/he feels the impact with far more intensity than the individual with a progressive loss over a long period of time.
S/he may even skip right past the Anger stage (or experience it lightly) and head straight for hte bargaining stage and depression. S/he moves through these stages faster but on a more profound level of intensity.
The Denial stage provides a useful function in that it allows you to buy more time to recover, blame others why you can’t hear…everyone mumbles…, from the initial shock of learning that your hearing is no longer “perfect”. It is the longest stage for most people. And too many people actually wallow in that stage. They refuse to admit something is wrong with them.
It is within this stage where one may begin developing a highly sophisticated compensatory response system. This system serves the individual so well it not only makes it more difficult for others to notice the hearing loss, but it also eventually convinces the individual that s/he just needs to be more attentive to details and that s/he does a splendid job.
• The compensatory response system may include:
• Looking at the speaker more;
• Asking for repeats but pretending a distraction was the cause of not hearing;
• Guessing at and assuming what was said;
• Watching gestures and body language;
• Acting too busy and/or feigning illness and tiredness to cover up when s/he didn’t hear; and,
• Accusing everyone of mumbling.
In this stage you’re very much aware of the problem but you hide the truth from yourself and others for as long as possible. You are buying time.
If your hearing never gets worse than mild to moderate loss then you may never experience the following 3 stages….that is, if you don’t have nerve loss.
If you don’t have nerve loss then you may skip to the acceptance stage. But for the person with nerve loss, then it becomes noticeable worse and you might enter the next stage. With family and friends now telling you more often that you have hearing loss may create anger and enter a battle with them through arguments that set up stress in a relationship.
Stage 2: Anger
This stage serves as a vent and is a “non-cooperative” time during the adjustment period.l Anyone who expresses anger is expressing a dissatisfaction of a personal need and in this stage anger is expressed in all directions:
• externally ; and
Feelings fluctuate between resentment of others and frustration with self. At this point, hearing loss has been admitted to self only but not accepted and it certainly has not been admitted to others. You now acknowledge you have a hearing problem but it is not your fault. You are now angry at the world and may find yourself ….
• asking other to repeat in a rude way; or
• accusing others of mumbling or speaking too softly; or
• leading others to think it is their fault you don’t hear…they don’t speak up or don’t articulate; or
• acts very indignant when someone suggests you try an aid/s…heavens forbid; or
• does most of the talking so you don’t have to listen.
Do you know anyone like that? It’s easy to identify people with hearing loss by their habits and it’s easy to locate what stage they are in as a result.
As one loses faith in others to help him, he begins desperately seeking ways to make a change, to help himself without having to admit to others he has a hearing loss. But with every turn he gets the same external response that clearly confirms the problem again. In the process he becomes…
• disappointed in self; and,
• loses his self esteem; and,
• loses his sense of humor; and,
• then becomes angry with himself.
The realization of the problem has now been supported by the family, friends and self.
This is a period of turmoil, like a fox chasing his tail. e runs in circles but as a result he eventually makes a break to move on. And, some move is better than no move at all. The decision to move on opens the door to new experiences. Unlike indecision, which keeps you in a no growth pattern.
Stage 3: Bargaining
This stage may go on for years. He has finally recognized the presence of the loss but still may not be willing to do anything about it. it’s become like a boil…it hurts too much to touch. The individual becomes desperate and despondent. He begins bargaining with God, self and others and usually in that sequence.
1. “God, if you give me back my hearing I’ll never ask for another materialistic thing.”
2. “God, if you give me back my hearing I’ll never have another extramarital affair again…I’ll be faithful to the end.”
For those of you who remember Danny Thomas a TV entertainer of the ’50’s – ’70’s I believe. He was losing his popularity and he bargained with God that if God would bring him back to where he was before, he’d build a hospital for sick children.” He regained his popularity and built St. Jude Hospital for children. What a bargainer he was! But his word was good!
1. “If I stop smoking and drinking maybe that will improve my hearing.”
2. “Maybe if I change my diet and lose some weight it will take the pressure off my ears.”
1. “If you would just stop mumbling, I could understand you better!”
2. “If you would just speak up I culd understand very well!”
3. “There is absolutely nothing wrong with me…the problem is out there.”
And, after the bargaining comes the excuses:
1. “I know I don’t hear perfectly…but it’s not that bad …yet!”
2. “I’m not old enough to wear a hearing aid!”
3. “I have a nerve impairment and aids will not help my problem.”
4. “I don’t know anyone who likes to wear an aid/s.”
5. “I get along just fine without an aid/s.”
6. “Hearing aids cost too much money.”
7. “My friend has a hearing loss and he gets along just fine without an aid. And, I can do the same!”
He continues to buy more time with compromises and excuses and as long as he continues to negotiate he will find himself regressing slowly back to sate 2, Anger. He’s now angry and disappointed in God, Self and Others. Angry because what he’s doing doesn’t seem to be working in his favor. This time his anger becomes profound and internalized. Internalized anger leads to depression.
Stage 4: Depression
This is the most difficult period. a time when he reaches his lowest ebb in the process of the adjustment. He probably has even lost more hearing by now. He may listen to what others have to say but he’s not sure he wants to do anything about it anymore. He is now in limbo. It’s the grieving period. A period of negativity where he feels some or all of the following at one time or another during this stage:
• A feeling of inner emptiness;
• Life seems hopeless;
• Withdrawal from family and friends;
• A feeling of giving up …so what’s the use?
• A feeling of being left out of the fun by family and friends;
• The inability to sleep or would rather sleep all the time;
• A loss of appetite or compulsive eating habits;
• A loss of self esteem and poor self image;
• Becomes emotional (cries a lot and easily);
• Thinks and talks about all the things he can’t do; and,
• in worse cases….
• Nothing to live for anymore; and
• Suicidal feelings which may include writing notes or even attempts.
In his deepest level of depression and introspection…this is where he does most of his real deep thinking and observing ….he’s at his lowest ebb and begins to ask himself questions and providing his own answers.
• Why me?
• Of all the millions of people out there….why me?
• What did I ever do to deserve this?
• How did I get in this lonely boat anyway?
• Why aren’t people more understanding?
• Why doesn’t someone help me?
It is in answering that final question and attempting to answer that he realizes that he, himself, is someone and he can help himself. Even though he may not have an answer to all those questions, he is asking the right questions that lead him to that final question and his answer. He is now learning to adjust. It is within this step that he begins to accept his fate. And, so quietly slips into the 5th stage…tired and worn out physically, but he has a whole new set of tools to work with now.
Stage 5: Acceptance
This is the stage of mixed emotions and the body is in somewhat of a shock. He feels trapped. It’s a highly progressive stage, however…when he finally realizes that to help himself he must take appropriate steps and follow through with action. He must do it himself. He may still feel that residue of his past experiences from anger, stage 3, to depression, stage 4, but they will be short lived now.
• He may still get the poor me’s occasionally but not as profound or as long in duration;
• He may still feel guilty about how he handled himself, expressed his rage, accusations of others “inadequate speech…mumbling, etc.”;
• He may feel guilty about having put his family and friends through all this;
• He may even feel embarrassed about having the loss in the first place;
• He may feel humiliated by not doing something about it sooner to help himself; and,
• He may even ask himself why he didn’t do this in the first place!
He kicks and licks himself throughout this period. He’s reached deep inside and he found more answers and strength to cope as well as empathy for others who may have problems. He’s put his false pride aside now and he no longer feels the same about the problem. His attitude is more positive now about himself, the problem and others. It is about this time when he decides to enter a rehabilitation program, a speechreading class or a self-help group. He may even decide to see an Ear Specialist or an Audiologist.
