S-Word, Part 2

 

October 27, 2023

S-Word, Part 2

It’s Almost Halloween: Look Stigma in the Eye and say BOO! 

My article, “The S-Word,” sparked some strong reactions and led to an interview with Brian Taylor on This Week in Hearing, all of which prompted me to try to further clarify my perspective.

Essentially, I think trotting out the “s-word” does us all a disservice. By “us all, ” I mean everyone. I am not saying that stigma does not exist. Who has not felt the sting of stigma at some point or other? I’m not saying it doesn’t feel lousy. But really, what is it?

When you are stigmatized,

  • you are perceived not for who you are but for someone else's projection onto you. 

  • you are dismissed out of hand — a superficial rejection that cuts deep.

  • it may have to do with how you are perceived, but it really has nothing to do with who you are. Nonetheless, stigma can trigger shame and doubt, which is how it can be so debilitating. 

And perhaps the feeling of being ignored or dismissed when you can’t hear the conversation, or feeling belittled by some joker responding with an exaggerated, “WHA-T?!” if you tell them you have hearing loss — such experiences might contribute to a sense of being stigmatized.  

But, let’s back up.

Why is it?
I think stigma is fear or discomfort looking for an alibi. My hunch is that stigmatizing behavior probably originates in a fear of infirmity and fear of death. Which is to say, I don’t think stigmatization is likely to go away.

Beyond whatever originates stigma, I believe that every time someone refers to the stigma-of-whatever-it-is, it actually regenerates and reinforces the phenomenon, making it even harder to shift to a healthier paradigm. 

President of the Netherlands Swiss Chamber of Commerce Oliver F. von Borstel commented on LinkedIn that promotion of stigma is often unconscious: 

“My experience as personal coach of Aud, HIS, HCP, Audiometrists is, that many of them ‘promote’ the stigmatization themselves, unconsciously. This by e.g., saying “…you want them being invisible, right?”, or, “…we choose a color of your hair so that they are not visible.” This behaviour does not help to eliminate stigmatization because it gives the patient the confirmation that wearing hearing aids is a sort of a handicap.”

What can we do about it?
On a personal level, rejecting stigma is probably our best defense. Eleanor Roosevelt is reputed to have said, “No one can make you feel inferior without your consent.” (I repeat this as a mantra, as I try to manage copious doubts that can assault me on any given day.)

On a professional level, can we convert defensive phrases like “fighting stigma” to concepts of empowerment? Maybe something more along the lines of “fostering connection,” “facilitating community,” “advancing hearing health?” 

Acknowledging the relatively low adoption rate of hearing aids, can we revisit how we talk about hearing devices? 

Can we validate patients and be sensitive to challenges they may face, without reinforcing those challenges? When someone is resistant to getting hearing help because they “don’t want to appear old,” for instance, can we gently point out that it is more and more common to have things in your ears these days, and in terms of how you are perceived, sporting a hearing aid is far preferable to missing or mishearing what is said, repeating a point that was already made, or responding to a question that wasn’t asked.

Can we recognize that even though a good “fit” can still be elusive, technology and protocols have evolved and continue to evolve. 

Can we acknowledge that so many factors influence how people hear, there is no one-size-fits-all, no one-approach-fits-all. 

Can we encourage individuals to engage in listening and encourage them to co-direct their care? 

It’s almost Halloween: Look stigma in the eye and say BOO!

~ ~ ~

 
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