Communicative trauma and hearing loss: I had forgotten
I’m sitting alone in the living room with a sinking feeling in my stomach. My friends are engaged in boisterous conversation on the poorly lit porch outside. Do I take a seat out there and not be able to participate, or do I stay here and not participate? Both options feel terrible and awkward…the usual double bind. By the end of the week I am exhausted and in tears. How had I managed to forget this part?
I was excited to attend a week-long reunion with a group of friends from my college years. In my anticipation, I imagined connection and conversation and laughter all week long. Yet, despite years of evidence to the contrary, I was still completely caught off guard by the reality check of my hearing loss dilemma in the living room. How is this sort of denial possible?
I have bilateral sensorineural moderate-severe hearing loss (between 65 to 85 dB depending on the frequency) since infancy. The atypical reverse slope (I hear high frequency better than low) enables me to speak well and “seem” more hearing than I actually am. I live with my husband and two children. As a therapist, I meet one-on-one with clients. I see friends in small groups in quieter settings. I use social media and chat apps for communication and self-expression. Within these settings, I can be myself. I am connected, comfortable, respected. On a regular basis, I have rewarding, substantial conversations that make me come alive.
For the first 30 years of my life, this was not the case. In the 1980s and 1990s, my clunky analog hearing aids amplified all sound to the same loudness. I was mainstreamed in public school amidst the noisy chaos of the hallways and cafeteria. The hierarchy was spelled out at the lunch table, and I dreaded it. The popular kids sat comfortably at one end of the long rectangular table, and the table became less popular and more crowded the further down it went. I would approach the less popular side, gripping my tray, and kids would grudgingly clear a space for me to hang off the end. Their conversation was a dull roar that blended with the background noise. I would eat in silence, feeling imprisoned and paralyzed, and wonder why I couldn’t do this any differently. The days were long, but the 20 minute lunch was the longest.
In rural, pre-internet New York State, I seemed to be the only one my age with hearing loss. I was a good student, so it did not appear that I needed extra support or resources. The old fashioned telephone was the apex of social life, and for me it was a source of excruciatingly awkward interaction. I was cut off from parties and dates, the gossip and drama, the fun and the flirtation. As an athlete, I was often socially disconnected from my team, staring out the bus window during rides to and from sports events. I hated every minute of high school and yearned- with the type of yearning that only an introverted, romantic, adolescent bookworm is capable of- to be a part of things, to be seen.
After graduating high school, my sense of self continued to be defined by noisy social groups at my summer job, college, then graduate school. I was a foreigner in my own country, catching bits and pieces, just enough to convince myself I only needed to try harder to catch all of it next time. Logically I knew I had hearing loss, but emotionally I believed I was hearing… just not good enough at it. I chronically compared myself to the impenetrable, chatty, close knit groups around me and fell short every time. I could always tell when others saw only my frozen self and not my real self.
By the time I was 25, my social life was one of confusion and low self-esteem. I was overly dependent on the peers that I did connect with; to me, the connections were deeply felt miracles. Even so, my friends couldn’t be the bridge to self-expression that I needed. I felt easily replaced by more personable individuals who seemed to so rapidly grow closer and more connected to my hard-won friends than I was. I sometimes abruptly terminated friendships when I couldn’t handle it anymore. The pain of repeatedly perceiving abandonment and being replaced in social situations- and my less-than-stellar coping skills which tended to bring about what I feared- became too much. I went into therapy and told my therapist: “I just want to be able to be myself.”
How do you diagnose or fix being ‘unable to be yourself’? Until I saw the contrast between my life in the context of social groups and my life outside of it, I didn’t have an answer for this. Throughout my 20s, however, the setting of my life began to change. I got married, I finished graduate school. Group situations went from occurring most of the time to mainly just work meetings and the office environment. Then I went into private practice and successfully cut out group encounters. For the last ten years I have been “me” most of the time. Clearly, my former experience was due to being young and insecure and not knowing who I was. I had done the work, it was figured out. The rest belonged in the past!
Then… I attended my reunion. Suddenly, there I was again: stuck, anxious, self-critical, my sense of humor the first to go. My energy drained from such sustained focus on the conversation around me. I realized how tracking the conversation required so much cognitive focus that it was difficult to participate even when I was hearing what was being said. Then the pain set in- the incredible, peculiar pain- of being powerless, unable to express myself, unable to participate and be seen and included in the way that I wanted to be.
