Winston Churchill once said that “perfection is the enemy of progress.” This same philosophy aptly describes the rehabilitative process following cochlear implantation.

I dedicate this blogpost to some of my fearlessly perfectionist patients. Being a perfectionist is challenging. Even if we are aware of this aspect of our personality and try to mediate it, being a cochlear implant recipient and going through rehabilitation can add an additional emotional burden to our life.

Adult CI candidates and recipients in the early stages of CI-usage typically have various assessments and evaluations in which they get “low” scores. Who feels comfortable getting a score as low as 30%? Most of us would not and those who most feel negative about their evaluation outcome are those who go about their lives as over-achievers or perfectionists.

Progress after cochlear implantation can be slow and confusing. The test conditions can affect test “grades.” One of my patients noted "I have 90 percent correct in quiet but only 60 percent in noise. What does that say about me?” Another asked “How come I have only 40% correct for short (monosyllabic) words? Did I fail the test?"

The Problem with Perfection

For perfectionists, outcomes that they view as poor can be almost unbearable. They want to see progress and forward movement. They know improvement requires listening practice but repetitive exercises can be frustrating. Use of drills that involves repeating sentences and words provides clear right or wrong feedback, which may push them to stop practicing—especially if they find themselves making mistakes over and over again.

When you are dealing with these challenges alone without a professional’s oversight and encouragement, there may be no one to explain the meaning of the scores. Without a clinician’s support, it may be difficult to recognize improvement and achievement beyond numerical scores. This can be tough to bear alone. People need to find ways to challenge themselves without being frustrated; frustration can lead to a recipient abandoning rehab that could help them.

People who are perfectionists should avoid using practice materials that evoke a sense of being tested and graded. Self-practice software and apps that give true/false feedback and scores may discourage more than help. Therefore, training materials and methods that would not induce this kind of stress can be a much better option.

Dealing with Perfection in Auditory Rehab

Although pursuing perfection is the way to success for many, we also need to remember that auditory learning and improving listening skills is a gradual process that takes time. As with any kind of training, we should adjust the exercise materials and training tasks to someone’s level and carefully consider the starting point.

For example, if someone chooses to practice auditory comprehension by listening to audiobooks, I encourage them to get started by listening to short articles that are read clearly and at a slower speaking pace. You can find such on English learning sites for people who learn English as a second language.

You can also use recorded articles or text-to-speech software and apps.

When choosing recorded stories, take care to not use content with background music or environmental sounds initially; save those for the future when someone becomes a more advanced listener. Initially, choose texts with simple, everyday language. Investigate hearing comprehension while practicing different language levels.

I recommend that someone start listening as they follow the written text. Then, as someone becomes accustomed to the presenter's voice and speaking style, they can move forward by first reading one or two sentences and then listening to them without looking at the text. The more progress made, the more sentences someone will be able to repeat after reading them; this process helps develop auditory memory as well as developing listening skills.

Summary

The more that someone leans towards perfectionism, the harder it may be for them to deal with a situation in which they are not entirely successful. My advice is for such individuals to curb use of auditory training that relies on scoring as the only measure for progress. It is essential to find and use training materials that gradually increase the following:

• Complexity of the materials with which they are coping (e.g., daily conversation versus literary language)
• Complexity of the practice task (e.g., repeating versus understanding)
• Complexity of the presentation of the auditory stimuli (e.g., fast, regular, or slow-paced speech; in quiet versus in background noise)

If a CI recipient finds it too difficult to deal with the imperfection inherent to practice materials, change the process to fit the person. Find training materials that (s)he feels comfortable with, work hierarchically, and give the process time. Additionally, the recipient may benefit from keeping a journal to track their experiences over time. Doing this will provide perspective on progress. Most importantly, it will allow the individual to better enjoy the process and celebrate achievements.

Good luck!