Stage 6: Rehabilitation
The higher degree of acceptance, the more effective his effort will be in creating opportunities to lead a near normal life. In this stage he begins investigation of the options available to him and this may include the following:
1. Seeing an Ear Specialist, ENT and with an open mind believing what he has to say and following up on his recommendations; and,
2. Seeing the Rehabilitation Specialist to develop coping skill, awareness of options available, and understanding the problem. Learning how to regain, retain and maintain the comfortable lifestyle he once took for granted.
As acceptance is slowly acknowledged it becomes a part of the person’s existence. The strength to fulfill his life, independence and dignity by following through the newly learned strategies. The need to view himself as in control of his own life is great.
Even after the arrival at this stage, there may be more periods of regression. Having the present knowledge and skills will assist the individual in working himself back to this level at a more rapid pace. Once he realizes that his liberation lies in acquiring the knowledge of understanding the disability, learning precisely what his needs are and how to fulfill and maintain those needs he will finally accept the fact that, although he may always have the disability, but the handicap can be overcome.
These stages are normal growth patterns when an individual acquires a major loss. Anyone who acquires hearing loss should be able to progress through these stages that are necessary to his needs within a year. In the past many people have taken as long as 25 years or more to work through these stages and thereby, prolonging the cure. The longer it takes to go through these stages the more intense and profound the feelings. And the more stress it places on the body. This is not to mention what it does to close family members and friends.
Although it’s important to experience these emotions it’s also equally important to keep the duration period at a minimum to relieve stress. This can be done if the individual would see his ENT immediately after the first sign of a loss, hoever slight. This would be in the Stage 1 level. It is during this period when the individual should consider entering a rehabilitative program and learn as much as possible about the problem before it becomes progressively worse and before being stressed out. A well-structured program would provide the individual with the following:
1. Development of realistic expectations for what can be gained from rehabilitation;
2. To stimulate the patient to move from his present level of message perception to a higher level;
3. To encourage the individual to compensate and work through his social-psychological and communicational problems more effectively;
4. To provide the individual with an understanding of hearing loss and how he hears;
5. To assist the individual in the acceptance of and responsibility for the disability on a comfortable level with self and others;
6. To assist the individual in learning independent and interdependent skills;
7. To acquaint the individual with resources available for follow-up upon completion of the program;
8. To motivate the individual to follow-up on these available resources to improve communication skills; and
9. To encourage effective supportive skills by family members and friends.
Another check up may be forthcoming 6 months to a year later while still in Stage 1 or advancing to the final stage and bypassing all the painful stages one puts themselves through unnecessarily.
Although the rehabilitation program will not prevent the loss from getting progressively worse. In a sense, it is a true alleviation and it will serve as a “bridge” and shorten the duration periods and intensity in Stages 1 through stage 3 and partially eliminate the intensity of Stages 4 & 5. People with acquired hearing loss of the nerve type must take responsibility for their own rehabilitation. And, I believe most are willing to do so. That’s what the Rehabilitation program is all about. Trying to solve the problem by oneself can be a long and painful experience. One does not need this much pain and suffering to find his way back to an acceptable lifestyle.
I believe by looking at the Maslow hierachy one can see why the individual with nerve type loss loses so much of his/her lifestyle and this sets up stress. They feel the loss of friendship, chit chat, belonging to a group equally, conversation that bounces back and forth. It is all these things that pull friendships together and binds them.
» posted on Thursday, January 20th, 2011 at 7:17 pm by Bobbi
Suggestions for Family Members and / or Friends of those who have Hearing Impairment:
I write first about family members and/or friends support because one who has a severe hearing impairment of the nerve type needs this support before s/he can help him/herself. No one can truly understand what it’s like to have hearing impairment of the nerve type. Oh, they can read books and learn a lot but after they read books they’ll only understand it in their head. They can’t possibly understand what it’s like to have hearing impairment from the heart.
It’s like blindness. One who is not blind can only understand it through his/her thought processes and experiences with those who do have blindness; but, they cannot understand it from the heart. This write is going to attempt to help you understand hearing impairment so you will be in the position to provide support in the best way possible for your family member and / or friends who have hearing impairment.
Hearing impairment is a mental and emotional strain on the entire system. If the person speechreads his/her eyes will get tired and the body feels the exhaustion involved. That’s because the eyes have muscles. The ears don’t have muscles. And, they work even when you are sleeping. In short, your ears is your security system and always on alert.
Hearing aids and speechreading can help relieve the strain but true alleviation comes when s/he has the full support of his/her family members and/or friends even coworkers. The following may be helpful in that endeavor:
Don’t shout. In fact, don’t raise your voice at all. speak as naturally as possible but just a bit slower. Pause between thoughts in long statements. If you speak rapidly…slow down but without exaggerated enunciation. If you need to repeat a statement, do so, but use the same level of voice sound. Again, don’t raise your voice. If the individual still does not understand what is being said, then rephrase it. Use longer words that have the same meaning as it gives them more to work with. For example it is easier to see the word elephant but the word cat is invisible. The point I’m making is use words with more than one syllable. Another example is don’t use contraction words such as “can’t” , instead use the word “cannot”. Why? Because you cannot see the difference between “can’t” and the word “can”. When I was a little girl I was always in trouble because I could not tell the difference between “You can” and “You can’t”. They both look exactly alike on the lips. So I just did what I wanted to do. That didn’t mix well with my mother needless to say. She just thought I didn’t listen. Some words are totally invisible and so many words look the same that it’s easy to respond inappropriately unless you ask someone to please spell the word used.
I remember when I was in college taking a course in Audiology in 1980. Every book I picked up on the topic I found Dr. Aram Glorig being quoted. It was so frequent and I admit I loved the things he said because he spoke so clearly in his writings that one day I told myself, if I see his name one more time I’m going to look this guy up and go meet him. Then I turned the page and there he was again! It was almost as if he was talking about me in some of his writings. And, sometimes I felt he was there to tantalize me by reminding me constantly about my hearing impairment. But I kept my word. The teacher gave us an assignment to do research that day, so I started calling around to find out where he worked and lo and behold he had an office in Los Angeles at the House Ear Clinic where my personal ENT worked, Dr. Howard House. I called Dr. Glorig and made an appointment to meet him and to ask if I could go through his research files. The day of my appointment I dressed very nicely I wanted to be sure he’d share his papers with me, a student. When I arrived I went to the desk and asked for him or directions to his office. I was escorted there and he was waiting for me, sitting behind his desk with his glasses drooped down over the tip of his nose. He stood up when I walked in and he offered me a chair. We talked a bit and I asked if I could kind of roll through his files for a research paper I was writing and he handed me the keys to his file and escorted me to the file room and told me to pull whatever I wanted. Then he left the room. I spent about an hour going through his writings, chose a few papers, closed the file and locked it. Then, I quietly made my way back to his office. He was still sitting there with his glasses on and he ask me to take a seat which I did. I did ask him if he wanted me to return these papers or would he prefer I copy them before I leave and he told me to just take the originals and return them at my convenience; and if I could understand his writings I would know more than all the professors at Long Beach State University in the Audiology department.
I thanked him and as I started to stand up he reached across the desk and took my hand and said, “Bobbi, of all the doctors you know, why did you come to me? And, I said, “Because you’re an old master!” He looked me in the eye and said, “Please spell those last 2 words! And, we had the best laugh over that and we never forgot it. So why was that so funny? Well, the 2 words “old master” look the same on the lips as “old bastard”.
