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.
What 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.