The Hard of Hearing Therapist

It’s taken me a long time to be ready to write this article. Some months ago I told myself that I’d release it for National Disability Employment Awareness Month in Canada, and when, I looked it up last week, I was shocked to learn it was this month. “Ooof. Now or never,” I thought.

Some of my past and present clients know about my hearing loss but I have never – er – announced it publicly. So, with a mix of fear, anticipation, unease and excitement, I would like to share my story, talk about why it’s been difficult to tell it, and hit on some bright spots in all of this.

A Sort-Of Synopsis

Circa 2011, I am a super-excited clinical social worker, living my work dream of being in private practice. I am about 2 years in and doing the most fulfilling work of my life. Willow Tree Counselling is in full swing: I am working with incredible, voluntary clients and I am learning a ton about how to run a practice, having had no previous business experience. Heady times.

If I lived at my office, I might not have known about my hearing loss for a very long time, as the problem introduced itself to me at home.

“Mom!! Mom!!! Mooooommm!!!!!” from another room. Silence.
“I told you about that already!” Me: “No you didn’t!”
Me: “Can you please not mumble?!”

I asked people I knew if they thought I had a problem with my hearing. It was a mixed reaction: some thought they had noticed something, others thought I was too young. Gah. I was in my late 30s and I even doubted it too: Hearing loss in my thirties??

I saw my family doctor, who referred me to an otolaryngologist (ear doctor). It was, to be frank, a terrible visit. Without childcare that day, I was trying to look after two young children while getting my hearing tested (hardly ideal) and at the end of it all, I was told that there “may” be some minor hearing loss but there was nothing to be concerned about.

But my hearing problems kept happening at home, but not at work, so, did I really have a problem?

I don’t know what the tipping point was but I decided one day that I wanted to know more about what audiologists did and whether one might be able to help me. I was pleasantly surprised to learn that they had Master’s degrees and, while not covered under the BC Medical Services Plan (unless seen in hospital), a member of the public—like me—could make an appointment to see one and pay to have a comprehensive hearing testing performed.

And it was one of those moments in life where I was extremely grateful to have my social work (AKA systems navigation, resource finding) training. I discovered a non-profit society, now called the Wavefront Centre for Communication Accessibility, where an audiologist took my call and explained the types of help and options available to me. And most importantly, this person was extremely kind and helped me to understand that my concerns were valid and warranted further investigation. I was then referred to the incredible audiologist that I still have today, who tested my hearing and recommended a hearing aid for my left side. And because it was a non-profit, I felt a greater degree of trust that I wasn’t just being sold a hearing aid for the purpose of making a sale.

I was shocked to learn that I had moderate to significant hearing loss in my left ear. My first reaction was one of doubt: was this just an overreaction? However, when I was subsequently referred to a hospital clinic for further testing, this diagnosis was confirmed and I was given the news that this problem was genetic and that there wasn’t anything that could be done surgically to fix it. I sat in that clinic room and cried—sobbed, actually—and the audiologist there handed me a tissue and offered her kind presence. It obviously couldn’t change my situation but her compassion was greatly felt.

Over the past decade, I have experienced a slow decline in my hearing and also now have two hearing aids.

But what does all of this mean when you’re a counsellor, dependent on hearing to do one’s job? I’ll get to that in a sec.

Reservations

If you’ve done the math, you’ll notice that it has taken me 10 years to publicly share my hearing status. What took me so long? I’ve faced a number of challenges—mostly internal—which made me reluctant to disclose:

Ableism

Society’s message that able-bodied people are superior, and that those with disabilities are problematic and “less-than.” This message is rampant in society and I have also internalized these messages—hence and also: internalized ableism.

Counsellor Stigma

The (thankfully, waning), false idea that counsellors should always be “put together,” be fully realized and have no problems of their own.

Fear of Public Misperception

Fears that clients, or potential clients, would believe that I would not be able to hear them in their sessions.

Fear of Judgement or Ridicule

That it was somehow “hilarious” or “ironic” that this counsellor—who hears for a living—has hearing loss. And yes, there is irony here that I am gradually accepting. And there is humour to be had the name of this newsletter–The Listening Ear–titled before knowing about my hearing loss is amusing!

Fear of Embarrassment

Related to a fear of judgement. For example:

  • Fear that any “pardon me” in session could be over-pathologized or attributed entirely to my hearing loss.
  • Fear that I might inadvertently talk louder than necessary in a situation (read: internalized ableism + the fact that I have talked loudly when enthusiastic my whole life).
  • Social awkwardness/perception of “insensitivity” – asking for a repeat of a sentence or word when a client is expressing emotional vulnerability.

I compensated for these fears over the years by mostly saying nothing about my hearing loss to clients, and also having my hair cut in such a way as to hide my hearing aids. I don’t feel this way exactly anymore, but I’ll touch on that later.

Challenges

While my hearing challenges have never manifested in the office to the extent that they have at home, there have been a few hurdles in the counselling context:

Masks

I have asked clients to wear masks in my office, as do I, all through this pandemic. And I still do. And, previous to COVID-19, having never worn masks in my lifetime, except at Halloween, I was surprised at how much they muffle voices. (But, still much better than face shields, which are an auditory nightmare for me!)

