Learning to Hear

By Beverly Biderman

This is one woman’s experience of hearing loss and her voyage back to hearing through a cochlear implant. Beverly Biderman shares her experiences in Chapter 2 of her book Wired for Sound: A Journey into Hearing. For those interested in cochlear implants, this one is a must read.

Learning to Hear

The first piece of recorded music that sounded fine with my cochlear implant was Glenn Gould, pounding out The Goldberg Variations on the piano. That music was so exciting, so intricate. I listened to it over and over, and then moved on to other pieces played by Glenn Gould and other compositions by Bach. Baroque music, especially that of Bach, was the most pleasurable in the early months, since it was highly rhythmic and predictable. ... Beethoven’s crashing music, however, sounded too loud: the sudden crescendos were uncomfortable. Music that I heard directly through my patch cord was clearer than music I heard from regular speakers, through the air. I became so enraptured by music, that I found it hard to walk past a radio or tape deck without looking fondly at its output jack, suppressing an almost biological urge to plug myself in.

I attribute my success with music in part to the fact that I had never heard perfect music, and so was not comparing the imperfect music I was hearing with my implant to some ideal music in my past. Some people who have a good memory of how music is supposed to sound are disappointed. Beethoven, for example, would almost certainly have been cruelly disappointed had he been able to make the leap forward in time to get a cochlear implant to give him back some version of his sorely missed hearing.

… I listened to the Beatles and for the first time was able to pick out their voices from the music of their instruments. I listened to Stan Rogers belting out ANorthwest Passage while following the song with the lyric sheets in front of me, just as I had with the talking books. I could hear the passion in Stan=s voice, and the emotional meaning behind his song, as I never had before, even when I saw him perform in person years ago. Many songs moved me to tears.

A lot of things moved me to tears in the months following my turn on. It seemed that my emotions were often close to the surface and would come spilling out at strange times. I found some deep bass sounds disturbing. They frightened me in a way I did not understand. Some high-pitched sounds were so pretty. Some voices were unspeakably beautiful and touching. Chuckles on the phone and the radio and television warmed my heart. I realized I was responding to the emotional content of sounds, and finding there was emotion everywhere. The monochrome sounds I had heard before were now rich with color, some beautiful and some not.

Anthony Storr, in Music and the Mind, talks about the close link between hearing and emotions. He points out that hearing is much more closely related to emotions than vision is. If we see a wounded animal or person, he says, we are never as moved as we are if we hear the animal or person=s anguished screams with our ears. He theorizes that the strong link between hearing and feeling may be related to the fact that we can hear before we can see, as the sense of hearing is developed in the womb early, before the sense of vision is formed.

… My expectations, however, continued to be a problem. By actively working at learning to hear, I was setting myself up for disappointment, in a sense, because there was no guarantee that my efforts would be rewarded by proportionately better understanding of what I heard. When I seemed to reach a plateau, but still relied on lipreading, I became depressed. Bob tried to remind me of how far I had come since getting my implant, but he was often unable to console me. At a certain point, my rehabilitation Awork@ [with talking books and music] seemed to be of no avail and, rather than giving me a positive feeling about my prowess, made me feel more depressed about what I could not understand.

Deep inside, unknown even to myself until then, had been growing slowly and quietly the hope that I would achieve the miraculous, and understand easily on the phone, and understand people without lipreading, and become more like a hearing person than the deaf person I was. I could not admit it to myself, this hope, before I underwent surgery. I couldn=t even admit it to myself in the first few weeks or months afterward when I was sometimes overwhelmed with disappointment about what I was hearing. But gradually, I had to acknowledge that the bitter taste in my mouth when I heard the loud strange sounds of speech but did not comprehend them except through my eyes was from the disappointment of remaining, after all, deaf.

I obsessed about the half of the cup that was still empty. I analyzed what was wrong with my implant (Abasses boomed too much@). I analyzed what was wrong with the electrode array in my ear (Ait=s responding too slowly, sounds are bleeding into one another@). I am a computing systems analyst by profession and accustomed to solving problems by analyzing them, breaking them down into their component parts, and coming up with a solution. But this problem, of hearing with my new device, was proving to be a tremendously difficult one to solve. I decided that the biological limitations of my ear and brain, and the technological limitations of my device had finally met each other, been introduced, and were sitting down in a stalemate. I glumly decided that being able to follow Make Way for Ducklings was no big achievement after all. I wanted to be able to hear and understand everyone at meetings at work, even when I wasn=t looking at their faces. I wanted to be able to talk on the phone to everyone. I wanted to be more hearing-like. It=s hard to be deaf in a hearing world, and even harder to be given a taste of hearing and not want more. It has been said that joy lies in the freedom from all expectations. If so, then joy in my imperfect, newfound hearing meant letting go of expectations. It meant Aletting it happen.@ I was having trouble with that idea.

… I was having an enormous amount of difficulty breaking away from my visual orientation too. I found myself thinking that I could not possibly understand speech without seeing a person=s face. I just could not trust what I heard. If I could see just a slice of the face, however -- a chin, a nose, a cheek -- amazingly, I would often hear and understand. Obviously there was something more than hearing at work here; my visual and hearing senses had become accustomed to working together.