The experience at the reunion brought home new realizations for me. I could see the contrast between my current everyday life that is no longer triggering and the state I experience when I am in groups. The toll of group situations on my earlier life, particularly during a key developmental phase of forming identity in adolescence, becomes truly understandable. When I become frozen in social situations where I feel powerless, it is experienced as involuntary and gripping.
Michael Harvey (2001), a psychologist and author, writes about the experience of those with hearing loss in repeated social encounters that are discouraging, painful or isolating and exceed ability to cope. He calls this communicative trauma. Years of repeated failed social interactions and ingrained responses are wired in my nervous system. I’m truly stuck, and triggered.
Even so, isn’t trauma an awfully strong word to use here? Isn’t trauma something that happens when one experiences a life or death situation or abuse? A key defining trait of trauma is perceived powerlessness, when the situation feels out of one’s control, and repeated exposure to this can take a toll. This phenomenon of an activated nervous system, due to social powerlessness, is legitimate even if, in the case of hearing loss, it does not involve threat to physical safety.
The symptoms of post-traumatic stress disorder (PTSD), which includes flashbacks and dissociation or numbing, may sound more familiar. Communicative trauma has its own set of symptoms. I was surprised to realize that aspects of my hearing loss experience fit Harvey’s description. I noticed at the reunion how internalized, intense self-criticism built up rapidly. Negative self-talk, followed by resignation and passiveness- the consuming paralysis that so perplexed and frustrated me most of my life- are also symptoms of communicative trauma. (Others with hearing loss might take the opposite stance and try to control and dominate the conversation in order to cope with communicative trauma). Even when I have the chance to join in, my mind- numbed and overwhelmed, meekly convinced by my self-talk- goes blank. Why am I here? They don’t like me. I don’t like me. The self-consciousness grows, furthering inhibiting self-expression.
Hearing loss is a nearly invisible condition, despite the hearing aids. It does not incite others to offer assistance or to recognize and remember what might be needed. In some situations there’s no problem at all and in other circumstances it is crippling, and the situations may seem outwardly indistinguishable from each other. In social groups, not only am I cut off from other people, I am cut off from my real self. My default response was to keep smiling and pretending through it, while managing scathing internal self-talk.
I’m not hearing, I’m not Deaf. I’m in between. The version of myself with others in groups does not match the self that I know I am, and that divide creates pain. Being able to participate in social situations is linked to self-expression, identity, connection, belonging and acceptance. We are social beings biologically wired at birth to define ourselves in the context of others and how they respond to us. We feel tremendous pain- brain scans have shown that it is neurologically identical to physical pain- when those needs are not met and we perceive being left out or rejected. Not belonging in the hearing or the Deaf world is to attempt to straddle a faultline of the psyche’s experience of the self and its expression.
While working out the framework of communicative trauma for myself, I realized the answers lie in self-compassion, acceptance and advocacy- and, unexpectedly, in healing trauma. Rather than being embedded in denial, I need to accept the reality of my limits. I’m never going to hear everything, no matter how hard I try, and that’s okay. Rather than pretend, I need to speak up, enlist help, educate others, make the invisible visible. Rather than berate myself, I need to have compassion. Even as I write this, it feels like platitudes that I am parroting. All this is far easier said than done, and I resist sometimes how I have to take on this responsibility that I’ve denied for so long. The invisible paralysis is a prison, but it’s also safe and familiar!
The more I can process communicative trauma, the more I can free up space- space to make new and different choices, regulate my nervous system, and activate my voice. True self-acceptance, where “I have hearing loss” rolls off my tongue comfortably and easily to cashiers, hairdressers, bank tellers, colleagues and groups of friends isn’t a reality in my life yet. Trauma symptoms of minimizing and shaming are kicking in even now- This isn’t that big of a deal, it could be a lot worse. You should be over this, seriously you’re still grappling with this?
I have a ways to go. I may have forgotten, but now I remember.
Harvey, M. A. (2001). Listen with the Heart: Relationships and Hearing Loss. San Diego, CA: DawnSignPress.
