A question that is often asked around the second week of the MindfulTinnitusRelief.com course is “Isn’t it just best to try to ignore the tinnitus?” This is really a great question. I am a big fan of ignoring something bothersome; if you can. The problem we have so often with tinnitus (and many other bodily bothers) is that sometimes we just can’t push it away no matter how hard we try. It may seem simple to ignore the ringing when we are engaged in an activity that we enjoy. But all bets are off if we awaken in the middle of the night without the distractions of daytime activity. That is where mindfulness comes in—it helps us to experience the moment to moment unpleasantness of the ringing without needing to escape it. What we find is that when we “move into” the tinnitus sensation (without all of the stories, fears, and expectations our mind tends to create around it) we realize that we can handle it in that moment and we notice the impermanence of the sensation—nothing lasts forever and in that moment we practice just being with the unpleasantness. It takes a ‘simple’ but ‘not an easy’ shift in perspective. The exercises in the course give you practice in just being with the tinnitus while bringing awareness to the stories our mind creates. Like learning any new skill for the first time, this may seem difficult at first. But keep practicing! You can certainly use tools (like a sound generator—noise machine) to help with the tinnitus intensity while you are meditating (this is encouraged if a sound generator helps you to relax).
Many people with tinnitus complain that they cannot concentrate the way they used to before tinnitus began. At its worst, people with tinnitus state that they have had to leave careers because their concentration difficulty has made their work responsibilities impossible to complete. That said, having concentration difficulty actually makes sense when we think about how attention and inattention is modulated in the brain.
Each person has a finite amount of “stuff” that they can attend to at any given moment. This varies greatly from person to person. But when your “attention limit is reached”, like a glass filled to the top with water, no more can fit in. With this finite capacity, it is helpful to bring awareness to what our attention is filled with. We can then monitor, appraise and manage where we choose to place our attention and prevent what might be hindering our concentration.
So how does this apply to tinnitus? Tinnitus can basically be an ‘attention suck’. Similar to chronic pain, the perception of tinnitus can be so unpleasant that there is no room to pay attention to anything else. Even when you try to ignore tinnitus it often stays in the back of your mind, screaming for attention, draining away all of your energy and concentration resources. This is where training your brain to see tinnitus for what it really is, a benign (albeit terribly unpleasant) body sensation, is so important. When tinnitus is no longer mis-perceived as a potential threat calling for attention and constant vigilance, the mind has more space and freedom to re-focus attention and concentrate on an area of your choosing. But like breaking any old habit, this new way of perceiving tinnitus takes practice.
In the 8-week MBTSR course you are given ample opportunity to practice bringing your attention to where YOU choose your attention to go. Each time your mind wanders (as it naturally will at times) during a Body Scan, Sitting Meditation, gentle Yoga pose, etc. you are presented with an opportunity–an opportunity to strengthen your mind’s ability to bring your attention right back to the object of focus of the meditation. Like a bicep flexed at the gym, the practice and repetition of shifting attention to something other than the tinnitus stimuli is strengthened. With this strengthening comes space and freedom to concentrate on things other than tinnitus, if you so choose. If your focus is on the moment’s tinnitus sensation, let that be a choice rather than a sentence.
The strengthening of the neural networks that allow the brain to shift attention on command, takes practice. Being able to concentrate on what YOU choose to concentrate on requires dedication. Throughout the 8-week program, you are presented with ample daily opportunities to give your concentration a workout. Go to MindfulTinnitusRelief.com to get started.
When Everyday Sounds are Just Too Loud!!!
Hyperacusis & Mindfulness: A Lesson in Healing
Firstly, what is hyperacusis? Hyperacusis is a condition where a person perceives everyday common sound(s) as being too loud and even painful. As many as 60% of people who experience tinnitus also experience hyperacusis! A person with hyperacusis may begin to notice that they avoid certain sound environments for fear of exposure to intolerable noise levels. This can be very limiting if the sound of a car horn, clanging dishes, children’s laughter, or a ambulance siren (and the list goes on) elicits pain and bother. All too often, it is the fear itself of being exposed to offending sounds that is enough to isolate a person from activities they used to enjoy. In reality, these everyday sounds do not cause damage to a person’s hearing, though they sure feel like they might. Rather it is a person’s erroneous belief that these noises may cause harm that is the real culprit and keeps us locked in a habit of reacting to everyday sounds with trepidation and fear.
