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Welcome back to the All About Audiology podcast. I’m your host, Dr. Lilach Saperstein and on this show we talk about how audiology interacts with your life, how it matters to you, and why you should care about any of the anatomy and all these technical things. But really, when we talk about audiology, we are saying, how does hearing and communication impact your relationships (and how does it) impact how you survive in the world. Especially for kids, we have tons of wonderful listeners who are parents. You want to give your kids everything you can, you want to advocate for them.

So, welcome to the show!

I’m so, so excited today to introduce you to Margo Helman who is a clinical social worker and therapist. She has a very interesting story to share. We have a little bit of a theme going on in the last couple of episodes where people have reached out to me and want to share their personal stories with hearing loss, audiology or communication and there’s a surprise. So, I’m excited to introduce Margo.

Dr. Lilach Saperstein: “Welcome to the show. Tell us a little bit about yourself.”

Margo Helman: “Hi, thanks for having me. First of all, it’s so cool what you do. It’s great and so important. So, I’m really happy to be here.”

LS: “Thank you. It’s truly a labor of love and a mission from my heart. It’s fun.”

MH: “Yeah, I want to hear more actually about how you got into it. Maybe I’ll talk to you later. Your listeners probably know all that already. Hahaha.

So, I’m Margo, as you said, Margo Helman. I’m a clinical social worker and therapist. I work with people here in Jerusalem or online, coping with all of the things, normal difficult things about life. So, anxiety, difficult relationships, illness and loss. That’s my thing. I’m also passionate about mindful listening. Maybe I’ll tell you a little bit about that.

A lot of us have practices where we self-soothe and we can get ourselves really calm. Maybe some of us meditate or do yoga, little inner things too. Let’s say we’re meditating or doing yoga, we get off the cushion, we get off the mat, we walk into the kitchen or the living room where all the action is and then we can lose it at the people who are most important to us. It’s normal obviously, but sometimes, especially we know we are good at soothing ourselves in other situations, it can feel horrible and ruin our day and get us off track.”

LS: “Do you mean that people yell at their loved ones? Hahaha. That’s something that happens a lot? Hahaha.”

MH: “It does, Lilach. I can see you are very innocent about this. Hahaha. Yeah, we usually yell or get terribly upset and it throws us off so much. It’s both fascinating to me and really I want to create a movement, if you want the truth. I want to create a movement of bringing our inner practice to those moments with the people we love the most. Because that’s where we need it. I’ve come up with little tools and ways of doing that.”

LS: “Oh, wow. I really resonate with that. I want to hear lots more about that. One of the things we talk a lot about is advocating. My method, called the F-I-G Method, people have heard about it, and I’ll link it in the show notes but it’s basically about how do you take all that advocating energy and take it also to random people in the parking lot who just say the rudest thing to your kid. Like, you come in and you have this advocacy hat, but you have to wear it all the time when you are a parent to a child with extra needs or different needs. Honestly we all need it all the time.”

MH: “I say, we all have special needs, right?”

LS: “Exactly. So, I’d love to hear how we could do that switch, when you are in the flow, in the zone, you’re taken care of, you’re taking care of yourself, things are good. But then things get rocky.”

MH: “Yeah, so the first thing is just to notice it. To notice it. I remember a moment when I realized I need to be able to self soothe when I’m talking to my husband or my kids, or when my husband and kids are talking to me. I have to be able to bring those tools. Everyone has their own tools. But just first to notice it, we need them there. If your tools include mindfulness which is connecting to hear and now through your senses, through vision, hearing, through body sensation and touch, maybe taste and smell. To pay attention when you are listening to someone, you are not in the present at all. Often, especially if you are upset.

You can get back there. It’s not complicated to get back there by just looking up. Look up and look around you and notice where you are. It’s really important to me when I talk about dealing with difficult feelings or difficult reactions, we are not trying to shut off those difficult feelings, because that can make you nuts. The nature of feelings is that they change, but if we struggle against them and pushing hard against the ceiling, then we are actually increasing the contact with it. Not to try to shut out that feeling, but to add something else. To notice where you are right now, everything is fine in 99% of our moments.”

LS: “I love the mindfulness anchor, I guess you can call it. Just noticing your feet on the floor making contact, or noticing your feet inside your shoes. I don’t know, but I think I probably heard that in a class or a recording and that really stuck with me. Often, I think about how I’m like literally floating in my mind, but at all times, my feet are actually connected to the earth, to the floor, even though I live on the fourth floor. Hahaha. It’s connected to a floor that is connected to the earth.”

