"I just wasnae me anymore": Individual Experiences of Identity Loss, Identity Negotiation, Acceptance and ‘Adjustment’ in Acquired Hearing Loss

Abstract

Objectives: There appears to be growing evidence that living with acquired hearing loss (AHL) results in people experiencing increased psychological distress. However, there is currently a dearth of research examining psychological adjustment to AHL. The available models assume that psychological adjustment to AHL is a sequential process. Personal accounts of AHL and evidence regarding other disabilities suggest that psychological adjustment is a far more complex process. Consequently, the present study aimed to explore individuals‟ experience of the process of psychological adjustment to AHL. In addition, individuals‟ understandings of the concept of adjustment were also explored. Method: Ten semi-structured interviews were conducted with individuals who had acquired a moderate, severe or profound hearing loss in adulthood. These were transcribed and analysed for recurrent themes using Interpretative Phenomenological Analysis. Results: Data analysis revealed that 9 super-ordinate themes represented participants‟ experience of adjustment to AHL. Findings indicated that AHL resulted in participants experiencing identity loss and changes in the dynamics of their relationships. Participants suggested that acceptance was a difficult but vital process that reduced psychological distress. Acceptance was hypothesised to be a multi-dimensional continuum along which participants moved back and forth. Identity negotiation appeared to be an important psychological process associated with acceptance. Participants believed that there was a “right” way to “adjust” but none felt their experiences matched this ideal. Consequently, it appeared that there was a discrepancy in the way participants and the researcher understood the concept of “adjustment.” Discussion: The findings suggested that psychological “adjustment” to AHL was a complex dual-directional process. Participant narratives appeared to be consistent with the recurrent model of acceptance and adjustment proposed by Newsome and Kendall (1996). It was suggested that findings regarding participants‟ perceptions of “adjustment” had important implications for clinical practice and these were described. It was recommended that future qualitative research should attempt to explore individuals‟ assumptions regarding “adjustment” in more detail.