I knew immediately that he understood homophenous words. Those are words that look the same but sound differently if only you can hear! Three years later he tracked me down and asked me out to dinner. And, that’s another story for later. But I married the man in 1983 and lost him to cancer in the summer of 1998. This man was one of the most famous M.D./Audiologist/Researcher’s in the world. He wrote textbooks, papers and more papers and presented them to the best journals for M.D.’s and Audiologists and to all the conventions where he not only presented his papers he was always the drawing card and the last speaker at the final banquet meeting. He traveled to meetings all over the world and had friends on every continent.
Everything that has happened for hearing aids today is a direct result of his research. And, it was Dr. Glorig who made the statement that everyone with hearing impairment in both ears, regardless how little or how much, should wear 2 aids. Why? Because we have 2 ears and they were both meant to be used for a purpose. If one wears 2 aids s/he can locate where sound is coming from. One cannot do that if one wears only 1 aid.
That one statement at a banquet dinner got a 10 minute standing ovation. The room was full of Audiologists, hearing aid manufacturer’s, and hearing aid sales people from around the world, and from that point on it doubled the sale of hearing aids across the country and around the world. He was a king to the manufacturer’s of hearing aids and the Audiologist who sold hearing aids. He was a most interesting man. He didn’t talk much but when he did, he said something worthwhile but everyone may not like what he had to say because her really spoke his mind. He never hesitated to speak up if he disagreed with a statement made by others who were presenting papers. He was a man from the old world. He was a powerful man and sometimes he could also be a very charming English gentleman.
Let’s get back to helping others …help themselves….
Pronounce your words distinctly. Do not cut word endings. And, the less jargon used the easier they understand. Look at the person and develop eye contact. Avoid smiling or laughing while speaking as it changes the lip formation and makes it even more difficult to speechread. If you smoke, remove the cigarette from your mouth while speaking. Please don’t put pencils in your mouth or cover your mouth while speaking. His/her ability to speechread you when speaking depends greatly upon how well you articulate and form your words. No one can read lips that don’t move. For an exercise….try to read Donald Ducks lips in a cartoon. Believe it or not, some people do talk that way.
If you have a family member and/or friend who you suspect has hearing impairment, it’s best not to confront the individual. If s/he hasn’t told you then s/he is not ready to admit it….s/he is still in denial. If one is denying the impairment exists, confronting will only add to the frustration and even anger. Give it time. S/he will eventually admit the problem, but s/he has to admit it first to himself before it can be admitted to others. Respect his/her space. The closer you are to this person and the more respect you show him/her, the more likely that s/he will choose you to share his problem with and it’ll probably be the first time it’s been shared and/or admitted. That’s the time to really let him/her just talk and pour it all out.
Talk with the person with hearing impairment the same way you would anyone else. If you need to repeat something, do so, but don’t cut it short and please don’t say, “Oh never mind.” or, “Oh, it was nothing!” Give him/her the full account of what was previously presented. It take a lot of courage for a person with hearing impairment to venture forward and ask someone to repeat. Consider it a compliment that he cares enough about you to want to know what was said.
Be Aware of Your Expressions
Anyone who has suffered a hearing impairment has become super sensitive to the feelings of others. Since s/he no longer hears well s/he relies very much on what s/he can see. S/he is constantly searching the face for ay possible clue to what you are saying. In the process of this search, over a period of time s/he develops some reliable insight and if you don’t want to repeat a statement, it’s going to show up in your eyes.
Don’t talk in the 3rd Person
Speak directly to him/her ….not about him/her in his/her presence. It’s embarrassing and strips the individual of his dignity. If you don’t want someone to hear something, then maybe it’s best to be unsaid. Never underestimate their mentality. They are sharp …they just can’t hear. Their mental capacity is still in optimal operation.
Don’t Ever Answer For the Individual
Never respond for a person with hearing impairment. If you truly want to be of support then kindly tell the individual what was meant for his/her ears and let him/her respond for him/herself under all circumstances. Act as an interpreter, not as a mother. S/he can respond and his/her dignity is left intact.
Inappropriate Response Support
If a person with hearing impairment responds inappropriately, take it upon yourself to get the correct message across…use humor…do something …don’t just leave it hanging in the air. Be the strong supporter but don’t place the person in a bad position or make him/her feel badly…s/he’s already in a bad position.
Find a Quiet Corner Wherever You Are
At a social event the conversational background noise is unbearable for those with hearing impairment and especially if they wear an aid/s. Suggest to find a quiet corner or someplace where there are fewer people in back of the person who wears an aid/s such as in a restaurant. The aid/s is usually behind the ear/s and it picks up everything in back of the person but it won’t pick up the conversation in the front of the wearer. If the person has too many bad experiences in a large social event s/he’ll eventually just shy away and stay home alone where it’s nice and quiet…but lonely. The hearing aid/s does one thing…it amplifies sound…all sounds. When one wear an aid/s s/he hears from the inside out whereas the normal hearing person hears from the outside in. The newer aids are much better today and they are improving greatly all the time.
Getting the Person’s Attention
If you want the individual’s attention simply reach out and touch him/her. S/he’ll respond by turning towards you and will appreciate the gesture. Don’t use flashing lights, stomp on the floor, bang on the wall or wave a handkerchief for his/her attention. There is no reason to tell everyone in the room . If s/he is sleeping and you need to wake him/her to give a message, just put your hand on his/her arm and hold it there quietly for a moment until s/he wakes up, opens the eyes and let him/her focus for a few minutes before you begin to talk. People with hearing impairment use their eyes to hear and sometimes the eyes don’t respond that quickly
after waking up from a deep sleep.
Never, never introduce a person with hearing impairment and making that statement within the introductory. Simply introduce your friend as you would others. There is no need to bring up the topic of hearing impairment at that moment. Introducing someone and saying, “This is my friend, Sue. She has hearing impairment. ” That is the equivalence of saying, “This is my best friend Tom. He has hemorrhoids.” Allow your friend to share his/her impairment her/himself. That is his/her responsibility to share at his/her own speed.
Hearing Aid Limitations
Keep in mind that the aid/s have limitations depending upon the type of loss each individual may have. In most cases, the individual with nerve impairment may need more communication support even though s/he wears 2 aids than the person who has a conductive impairment. The new aids are a great improvement over aids of the past. However, the aid amplifies sound…it does not clarify words spoken. With all the new technology the aids of the future may do just that. But we are not there yet.
With Your Knowledge and Support S/he can Overcome More Rapidly
Almost every individual who acquires hearing impairment of the nerve type and on the level where it hinders his/her communication skills feels uncomfortable, embarrassed and often times confused in social events, family gatherings and / or in a situation of more than 2 in the group. Some can handle 3 – 4 in a group but when it gets beyond that, s/he will either withdraw and become very quiet or find a reason to leave early.
This partially sets up the denial state and, in turn, creates frustration internally and externally. Once the individual realizes that his liberation lies in acquiring the knowledge of understanding the disability, learning precisely what his/her needs are and how to maintain those needs s/he will finally arrive at a reasonable acceptance of his/her disability and the fact that s/he can overcome the handicap.
Your acquired knowledge, support at the right time and in the right way, and your care factors will play an important role in how fast s/he arrives at that level of rehabilitation. How one deals with any major situational change in life is directly influenced greatly by the evaluation of it and his/her family and friends reaction to the hearing impairment. If considered a problem it may seem overwhelming; whereas, the same situation, considered a challenge may assist the individual to reach deep down inside and tap unsuspected internal reserves in rising above it and accepting the disability and embracing it. That is the first goal to achieve.
