Essay 6 – When the Ear Changes
- Art of Hearing | Dyon Scheijen
- Apr 10
- 3 min read
Hearing Loss within The Hearing Triptych
Hearing loss often begins in the ear, but rarely ends there.
What at first glance appears to be a problem of reduced auditory input develops in practice into a process in which the brain and the human being must constantly adapt to a changed reality (World Health Organization, 2021; Jastreboff, 1990).
Where Art Meets Science
The Hearing Triptych
Sound · Brain · Human Experience
Essay 6
When the Ear Changes
Why hearing loss is more than just hearing less
Hearing more than less
Hearing loss is often described as a decrease in auditory input.
The ear picks up less.
The signal changes.
The audiogram shows what someone can and cannot hear anymore.
But what looks like a loss on paper,
is rarely so simple in everyday life.
Hearing loss means:
– conversations that take more energy
– difficulty following speech in noise
– constantly having to compensate
– and the feeling of having to stay alert
It is not only listening that changes.
Also the life surrounding it.
What changes in the brain
When the input from the ear changes, the brain does not remain still.
It adapts.
The auditory systems attempt to compensate for the reduced signal.
Sometimes by amplifying signals.
Sometimes by filtering differently.
This process is described as central gain, in which the brain attempts to compensate for the reduced input by amplifying signals (Jastreboff, 1990; De Ridder et al., 2011).
What is intended as an adjustment can simultaneously cause sound to be perceived differently.
Sharper.
More present.
Or in some cases:
that sound is perceived that is not present from the outside.
The bridge to tinnitus
At that point, hearing loss and tinnitus intersect.
What starts as a change in the ear,
can develop into an experience that largely takes place in the brain and perception.
The sound is not only heard.
It is polite.
And sometimes also:
contested
(Jastreboff & Hazell, 2004; De Ridder et al., 2011)
The person behind the audiogram
But even that is not the whole story.
The impact of hearing loss is ultimately not determined by what happens in the ear, but by what it means in a person's life (World Health Organization, 2021).
Slow shifts can occur.
Conversations cost more energy.
Misunderstandings are increasing.
The matter-of-course nature of contact is disappearing.
And with that, sometimes also:
– the feeling of belonging
– ease in social situations
– the place at work
What used to come naturally suddenly requires effort.
And that effort often remains invisible to the outside world.
Some become more tired.
Others withdraw.
Not because they want to.
But because it is simply becoming too heavy.
Loneliness can creep in quietly.
Tensions at work can escalate.
The feeling of no longer being able to keep up can grow.
And sometimes that leads to dropouts.
Not because someone no longer wants to.
But because it is no longer possible.
This broader impact of hearing loss on psychosocial functioning has been extensively described in the literature (Nachtegaal et al., 2009; World Health Organization, 2021).
What begins in the ear eventually touches the whole of life.
Hearing loss within the triptych
Within The Hearing Triptych, hearing loss becomes visible as an interaction between three dimensions:
Sound
The physical change in input.
What comes in changes.
Brain
The processing and adjustment.
The system tries to compensate.
Man
The experience.
What it means in daily life.
Hearing loss is therefore not a problem of the ear alone.
It is a process in which sound, brain, and human must relate to each other anew.
Where space is created
Precisely because multiple layers are at play, space is also created.
Not only in technology.
Not only in amplifying sound.
But also in:
- attention
– meaning
– dealing with effort
– restoration of balance
Finding that balance is rarely a straight line.
But it is a process.
The question that remains
Perhaps the most important question is not:
How do we repair the ear?
But:
How do we help someone find their place again in a world of sound?
Where Art Meets Science
Sound · Brain · Human Experience
Literature
Jastreboff, P. J. (1990). Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neuroscience Research.
Jastreboff, P. J., & Hazell, J. W. P. (2004). Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. Cambridge University Press.
De Ridder, D., Elgoyhen, A. B., Romo, R., & Langguth, B. (2011). Phantom percepts: tinnitus and pain as persistent aversive memory networks. Proceedings of the National Academy of Sciences.
Nachtegaal, J., et al. (2009). The association between hearing status and psychosocial health before the age of 70 years. International Journal of Audiology.
World Health Organization (2021). World Report on Hearing.
Scheijen, D. (2026). The Hearing Triptych: Sound · Brain · Human Experience. Art of Hearing.
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