Wellness Corner…Considering Emotions in the Management of Hearing Loss

By Lori Rakita, Au.D., Phonak Senior Manager of Clinical Research

Anyone who works or interacts with individuals experiencing some degree of hearing loss can see the relationship between hearing loss and emotions. This relationship can be evident in the audiology office and in everyday life.

Hearing loss, both sudden and gradual, can play a significant role on relationships due to the loss of audibility, and it can impact feelings of independence and self-confidence. Emotion is a significant aspect of the hearing care journey for both the individual with hearing loss and their families.

Recognition, Feeling and Hearing Loss

Typically the first idea that comes to mind when mentioning the relationship between “hearing loss” and “emotion” is the way hearing loss makes people feel about themselves and those around them.

Recently, research in the area of hearing loss and emotion has revealed other connections between hearing loss and emotions, which may be less obvious when sitting down with patients and their families in the office. These connections are specifically related to two domains of emotions.

The first is emotion recognition, or the ability to recognize the emotion a communicative partner is conveying. As an example, if a family member is angry, does the individual with hearing loss know that he or she is angry?
The second domain of emotion is what the individual with hearing loss is feeling. How does he/she react emotionally to sounds in the environment? Are these emotional reactions the same as normal-hearing individuals?

The ability to recognize emotion and experience emotion in appropriate ways are essential skills for social relationships and well-being. Having social relationships directly impacts happiness¹(Bertara, 2005), success²(Martin, 2009), and even physical health³(House, 1988). It follows, then, that disruption of emotional interpretation or recognition can significantly impact quality of life.

Identifying Emotion With Hearing Loss

In the area of emotion recognition, Goy et al. (2016)⁴and a study at the Phonak Audiology Research Center (PARC) found that older individuals with hearing loss had significant difficulty in identifying emotion as conveyed by a talker, compared to older adults with normal hearing.

A Reduction in Emotional Range

In the area of emotional experience, or emotional “dynamic range,” a study by Picou (2016)⁵ investigated ratings of “pleasantness” for hearing impaired listeners in response to everyday sounds.

Individuals with hearing loss showed a reduced emotional range, meaning these individuals experienced less “extremes” in emotion as compared to normal-hearing peers.

Furthermore, on average, individuals with hearing loss rated sounds as less pleasant as compared to normal-hearing listeners. This range was further constricted when the stimuli were presented at louder volumes.

Looking Beyond the Hearing Aid

The results of these aforementioned studies demonstrate some key considerations for hearing healthcare providers. It is important to see patients through this lens of the “individual beyond the hearing aid.”

The Phonak Family Centered Care (FCC) initiative speaks to this type of approach to hearing healthcare. In this approach, both the needs of the patient and family members are recognized. Given that emotions are strongly intertwined with family dynamics and relationships, it makes sense to include the family as audiologists counsel patients on the impact of hearing loss on audibility of sounds, but also the impact on less “tangible” aspects, such as emotion.

Acknowledging and creating an awareness of these potential connections between hearing loss and emotions can facilitate meaningful conversation in the audiology office, and focuses rehabilitation on holistic well-being, as opposed to “just” treatment of a hearing loss.

Speaking to Emotions

How can these conversations around emotions be approached in the office?

As a hearing healthcare provider, acknowledge that the discussion will extend beyond what the patient can/can’t hear — that it is about overall well-being.
Inform and inquire to patients and their families about the relationships between hearing loss and emotions. For example, “Have you ever felt that it has been difficult for you to read the emotion of your spouse/family member/significant other?” Get the perspective of both the patient and the family member(s).
Provide strategies to help in these interactions at home. A suggestion is that family members state the emotion he/she is feeling, for example, “I’m really angry right now because…”
Because of these findings related to emotion, it becomes even more essential that families are aware of the impact of loud environments on the individual with hearing loss.

These loud environments may be less pleasant to the individual with hearing loss as compared to the normal-hearing members of the group. Going to restaurants during off hours, for example, would be an important step in ensuring the individual with hearing loss is as comfortable as possible and feeling encouraged to participate in social activity.

It’s also important that individuals with hearing loss are able to advocate for themselves, asking for background noise levels or background music to be turned off to make a more pleasant listening environment.

Hearing healthcare that widens scope — takes into account not just the hearing, and not just the individual alone, but the individual along with the family that surrounds him or her — will have the greatest impact.

It is all of these individuals for which hearing loss can have an impact, but also the family that can help make the hearing journey a success. Encouraging and facilitating these conversations makes the audiologist a vital asset in this pathway to success.

Considering Emotions in the Management of Hearing Loss