» posted on Thursday, January 20th, 2011 at 6:35 pm by Bobbi
Understanding the Terms
Let’s begin by defining terms. We all need to understand what each of these terms mean. Then we’ll talk about family and /or friends much needed support as the first step in assisting in acceptance of self and the disability.
The ability to read words on the lips of a speaker. Everyone reads lips naturally. That’s why we look at our speaker when s/he is speaking. Most don’t know they are reading lips because if they have normal hearing they depend mostly on listening. It’s only when they start losing hearing that one starts noticing lips more.
The ability to understand what is being said by watching the lips, facial expression, body language, gestures and having command of a broad vocabulary. That is the key and the difference.
While everyone may lipread, not everyone speechreads. It’s two different skills. Admittedly, one begins with lipreading like one begins in kindergarten. It’s a starting point and it comes natural just by observing the speaker. It takes a lot more effort, study, expertise, knowledge and the ability to laugh at oneself to accomplish the skill of speechreading. And, it takes something else: A positive attitude and the ability to get people in your corner without cornering them as well as ongoing family and close friends who provide valuable support as needed. Generally speaking, how well one accomplishes speechreading also depends greatly upon how well the speaker moves his/her lips. We cannot speechread lips that don’t move. That’s why most deaf or profoundly hearing impaired children don’t watch cartoons, that is, before they learn to read the captions.
Those who are born without hearing and/ or having a profound loss of the nerve type prior to learning the language at the tender age of around 2 or 3. That age varies with the child. Very few children are born with total deafness. Most have some hearing that can be amplified if they chose to wear an aid/s to bring them into the world of sound. Many turn to Sign Language only and prefer the quiet world without the aid/s. Just as many believe there is nothing wrong with them that they are whole as they are and resent being considered handicapped; and many also believe that they just speak a different language and that it should be accepted as it is.
While some choose to have or the parent chooses for a young child to have the Cochlear Implant early in life there are just as many deaf who believe the Cochlear Implant should be banned and that they should be accepted just as they are. That’s just part of the controversy involved in what is best for the deaf child. I’m not going to discuss much about this topic, Cochlear Implant, because I believe that should be left to the M.D. to present as s/he has the research results on this matter.
I can discuss my personal experiences of some of my students who had this Cochlear Implant and also my girlfriend who has a grandchild born with a profound nerve loss. But that is a discussion on its own and I will cover it at a later date in another email as it is a broad topic and new things are happening in the field of technology that may change everything as we know it today.
Challenges of those who are Deaf:
The challenge is derived from having to fit into a way of life which they have little auditory knowledge and experience. To achieve normal development with abnormal hearing ability may be a tremendous challenge because the problems are developmental.
Hearing Impairment or Hearing Loss…both terms are used:
Having lost hearing after learning the language. It could be early in life, teens, and anytime thereafter. It is no longer considered age related. Mostly people lose their hearing as a result of environmental noises. Loud rock music stole the hearing of many of the rock stars as well as those who loved their music. The 60’s & 70’s produced the largest group of people with hearing loss than ever before in history….they are the baby boomers. Additionally, more teenagers are now being fitted to aid/s as a result of all the music they listen that is pumped directly into their ear drums and cochlear with ear pieces they wear constantly. We know from research that 8 hours of listening to loud noises can create nerve impairment which is the worse type of hearing loss one can have and the most difficult to overcome.
Challenges of those who have Hearing Impairment of the Nerve Type (Sensori Neural Loss):
The challenges arise in that they no longer understand what is being said in small groups and certainly the larger the group the more difficulty in understanding. As a result they feel they are being left out of a world they were once a vital part of and their lifestyle is fading into the distance. Whereas most were always in the position of helping others they feel now they are in the position to be helped and they are very uncomfortable. The result creates a deep feeling of isolation within a group and if they don’t have the proper support it can become a psychotraumatic concern and even may have suicidal tendencies.
So Let’s Define the Difference Between the Two:
The natural habitat of those who are deaf is a world without sound, whereas, the natural habitat of those with hearing impairment is the wonderful world of sound. One does not miss what one never had. Those with hearing impairment know what they are missing and they don’t like the way it feels. If left alone for too long without support it may send them into a downward spiral.
Those who are deaf don’t care who know they can’t hear. In fact, they are “out of the closet” and into total acceptance with the disability almost from day one. The fact they are so comfortable with living with the disability or living in the soundless world is the first step in acceptance of self and in removing the stigma attached.
Those with hearing impairment live in fear of anyone finding out. They not only cannot admit to others, they can’t admit it to themselves. They live in a world of denial sometimes for many years. They actually mourn the loss much like they mourn for the loss of a loved one. It is like losing a piece of yourself because they miss the chit chat, the jokes, the fun, the laughter and knowing what is being said around them. Be sure to read the ebook, “The 7 Stages of Overcoming Hearing Impairment.” This ebook will help those who have hearing impairment work themselves through to acceptance and helps those who are normal hearing understand what his/her family member and/or friend is going through and why it’s so painful.
Men and women who have hearing impairment and climbing the ladder cringe at the thought of their boss or associates finding out s/he has hearing impairment. It sets them apart from life as they once knew it, it puts them in a bad position in board meetings and when they are nervous they understand even less than if they could just relax. They get left out of the loop. They can’t hear the questions or statements made from the back of the room nor the answers from the front of the room. They miss out on all the fun stuff going on around them during break and over coffee. They are afraid to give input or to respond for fear of giving an inappropriate response that puts them in a bad position. They are afraid of being treated less than and being left out of conversations as well as power lunches and /or the 5 pm cocktail party scene. This creates a feeling of isolation and loneliness in a room of several people they may have worked with for many years.
Why do those with Hearing Impairment feel such fear and embarrassment? I can answer that question easily. They have observed how others with normal hearing treat those who have hearing impairment and they don’t like what they see. This, in itself, prevents those with hearing impairment from accepting the disability openly. Some remain “in the closet” for many years before they can even admit it to themselves. They don’t want to be treated differently. As a teacher and professor who worked with adults with hearing impairment of the nerve type for 30 years, that was the most frequent response given when asked that question.
I’ll leave it up to you, the reader, to decide who you believe has the most challenging lifestyle between the two. So what can we do to provide support for those with hearing impairment? Let’s move on to the next section.
» posted on Thursday, January 13th, 2011 at 6:57 pm by Bobbi
I’d like to share my Personal Experience in Teaching Speechreading & Psychology of Hearing briefly….
One of my classes I was teaching was “Speechreading & Psychology of Hearing”. And, the finest people came through my classroom door…All of them over the age of 35 …and losing their hearing in the mid stream of their life! They were there to learn compensatory skills and solutions to the social-psychological aspects of hearing loss and of course, Speechreading.
At the beginning of each semester, I took a survey to find out what the background was of each of my students. And, I found out I had M.D.’s, Psychologists, Teachers, Scientist, Ventriloquist, R.N’s, Entertainers, Magician, Business Owners, College Students ,Homemakers, Janitors….people from all walks of life.
I want to mention the Ventriloquist who appeared in my classroom one morning. This is a man who was losing his hearing and when he talked he didn’t move his lips at all. Every time he raised his hand to ask me a question I had to ask him to repeat not once but several times. Then he lost patience with me and slammed his fist on the table and said, “You know something? For a Speechreading Teacher you don’t read lips very well!” The students started laughing and I said to him, that I do read lips but they have to move before I can read them. He truly hadn’t looked at himself….only others and even said that most people don’t articulate anymore. This was one student who really learned something when we had the mirror exercise. He just hadn’t thought about it.
