Wednesday, June 6, 2001

Effects of hearing loss on intimate relationships

In previous issues we reviewed research that indicates hearing loss affects not only communication, but also quality of life and health status.

A less well understood area is the effect of hearing loss on intimate relationships that is, the relationship between the person with the hearing loss and his or her partner.

Do the communication difficulties caused by hearing loss interfere with personal relationships between the person with a hearing loss and others? Surprisingly, this area has not received much attention in the audiological literature.

Hetu published a comprehensive review of research on the effects of hearing loss on intimate relationships. They summarized their findings:

"Intimate relationships are very vulnerable to the effects of hearing impairment. Both partners experience relatively strong antagonistic and sometimes ambivalent feelings about the hearing difficulties; these feelings are rarely shared, much less negotiated to develop mutually beneficial outcomes."

These findings are not surprising. Communication is an interactive experience, one that must be shared with others.

Among the conclusions reported by Hetu:

"both intimate partners may experience severe consequences if one has a hearing impairment," and

"the closer the relationship, the stronger is the impact of hearing difficulties (on the relationship)."

Onset of the loss

Hetu distinguished between sudden hearing loss, which almost forces the patient to experience a mourning process, and progressive hearing loss.

In cases of progressive hearing loss by far the more common type awareness of the hearing loss develops slowly, if at all.

Thus, "the partners are tacitly involved in a process of coping with hearing difficulties while they are becoming aware of them. Adjustment takes place before a clear awareness of the impairment and its consequences emerges."

The adjustment process

Several factors interfere with accepting and adjusting to hearing loss:

Lack of internal reference. Since hearing loss usually develops very gradually, there is no clear internal reference to judge that one is not hearing as well as previously: we don't know when we don't hear something!

When an individual finally accepts that he or she may have a hearing loss, it is almost always due to the encouragement (or complaints) of other people.

Blame. The person with a hearing loss may violate social rules by talking too loudly, turning TV volume too loud or complaining about people not speaking clearly. When people complain or blame ("Are

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