MH: “Feet on the floor. That’s a great one because it comes from something that is meaningful to you. You have a little bit of a story about it. You know, you feel like you are floating, but you are not, you’re on the floor, you’re connected to the earth. So, it’s a great resource for you. It’s integrated with you.”

LS: “So, what can you share with our listeners for them to have a practical tool that they can use when they are stressed out?”

MH: “It’s good to just go through the senses, or whichever sense, pick one sense. There are so many different ways to do it. Let’s say two different options. You can pick one sense like what you see and just look up and notice what you see around you. Even, you can find something that you like to look at. All of this sounds like, wait, I’m in the middle of something. I can’t pay attention to something else, I’m doing something. But it can be one moment of just looking up and noticing. There is a beautiful plant that someone gave me right across the room from me, and just looking up and noticing it. And I see it every day, right, but just focusing on it and noticing a little bit more like I’m noticing there is one leaf that’s kind of curly and has dark green on the middle and light green on the outside. I’m seeing it in a way that I don’t usually see it because I’m bringing my attention to it.

That interrupts the noises in my mind. So, picking a sense, it could be body sensation speaks most to you or it could be vision or it could be sounds and just connecting to what’s going on, here and now through that sense. That’s what mindfulness is. It’s connecting to here and now through the senses.”

LS: “So, speaking of hearing, would you share with us your experience with audiology and you have a good story to tell me. I’m excited to hear it, haha.”

MH: “Sure, I’m happy to do that. It’s funny because I’ve never been the focus of attention because of this, it’s funny. I have a story of hearing loss and what’s interesting is, what I was saying earlier about the importance of mindful listening and the importance of being able to listen, completely comes from my hearing loss. So, I’ll get to that too.

What happened was, I’ll start from the beginning as first we knew it, which was when I was six years old and we were starting in the kitchen on Glengrove Avenue in Toronto and we were talking on the phone. I’m older than you, so I don’t know when you grew up, but there was this wall phone with a long chord and a dial. I’m sure you remember them. We were on the phone talking to my grandmother, my bubby, that’s what we called my grandmother. She didn’t live far away, it wasn’t a long distanced call. We were just saying hello to my grandmother. I don’t know whether it was a special day or what. So, I’m six years old and someone handed me the phone. Also something that was different about those days, a long time ago, it was actually fifty years ago if you want to know, was that I was maybe just starting to use the phone at that age. It’s a big change. It seems to me that if that wouldn’t have been the case, we would have known this already.

So, they handed me the phone and they handed it to my left ear and I said, wait a minute bubby, that’s my bad ear. That’s the first that anyone knew that I am deaf in one ear. My grandmother freaked out, haha, because that was her nature to be nervous about things. I don’t really remember much about it. I remember that happening and then mostly I remember the stories. And then, we went to get it checked out and we figured out that it was probably because I had a very, very high fever when I was one years old and they gave me phenobarbitol, so I think, maybe there are conflicting opinions. Someone told me it was just because of the fever but when we went to a pediatrician with my son and I told him that, he said, no you can’t get deafness in one ear because of fever. So, then someone said that it was because of the Fenabarb. Who knows? Do you know?”

LS: “I mean, again, it’s difficult to have all the information from so many years ago but is there anyone else in the family who has this, even like extended cousins or anyone?”

MH: “No.”

LS: “Because that would be interesting. What I find so fascinating about your story and your experience is that maybe it was just part of what your experience was but you were able to put language to that as a six year old. But it was the situation. Yeah, this was your bad ear. There was no drama about it, it seems.”

MH: “There was no drama about it. In fact, there was never any drama about it which was great. So, I was not a really confident kid but it had nothing to do with that. I was never shy about telling people that I need to walk on this side, or without even telling people, just gravitating to the correct side of people so I could hear them.”

LS: “Do you have hearing in that ear, in the left ear?”

MH: “I don’t have any hearing in the left ear. It seems to have been nerve damage. When you just said oh wow, I don’t experience it that way at all. There are two problems I’ve ever had with this, they’re not very complex, they are not big problems at all. One was that in University classrooms, big lecture halls, someone would call me but I had no idea where they were calling me from. And after feeling really foolish a few times of turning all around and figuring out where they were calling me from, I made a decision. I’m standing here if they really want to talk to me, they’ll come here. So, that’s one of the two main ways where it was like a “problem” in my life, which is tiny, right?

The other way was that if I wouldn’t tell people that I need to walk on the other side, or figure out how to walk on the other side without telling them sometimes, I would sometimes bang into trees. Hahaha. Because I’d be walking with my head turned like this to hear someone and someone would say, with my head turned all craned all the way around, and they would say, ‘Hey, watch out!’ and I would turn around just in time to bang straight into the tree.

