Download Communication: Is it Mishearing or Misinterpretation? For a Virtual

4/26/2016
Communication:
Is it Mishearing
or Misinterpretation?
Alison Freeman, Ph.D.
CPA Annual Convention
Irvine, California
April 18, 2016
For a Virtual Experience
Put earplugs in your ears and just notice…
what sounds sound like….
Turn to your neighbor on your right and for 3
minutes:
Introduce yourself
Tell where you work and what your specialities are
Tell what you hope to get out of the workshop
today
Premise of Today’s
Workshop
Need for clinical assessment of
hearing loss in relationships.
Need for clinical observation in
making differential diagnosis of
hearing loss versus communication
psychodynamics.
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“Blindness cuts us off from things,
but deafness cuts us off from people.”
- Helen Keller
“Hearing loss does not just affect an individual, but also
one’s family and friends.”
- Michael A. Harvey, Ph.D.,
psychologist, author of
Listen with the Heart:
Relationships and Hearing Loss
Introduction
We are all affected by hearing loss at some
time in our lives, in either ourselves, or in
someone that we love.
World Health Organization definition of
hearing loss - not being able to hear sounds
of 25 decibels or less in the speech
frequencies.
Not only affects volume, but more importantly,
discrimination (comprehension).
Definitions
Mishearing - information not being received auditorily
v.s.
Misinterpretation - problems of perception
(mind reading, negative thinking, assumptions)
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We’ve all been there…
Some instances of miscommunication can often be
funny; some common examples are:
Pledge of Allegiance
“I pledge the allegiance to the flag”
…I led the pigeons to the flag..
The Beatles
“the girl with the kaleidoscope eyes …”
… the girl with colitis goes by
Rolling Stones
“I’ll never be your beast of burden”
…I’ll never leave your pizza burning..
What does a
conversation
sound like with a
hearing loss?
Statistics
– 48 million American adults have
some degree of hearing loss
– As baby boomers reach
retirement age starting in 2010,
this number is expected to
rapidly climb and nearly double
by the year 2030.
– Today, one-third of Americans
between ages of 65-74 have
hearing problems
–
One-half of Americans 85 and
older have hearing loss.
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Lifespan Issues
Communication errors in parenting of
children
Manifestations of poor self esteem in
children, adolescents and adults
Communication difficulties in dating
Sudden hearing loss - in trauma victims
Age related hearing loss in baby
boomers and seniors
Effects of Untreated
Hearing Loss
Hearing loss is currently untreated in 85% of those
affected. Typical manifestations of unidentified hearing
loss commonly present as:
communication difficulties
social withdrawal
low self-esteem
depression
unexplained frustration and anxiety,
and frequently result in medical misdiagnoses.
Impact on Relationships
Marital Relationships
Sibling Relationships
Parent - Child Relationships
School participation, or lack thereof
Professional relationships
Community involvement
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A Game of Catch with a
Ball of Clay
Metaphor to describe complexity of communication
between two people
Each time one touches it, they shape it to form their
own perceptions based on any number of variables.
* past knowledge, family history and
experience
* race, gender, age and religion
* family background
* unique understanding of semantics and
connotations
and then add hearing difficulties?
Relationship Stress
Men more typically
have hearing loss
Talking is easier than
listening (form of
conversation control)
Clinically - Reflective
listening becomes
primary tool
•
As therapists, we need to
entertain the idea that what our
clients hear may not necessarily
correlate with any objective,
external reality.
•
Rather, it reflects their internal
processing where they may
impose their interpretations and
assumptions. Thus, reflective
listening minimizes and/or
clarifies this disconnect.
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Research:
Untreated Hearing Loss
In a study conducted by the National Council
on the Aging, 2300 Americans over the age
of 50 with hearing loss and 2100 of their
family members and significant others were
asked questions about the effects of untreated
hearing loss in their lives. The results yielded
significantly higher rates of sadness, paranoia,
social withdrawal, worry and anxiety and
feelings of emotional insecurity (NCAA,
1999).
Invisible Disability
The primary disability of hearing loss at any age is
that it is a communication disability rather than a
mere medical diagnosis of just not being able to hear.
This ambiguity is a daily stress that one must
continually adjust to, in every situation throughout the
day.
Struggling to understand conversations, music or
professional interactions is a constant stress
everyday.
The true disability of
hearing loss is one
where there is a
reduction or a lack of
communication which
leads to social
withdrawal, loneliness
and/or depression.
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Mindreading=misunderstanding?
Hearing through the Brain
We hear from our brains, not our ears
Ears are a pathway to our auditory
systems. As such, any sensory
deprivation, such as hearing loss, could
lead to wider adverse effects on brain
vitality.
Audiogram
QuickTime™ and a
decompressor
are needed to see this picture.
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Intake Considerations
As psychotherapists, it is important to consider
the possibility of hearing loss when
communication difficulties are the presenting
problems and/or when dealing with certain high
risk groups such as baby boomers, veterans and
seniors.
Therefore, during intakes, we must not assume
that the client will tell us about their hearing loss
as they may not realize that they even have a
loss.