Then I had a movie celebrity come to class. He had a full blown mustache that covered his lips and a beard. His eyebrows were over grown. He was about 65-70 years of age. He stated he had hearing impairment and had difficulty understanding other people because they didn’t move their lips. I asked him if he had considered trimming his mustache above his lips and his wife immediately spoke up and said No he’s not going to do that! I reminded them both that most of the students in the classroom had hearing impairment and no one would be able to understand him and his wife said, “We don’t care about that. He’s here to learn to read lips.” I reminded her that this program is about “Weism” not “Meism” It has to be a Win/Win situation or it won’t work. I then suggested he take private lessons because the students will not be able to read his lips and they are here to learn speechreading as well. He would learn a lot more in the classroom setting than he’d ever learn in a private setting. They requested private lessons but he then only had his wife to learn with, outside of me as his instructor. That’s good to a point but he still needed a variety of people to learn with and he asked to go back into the class. I told him could if he wanted to but the students still will not be able to read his lips and it would be a one sided learning lesson. He went back into the class but then he only wanted to work with his wife. They did get a lot out of the class from the different exercises and they did finish the semester and were happy with just working with each other.
The first assignment given in that class was for each student to write an Essay titled “What Hearing Impairment Means To Me.” For the student who came as a support system for his/her spouse I had them write an essay titled, “What It’s Like To Live With Someone Who Has Developed Hearing Impairment”. Let me share one of those with you.
The following is one of the essays written by a student with hearing loss as her homework from the first day of class:
What Hearing Impairment Means To Me
I’ve been losing my hearing progressively over the past few years, and it’s becoming increasingly difficult for me to communicate with my co-workers, my family and friends. My usual high spirits have slithered to my feet with the rest of my confidence.
My mind is as sharp today as it was some 30 years ago…I still have great ideas, opinions, feelings and the like, but I notice some people just won’t take the time to speak more slowly. So I’m not able to give input. If I ask for a repeat they usually show marked irritation and/or they raise their voice and that makes things worse because embarrasses me.
Just because I’m over 55 some people act as if my intellect is not quite up to par or they automatically assume I’m senile. I find myself withdrawing from a life I was once a big part of. I’m close to the top in my profession but I live in fear of being demoted and/or my coworkers taking advantage of the fact.
This is a disability I didn’t expect this late in my career. Hearing Impairment to me means isolation, real torture and possible loss of my position in a field I enjoy so much. On the personal side I cannot understand my grandchildren and they seem to hang back from me as a result. My life at this time is losing its meaning because I’m missing so much in conversation at the dinner table, playing cards, the jokes they tell and all the chit chat around me. These are the activities that make life worth living and I feel I’m no longer a part of it. My husband is impatient. He doesn’t seem to want to spend time with me. He would rather go golfing with his buddies. I’m alone and no one wants to sit down and talk with me anymore. I miss that terribly. Sometimes I think my husband wants a divorce because he just doesn’t act the same with me anymore. I miss all the attention he used to give me and we go to parties he’s off and talking with his buddies or dancing with the females and I’m sitting alone. I don’t like the way it feels.
Now, let’s hear it from the standpoint of the spouse. Here is his story.
What It’s Like Living With Someone Who had Hearing Impairment
Our lifestyle is not the same anymore. She either can’t understand me or she doesn’t listen and I suspect the latter more often than not. She seems to know what I’m saying clear across the room when I’m talking to someone else, but she can’t understand what I’m saying when I’m standing next to her. I feel like she’s turning me off and pulling my leg.
I can be in the other room rummaging through my drawer looking for my golf socks…when I can’t find them I have called out to her asking her where my golf socks are and she is in the kitchen. She responds and says, “You have to come in here so I can hear you. You know I can’t hear you from the bedroom.”
The other day when that happened, I lost my cool. I charged into the kitchen and asked her, “What do you mean you can’t hear me from the kitchen? How in the hell did you know I was even talking to you in the first place, if you can’t hear me?” I finally found my socks where she had folded them neatly and placed them with my golfing shirt. We go around and around with these kind of senseless arguments. And then, for some stupid reason, I feel guilty.
The other day she got new hearing aids. And when I came home she told me about them almost in detail and how great they were. So I asked her what kind is it. And, she said, “It’s 4:15”. It’s stuff like that, that drives me up the wall.
She no longer likes going out to socials. She wants me to sit with her all the time. And, I want to have fun. I wish she’d join me but I can’t get her to move around in the social. So I go alone and socialize while she sits.
I admit I have considered a divorce but I haven’t told her that yet. I thought I’d take this class with her and see what kind of improvement she can make for herself. My wife used to be so much fun and very loving and she probably would be more loving if I had more patience and gave her more of my time. But it’s hard for me to do. I feel like my life is passing me by.
There was a time when I felt most of what she’s talking about so this was easy for me to understand where she was coming from. That’s another story down the line but let’s move on with our topic for the day.
Some things have changed and more people are aware now of hearing loss but the above 2 essays of this one couple with the wife having hearing impairment left an indelible impression forever on my mind and set forth my wheels in motion for my future career working with those who were losing their hearing in mid life.
What we learned from the above 2 letters from a beautiful couple who had planned on retiring early in life were now experiencing chaos and only because the wife now, not only has hearing impairment, she doesn’t understand her hearing impairment so she can’t explain why she can hear her husband from the bedroom but she can’t understand what he’s saying; and the husband, although he’s impatient, certainly doesn’t understand it either. So we have 2 people who don’t understand what to do. That, in itself, causes chaos! And, the secret for overcoming any problem is to understand the underlying causes, find a solution and move forward. It comes with education. And, if you think education is expensive …..try ignorance!
The wife has a nerve impairment. She can hear sound…she cannot understand speech without seeing her speaker. Without telling the students who said what in their essays I just covered the topics and their mouth just dropped open. We had another exercise where I asked each of them to bring in a small hand mirror. Then I asked them to write a short story in 3-4 sentences. When all were finished I asked them to read their short story silently…just move your lips while saying the words and watch yourself in the mirror. The question upcoming was, “Could you read your own lips if you had to?” There was a lot of laughter but I can tell you this husband learned so much in that class without me even talking directly to him. I didn’t have to tell him what he was doing wrong….he found out himself without my input. Then I had a speaker come in to the class and give his speech in a foreign language. That’s right! They could hear him but they couldn’t understand him. These kind of exercises are mainly to help them understand hearing impairment. They can hear…they cannot understand and that’s why a person with hearing impairment can hear someone calling from another room but cannot understand what s/he is saying.
I then passed out another exercise of a short story. But I had removed some or most of the high pitch consonants in the story and I asked a normal hearing person to read the story. He said he couldn’t read it. I asked him why? And, he said all or most of the consonants are missing. So I said that’s how those with nerve loss hear. So I ask him to read what he could and he then said it doesn’t make sense. I agreed with him and said, “That’s why those with nerve loss respond inappropriately sometimes, or don’t respond at all.”
My goal was to help them see themselves in an exercise without being told what they were doing wrong. One time I walked in the classroom with dark reflective glasses on and I started talking to them without moving my lips, showed no facial expression and no body language. For a moment they were shocked….then they started laughing…and I said what would you want me to do? And they said, “Take off those glasses so we can see your eyes.” I said, “Ok” and I removed them but I kept talking with no lip movements, no expression and no body language. Then they said, “Move your lips”. I said, “Ok” then I was moving my lips and they could see my eyes and I said what else do you want me to do? And they said, “Where is your facial expression and body language. Show us that!” So I did. Then I said, now when someone is talking to you and you cannot understand them, define the reason why and ask them to do what it is you need. They don’t know what you need. If anything, if you tell them you have hearing loss, they’ll raise their voice and that’s what you don’t want them to do. You have the responsibility to let others know what your needs are. Identify it and express it …but pull the problem back in your lap. Most people will be very supportive if you tell them what you need without blaming them because you can’t understand what they are saying.
