Tinnitus and The Science Behind Change

We have learned from neuroscience that the mind is changeable or “plastic,” meaning the actual structure of the brain can change with experience. A mindfulness practice is a way of influencing this change and positively creating new wiring in the brain circuitry.

For the person experiencing bothersome tinnitus, this is certainly good news. According to the American Journal of Medicine, about 16 million people were bothered enough by chronic tinnitus in the past year to report tinnitus to their doctors. Some 1 to 2 million people live with tinnitus that is severe enough to interfere with their abilities to function in daily life.

Using mindful awareness, we can shine a light on the mind’s inaccurate, habitual reaction to tinnitus signals and see it for what it really is: a sensation that does not need to be monitored by the mind, poses no credible threat to survival, and, therefore, can safely fade from our conscious awareness. 

Compelling studies support the argument that mindfulness can lead to more adaptive changes in a patient’s response to old and new stimuli.

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Tinnitus: Changing Perception

Mindfulness is a way of approaching each moment by focusing one’s attention and purposefully living in the moment as a way of relieving physical and emotional pain. This is not a new idea. Rather, mindfulness is a 2,500 year-old practice that is experiencing a resurgence, in part because of recent scientific findings that substantiate its myriad healing benefits.

EarPuzzleA growing body of research has shown the efficacy of mindfulness-based approaches in managing chronic pain, sleep disturbances, depression, anxiety, multiple sclerosis, cancer, and long list of other health maladies. My own research suggests that mindfulness can also be particularly useful in managing tinnitus.

I first learned about mindfulness as a pain management tool when I was a clinical psychologist and researcher at the University of California, San Francisco. After seeing the positive impact it had with other conditions, I wanted to study the impact of mindfulness therapy in changing a person’s relationship with bothersome tinnitus. With several colleagues, I organized a pilot study in which eight tinnitus patients received eight weeks of Mindfulness Based Tinnitus Street Reduction (MBTSR).

The results of this study were stunning. We found that mindfulness therapy greatly reduces the perceived burden and handicap of tinnitus. What’s more, the benefits were enduring, with improvement lasting through the end of the 12-month study window. In addition to a decrease in tinnitus burden, depression and anxiety scores went down and quality of life scores went up after program completion.

images-3So what is mindfulness and how does it improve a person’s perception of tinnitus? Mindfulness is a way of approaching each and every moment that arises with a “special” kind of awareness. By “special” I mean not just an ordinary awareness but rather full consciousness of immediate experience, approached with curiosity, acceptance, openness to whatever arises, and a gentle self-compassion toward one’s self.

Tinnitus patients often try to avoid awareness as a way to ignore the ringing in their ears. This works for some, but it also closes people off from living a full, unencumbered life. Mindfulness teaches that we can benefit by fully embracing our experience with tinnitus. By leaning into our tinnitus, we can break through to a better, fuller experience. Mindfulness also helps relieve the anger and apathy that so many tinnitus patients experience.

MBTSR: The Online Decision

How a tinnitus online course reaches those who might not benefit from in-person tinnitus group care.

EarPuzzleCreated in 2009, the MBTSR curriculum was initially designed as a group, in-person skill building course. Each class brought people with tinnitus in the Bay Area community together for 2 hours per week over an 8-week period to practice the skills needed to support change in a person’s relationship to living with tinnitus. The research results were astounding, as I literally watched the healing transformation in participants each week.

So when I began designing the MBTSR online course, I was worried that an online course—where the weekly MBTSR classes were practiced separately, in the privacy of each person’s home — would not be attractive to people. But as the weeks passed by and people with tinnitus began taking the class, I began hearing encouraging statements from participants. For example:

“The MindfulTinnitusRelief.com course is warm and inviting and gives the tinnitus patient an honest opportunity, without false hope, to feel better. I also like the way the modality appears to encompass CBT and Buddhism with its mindfulness main principles.”

That’s when I began to realize that there are many people who — due to geographical distance, demanding work schedules, health issues, and discomfort participating in a live group setting — would now have easy and comfortable access to a novel new treatment for tinnitus.

Why Go Online: Pragmatic Benefits

•  Less expensive per participant
•  Reusable components
•  Easier recruitment
•  Available to more people with less burden
•  Serious dissemination

Why Go Online: Effectiveness

•  Facilitates daily learning and practice
•  More effective monitoring
•  Easier faster participant contact
•  Simplified record keeping
•  Reach a different audience

Why Go Online: Challenges

•  Less personalization
•  Less personal contact / sense of commitment
•  Only works for skills interventions
•  Not, e.g., acupuncture

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.