The five stages of grief are often cited as the path that people take in overcoming or managing the emotional trauma of hearing loss. But typically the five stages (denial, anger, bargaining, depression, and acceptance) are only discussed as they relate to the individual with hearing loss. There is no denying that in a family system, the emotional effects of hearing loss are most profound for the actual person with the loss. However, all family members are affected by hearing loss.

Unlike most other physical conditions, hearing loss has a unique and direct impact on interpersonal communication. Interpersonal psychology pioneer Harry Stack Sullivan claimed that one's personality could be thought of as the sum total of his or her social interactions with others. Taking a cue from Sullivan, it would not be a stretch to say hearing loss, which has obvious effects on communication, affects one's personality. The implication is that the grief of someone with hearing loss does not occur in a vacuum. However standard grief models are typically applied to individual situations, not couples or families. The fact is, when one family member has hearing loss, all are affected; each member. The stages of grief apply not only to the person with hearing loss, but also to each of his or her family members. What makes matters even more complex is that it is unlikely that all family members ever experience the same stage of grief at any one time.

Imagine a husband with hearing loss in the depression stage of grief who feels that life is not worth living and so is reluctant to consider using hearing aids or ALDs let alone seek emotional help. Now consider that man's partner who may be in an earlier stage of anger. On the surface she may seem angry that her partner won't help himself by going to an audiologist, but in reality is probably angry that she has lost her hearing spouse who once was much more supportive; emotionally and perhaps otherwise. Finally, imagine that the couple has a teenaged child who is in the even earlier stage of denial. The teenager seeks to protect herself by denying that the problem exists. This however, is not the end of the dilemma. Real healing cannot take place until the family comes to realize that each person's stage is likely impacting the other persons'. Many families attempt to maneuver through their staggered grief responses over a period of years and even decades; sometimes without resolution. Imagine a single family automobile where each family member has his or her own steering wheel, accelerator and brake as the family attempts to drive down life's highway and you get a picture of confusion, chaos and lack of direction.
There is however, good news about this family or compound grief. In fact, the good news is the same as the bad news: Each person has an impact on the other person's ability to manage their individual stage of grief. Things tend to go wrong when each family member attempts to manage each stage on his or her own. On the other hand, with the appropriate outside intervention, the family could learn to manage the familygrief by considering each other member's specific stage and understanding how each person impacts every other person in the family.

The secret to managing family grief is to develop an overt language of expressing thoughts and emotions to one another; to learn to 'talk about talking'. Each family member likely experiences the impact of hearing loss in different ways. For this reason, it is important to encourage each family member to explore and share how the grief of hearing loss has affected them. Though each might feel alone in the family or relationship, it's important to recognize that there IS common ground; even if it is the common ground of feeling jolted out of their pre-hearing loss family roles. Talking about grief responses is even more important in the case of hearing loss because as stated earlier, hearing loss directly impacts communication in ways that are unlike other kinds of loss or emotional trauma. While some families naturally learn to discuss and resolve their compound grief, many do not. In such cases a family therapist can help people with hearing loss and those living with someone with hearing loss, navigate the waters of hearing loss-related, compound grief.