Tinnitus and Treatment

The following blog is a letter written by me in response to a physician’s questions regarding a woman he is treating with tinnitus:

March 19, 2014

Dear Dr. M.C.,

I’m glad you contacted me about your patient who has been struggling with severe tinnitus for several years. You mentioned that she has been to many specialists and has found little relief from treatments she has tried. Right now, I am flying back from New Zealand after speaking at the 8th International Tinnitus Research Initiative (TRI) Conference, so I had an opportunity to learn up-to-date information on tinnitus from top researchers and clinicians from around the world.

Because of the heterogeneity of tinnitus causes and severity, there is really no silver bullet that can be relied on to bring relief to all people with bothersome tinnitus at this time. Furthermore, there are no FDA approved drugs for treating tinnitus. Nevertheless, drugs to help with frequently accompanying symptoms such as depression, anxiety, and sleep difficulty can be a help as well as anything that aids her in relaxation (stress is a big trigger for bothersome tinnitus).

Because there is no “cure” for tinnitus for all people and the effectiveness of many treatments has not been proven sufficiently in the research, I have decided to go a different route with my work. I’ve turned my focus away from conventional treatments to instead explore what a person with tinnitus can do to use their own internal resources for “healing”–putting the responsibility for wellness into the hands of the patient. 

MindfulTinnitusRelief.com is the online version of the 8-week Mindfulness Based Tinnitus Stress Reduction (MBTSR) course that I developed at the University of California, San Francisco (UCSF) Audiology Clinic. The pilot study indicated large effect sizes with a 12-month follow-up study showing an enduring and continued drop in tinnitus handicap. So the benefits appear to last. The MBTSR skills are taught through mindfulness meditation, breathing exercises, Discussion Forums, gentle yoga stretches, readings, home practice assignments, and various activities.

anatomyWhat makes MBTSR special is how it encourages her to continue other approaches to tinnitus management she is currently trying in conjunction with the Mindful Tinnitus Relief 8-week course. For example, if she uses hearing aids, sound therapy, TRT, CBT, talk therapy or any other management tools that she finds helpful, the MBTSR program encourages her to continue their use while participating in the MindfulTinnitusRelief.com program. MBTSR nicely supports the effectiveness of other devices and tools that she might already be trying. It is worth noting that although efficacy is not consistent in the research, there are some accounts of people finding at least partial relief (effectiveness) with a hearing aid and various sound therapies (I’m guessing she has tried these).

I would recommend highly for her to take the online course MindfulTinnitusRelief.com in conjunction with other treatments she is trying. (Though I recommend a conservative approach to any drugs she is prescribed). Brain imaging studies looking at Mindfulness have found cortical growth in areas like the pre-frontal cortex and right insula in advanced meditators. This suggests that with a mindfulness practice, she can “strengthen” the parts of the brain that down regulate limbic system firing, leading her to experience the tinnitus signal as a meaningless body sensation not requiring her attention.

I certainly recommend contacting Dr. S.C. He has a different perspective but I believe our approaches are complimentary. With tinnitus it seems best to ‘throw in the kitchen sink’ in hopes one or several concurrent treatments can be of some relief.

I’d be happy to discuss this further if you have any questions. The MBTSR course is not available in Chicago which is why I have developed MindfulTinnitusRelief.com, the online version, so people from around the world can take the course anywhere at any time from the privacy of their own home.

Warm regards,

Jennifer

 

A Recap of the 8th International Tinnitus Research Initiative Conference (TRI)

I recently attended the 8th International Tinnitus Research Initiative (TRI) Conference, March 10th through the 13th in Auckland, New Zealand. Every year the Conference brings together researchers, otologists, neurologists, audiologists, psychologists, and an array of hearing health professionals to report on their findings in the field of tinnitus.

jennzIt was amazing to have various disciplines from around the world coming together to share their work. Tinnitus research is being done all over the world, and the sharing of ideas is crucial to steady growth. I gave a workshop on the first day on my findings and experience creating Mindfulness Based Tinnitus Stress Reduction (MBTSR) and our online course, MindfulTinnitusRelief.com. There was great interest at the meeting in mindfulness as a management tool for tinnitus—and interest in the online version of the 8-week course, making mindfulness training easily available to people all over the world. 

The first day of the Conference consisted of workshops by leaders in the field, including: Dr. Grant Searchfield of New Zealand, presenting on sound therapies; Dr. Natan Bauman of the United States, presenting on Cognitive Habituation Tinnitus Therapy (CHaTT); and Professor Billy Martin from Singapore, presenting on building a tinnitus practice from the ground up, describing his experience setting up a new tinnitus clinic in Singapore.

The days following were filled with presentations covering a broad range of topics from transcranial stimulation, evidenced based treatments, sound therapy, brain imaging research, hyperacusis, and multi-sensory contributions to tinnitus and others. 

jennz2It is encouraging to see how different disciplines are coming to similar conclusions in their results. Josef Rauschecker, PhD from Georgetown University shared his findings implicating a decrease in cortical brain mass in people with tinnitus in the very same areas that mindfulness brain-imaging research is finding increased growth (specifically: Medial PreFrontal Cortex and right insula). This is very exciting to see, and a study combining neuro-imaging with the 8-week MBTSR program is a research direction to be explored. 

I left the TRI Conference very excited and inspired to share MBTSR with people around the world. This year I will be collecting data to present at next year’s Conference on findings of the efficacy of the MindfulTinnitusRelief.com online course for tinnitus relief.

Yoga & Tinnitus

 

The word yoga is a Sanskrit word meaning “yoke,” as in linking two things together. In the case of yoga, it is the yoking of the mind and the body. With each yoga pose, we bring awareness to immediate body sensations, using the breath as a guide, while keeping the mind calm, focused, and stable.