The above couple attended my classes on going for 2-3 years and they remained together and found love again. I admit I loved my work. To see this happen right before my eyes was the greatest payoff worth more than gold. It’s a win/win philosophy and it works.
We had lots more exercises to help both, those with hearing impairment and the normal hearing spouse. I taught these classes from 1972 to 1999 at both Garden Grove School District and was a founding instructor for Coastline Community College from 1996 – 1999 and retired as a professor. My classes were always full and students came from as far away as San Diego, Riverside, Los Angeles to be in one of my classes held in Corona del Mar, Seal Beach, Fountain Valley, Huntington Beach and / or Garden Grove.
Of all the sensory deprivations, hearing loss has the most devastating effect on communication skills of those who develop hearing impairment in mid life.
Older employees suffering from hearing loss will often respond inappropriately during conversation, creating a false impression in the listener’s mind the speaker is senile or had alzheimers. This erroneous assumption erodes mutual cooperation & understanding, leading to further isolation for the older employee at a time when he/she may most need support from his employer, especially his boss.
I remember one of my girl friend’s mother was diagnosed with Alzheimers and she was only in her late 50’s. I asked my friend if she had ever been tested for hearing impairment and she said she had not. I suggested that she take her in for a test because if she has hearing impairment of the nerve type, she may not be understanding anything or very few words. She reluctantly said she really does have Alzheimers because she forgets all the time. Well, I reminded her that people with nerve loss don’t forget as much as others think they do. They actually sometimes just pretend they hear something then turn around and ask the same question. In short, they fake it that they understand when they don’t. They don’t want anyone to know they have hearing impairment and most of the time they don’t understand why they can hear but not understand. They cannot explain that because they don’t know. When an M.D. gives them a diagnosis of Alzheimers that can be devastating to an individual’s self esteem and their health when s/he only has hearing impairment of the nerve type.
My friend and I had some real strong conversations about that. Finally, she took her mother in to be tested. And, she had a profound hearing impairment of the nerve type.
She took that information back to the M.D. who diagnosed her but this time she was wearing hearing aids and she had been briefed of her impairment. She was a different woman when she went back to the M.D. He couldn’t believe it himself what a difference it made. This lady lived a rather good life once she was fitted with aids, understood her problem and learned to let others know when she didn’t understand what was said. She was no longer responding inappropriately. She was enjoying life again and was socializing and she rejoined her card group. It was an amazing turnaround for the lovely lady. She was even singing in the choir at church after that .
As mentioned before, we always started our classes with a Thought For the Day by a student. And, we always ended the class with a story or a joke also told by a student. The following is a funny story told by a man in his mid 50’s who had normal hearing and had golfing friends who had hearing impairment. He was in the class to develop better communication skills with his friends and his wife. Here is his story….
Let me share a humorous example of inappropriate responses by 3 of my golfing buddies who have hearing loss.
We’ve been long time golfing buddies and one bright and early morning we all went away on a golfing holiday together. About half way thru the game
one man said “Gee, it’s windy already!”
The 2nd man said, Oh, no, it’s not Wednesday…it’s Thursdays!”
and the 3rd man said, “Yeah I’m thirsty too….let’s all go have a drink!”
That is common and it is very funny….
75% of those over the age of 60 have a hearing impairment of some degree. And, according to research studies, as a result of loud rock music of the 60’s and 70’s we have the largest number of hearing impaired individuals coming forward. We have the highest number of teenagers being fitted to aids than ever before in history now. And, hearing impairment is not age related anymore. In fact, we have more people under the age of 60 with hearing impairment than over the age of 60. And, with Social Security being what it is, we need to be sure we have Pro-Active employers and have a plan in place to provide jobs and the support needed for them to maintain those jobs.
As a small business owner and employer, I put the following question to a small mixed group of business people who were employers and had employees. Some had hearing impairment while others were normal hearing. The question: “What can we do…you & me…. to assist today’s employer and/or employee who has developed hearing impairment in the midstream of life in a way that is acceptable, supportive and effective for both, himself /herself and for the employer?
After much discussion this is what we came up with:
#1 Don’t be afraid to promote an employee to a leadership role.
Why? Because that’s really the best place for him/her if they’ve already proven themselves as dependable and effective employees. In that position everything is coming toward them, because the way society is set up, the other employees, under his/her leadership will automatically provide support and show more respect for them in that position.
#2 Provide them with the tools, your trust and support needed to perform the job effectively.
#3. Provide scripts /captions with all video’s in a training situation. And, in a large seminar, board room provide captionsverbatimpro service.
I guarantee you…..you will have a dependable employee that will go way beyond the call of duty for you.
How do I know that? Been there….done that ….as an employee and as an employer!
No one needs to go thru the fear of losing one’s job….or losing the respect of co-workers simply because s/he has hearing impairment. No one deserves to be demoted because of a hearing loss. And, yes, these things are still happening today.
Hearing aids are the greatest things ever invented but they don’t give total clarity of speech for all users. They do amplify sound….all sounds. Some of the sounds can be turned down such as surrounding sounds that drown out the speech. And, no matter how great one learns to speechread, we all still make mistakes…because some words look exactly the same on the lips and we blink our eyes and blink away the prefixes, suffixes and sometime entire syllables.
That brings to mind a story. Everyone has always told me that I’m an expert in speechreading. What I’m an expert in, is I understand Speechreadng and the limitations and how to get around it…and yes, I shared that with all my students. Everytime I hear someone tell me that I’m an expert speechreader… I tell them this story. I wanted them to know I have the same problems they have but it’s how we deal with the problem that counts and they can do that as well. We have to accept who we are.
Here is the story…..
My son, Tony, and I were watching the late night talk show one evening…I was a faithful follower of nighttime talk shows and went to bed with them every night for years!
Anyway we watched the program that night and had the greatest laugh. We were both tired from laughing and said our goodnights and went to bed. The next morning over breakfast I proceeded to share with the family what happened on the show.
Teasingly, I said to my husband, “Honey, you missed a great show last night. You’ll never believe what they did. They actually took a survey of all the men in the audience and found that more men today like legs better than breasts. I really had a nice pair of gams in those days so I was really beaming!
My son Tony almost choked on his cup of coffee, reached across the table and patted my hand….and said…….Mom, that was partially right….but they were not talking about women! They were talking about fried chicken!
With a blink of the eye…I missed the chicken! So much for being an “expert” in speechreading!
Now that could be embarrassing! And, it was for a moment ….but, then we all busted out laughing.
There is life after hearing impairment…but we have to make it enjoyable to ourselves and those around us. Attitude is extremely important for all concerned and our quality of life is what we do to create that quality.
» posted on Thursday, January 6th, 2011 at 7:36 pm by Bobbi
There are many barriers to hearing and understanding clearly when one has hearing impairment. And, depending upon what type loss the individual has determines the type of barriers experienced. I fully recommend that you read my ebook, Understanding the Two Types of Loss: 1. Conductive Loss and 2. Sensori-neural loss better known as nerve loss. This will help to understand why some people have more difficulty than others.
In this article we are going to talk about the 2 main barriers then we’ll talk about the solutions to those barriers. As you can see below, there are just about as many internal barriers as there are external barriers. That means you’ve got a lot more control than you may have thought you had. And, you need to learn how to “make” things work for you in both areas. You can do that. You must learn to get people in your corner without cornering them.