So, those were the two biggest problems I’ve had. On the other hand, I think that it has been something that has affected me for the good, not in ways that I would necessarily know about. But looking back, I think it really affected me for the good.

So, one good thing I was happy about as a little girl, I totally milked it sometimes. I’d be somewhere and my mom would call me that I had to do something and it was like, oh I didn’t hear you. Completely on purpose. So, that was fun.”

LS: “Sometimes, your children’s behavior is the situation and not their hearing loss. You have to keep an eye on that.”

MH: “Yeah, of course. A child with hearing loss, is a child. They are going to be, as much as they are kind of mischief makers, they are going to be mischief makers. I believe that my hearing loss made me a really good listener. And it developed kind of naturally over the years. And I think hearing loss also gave me a love of mindfulness. When I first discovered mindfulness, it was something that was kind of familiar to me in a way. I knew I loved it because I had to really attend to people in order to hear them.

So, my whole life is about listening, you know. I’m a therapist. Haha. And I sing also, I love to sing. It’s all these things that are important to me that have to do with, and are somehow connected. I didn’t always know they were connected but they are connected. I think, I really believe in that actually that we are, each of us, an incredible mixture of strengths, wonderful strengths, and sometimes quite difficult, even terrible challenges. That’s who we are and knowing ourselves and accepting ourselves, that mix of who we are. That’s how we can go out and make a life for ourselves, make a good life. So, that certainly happened with me.”

LS: “Yeah. You have a lot in common with another guest we had on the show, Jacquelyn, who is also a musician, a singer and she also has a unilateral hearing loss in one ear. I’m finding the term that is coming to my mind is this expression where people say they suffer from hearing loss. And Michelle Hu, who is an audiologist on Instagram, @mama.hu.hears, said, “The suffering from the hearing loss is separate from the hearing loss.” Those are two separate experiences, two separate things. There is a lot of factors that go into which way it’s going to go. What support you have and what resources you have, everyone experiences it differently. But I think it’s really interesting that you see it as, Oh, I had to attend more and I’m good at listening instead of the story of, ‘I had to work so hard and everything is so exhausting to listen.’ Because that’s other people’s experience of a unilateral hearing loss. Fascinating.”

MH: “I think that’s true in general. Things that are difficult as opposed to suffering or even pain as opposed to suffering. Challenges and even pain seem to be part of the package but we’re the ones that turn things into suffering. Partly, through fighting what is, which is I think part of the gift of mindfulness, of teaching us how to be with what is. Both, in noticing the beauty of what is in the present moment, but also in noticing that when we are in the present moment and we connect that way, all we have to deal with is the present moment. We have this illusion that we need to figure out so much ahead of time and we can’t. So, worry is all about trying to control things that we can’t touch because they are in the future. We can’t get there.”

LS: “Wow!”

MH: “But if we remind ourselves that all we have to deal with is the present moment and any bits of specific planning that I might need to do. But they are usually quite small compared to this load of worry that we have. So, I love what you were saying before that the suffering of hearing loss is not about the hearing loss itself, it’s about comparing it to what we think it should be, all that stuff.”

LS: “I’m curious to know, where you said before, you said your grandmother got nervous and then you went and got tested and you got your official diagnosis. What happened after that? Was there any intervention offered, or classroom accommodations, things like that?”

MH: “It was very low key. It could be that my parents talked to teachers. I remember I needed a seat up front and also on the left of the classroom so the teacher would be on my right. But it wasn’t a big deal. That worked really well. I guess it depends on what kind of system you are dealing with and sometimes you have to make a big deal, unfortunately.

So, I would go every year for a hearing test because there was a 100% hearing loss so I couldn’t benefit from a hearing aid, and cochlear implants weren’t a thing back then. I don’t know if that would have been something that they would have even considered. Do people consider cochlear implants now for a unilateral hearing loss?”

LS: “Yes. Yes. Yes. This has really been a change just over the last decade that’s showing that if implantation happens early during that critical language acquisition period, the first three years, then children have really good outcomes. Many children have really good outcomes when there is one good ear and a cochlear implant in the other ear.

But if your ear hasn’t heard in all these years and that nerve never got stimulated, it would be a different case and different expectations for someone to get a cochlear implant at that stage. But Jacquelyn who was on the show, she had a traumatic brain injury in a car accident. That’s how she lost her hearing and she got a cochlear implant. She was hearing all the years and then lost the hearing and now has a cochlear implant. It’s an amazing technology for the cases where it is appropriate.”

MH: “When it first became known about cochlear implants, people were saying, you should do it. You should do it! I wasn’t thinking about the fact that I had gone without hearing loss in that ear for decades. For me, it was like, my life is fine. Why would I want them to go and do this invasive thing if my life was just fine?”

