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Sunday, 27 November 2011 12:44

How to make sure your message resonates with how people see themselves and their hearing

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Eaten apple sees itself as a whole apple in the mirrorHow people see themselves plays a major role in whether or not an individual considers themselves to be “ready for hearing aids”, and yet we very seldom take this into account in the way we present and provide hearing care.

We are often so focused on trying to convince people that they have a hearing problem and should be wearing hearing aids that our communication instantly loses its audience. Our message lacks what psychologist Howard Gardner terms “resonance”.

This failure to communicate in a way that resonates with how people see themselves is possibly the biggest contributor to why people delay seeking timely treatment for a reduction in their hearing.

So how can we change this? What do we need to do differently to avoid falling into this trap?

In this article I'll explain:

  • The main underlying dynamics of how adults who develop a reduction in their hearing see themselves
  • Why they appear to delay doing something about their hearing
  • What we can do to change things.

“What's my hearing like?”

Let's begin by putting ourselves in our audience's shoes. How does an individual know what their own hearing is like?

Unless they have some sort of comparison they can use – such as a hearing test, or someone else pointing out they can hear birdsong when they can't – they will only have their own experiences to judge their hearing ability by.

Factor 1: The assumption my hearing is normal

This is our first contributing factor to how people see themselves in regard to their own hearing: by default, they start from the premise that their own experience of the world is 'normal', unless they have information to convince themselves otherwise.

And since people only hear what they hear, anything they don't hear is outside of that experience and so “doesn't exist”, which means by default they will automatically see their hearing as ‘normal’. This becomes a fundamental part of their belief about themselves.

Factor 2: The Actor-Observer Effect

The second contributing factor is something known in social psychology as the Actor-Observer Effect. The Actor-Observer Effect is the tendency for people to explain their own (negative) behaviour as a result of the situation or circumstances, but to explain the same (negative) behaviour in others as down to “that's the way they are”.

A good example of the Actor-Observer Effect is bumping a car.

If you see someone else bump their car, you're more likely to say to yourself, “careless driver” – in other words you attribute the behaviour (bumping the car) to the way that person is (i.e. internal factors). Whereas if you bump your car, you're more likely to look for reasons in the situation or circumstances to explain your behaviour such as poor visibility, or being distracted by something (i.e. external factors). The effect is even stronger if there is a threat to our self-esteem.

This principle applies to hearing. If we don't hear something, we will automatically assume it's because of the situation or circumstances: people mumble, my family talk whilst walking out of the room, it's the high/low ceilings in a building – in other words, our difficulties hearing are due to external factors.

But if someone else doesn't hear in those same situations or circumstances we are more likely to assume it's because of the way they are: their hearing is the problem – in other words, their difficulties are due to internal factors.

This natural bias clearly explains why there are so many frustrated discussions between family members with one accusing the other of mumbling whilst the other argues, “It's your hearing; you're going deaf.”

This is very important for us within the hearing care community to realise. We often assume it's due to an individual's stubbornness or pride or denial – whereas in fact it's simply evidence of a natural human bias.

This realisation has implications for us in the way we communicate, not only with the person directly affected by the reduction in hearing but with their ‘significant others’. Often ‘significant others’ feel it is their duty to “get through to them” and convince them that they're not hearing properly. But this approach is counterproductive because it reinforces that clash of perceptions.

So it is fruitless to try to resolve this mismatch in perceptions by trying to convince someone they are wrong (which is probably the most common approach). Instead it requires a totally different approach, one which we'll look at later in this article.

The Recipe for Attitude Formation

Most people don't have any real opinion about their own hearing. They don't need to; they just assume it's ‘normal’. But as soon as an external source draws attention to a possible inadequacy in their hearing, they are forced into having to form an opinion about their hearing in order to know how to respond to this new piece of information.

At this point all sorts of thoughts and feelings will run through their mind. These thoughts and feelings will be the ingredients that shape the opinion they have about their own hearing, beginning with their default understanding that:

  • “How I perceive the world is normal.”
  • “I can hear everything that's audible so I must be hearing OK. If I don't hear something, I assume it's because neither can anyone else or the sound doesn't exist.

Against this default understanding they will compare any new information that comes in including the proposal that their hearing isn't everything they believe it to be. But in order to properly compare this proposal, they need to know what that suggestion means, so they will ask themselves:

  • "What's the alternative to hearing normally? And does this alternative apply to me?"

The key to correct attitude formation

The importance of these two questions cannot be overstated. How they are answered is absolutely fundamental to any subsequent attitude formation.

And yet it is perhaps the most significant area where the hearing care community has been counterproductive, because the terminology we use and the messages we present suggest it is an either/or situation: you either have normal hearing, or you're deaf or hard of hearing. The problem is that we apply the terms deaf and hard of hearing to the complete gamut of experience, much of which will not be seen as relevant to our audience.

What springs to mind?

So when someone tries to answer these two questions for themselves they call to mind all the things that ‘deaf’ and ‘hard of hearing’ means to them, and in doing so they remember all the things that are easiest to recall. This will specifically include things that are salient and things that evoke strong emotions...

  • They'll remember the people on TV communicating in sign language.
  • They'll remember their great aunt's hearing aid whistling.
  • They'll remember the person at school who pronounced their words differently.
  • They'll remember the colleague coming up to retirement who always seemed 'a bit slow on the uptake'...

...and they'll ask themselves, does that really apply to me?

As people call these things to mind they will ask themselves two questions:

  1. “Does that describe me?”
  2. “Do I want it to describe me?”

By answering “yes” to one or other of these questions, the either/or nature of our terminology implies that they have to move out of one group (where they have spent their entire lives up until this point) and to move into another group, a group that they consider foreign to them.

Looking for counter-evidence

So they say to themselves:

  • Well I don't need to communicate in sign language because I can participate in spoken conversations.
  • I'm not like my great aunty who we all had to shout at – and I certainly don't want everyone complaining about me whistling.
  • I pronounce all my words correctly.
  • And I generally hear everything first time (as far as I'm aware) – everyone misses things from time to time, don't they?

All of which confirms in their minds that they don't belong in the new group, which must mean their hearing's OK.

The reason for the delay in seeking timely treatment

So a lot of the delay in people seeking timely treatment for their reduction in hearing is the time it takes:

  • For the hearing difficulties to reach a stage where they are forced to do something about it.
  • b) For them to resolve this conflict of ‘where they belong’.

The Transition Phase

Remember the Actor-Observer Bias described above? Remember that when something affects us that we perceive to be negative, we assume it's the situation or circumstance rather than being due to the way we are.

But here's the problem. All our messages and terminology suggest it's all about “the way they are”!

Here they are, convinced that the problem lies outside of themselves, but we keep on insisting that the problem is within them!

So this creates a conflict (or dissonance) in our audience's mind. And to resolve this conflict they have three choices:

  • Deny:
    They can pretend the conflict doesn't exist, either by ignoring it altogether or by continuing to attribute their hearing difficulties to outside factors.
    Examples include: “People don't speak properly these days.” and “I hear just fine.”
  • Trivialise:
    They can trivialise the matter so “it's not that important anyway”.
    Examples include: “My hearing's normal for my age.” Or “I hear everything I want to hear.”
  • Change:
    They can change their own attitude and behaviour to match the new knowledge.
    Examples include: “If I need hearing aids, I'll get them.”

Of the three choices change is the hardest of all: not only does it require more effort, it also threatens their sense of who they are and how they see themselves. It's as if a piece of them is being taken away. This is compounded by the prospect of moving from one group and into another, and all the implications this has for their sense of self and belonging.

Making the transition easier

The good news is that there are very practical measures that the Hearing Care Community can put into place with immediate effect that will make this transition so much easier for people. These measures will significantly decrease the time it takes for an individual to seek appropriate treatment for their reduction in hearing.

In a nutshell we need to:

  1. Change our language to make it functional (i.e. all about what hearing does or doesn't do) rather than attributional (you are hard of hearing) and avoid either/or terminology.
  2. Make our messages talk about the situation rather than the way someone is.
  3. Ensure our calls to action reinforce the way people see themselves rather than threaten it.
  • Give people a way to discover changes in their hearing before anyone else does.


Much of our current language in hearing care is what I would call “attributional”. In other words it applies an attribute to the individual. You can recognise attributional language because it works in a sentence like “You are…” or “S/He is…”

So “he is good-natured”, “she is hard working”, “you are approachable” are all examples of attributional language.

In hearing care “normal”, “deaf”, “hearing impaired” and “hard of hearing” are all attributional.

The problem of attributional language is that it potentially threatens someone's sense of who they are and how they see themselves if they do not believe it applies to them (or do not want it to apply to them!), and this is particularly true if the Actor-Observer Bias is in effect.

So if someone doesn't agree with your attribution, you've immediately lost your audience. Furthermore, you have probably strengthened their resistance to change due to the reasons explained above.

To side-step this issue we need to use language that is functional.

Functional language describes what something does. This will requires a much fuller discussion in a separate article because it very quickly becomes apparent that the hearing care community does not yet have an adequate vocabulary and so we'll need to develop one.

But as a simple guide, instead of saying something like “you have a mild to moderate hearing loss”, talk about what their hearing does or doesn't do for them (i.e. the function):

“Your hearing is currently missing some of the sounds within speech at everyday levels. This means…”

This immediately shifts the focus onto the SITUATION rather than onto “the way they are”.

You'll notice also that by talking about “your hearing is missing” rather than “you are missing”, you distance it slightly so you are no longer threatening their sense of self. It's much easier for people to be objective (and problem-solving) when it's a situation external to them.


If we want to be relevant to the individuals we're currently failing to reach, then our messages need to reflect the Actor-Observer Bias. So our messages – whether public awareness campaigns, advertisements, press releases, brochures, conversations etc. – need to focus on situations and circumstances, rather than on whether or not someone has a problem with their hearing.

Too many of our current messages run along the lines of “Do you have problems hearing TV or in crowded rooms? Then you might be hard of hearing.

Do you see the problem here? We've used a situation to say: “that's the way you are.” So we've threatened how they see themselves and set up a potential conflict in their minds.

Instead keep the message on the situation. Say something along the lines of:

“Crowded rooms: they may be a challenge. But you believe in stacking the odds in your favour.
Introducing the new Hear2000 Hearing System.”

In this message we've acknowledged the situation itself is a tricky one (they probably hear OK in one to one situations), but we've also shown that the hearing system is the solution to that situation, rather than a badge of a problem that lies with them.

Actually, we've gone one step further. We've also attributed a POSITIVE aspect to our audience. We've told them that the reason they use the XY2000 Hearing System is not because they're 'hard of hearing' but because they are a pragmatic problem solver.

In other words, if they choose to act upon this message (the call to action), they reinforce their sense of self – so we've avoided that potential conflict (or dissonance) in their minds of acting in a way that may be counter to how they see themselves.

Call to Action

So in any message you present, ask yourself what people will be saying about themselves if they respond to your message:

  • Does it agree with how they see themselves?
  • Does it agree with how they'd like to see themselves?

It cannot be stressed how important this is. It applies to public health messages, encouraging people to have their hearing checked, trying hearing technology, using hearing technology.

There is an abundance of positive messages for all of these things; it's just that we tend to forget them when we're formulating our messages because we have this erroneous belief that we have to convince someone their hearing's not as good as they thought it.

Opportunities for Self-Discovery

As explained above, if a third party (such as family member) proposes that an individual has a problem with their hearing, it initiates attitude formation which leads to a conflict of beliefs and a threat to self. This in turn increases resistance to change which increases the time it takes to do something positive about their hearing.

To avoid this situation, we need to give individuals opportunities to discover their hearing for themselves, and by far the most effective way is by establishing hearing tests as routine, not in order to catch a hearing loss (i.e. not "screening"), but to maintain healthy hearing: to keep your hearing working at its optimum throughout life (i.e. "baselining" and "montioring").


Once again we have seen that by making some very simple (and sometimes subtle) changes to the way we provide and communicate hearing care, we can greatly increase our relevance to our intended audience and stop ourselves reinforcing those old-fashioned attitudes that make our jobs harder.

Ultimately it comes down to how people see themselves and their hearing, and whether our language and messages are sympathetic to this. By keeping our language functional and our messages situational we avoid aggravating internal conflicts of belief in our audience and make it easier for them to respond to our calls to action. Our messages will gain that resonance they so desperately lack if we are to succeed in modernising attitudes to hearing care.

(Please note that if you have skipped most of this article to just read the summary, I highly recommend you take some time to read the entire article otherwise you'll have missed out on some important practical tools you can use in creating your own messages that resonate.)

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Curtis Alcock

Curtis J. Alcock is Founder of Audira » Think Tank for Hearing.

He was involved in design and marketing for 12 years before making the transition into hearing care nearly 12 years ago. He now runs an independent family-run hearing care practice in the United Kingdom and has spoken internationally on shaping the future of hearing care.

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