Clinical Manifestations
Social withdrawal
Depression
Low self-esteem
Unexplained frustration and anxiety
Decrease in typical assertive behavior
Increase in relationship stress
Monopolizing conversations
Memory issues (due to insufficient auditory
input vs. organic causes)
Symptomatic similarities between Alzheimer’s
Disease and untreated hearing loss
ALZHEIMER’S DISEASE
Depression, anxiety, disorientation
UNTREATED HEARING LOSS
Depression, anxiety, feelings of isolation
Reduced language comprehension
Reduced communication ability
Impaired memory (esp. short-term memory)
Reduced cognitive input
Inappropriate psychosocial responses
Inappropriate psychosocial responses
Loss of ability to recognize (agnosia)
Reduced mental scores
Denial, defensiveness, negativity
Denial, defensiveness, negativity
Distrust and suspicion regarding other’s motives
Distrust and paranoia (e.g. belief that others
are talking about them)
* Chartrand, M. Hearing Health and Alzheimer’s Disease in Hearing Review, November 2001.
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Factors Contributing to
Shame and Denial
Embarrassment - symbolizing being “old”
• Financial Burden
• Medicare coverage for hearing aids
• Would you rather be called “stupid” or hard of
hearing?
• “Fakery” / “bluffing”
• Cultural factors - certain cultures view hearing
loss as shameful, more resistance to wearing
hearing aids
•
Strategies for Optimal
Communication
Setting the “stage”
Lighting and Windows - do not sit in front of windows
Carpeting/upholstery/drapery - absorb sound
Enunciation and Eye contact -use of non verbal cues
Pacing and speed - speaking slowly as naturally as possible
Use of visual materials - drawing, technological aids
Ask for rephrasing or repeating of what you said
What did you hear me to say and what does that mean to you?
vs. sounding critical by just saying “what did I say?”
Examples of mishearing
Called my friend and asked how she
was because she was sick, and she
responded with, “I had an awful night”
and I responded “I am so glad to hear
that” and she laughed, knowing fully
aware that I misheard it. I had filled in
the blanks by guessing and knew that I
had a 50% of guessing correctly.
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Hearing Assistive Technologies
Use of technology and apps to help with communication and
lessen stress of hearing.
CTAP – free phones 1-(800) 806 -1191
Hamilton Captel phones
Subtitles Viewer apps - iphone
Clear Captions - tablets/phones
Closed Capp - (3.99) android
Live Caption (3.99) apple and android
Dragon Remote Microphone - free
The Deaf and Hearing Impaired - android app
http://www.interpretype.com - use of two mini computers for two
way conversation - both must be able to type
Resources
Hearing Loss Association of America (HLAA) www.hearingloss.org
local, state and national chapters with national journal as well as local
newsletters. HLAA provides free webinars.
* HLA-LA - local chapter - www.hlaa-la.org
Hearing Loss Californian - free newsletter
National Center on Deafness at CSUN www.csun.edu/ncod
Greater Los Angeles Association for the Deaf (GLAD)- www.gladinc.org
www.About.com.deafness -
Laurent Clerc (Gallaudet) National Deaf Education Center
clerccenter.gallaudet.edu
Weitbrecht Communications - Santa Monica -
California Telephone Access Program (CTAP) - free phones
http://ddtp.cpuc.ca.gov
References
Amieva H, et al. Self-Reported Hearing Loss, Hearing Aids, and Cognitive Decline in Elderly Adults: A 25Year Study. J Am Geriatr Soc. 2015 Oct; 63(10):2099-104
Chartrand, M.S., (2001B, November). Hearing Health Care and Alzheimer’s Disease: The role of hearing
healthcare in treating patients with Alzheimer’s disease. The Hearing Review, pp.26-29
Freeman, A. (2012) Emotional Aspects of Hearing Loss. Hearing Loss Californian. May/June.
Freeman, A. (2013) What…Me Hard of Hearing? The California Psychologist. Nov/Dec; Volume 46,
Number 6.
Freeman, A. (2014) Hearing Loss Across the Lifespan at www.zurinstitute.com
Freeman, A. (2015) Shouting Doesn’t Help! The Psychological Impact of Hearing Loss on Baby Boomers
and Veterans. Presentation to California Psychological Association Annual Convention, April 2015.
Hampsten, K.(2016) How miscommunication happens and how to avoid it. Retrieved from
ed.ted.com/.../how-to-avoid-miscommunication-katherine-hampsten
Hearing Loss: Facts and Statistics. Hearing Loss Magazine, Mar/Apr 2016.
Lin FR, Niparko JK, Ferrucci L. Hearing Loss Prevalence in the United States. Arch Intern
Med. 2011;171(20):1851-1853. doi:10.1001/archinternmed.2011.506
Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing loss and incident
dementia. Arch Neurol. 2011 Feb;68(2):214–220.
Mener, D., Betz, J. Genther, D., Chen, D. , Lin, F. Hearing Loss and Depression in Older Adults. J Am
Geriatr Soc. 2013 Sep; 61(9): 1627–1629.doi: 10.1111/jgs.12429.
Saks, O. (1989) Seeing Voices: A Journey into the World of the Deaf. NY: Vintage Books
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Contact Information
Alison Freeman, Ph.D.
310 712-1200
[email protected]
www. Dralisonfreeman.net
“Hearing Loss across the Lifespan” at Zurinstitute.com
(2 CEU’s course)
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