by Garth Brears, M.S., Aud(C) Clinical Audiologist
An interesting event occurs in one’s brain when they are developing a hearing loss. Their coping mechanisms improve significantly. These are strategies that an individual uses, often unconsciously, in order to offset the lack of sound that the brain is no longer receiving.
Specific coping strategies maintain “understanding” of what is being said even when someone has a significant hearing loss. This is an amazing brain phenomenon. Patients even with profound hearing loss simply do not believe that they have lost so much hearing because they can still understand when looking at the speakers face.
What is it to cope with a hearing loss? At its root, the individual is using a lot more mental energy in-order to get the same amount of “understanding” of a speaker that someone with normal hearing can accomplish with much less mental energy. This explains why many patients claim that they hear better in the morning than at night. Little are they aware that hearing has very little to do with this (see article on “what is hearing loss”), what changes is the level of mental energy available in the morning versus at night. Mental energy is the gas tank that drives “understanding”.
Patients that state they do not hear people when they talk fast do not understand coping mechanisms either. They fail to realize that they do not hear slow or fast speakers any better or worse, however, they do manage to understand the slow talkers better because their coping mechanisms work much more efficiently.
Finally, patients that claim they cannot hear in noise but they can when it is quiet, are also generally mistaken in their logic. In most cases it would be truer to say that they have a hearing loss in both places, however in noise, they do not use their coping mechanisms as affectively as in quiet. The key to remember is that this person’s hearing acuity was exactly the same in both places. Noise interrupts proper utilization of coping strategies, likely because they are hearing too much, all at the same time. In the end, this is not that different than listening to fast speech or being mentally exhausted. Think of it this way, noise is the last straw that breaks the back of the necessary higher level of focus.