1. Internal Barriers
2. External Barriers
1. Internal Barriers
a. Attitude about self
b. Attitude about others
c. Attitude about the problem
d. Communication skills
1. Assertiveness vs. Aggressiveness
e. Knowledge of the type of loss one has
f. Knowledge of resources available
g. Knowledge of language barriers
1. Homophenous words
2. Invisible words
i. Knowledge of communication aids available
j. Knowledge of the advantages and disadvantages…the limits
k. Knowledge of the stages one goes through upon learning s/he has hearing loss
(d – k will all be covered in separate ebooks as they are more extensive)
Let’s begin with the first 3: Attitude About Self, Others and the Problem:
How you feel about yourself…shows to others. It shows in your eye contact or lack of it, your facial expression, the way you move your lips when you speak, your body language, the words you use when you speak and your actions. It all tells on you. And, others will treat you the way you treat yourself. That is the level you have established for them even though you may not know that. Oh, but you can change it all…just like that! You need to take control of those things.
If you don’t like the way you are treated then you need to change the way you think about yourself and others, the words you use when you speak, develop eye contact when speaking and everything else will correct itself. That’s it! It works.
Your body follows your thoughts and the words you use when you speak. In short, your brain is the leader and your body is a follower. You have to convince yourself that you are worthy in spite of your disability.
Back in 1993, one of my Speechreading students brought in a beautiful thought that really demonstrates exactly what I had been discussing with the class. When I was teaching, my goal was to get all the students involved in the learning and communication process; and, I’d have a different student each class time share a “Thought for the Day” at the beginning of every class. The following is what one student brought in and shared:
A Philosophy for Living
Thoughts.….keep your thoughts Positive because your thoughts become your words.
Words….keep your words Positive because your words become your actions.
Actions…keep your actions Positive because your actions become your habits.
Habits….keep your habits Positive because your habits become your values.
Values….keep your values Positive because your values become your destiny.
I have seen variations of the above several times since then. I have a variation framed and it hangs in my dining room and was given to me by a dear friend. I’d love to know who penned this valuable piece as it defines how important our positive thoughts, our positive words, our positive actions, our positive habits and our positive values are.
The above applies to how you feel about yourself, others and your attitude about the problem. No matter what the problem is. And, we all have problems. They are of a different nature perhaps, but they are problems nonetheless. The problem is not the problem, itself, but how we deal with that problem; how we talk about it, the words we use when talking about it, our body language we express and our facial expression we use. Additionally, how we talk about others, the words we use defines our thoughts.
It’s just as easy and certainly more pleasant to use positive words when speaking. Think Solutions at all times about all problems because there are solutions to everything…no matter what the problem is. Your body will feel so good and you will feel that difference. Step up to the plate and think Positive solutions at all times. You will find people will be more responsive to you, more supportive and may even assist in the solutions that are more favorable to you. It works. That’s your first Step in helping yourself.
And, you have to show that you have done everything possible to help yourself before you have any right to ask for support. For example: If you have hearing loss and you don’t wear and aid/s, you cannot expect others to speak louder for you. It makes their voice hoarse. They may do it for you once in awhile but they will soon back up and just stay away. Get a hearing aid and wear it even if you have nerve loss. You have to do your part. Learn as much as you can about your loss and share it with others. Soon you’ll have a lot of friends and a lot of support that is deserving. There is a lot more to learn about this and we will talk more about it in detail later. However, this is a good place to begin helping yourself.
1. Change the way you think…think positive; think twice before you use a word and if it’s a negative thought…rephrase;
2. Change the words you use from negative to positve; and,
3. Think solution at all times…positive solutions.
I want to tell you a story about a normal hearing student who registered in my class: GED Preparation. On the first day of class I took roll call then proceeded to test students to determine their level of need in the 5 subjects I was teaching. Once the need was determined I then programmed them. So all the students were working on a different level of need.
The following student had a negative attitude about math and she hated math so much it showed on her face, her body language, her words, her actions….it was all there for all to see. Looking past all the negativity, I could see that she was a lovely black girl and if I remember correctly she was about 22 years of age. She was married and had a child or two. She wanted to get her GED so she could go on to college. This is her story.
This one young lady arrived in my class and stood at the corner of my desk telling everyone who would listen that she hated math. She used the word “hated” so extensively that I knew there was no room within her, for her to “learn” math. She expressed it so strongly she actually had fear in her eyes.
When it was her turn to sit down with me I just reached out and took her hand and said, “You don’t have to take math”. Her eyes got wide and excited and she said, “You mean I don’t have to take math to get my GED?” And, I calmly said, “I didn’t say that. What I’m saying is if you hate math as much as you say you do, you won’t learn math….so why take it?” She sat back, and said, “Then, how do I get my GED?” And, I said, “Well, then you have to take math and you have to pass the GED math test.”
Her big beautiful eyes sort of rolled back in her head then she took her forefinger and made a circle around her ear. Then she said, “What do I do?” I looked her right in the eye and I said, “Do you really want to know?” And, she firmly said, “Yes”. I said, “Ok. You have to change your attitude about how you feel about math.” She actually leaned back in her chair and slumped her shoulders and said, “Mrs. Barras I am who I am so how can I change my attitude about something I hate?” And, she ranted on and on about it! I just let her rant…then I responded with, “No, you are who you want to be and you can change the way you think about math and once you do then you will be able to not only enjoy math but you can pass the GED test.” She thought about that for a moment then she asked me how she could change her attitude with a doubtful expression on her face.
That was exactly what I wanted to hear her say. And, I said, “I’m going to give you some homework to do. When you go to the bathroom I want you to get 2 things done. 1. What you went in there to do and 2. I want you to say over and over and over again the following: I love math. I really love math! I want you to say it out loud where you can hear yourself. I want you to look in the mirror and say it with passion over and over and over again until you believe yourself that you truly do love math. When you love math enough come back and let me know when you’re ready to register in math, and I’ll be here for you. But, for the now, we will only get involved in the other 4 subjects you need.“ She looked at me like I had lost my mind but she got up and went to her seat, sat quietly and followed up on the other subjects I had programmed for her. I just knew she was going to be a successful student.
When the class ended she was the last one out the door…then she sort of backed up and leaned her upper body backwards, looked at me and said slowly, with a laugh, “Mrs. Barras do you really think that’s going to work?” And I responded with, “Absolutely it will work! But you have to do your homework!”
She came to class every day promptly and studied her other subjects and did well. Three months went by and one day she skipped through the door and up to my desk and pulled up the chair and was swinging it back and forth while she said sort of in a singsong way, “Mrs. Barras, I think I’m ready for math.” And, I said, “Great! Now, I’m going to give you an evaluation test just to determine what you already know. And, she quickly said, “I don’t know anything!” I continued with my talk to her as if I didn’t hear that and I said, “If you cannot do a problem just skip right past it…ignore it…put a big x in it if you want to…but don’t do anything you don’t know how to do. Solve all the problems you understand only.”
She completed the evaluation and scored 17% on a 5th grade math test. She started crying and I told her no… no… no… this is good! This is what I needed to know! Now I know what you know and we will concentrate now on what you don’t know and build to where you need to go in math. And, you’re going to pass that GED test! I’m not going to bore you with what you know. I gave her a tissue to wipe her eyes. Then I introduced her to my special math program I created for specifically for students who have missed something way back when. My job was to simply to find out what the student missed and fill in the puzzle pieces. It’s as easy as that!
