MBTSR: The Variety of Experience

We provide a variety of mindfulness exercises throughout the eight-week MBTSR course, largely because different people seem to have an attraction to certain practices more than others.

11Some have an affinity for connecting with their bodies through the “body scan” exercise. Others gravitate to the “sitting meditation,” and still others seem to prefer the “moving meditations” like the Walking Meditation or Gentle Yoga Stretches.

Although it is quite natural for the mind to place judgements and compare one more favorably than another, we want participants to “catch” their minds having these thoughts. We encourage people to try all of the different practices as they appear in the Weekly Classes.

The approach:

See if you can just notice the mind’s tendency to compare and show preference. And then approach these as just passing thoughts and preferences and continue to practice all of the different exercises with a stance of curiosity, openness, acceptance, and radical caring for your self. 

Breathing Exercises for Tinnitus

Most people with tinnitus notice that stress is a trigger for the worsening of tinnitus. This is why most management tools for relieving tinnitus include some form of relaxation as a way to lessen and prevent the discomfort. Although we are not certain, this may be the reason why acupuncture, deep breathing, exercise, a change in diet, getting more sleep, and certain medications have been helpful for some in reducing tension and stress and, in turn, relieving some tinnitus bother. 

What is great about using breathing exercises as a way to relieve tension is that breathing is free, it goes with you everywhere, and you don’t need a prescription!  Here is a deep breathing exercise to help manage the stress that is part of living:

images-4Whenever and wherever you need it—morning, noon, and night—simply push back from whatever you are doing and close your eyes (if that feels comfortable to you). Sitting or standing comfortably in a way that does not obstruct your breathing, placing your awareness on the sensation of this breath; breathing in through the nose and out through your nose. Allowing each breath to fill your chest and belly. Continue the gentle, even flow of each wave of breath for ten deep belly breaths. At the end of ten deep breaths, notice if you feel a release of tension. If the tension remains, continue with ten more deep belly breaths. When you are ready, open your eyes knowing that the breath is always there to help you find balance—no matter where you are and no matter what life throws your way.

About Yoga & Its Role in a Mindfulness Practice

Meditation.jpgA practice of yoga is an important part of any mindfulness practice. Yoga is a Sanskrit word that means “to yoke” and can be viewed as a moving meditation linking or yoking our awareness of the body’s movements and sensations with the mind. So we practice gentle yoga postures, linking the breath with each movement. Breathing in deeply with each posture, we notice the world of sensations felt in our bodies. This often is an opportunity to notice the mind’s habitual reactions to the pleasant, unpleasant, and/or neutral sensations we feel in any given moment. The tendency to want certain postures to end, the judging of one’s performance, the comparisons to others or to yourself at a different moment in time are noticed and observed as just activities of the mind. We bring awareness to the habitual clinging to these thoughts and automatic reactions as we gently and lovingly return our attention to the breath, to the body’s posture in the present moment. We observe whatever is there to be felt.

There are many different kinds of yoga, from Bikram Yoga to Ashtanga to Flow and Restorative Yoga. People often come to a specific type to address chronic pain, for relaxation, or to cope with stress. What these practices all have in common though is the coming together of the mind, the breath, and the body in a practice of bringing awareness to the present moment.

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,



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.