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The Consumer Handbook on Tinnitus
Chapter 2
Hearing Loss and the Family

David Luterman, D. Ed.

Family therapists tell us that the family is a system in which all of the parts are interconnected (Minuchin, 1974). This means that if one part of the system is not functioning well, it affects all of the other parts; even seemingly, remote ones. When a child is diagnosed with a hearing loss, then we have an entire family system with a hearing problem. This is a difficult concept to grasp; many professionals fail to do so, because of a lack of training in family dynamics. It is the inclination of everyone involved to try to “fix” the defective part, ( i.e. the hearing of the child). In actuality, everyone within the family is suffering the pain of the diagnosis of the hearing loss and attention needs to be paid to the entire system. In order for the child to be successful, he or she needs to be within a family that is nurturing and functioning as optimally as possible.

There are characteristics of the optimum family discussed within the therapy literature that are useful in understanding what makes a family system function well. These are idealized family characteristics. No family will be able to incorporate all of these to perfection. Satir’s book (1971), People Making, describes many of the characteristics of the ideal family and Napier and Whitaker’s book (1978), The Family Crucible, details the way therapists work with the family unit. While both books are old, they are classics and may be read with profit by the interested reader. The website for the American Association of Marriage and Family Therapists ( provides contemporary information on therapeutic approaches to families in stress.

Clear Communication

Almost any therapist who writes about family systems is concerned with the patterns of communication within the family. Dysfunctional families have implied communication in which much is “understood” but not said. These are silent “rules” that a family follows that are usually understood by every one in the system. For example, a family may decide not to talk about how they feel regarding their child’s hearing loss. If there’s an implicit directive that emotions are unacceptable, family members often feel isolated in their pain. A child’s hearing loss causes high emotions to flourish within the family, not only for the parents, but for siblings and grandparents as well. If the family has no mechanism for talking about their feelings, the family system is stressed. This can take many forms. For example, the unexpressed and unacknowledged anger is often displaced on another family member. The angry person does not recognize the source of the anger as the repressed feelings about the hearing loss. Conflicts in dysfunctional families are seldom about what they’re really angry over because parents lack the skills for direct non-threatening confrontation.

Another common emotion in less than optimal families is guilt. If not acknowledged, it leads to super dedication and overprotection of the child. This leaves little time for siblings or energy to maintain the marriage. A healthy family system would allow for clear direct communication where both feeling and content are expressed. . .