LS: “There you go. Someone with this exact same hearing loss in one ear, good hearing in the other, might say that they have such a hard time and they really want to try anything that can help them.

Have you heard of the CROS hearing aid? It’s basically where you put a little microphone on the left side and it transmits to your right ear, just so that you don’t have to actually crane your head. So, that might be an option if you’re interested. Those are some of the options that are out there.”

MH: “That would be interesting.”

LS: “Yeah. My favorite story about someone who loved their CROS so much was a veteran that I worked with in the Veterans hospital in Brooklyn. He played in a band so he was always on the side where his ear could hear the rest of the players. When he got the CROS hearing aid, he could be anywhere on the stage so he was very happy about that, that he didn’t have to be limited in the one spot. He could be in the middle or on the other side. Hahaha. So, it’s really very situation-dependent.”

MH: “Yeah.”

LS: “But if you are a therapist, you are usually talking to people one-on-one and in quiet rooms. Your situations are different than say, a classroom teacher or a university student.”

MH: “Right. I work with families sometimes. I don’t experience that my hearing loss makes it problematic for me when I’m doing therapy in larger groups. I also lead groups. I think that it’s given me naturalness of saying, I didn’t hear what you said, which is really important in therapy. Or I didn’t get what you said, I didn’t understand what you said. Again, that aspect of listening and making sure that we are understanding and checking to see if we understand the other person. Listening, I think has very little to do with the ears.”

LS: “Absolutely. Hearing itself happens within the brain. So, our ears are the tool, the sensory organ that picks it up but all of that happens in the brain. Further, is where you add your understanding, your context, your language. Like, do you even know that vocabulary word, do you understand what they are talking about. Yeah. That’s so important. So, then you really focus on mindful listening and how when we are in a conversation, we are not thinking about the next thing we want to say or how to answer them back and think what’s the big comeback? We actually just listen to what they are saying. How do we do that??? Help!!! Haha.”

MH: “It’s real. It’s a practice, right? We were talking before about practices that we use for self-soothing like meditation, mindfulness or yoga or any little thing that you do, is a practice. So, mindful listening is also a practice. It is what you just mentioned. Instead of saying not planning what we are going to say, I like to think about it as noticing when we are planning what we are going to say and coming back. All kinds of things happen when we are listening. Part of the reason it’s so difficult to listen is because when we are hearing someone, especially in those moments of conflict, that person is saying things that are difficult for us to hear or they are saying things that we really disagree with and we think it’s really important for them to get that they are wrong. Right?!

Maybe we may think that that’s true or maybe not. Maybe it is true but the thing is when someone is heated up, they can’t hear us anyway. There’s no way to convince someone that they are wrong if they are angry or intense past a certain point. The best thing you can do when someone is upset is be mindful of your own reactions. Be mindful of everything in that moment. What we do when we are mindful of everything in the moment, the attention moves. Like I was talking about, paying attention to the plant over there, or the person’s face, noticing that my shoulders are all intense, noticing my thoughts and feelings. It’s a whole array of different stimuli, different things that I’m experiencing in the moment and going back over and over again to listening. I can hold on to myself in a moment of conflict. I can choose my response and feel better about my response and create a better outcome.”

LS: “Absolutely.”

MH: “It is a practice. What I love about it is, one of the things I love about it is that, it takes relationship conflict or those difficult moments that we have with people that are the most important to us, and turns it into a key part of our inner practice. There’s something also very spiritual about it. It turns it into a key part of our spiritual practice. Usually, we often see these things as separate. Like, people in my life are getting in my way of being as calm as I can, haha, but we are actually more important than that.”

LS: “That’s really interesting. We’re really integrated into your every day life into those situations that you’re in all the time. Especially people who are in quarantine or stay at home, or kids that are home now for remote schooling. There’s just so much more contact that we have as opposed to saying, see you at the end of the day. There are a lot more interactions throughout the day. At least that’s what our experience has been.”

MH: “Absolutely. And to see you at the end of the day, where we have that time where we have more choice about how to spend our time, then we go back to our kids or our spouses, refreshed. When we are home all day together, it can be really, really difficult for a lot of us. It can really be painfully difficult. So, finding ways where you can take, I think of it sometimes as a mini vacation, of just taking a breath and just noticing your breath. That mini. It’s super important.”

LS: “Yeah. I’m doing that right now.”

MH: “Especially with kids, there’s even more of a… Did you just say that you are doing that right now?”

LS: “Yeah, I was just breathing as you were talking about it. In fact, everyone, do that as you are listening to this podcast. Take a deep breath.”