The unpleasant nature of the tinnitus sensation—and the seeming lack of control a person has over it—can foster a dislike and distrust of one’s own body. Feelings of anger, guilt, fear, and blame may arise with this feeling of lack of control. After a while, it is not uncommon for person to feel helpless, disconnected, and just “cut off” from their own bodies.

MeditationYoga is an important teaching tool in any mindfulness practice, especially for those feeling cut off. With each movement of the body and with every pose, using the breath to ground us in moment-to-moment sensations, yoga is the practice of building awareness and acceptance of the present moment, whether a body sensation is sensed as pleasant, unpleasant, or neutral. We observe and explore how all body sensations change. For the person with tinnitus, practice with tuning into the sensations of the body lays the groundwork for the person to re-connect with what has been a dis-connection. When the re-connection is re-established, the person with tinnitus can then choose a wise response to explore the tinnitus sensation without the fear, dis-trust, and dis-like that may have been preventing the linking of mind and body.

Yoga is a practice of coming back: reconnecting, befriending, and “yoking” the mind with one’s own body.

Tinnitus: Holding On & Letting Go

Perhaps you or others feel that the ringing, whooshing, crickets, chirping, etc.—that so often characterizes the sound that we call tinnitus—is all in your head? Well it is! But it may not be coming from where you think it might be.

EarThumbsUpOften people think that tinnitus must be coming from the ears. What we now know is that the sound we call tinnitus is actually coming from deep within the brain. There are several theories as to what is happening in the brain when tinnitus is perceived, but here is one that’s very compelling. Scientists today describe the emergence of tinnitus as the brain’s misinterpretation of an otherwise benign stimuli. While some of us are able to tune out the tinnitus, others find that their brains have trouble “letting go.”

Some people’s brains keep a close watch on the tinnitus signal, believing it is somehow important to pay attention to (for example, it might be a signal of danger and thus must be given that attention). Others seem to interpret the tinnitus signal as something unimportant, and so they focus their attention elsewhere, much like we might ignore the humming of the air conditioner after a while.

For those who experience tinnitus, you can train your mind to bring you from a place of awareness to a letting go of awareness with the practice of mindfulness. A program like the 8-week MBTSR course can start you off on the practice of mindfulness, teaching you to see what tinnitus really is rather than what it is not. This skill building begins the practice of letting go and simply being with moment-to-moment experience—attending to what is rather than what may or may not be here.

MBTSR Officially Launches

MindfulTinnitusRelief.com Launches First-Ever Mindfulness Based Tinnitus Stress Reduction Online Course of Its Kind

Teaching Millions How to Live With Rather than Against Tinnitus

MindfulTinnitusRelief.com, LLC today announces the launch of the Mindfulness Based Tinnitus Stress Reduction (MBTSR) © online course. The first web-based course of its kind for learning how to live comfortably with tinnitus, MindfulTinnitusRelief.com is a self-administered online skill-building program that includes in-depth tinnitus education and mindfulness skill-building.

images-3Each week’s class integrates elements of deep breathing, gentle yoga, relaxation and meditation to help people cultivate new, more effective ways to relate to the experience of tinnitus and stress in their daily lives. The program encourages participants to collaborate and network with their instructors and fellow participants through online discussion forums and in-depth Q&A sessions.

Tinnitus, or “ringing in the ears,” affects approximately 10% of adults in the United States and an estimated 260 million people globally. Tinnitus is the primary medical complaint of American military veterans returning from war. The condition can be extremely debilitating, leading to depression, anxiety, difficulty sleeping and concentrating. It is most often related to hearing loss, especially that caused by noise damage or head injury.

Mindfulness is an approach to the present moment, using a special awareness to shape activity in our nervous system to promote integration and well-being in our lives. Mindfulness has been applied successfully to several human ailments including depression, anxiety, chronic pain, cancer, high blood pressure and heart disease, to name a few.

Dr. Jennifer J. Gans, a clinical psychologist and researcher, developed Mindfulness Based Tinnitus Stress Reduction (MBTSR) © at the University of California, San Francisco (UCSF) after learning about the benefits of mindfulness in pain management. In 2008, she began studying the science behind mindfulness and its role in helping to change a person’s relationship to living with bothersome tinnitus.

After completion of the initial eight-week MBTSR program pilot study, participants reported: decreased tinnitus annoyance and severity; reduced anxiety, fear and feelings of panic; reduced depression and sleep difficulty; reduced stress, tension and irritability; improved communication with loved ones; and increased relaxation and concentration. The benefits were long-lasting, with continued improvement 12 months after study completion.

Today, MBTSR, an evidenced-based program, is accessible to millions of tinnitus sufferers around the world through the MindfulTinnitusRelief.com online course, which can be accessed at any convenient time and place on a home computer, laptop, tablet or smartphone.

MBTSR2“We are excited to launch the MindfulTinnitusRelief.com online course, giving millions easy access to mindfulness training, instructional audio and video files, opportunities to communicate with others with tinnitus, and up-to-date tinnitus education,” said Dr. Gans. “We have designed a program based on scientific research at UCSF, putting your health and well-being back into your own hands, as you learn ways to live with rather than against tinnitus.”

Click here to visit the MBTSR website. For more information on MBTSR or to schedule an interview please call Elizabeth Landau at 415.244.7711 or email at admin@MindfulTinnitusRelief.com.

About MindfulTinnitusRelief.com, LLC.
Established in 2009, MindfulTinnitusRelief.com, LLC is a privately-held education company, with the mission to revolutionize tinnitus treatment and provide relief to the millions of people suffering the effects of tinnitus. The MBTSR program, the only online course of its kind specifically focusing on managing bothersome tinnitus symptoms, is now accepting registrations at MindfulTinnitusRelief.com.