It seemed that all my successful adaptations to deafness, my strategies for dealing with it, my visual orientation, conspired against my understanding speech with my new prosthesis. Oliver Sacks, writing about Virgil, a man who after almost a lifetime of blindness has his vision restored, says that Virgil could not Asee@ a building when he first stood in front of one. It was only after he held a toy building in his hand and felt its form with his fingers while looking up at it that he could actually see the building and understand what he was looking at. So too, the sensation of sound alone was not enough for me, and my brain had to somehow understand those sounds and attach meaning to them. Usually that meant bridging sound to meaning using my visual sense, just as Virgil used his sense of touch to bridge vision to meaning.

… I started to become increasingly critical of the sounds I was hearing. In the first few months following my turn on, my criticisms of the sounds had been helpful in adjusting and fine-tuning my processor=s map. I would point out to David, my audiologist, that the >>basses boomed== and we would soften them. I would point out that I had to keep my sensitivity knob turned down too low, and we would soften all the sounds across the board so I could turn up my sensitivity knob to an appropriate level. But then we reached a point where there seemed to be no more fine-tuning tricks left in David=s bag, and I had to simply work with what I had.

Perfectionist that I am, I had trouble sleeping because I would rack my brains during the night to figure out why I couldn=t hear better and to think of what I could do that might help. I would go into work in the morning with black circles under my eyes. I was in such a fog that I once showed up at work wearing two left shoes -- and didn=t realize it until noon.

It was difficult for me to move ahead in learning to hear while I was feeling negatively about the sounds I was hearing. Sometimes I even found myself lapsing back completely into my old mode of coping, and not listening at all, but simply alternating between lipreading and tuning out. I found myself recoiling from some of the sounds and criticizing their loudness and quality and clarity. So too, Oliver Sacks=s Virgil, whose vision had been restored, rejected the images he was seeing with his eyes. He began to turn out the light and look away from the mirror when he was shaving himself. Eventually, unable to cope with his new vision and to make enough sense of it, Virgil grew gravely ill and lapsed back into blindness.

It seemed that the fabric I had woven of my life had become unraveled. In those months following my turn on, I had an overwhelming feeling of things falling apart. It seemed too that my balance was upset, and my carefully constructed adaptations to deafness had been torn down. I felt thrown back into a state like that which I must have experienced as a child with gradually worsening hearing. I was in despair, and felt helpless to do anything about it. I could not go back to my previous deaf condition, having tasted so much hearing, but I could not move ahead either. In some quiet, calm moments, I felt, quite simply, that I wanted to die. I felt this not with passion, but dispassionately, almost rationally. I wanted to peacefully slip away from the raucousness, the striving to understand, and even the small successes. I could confide this despair to no one, not even to Bob, because it frightened me, and my apparent seriousness and lack of emotion frightened me even more.

Oliver Sacks seems to be describing my own experience of things falling apart when he says: APerceptual-cognitive processes, while physiological, are also personal -- it is not a world which one perceives or constructs but one=s own world -- and they lead to, are linked to, a perceptual self with a will, an orientation, and a style of its own. This perceptual self may also collapse with the collapse of perceptual systems and alter the orientation and the very identity of the individual.@

I did not understand then, in the months following my turn on, what Sacks is describing; that understanding only came much later. However, I did realize that in order to move beyond my despair, I needed to accept the sounds I was hearing and find joy in them.

One change that helped me accomplish this was that I had the settings for my processor=s map made much softer and more comfortable. Another event that helped was a series of formal rehabilitation exercises at my implant clinic. Six months after I received my implant, my clinic, now aware that rehabilitation especially for those long-time deafened like me was needed, was ready to proceed with a program of auditory rehabilitation for its clients. My therapist, Linda Hanusaik, gave me a variety of practice exercises. We went through word lists to see if I could distinguish (without lipreading) between words with different consonants (Atab,@ Atap,@ Atack@), and words with different vowels (Ahood,@ Ahid,@ Aheed@). She would introduce a set of sentences by saying, AWe=re going to talk about the weather@ and then present sentences to me, one by one on that topic. I would try to repeat as much of each sentence as I could understand, and she would encourage me by telling me that I had Agot some of it,@ or Agot most of it@ or Agot all of it.@ She asked me to bring in magazine articles that interested me, and she would read them slowly to me. I would track her speech by repeating back what she said after each short segment or sentence.

If I squeezed my eyes shut and concentrated hard, I could understand her and repeat whole sentences quite successfully. I was drained emotionally and physically after these sessions, but exhilarated and inspired too. It was exciting to see how much I could comprehend without using my eyes. The exercises gave me the confidence to pay attention to what I was hearing and to persevere. Slowly, my attitude toward my hearing prowess turned around, and I started to again feel positive about my successes, and to accept the sounds I was hearing. My skills improved, and I started to relax and enjoy the sounds.

… I found that with hearing, the world seemed like a less hostile place. People seemed kinder, more caring. Suddenly when I started to understand a bit of speech without lipreading, I would catch people saying AHave a nice day.@ They would say it to me in the store when I was looking down to put my change in my wallet. Or they would say it as I turned my back and walked away from them. Or they would say, AIt=s a beautiful day today, isn=t it?@ while I was looking away from them. I would never have caught those pleasantries before. I understood them now and felt a sense of warmth and comfort from them that I did not have when I heard nothing unless I was looking for it. These found seconds of comfort were lovely. …

Beverly Biderman is an SHHH member from Toronto, Canada. The above is excerpted and adapted (with permission) from Chapter 2, "Learning to Hear" in Wired for Sound: A Journey into Hearing by Beverly Biderman (Trifolium Books Inc.). Wired for Sound has been named a "Globe and Mail Notable Book" and an "American Library Association Outstanding Title."