Adults with Microtia or ear loss through trauma (e.g. human bites, accidents or illness) can experience low self-esteem, low mood and anxiety. If you have lost your ear through an accident, an assault or an illness, you may experience post traumatic symptoms such as nightmares, flashbacks or panic attacks, and the appearance of the injured ear can be a reminder, bringing back distressing memories. Similarly, for adults with Microtia, the appearance of their small ear/ears can be a reminder of teasing at school, or unsuccessful attempts at surgical ear reconstruction as a child.
Commonly reported responses to Microtia and ear trauma in adulthood are:
- Always wear hair down; don’t let hair get wet; avoid hairdresser or swimming pools
- Always wear hat/headband (so may avoid holidays in hot places)
- Avoid photographs or looking at photos; avoid mirrors
- Avoid questions about ear/appearance
- Avoid social situations including relationships
- Avoid physical activities because of fear of being bumped or don’t want to wear hair back
- Avoid special occasions because would have to remove hat, lots of people etc
- Avoid college/work because worried will get teased
- Feel self conscious, ugly, angry, paranoid “everyone looking at my ear”, may get into confrontation
- Reduced confidence
- Increased alcohol and drug use
- Lower mood
- Increased anxiety
- Sleep difficulties
From the research carried out so far and from what we see in clinics, ear reconstruction can improve psychological wellbeing. It is worth noting that we regularly meet children, young people and adults in clinics with Microtia who choose not to proceed with reconstruction, whether that is because they are contented with the appearance of their ears due to personal acceptance or resilience, positive reactions from others, or that they simply do not wish to undergo surgery.
Dealing with the reactions of others
Other people’s reactions are greatly influenced by the way we present ourselves. If you feel able to, it helps to have good eye contact, positive body language, and to join in conversations and ask questions. Sometimes people ask unwanted questions about visible difference which brings unwanted attention.
It can be helpful to think about who they are when deciding how to respond:
People you will never see again (strangers)
You don’t have to make it okay for them
It doesn’t matter so much what is said to them
People you will see sometimes
You might want to say a little bit
People you will see a lot e.g. work colleagues, parents at your child’s school
It can be helpful to invest time in addressing the issue positively
A really useful strategy is:
EXPLAIN
REASSURE
DISTRACT
An example of this is:
“That’s just my small ear, I was born this way” or “I had an accident” (explain)
“I’m ok, it doesn’t hurt” (reassure)
“where are you heading?” or talk about the weather (distract)
It is important to remember that not everyone who stares is being rude. Often people are curious if it’s something they haven’t seen before, or they may even be daydreaming. If you feel uncomfortable you can say:
“Can we talk about something else? I’ve already had lots of questions today.”
“Please don’t stare. I would prefer you to say hello or ask a question if you are curious.”
“Sorry I am busy / in a rush”
Coming to hospital
Coming to hospital or clinic for an appointment or a procedure can be stressful. As a team we can help you with any concerns you have in relation to your hospital visit, and can answer any questions about what will happen in advance or arrange a familiarisation visit. We also have leaflets about what to expect when coming into hospital for ear reconstruction.
Managing psychological distress
If you are experiencing symptoms of psychological distress you should contact your GP in the first instance who can provide advice about counselling services or medications that could help.
For information and advice on dealing with stress including sleep issues, anxiety/depression and physical symptoms visit https://www.nhsinform.scot/healthy-living/mental-wellbeing/stress/struggling-with-stress
Useful apps to promote mental health and wellbeing can be found here: www.nhs.uk/apps-library/category/mental-health
We all feel overwhelmed from time to time. A useful phone line is Breathing Space which is confidential and for anyone in Scotland over the age of 16 feeling low, anxious or depressed. Phone: 0800 83 85 87 or visit their webpage on www.breathingspace.scot
If you have suffered ear injury as a result of trauma you may be experiencing symptoms of post-traumatic stress disorder or PTSD, which is an anxiety disorder caused by very stressful, frightening or distressing events. Symptoms include reliving the traumatic event through nightmares and flashbacks, feelings of isolation, irritability and guilt, and difficulties with sleeping and concentration.
Find out more about post traumatic stress disorder at www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd
People often drink, smoke or use drugs to relax but these often make things worse by increasing stress and damaging health.
For advice and help about alcohol use phone Drinkline free on 0300 123 1110 or visit www.nhs.uk/live-well/alcohol-support
For advice and help about drug use call Know the Score free on 0800 587 5879 or visit www.knowthescore.info
For advice and help about smoking contact Smokeline free on 0800 84 84 84 or visit www.nhsinform.scot/healthy-living/stopping-smoking