Noise Cancelling Technology

Personally chosen and professionally installed in my downtown counselling office after my hearing loss diagnosis, and essential for stopping speech from being understood in neighbouring offices, I made a decision that I would have it at the maximum level for ensuring client privacy that would still allow me to hear. And yes, it is an extra noise that is tiring!

Voices

Ultra-soft, ultra low or voice distortion related to crying – This is generally beyond my control in an in-person environment and is secondary to the fact. and the understanding that most folks are attending counselling because they are distressed; this naturally affects how voice is projected and articulated. Fortunately, significantly changed voice scenarios are more the exception than the rule.

Hearing Fatigue

I have always held a high standard for listening, but when hearing loss is a factor, there is no room for losing focus. At the end of a day I am tired and some of this fatigue is related to concentrating in the deepest way I can.

Solutions

Headphones

I never thought I would consider a pandemic a boon when it came to my hearing loss, but the switch to primarily phone and video sessions has come with an improvement that has reduced my hearing fatigue substantially: the wearing of my giant “pilot’s” headphones that fully encase my ears and allow me to adjust clients’ voices to a comfortable volume. They are extremely goofy and un-counsellor-esque, but have been a wonderful addition. They’re super-comfortable too – like clouds on my ears!

Office Acoustics

My downtown office is set up to improve acoustics: soft furnishings/area rug and a standard-size ceiling with sound-absorbing panels—all contribute to decreasing echo.

Positioning

I am so blessed that the typical posture in counselling is that client and counsellor face one another straight on or at an angle. All of this is ideal for focusing, listening and hearing.

Not Pretending

Pretending to hear, out of embarrassment when you can’t, is a no-no. This happens to hearing people too and is not just a hard-of-hearing issue. If I’ve said pardon twice, and I can’t hear the word you’ve used, I’ll probably ask you to rephrase your sentence.

Benefits

I have a lot to be grateful for.

Having a disability has opened up my thinking about disabilities in general – my mindset has been shifting from that of seeing limitations, to embracing diversity and its essentialness in a healthy society.

I’ve also been prompted to innovate more and come up with more grassroots solutions to enhance my practice. I have done a lot of internet research and I have regular conversations with my audiologist about acoustics and auditory solutions and am learning about future options, one of the most exciting being bluetooth hearing aids which will be able to be used for phone and video calls, ultimately doing away with my pilot’s headphones. (I’m not ready to let go of them, yet, though!)

I also feel that my experience thus far has increased my sensitivity to the importance of accommodations for people with disabilities. If I meet folks that disclose a disability, I see my job as one of being observant and asking along the way if there is anything I can do to help.

Things That Can Help

Sometimes clients that know about my hearing loss have asked if there is anything they can do to help. The first time this happened I was both surprised and delighted. And I am still delighted when people say this. So while it is never a client’s job to caretake me, here are a few things that can help:

  • Speaking clearly in-office when wearing a mask. Or alternatively, choosing a phone or video session if this would feel too unnatural or be too tiring.
  • Understand that you may encounter a few more pardon me’s in the course of a session. My philosophy is that it is much better for clients that I clarify and understand what is being said, rather than misunderstand, even when a little less convenient.
  • It’s rare, but if I am r-e-a-l-l-y not hearing a phrase and you have repeated it more than twice, please consider saying the same thing in a different way.
  • For those on phone sessions, if you’re outdoors where there is a lot of ambient noise, such as wind sounds, this could impact my ability to hear you clearly. If this is the case, I will let you know. Please see if you could move to a more sheltered or quiet place.
  • Poor connectivity – if you are having a phone session in an area with poor phone reception or bad wifi, the ability to catch everything in a smooth way is impaired. This is true for hearing counsellors too, although the effect is magnified with hearing loss because additional brain processing effort is exerted in attending to conversations. Please try an ethernet cable or an area of your home with better reception.
  • Kindly avoid the use of speaker phones, if possible. Not only do they compromise your privacy in shared environments, they cut out at unnatural times such as when the counsellor makes even the slightest noise such as “mmm-hmm,” producing confusion and disruption, which can also affect comprehension.
  • If you are worried that I didn’t hear you properly, please ask. I’d be happy to share what I heard and am very open to any amendments if I have mis-heard.

The Future

Like much of life, one of the things about hearing loss is you never know what the future will hold: how much of a drop there will be in hearing from year to year and how long it will progress before levelling out. I’ve experienced a gradual decline in my hearing–nothing sudden–and I am only scheduled for hearing tests every three years, which I think says something in and of itself. I am very grateful to be able to still function very well in my capacity as a counsellor.

This experience, however, has awakened an interest in working with more hard of hearing clients and, clients with disabilities. I am keen to also receive more specialized training to be of better help to people with disabilities. This to me, is very exciting! I’d also love to meet more counsellors with hearing loss. Please be in touch!

The stigma for me around hearing loss is lessening, hence my decision to write this article. I am opening up about my hard-of-hearingness more to clients and I now get my hair cut how I want, whether or not my hearing aids show.

Now that I’m done this article, I have surprised myself by how long it is. If you’ve made it to the end, thank you. I guess I had more to say than I originally thought!

Thanks for listening, everyone 🙂