I told her she had to transfer the problems to her own paper and not to write on the original paper. The reason for that is she needed to learn organization skills. And, I wanted her to get her muscles involved. I believe in muscle memory. When you get your muscles involved when you’re learning something…you never forget it. Additionally, She had to show me how she got to the answer and it had to be neat. I asked her to circle her answers. If she couldn’t do the problem she was to come to my desk and I would go through each problem with her step by step until she could do it on her own. Then I had her do one more page just to lock it in her memory bank then she moved on to the next lesson.
After about 8 weeks she was ready to test and she scored 97% on her math test! So I sent her out to go take her GED math test by the independent tester. It took about 2-3 weeks for her to get the results back but when she got those results she came flying through my quiet classroom door and disturbed the entire class …..screaming, “I passed the GED Math test!” and up to the front of the room to my desk she came. She grabbed me and started dancing so I turned that into a positive lesson for other students who were struggling with the same issues. I explained to the class that this is how one feels when they accomplish something they never dreamed they could do! Then she stood at the corner of my desk talking to the students about how proud she was for hanging in there. She ended her talk by saying, “I’m so happy because now I can help my little boy when he comes home and needs help with his math.” And, I said, “That’s wonderful. But tell me something. What are you going to tell your son if he says, Mom I hate math?” And, she gleefully said, “I’m going to tell him to change his attitude and to go to the bathroom and get 2 things done…….”
At the end of school I gave a $250 scholarship to the student who had come the farthest. The purpose was to purchase books for college the following September. Before I introduced the student I told the following story.
“You know the bumble bee is not supposed to fly. That’s because his wings are too small and his body is way too big. And, according aerodynamics testing it’s impossible for him to fly. But the bumble bee who is ignorant of that fact….went ahead a flew anyway!”
And, the student who will receive this award reminds me of a bumblebee because she didn’t know she could do math but with the right attitude….she did it anyway! It’s amazing what a positive attitude can do for you!
That is what happens when one changes their attitude. It works!
2. External Barriers
a. People who don’t …
-move their lips …articulate
-wear reflective glasses
-use facial expression
-use body language
-use eye contact
b. Poor lighting
c. Background noises
d. Echo’s in buildings or certain rooms
e. Large gatherings where one needs to “make” conversation
f. More than 3 in the group discussion
g. Large gathering where one is in the “listening” position such as at church or seminars
So, what do we do in these situations where we think we don’t have any control over? The interesting thing is….we have control over all of it but we have to know how to do it. One thing we need to stop doing is blaming others and using excuses/reasons for why we are not understanding. We have to learn how to get people in our corner without cornering them.
I hear so many people say anyone of the following and many other excuses/reasons why they are not hearing/understanding well. And, those who use these statements sometimes put a lot of anger in the statement. I’m talking about people who have had their hearing and then lost it later in life. These are people who know what they are missing. They have always been in the position to help others and now they feel like they are in the position of being helped and they don’t like the way it feels. This is a different group with a different set of problems than those who were born hearing impaired. Those who were born deaf have developmental problems and unfortunately most don’t wear hearing aids so they do not know what they are missing and most don’t think there is anything wrong with them. They like their quiet world and don’t want to be considered handicapped in any way. That doesn’t mean they don’t hear sound….most don’t hear words which is a different thing altogether. Here we go….
“I can hear good for my age and if others would stop mumbling I’d hear just fine!”
“I hear just fine but other people mumble”
“I could hear better if there was no background noise”.
“No one seems to be articulating anymore!”
“I cannot understand my grandchildren because they have not been taught to speak clearly!”
“I don’t need a hearing aid. Others need to speak up. They don’t do that anymore!”
“I don’t like to be in a group because the conversation escapes me…they all talk way too fast!”
“Everyone speaks so softly. I wish they’d speak up!”
In all the above statements, and there are many more variation of saying the same thing, the speaker is blaming either other people or other things for not being able to hear/understand.
The most important thing to do is to ACCEPT the fact you have hearing loss. You do this in steps starting with those closer to you and YOU are the closest and the first place to begin. First you have to admit it to yourself, then to others in your direct family, then to your extended family, then to your friends and associates and to anyone you need to tell if you don’t understand and that includes anyone who you think mumbles, or whoever you don’t understand! Once you can do that…then you will come full circle back to yourself, then you can take a deep breath and accept it as it is and do everything possible to help yourself.
Admittedly, it’s very difficult to admit there is something wrong with self. But it’s easy to put the blame on someone else or something else. It provides a temporary fix. But it doesn’t work. It’s difficult because there is a lot of inner turmoil going around in one’s head. It hits the self esteem button head on. The truth is once you reach acceptance and own the problem, the turmoil will go away completely. But that takes time. The hearing loss will still be there but it’s more manageable now. It is how you solve the problem that counts.
So why is it, that people with hearing loss have a difficult time admitting they have this loss? The answer to that has been said many time by my thousands of Speechreading students who passed through my classroom door over 30 years. I’ve heard them all but the one that is said the most is the following:
“I have observed how others treat those with hearing loss and I don’t like what I see. Therefore, I will never admit I have hearing loss ever to anyone.” That statement was strong enough but the following 2 statements hit me the hardest and both were said by a senior citizen who lived in a Senior Citizen Complex.
“I overheard one of my best friends say that there are 2 kinds of people I don’t ever want to travel with. One is someone who is crippled in any way and the second is anyone who has hearing impairment. They are both a pain in the backside. I sat down because my body became numb when I heard her say that, and I cried for a month and couldn’t look at my friend again and, she’ll never know why.”
Hearing impairment is invisible. No one knows you have it and if they do they forget about it fast. Those who have visible disabilities get more attention and empathy. Those in wheelchairs and/or have blindness have a problem getting from point A to point B and once they get where they are going, everything is fine. But those with hearing impairment have no problems getting where they are going but once they arrive especially where there is conversation going on or in an educational setting…..the problem begins.”
The interesting thing is Helen Keller had both problems: Deafness and Blindness. One of her statements was the following: “Of both my disabilities I find deafness to be the worst. Good eyesight provides the ability to see things and people but hearing provides one the ability to communicate with others. If there is no communication …there is nothing.”
And the next one….
“I finally went to see an Audiologist and when he recommended I wear a hearing aid, my self esteem slithered to my feet and it’s been there ever since.”
On the first day of each of my Speechreading classes I gave out homework. Some students came with their normal hearing spouse and others came alone. Students were of all ages and I had equal males to females. My goal was to have couples especially if one had normal hearing and the other had hearing loss. Why? Because it takes a partner to get through this faster. Someone who cares enough, has the perseverance and provides support when needed. For those who were married and came alone, I recommended they bring their spouse. For those who were single I recommended they bring a family member and/or someone they had a close relationship with.
The homework provided was for each of those with hearing loss, write a 1-2 page summary titled: “What it’s Like to Live With Hearing Impairment”. And for those who had normal hearing, write a 1-2 page summary titled: “What it’s Like to Live With Someone Who Has Hearing Impairment”. I asked them to pour their heart out….stick to reality…the way it is and don’t share the paper with your spouse who comes with you…not yet.
There was so much pain from both sides and even long time marriages were headed for divorce and/or separation and the only reason given on both sides was….hearing loss. Several students who were climbing the corporate ladder lived in fear of their boss or others in the office finding out he/she had hearing impairment and being bypassed. Some were terrified of attending the next board meeting and coming away without the information discussed or the boss calling him/her in for not contributing to the conversation in a productive manner. Others dreaded the family holiday get together and not hearing/understanding everything being said, missing out on the chit chat, the jokes, the fun and feeling empty after it’s all over.