I didn’t understand at the time that becoming hard of hearing would change the way I listened.
A number of years ago, while completing my practicum to become a therapist, I lost a significant amount of my hearing. The timing felt almost absurd. I was learning how to sit with people, create safety, remain present with difficult stories, ask questions, and listen deeply, and suddenly one of the things necessary to do that work had changed. I was shocked and grieving, learning how to use hearing aids and trying to understand how I was going to move through a world that suddenly required more effort from me. Underneath all of that was a deeper fear: What does this mean for the therapist I am becoming?
I had unconsciously created an image of what a competent therapist looked like. A therapist could listen effortlessly, follow every conversation, pick up on everything happening in a room, and remain fully present without having to think about whether they had heard correctly. I had never questioned those assumptions because I had never needed to. Now I did.
At the time, I understood my hearing loss primarily as a story about loss. There was frustration, fear and uncertainty about the future I had imagined for myself. But the experience also began to challenge assumptions I didn’t realize I carried about disability and competence.
This is one of the complicated things about ableism. We often talk about ableism as something other people do to disabled people, but it can also become something we absorb about ourselves. We can begin to believe that our differences make us less capable, less professional, or somehow less than the person we would have been without those differences. We can measure ourselves against standards that were never designed with us in mind and then interpret the difficulty of meeting those standards as evidence that something is wrong with us.
Part of adjusting to hearing loss involved separating the experience itself from the meaning I had attached to it. Losing hearing was a real loss and I didn’t need to deny that in order to find something meaningful in what followed. I began to recognize that some of my distress came not only from what had changed physically, but from what I believed that change said about me.
Over time, I also began to realize that I could change my environment rather than continually expecting myself to adapt to an environment that wasn’t working for me. I could be intentional about where I sat, reduce competing background noise, ask people to face me when they were speaking, let people know what made communication easier and adjust my hearing aids depending on the environment.
The question shifted from “What do I need to do differently so I can manage this?” to “What is happening in this environment that is making this difficult, and what could change?” That distinction has stayed with me.
Years later, learning that I am autistic gave me another way to understand this question. Autism helped me recognize that listening and processing are not the same thing for everyone. The amount of sensory information entering our nervous systems, the way we filter that information, the effort involved in processing language and the impact of competing sounds or environmental stimulation can vary enormously from person to person. What looks like effortless listening from the outside may involve a tremendous amount of internal processing.
It also made me think differently about what we mean when we say someone is listening. As therapists, we can place a great deal of emphasis on spoken words. Of course, what a client says matters enormously. But listening in therapy involves so much more than the words being spoken. We listen to tone, pauses, pacing, emotion and the things that seem difficult to put into words. We notice what someone returns to, what they move away from, what changes when they talk about certain experiences and what is happening in the relationship between us.
We also need to make room for different ways of listening and communicating. As therapists, we can easily assume that we know what listening looks like: eye contact, facing us, stillness, quick responses, or an engaged facial expression. But these outward behaviours don’t necessarily tell us what is happening internally. Someone may look away because doing so helps them concentrate on what is being said. Someone may need more time before responding because they are still processing. Someone may communicate more clearly through writing because spoken language becomes more difficult when they are overwhelmed. Someone may become quieter when there is too much sensory or emotional information to process, while another person may talk at length because speaking is how they organize their thoughts.
None of these ways of communicating automatically tells us whether someone is listening, engaged, or connected to the conversation. They remind us that we cannot always see listening from the outside.
This is particularly important when working with autistic clients, whose ways of processing and communicating may not always fit conventional expectations of what engagement is supposed to look like. If we mistake a difference in communication style for a lack of interest, resistance, or emotional disconnection, we may end up responding to a problem that isn’t actually there. Instead, we can become curious about how this person listens, processes, communicates and experiences the therapeutic environment, rather than measuring them against our own expectations. If we have a narrow definition of what listening looks like, we can easily mistake difference for deficit.
My experience of hearing loss made me aware of how much communication depends on the environment. Learning that I am autistic deepened that awareness by helping me understand that sensory processing and communication are not neutral experiences. The same room, conversation, lighting, background noise, pace and social expectations can be experienced very differently by different nervous systems. This matters in therapy because the therapeutic environment itself is part of the work.
Before we interpret a client’s difficulty as resistance, avoidance, lack of motivation, poor insight, or a symptom that needs to be changed, we can become curious about what else might be happening. Is the room overwhelming? Is there too much sensory information? Is the person trying to process several layers of information at once? Are they masking? Are they struggling to find language for something they understand internally but cannot yet communicate verbally? These questions invite us to slow down before deciding what a behaviour means and to consider the person within the context of their environment, nervous system, relationships and lived experience.
As therapists, we have an enormous amount of influence over what we notice and what we name. If we are listening only for symptoms, we will find symptoms. If we are listening only for deficits, we will find deficits. If we are listening only for what needs to change, we can miss the adaptations, strengths, relationships, values, sensory experiences, and protective strategies that are already present. This is why I return to the question: What are we noticing, and what are we missing? Listening differently means being willing to look beyond what is immediately visible and spoken, and to remain curious about the whole person rather than reducing them to the difficulty that brought them to therapy.
The goal isn’t to stop noticing disability or neurodivergence. It isn’t to pretend that differences don’t create real challenges or that accommodation solves everything. The goal is to notice without reducing and to remain curious without turning curiosity into scrutiny. To hold a person’s difficulties alongside their strengths, adaptations, relationships, values and full humanity.
My hearing loss taught me that I could listen with more than my ears. Learning that I am autistic helped me understand that lesson in a deeper way. Both experiences have challenged me to think less about what it means to fit and more about what it means to create conditions in which people can participate, communicate, regulate, connect and flourish.
Perhaps listening differently means becoming willing to hear the person beyond the diagnosis, the story beyond the symptom, the meaning beneath the words, and the human being beyond the thing that makes them different.
It means staying curious enough to let people show us who they are, rather than deciding in advance what their differences mean or what we believe we already know about them.