Assistive Listening Technology
February 3, 2017
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February 7, 2017

The Psychology of Cochlear Implants

Personality and psychological factors can affect the surgical outcome in cochlear implantation. Professionals working with cochlear implants acknowledge a great deal of variation in satisfaction and performance with implants.

Some of the factors that affect outcome—which is traditionally measured by speech-recognition ability—include length of deafness, IQ, speechreading ability, and hearing ability before implant. Research also notes certain psychological factors that can affect outcome, such as an individual’s point of view (pessimist/optimist), expectations (realistic/non-realistic), and type of support system.

There is a dearth of literature on the relationship between personality and cochlear implant surgery outcome. Personality can be thought of as the complex total of who we are, how we think, how we perceive information, and how we interact with the world. Cochlear implant surgery is a life event that will interact with and be shaped by our personality. The way an individual responds to stressful situations, illness, and physical stress in general will predict, to a certain extent, how that individual responds to an implant. Thus, a person who is rigid and pessimistic may look for, and comment on, all of the bad things about an implant, regardless of how it functions. While it may be healthier for an individual to observe the implant as part of a long process and to feel positive, it is very difficult to change the way people evaluate the world. Most people adapt in their own way over time. If they do not, they may benefit from talking with a therapist.

People with hearing loss also are affected by a society that values physical perfection and beauty. There is an often subtle and unconscious bias about people who wear hearing aids and cochlear implants. In general, these prejudices are not mean-spirited, but the expression of fear—a fear of facing some of the bad things that can happen to people in life. People tend to want to feel good all the time and do not welcome exposure to things like disability, illness, and death. People often want to avoid exposure to situations and individuals who remind them of these concepts. Try having a conversation about death and dying at your next family gathering and watch the room clear out. This is simply a psychological fact of life, and professionals need to be aware of it.

Speech-language pathologists and audiologists can benefit from a collegial relationship with a therapist that works with patients with hearing loss. We often present small group lectures at clinicians’ request to encourage clients to understand the emotional effects of hearing loss. One of the goals of good psychotherapy is to help individuals understand how their personality works so they can observe it in operation and see how it affects their point of view.

Finally, professionals working with clients with hearing loss must always pay attention to the many variables of hearing loss. The important ones include when the individual became hearing impaired, the cause and degree of the loss, and the progressive nature of the loss (gradual or sudden). The more severe the loss, and the earlier the age at which it was acquired, the greater the impact can be on psychological development. When working with individuals with hearing loss, it is imperative to establish a dialogue that invites information about the history and nature of the loss. The onset and degree of hearing loss make for a diverse group. This diversity can create an identity crisis for individuals who are neither “hearing ”nor “Deaf ”as they find where they fit in society. Professionals must have a go od grasp of both the physical realities of the individuals’ hearing loss (degree, cause, course) as well as where individuals feel they belong on the cultural continuum of hearing loss.

Many of these issues are common and can be present in individuals with hearing loss without necessarily being problematic. Whether or not they rise to the level of being a problem is determined by a complex combination of personality and environment. Clinicians can become more empathic listeners and more effective providers when they are educated about these generalities and the specifics of their clients’ hearing loss. This includes both physical and psychological information. In the end, the latter will often affect how the client uses the physical information and assistance offered to them.



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