MH: “Yeah, (breathes in deeply), like that.”

LS: “It’s really restorative, even just one breath. It really brings you back.

The most impactful and really long-lasting lessons that I learned from being in therapy, highly recommended, is that I actually experienced what you are talking about. The conversation just goes much slower, because there isn’t necessarily a back and forth of two people interacting in an equal sense. It’s like the other person, the therapist, is literally there to hear what you are saying and has no invested interest in the conversation for themselves. So, all of a sudden, you get to hear for yourself what you are saying and then process how that sounds. It’s very analytical where you are analyzing what you thought or what you said without the other person’s volley as a regular conversation in real life, sort of.

And I remember that in the beginning, I would be like why isn’t this person giving their opinion, their response, their answer. This is a very different version of conversation so I’m a big fan of therapy. It has definitely helped me learn what are those, the juj like you said, the gears turning and how sometimes that like goes so fast, you can’t even hear it yourself until you slow it down and then the therapist is kind of a mirror to that. I really appreciate what you do.”

MH: “Thank you.”

LS: “So, many of the listeners on the show are also providers, audiologists, speech therapists, teachers of the deaf. We always try to also give the other side and that’s kind of the podcast too. We all come together and try to have these conversations as a group and it’s not like provider vs. patient. We’re all people. The audiologists and the teachers on the one side are asking themselves the questions that parents are asking themselves. How to do the best by the kids and how to be supportive and give them the best environment and take care of them and ourselves. I’m wondering if you can talk a little to those listeners, our listeners who are providers, how we can incorporate this into our health care practices.”

MH: “I think in a macro sense, the main thing is that each of us as human beings need to do our own work and figure out what helps us and figure out what are source of inspiration and strength are. I’m not exactly sure if that speaks to your question. I think to know that if we find ourselves reacting in certain ways, we need to understand what is getting to us and to understand what we need in order to nourish ourselves and to learn skills to help ourselves.”

LS: “That’s so important. So powerful. I think there is this concept of self-care that gets over-applied. Which is like, any problem that you have, (gets a response of ) well you didn’t take a bubble bath for forty-five minutes. That’s not in everyone’s ability and life and resources to do that, especially parents, I mean all parents again, but parents that have kids with special needs have very limited time and resources and so, it’s kind of like the burden of the care is now your problem also. We need care from others. We need support from our community, from family, from the schools and providers, all the therapists and things like that. And I wonder your take on that, on self-care versus getting support from elsewhere.”

MH: “I had a client once, actually she was a therapy student, a supervisee, who said to me that sometimes she thought therapy was against her social actions. Because therapy is all about getting used to things that maybe you shouldn’t have to get used to because maybe there should be social change. I hear that a little bit in what you are saying. And there is an aspect to truth in that. The whole self-care bible where everything is about self-care, on the one hand, absolutely if it gives you permission, it should be about giving yourself permission as much as possible in your life’s situation to do what you need to do. To say no, for instance, or take a forty-five minute bubble bath if you can, if it is really important to you, but self-care should not be a whip that we then use against ourselves. We turn so many things, our society or we do it together, turn so many things into something that we use against ourselves. It’s true. There’s a lot of things that should be as part of our world, certain basic resources and support that aren’t there. Changing those, would that be better than self-care, sure. We need them both.”

LS: “Yeah. It reminds me also of the conversation we are having all over about screen time and remote schooling. So many screens. It’s like the screen is not the enemy. It’s kind of like what you do with the screen. There’s mindless scrolling and there’s amazing interaction and support and community that happens on social, things like that. Everything is a tool and I’m excited to hear about the tools that you want to share with our audience.”

MH: “Yeah. I have this one thing that has been an amazing tool in my life that I decided to write up and give it away. It’s called The soft belly method for staying calm during conflict. It’s a very simple, three step practice that’s basically looking up,, noticing your breath and doing this attention focus that’s about softening the belly. It really has a physiological effect and it also takes our attention back into ourselves rather than being all over the place. I have a link if people want to get that at bookme.name/margohelman. It’s there for you for free and it’s been really wonderful thing in my life and I hope it’s helpful for people.”

LS: “Thank you so much Margo for sharing that with our audience. There will be a link in our show notes at allaboutaudiology.com as well as a full transcript of today’s conversation as always.

Thank you so much for being on the show. Any last words?”

MH: “It was a pleasure. I love what you do. Thanks so much.”

LS: “Are you on social media?”

MH: “I’m on Facebook, Margo Helman MSW. I actually have a Facebook group called Calm During Conflict if you are interested, if people are interested more in that.”

LS: “Awesome we’ll link that as well. Thank you so much.”