For people with sound sensitivity (as is the case with tinnitus and hyperacusis) it is not the sound itself that is the problem but rather our knee-jerk reaction of fear and avoidance that maintains the unpleasant condition. Below is a link to an article that I wrote that explains what is happening in the brain of the person with tinnitus (and hyperacusis). It addresses the web of stories, predictions, and regrets that our mind habitually creates around even a neutral sound either from inside our heads (as is the case with tinnitus) or from the surrounding environment (the case with hyperacusis). The brain of the person with hyperacusis inadvertently creates the perception of increased volume and even pain.
The Mindfulness Based Tinnitus Stress Reduction (MBTSR) course is designed to aid the person with tinnitus as well as hyperacusis to address the habitual erroneous and magnified fear reaction when certain sounds are perceived. Through practicing skill building mindfulness exercises, the brain’s habit of false perception is interrupted replacing a fear reaction with calm and balance. Throughout the remainder of the course, you are encouraged to apply the mindfulness practice to both tinnitus and to hyperacusis reactions, if one or both exist for you. Through re-perceiving sound by bringing awareness to stories we create, relieving stress and calming false fears, the brain is opened up to new ways of wiring and firing towards a less bothersome and more adaptive approach to sound sensation.
The practice of mindfulness involves bringing radical awareness to the fear-based stories, regrets, and expectations the mind habitually assigns to sound perception (tinnitus and hyperacusis). Once awareness of the story’s creation is recognized, there is space to insert a more adaptive response; a response that is based on fact rather than fear.
I get the question quite often, “Do anti-depressants help tinnitus?” The short answer is: anti-depressants don’t “cure” tinnitus but by helping to elevate mood and reduce stress, they certainly can help relieve some of the bother a person with tinnitus may experience when tinnitus is perceived as unpleasant. Basically, an anti-depressant may help a person to better handle the emotional struggle that so often results from living with bothersome chronic tinnitus. The well-being gained from elevating a low-mood opens a person up to making better adaptive choices.
Now for the slightly longer answer:
Tinnitus is believed to start with some loss of hearing (although not always detectable on an audiogram) but after the initial loss, it is what the brain “does” with the tinnitus sound sensation that makes or breaks whether the tinnitus is bothersome to a person. Depression, anxiety, and sleep difficulty are the top three complaints of people with tinnitus (and hyperacusis). These complaints can put a person over-the-edge making it ever harder to see tinnitus for what it really is—a benign (albeit unpleasant) body sensation that is misunderstood as something threatening calling for the mind’s constant vigilance. So by reducing stress and relieving a symptom such as depression with the help of an anti-depressant, the person with bothersome tinnitus might be much less bothered and better able to re-appraise tinnitus as the non-threatening body sensation that it is—thus allowing the habituation process to naturally and normally take place.
A good rule of thumb to remember is that “stress increases tinnitus bother; relaxation decreases tinnitus bother”. Taking an anti-depressant really helps some people to relax their system and quiets the mind—while the antidepressant does not “cure” tinnitus, you may find that the “edge” that is taken off can make living with tinnitus more manageable. And yes, antidepressants (and really any treatment you choose that relaxes you — acupuncture, sound therapy, exercising, eating a balanced diet, etc) all go hand-in-hand with the mindfulness approach. I recommend taking the 8-week online course MindfulTinnitusRelief.com where you can learn new ways of relating to tinnitus in addition to relieving the depression, anxiety, sleep difficulty, and concentration problems that plague so many.
Check out the site MindfulTinnitusRelief.com and hope you will join the hundreds of people who have really changed their lives with this approach.
There are several easy ways to learn about MBTSR and MindfulTinnitusRelief.com. I can be contacted at jg@MindfulTinnitusRelief.com and am happy to answer any questions that readers may have. I’ve included some links below connecting you to the MindfulTinnitusRelief.com course, MBTSR research, articles, blogs, and videos: