The start of my relationship with my tinnitus patients is goal setting, where I explain that the only goal of tinnitus work is habituation. But what does habituation look like?
I can imagine that if you are still in the midst of your tinnitus journey, it’s difficult to imagine being happy with it. You are perhaps striving for absolute silence, like you used to have. Of course we do want that, but with something that can’t be cured, we have only habituation as a feasible endpoint. And this is not the same as “just get used to it”.
I know I’m ‘lucky’ in this regard. As a twentysomething, I was already expecting a hearing loss and tinnitus. Family genetics dictated it. So when the “peep peep“ noises started, all I really thought was:
Well, I’ve had a good innings
Immediate acceptance, you could say. From then on the noises became gradually more consistent until after five years they were constant.
So yes, it’s constant. Sometimes I don’t realise it’s there, but if I were to pause (or say Tinnitus, or write a blog post on tinnitus), then I “check in” with it and yes it’s still there. Fundamentally though, it’s just the background track to my life, just like when I’m outside and the traffic is audible, when I’m inside and the TV is on but I’m not watching. Tinnitus is there, but it’s not something I am thinking about. I’m not harbouring any negative thoughts about it, and I certainly don’t check in with it to see if it will get louder, because I know it will if I do!
That’s habituation. To borrow from Futurama, it’s a Beige Alert. Nothing to see here, no action required.
Some days when I’m stressed out, anxious or have a deadline, it gets more prominent. It is no longer the background but the foreground for a time. I have been through this a thousand times, and I know there is no cure here but to work on through the stress, meet the deadline. Similarly, if I turn on the car stereo (yes, loud, I like it!) it jumps up immediately. I know I’m not going to turn my music down though, so I listen to the music and when I get out of the car I go about my business. I couldn’t tell you how long it takes for the tinnitus to go ‘background’ again, because I’m not watching for it. I’d guess ten minutes if I had to, but the point is I’m not waiting for it. If I waited for it, it wouldn’t go down, because I’d be thinking about it.
I know my tinnitus inside and out, because we’ve been together for nearly twenty years. It is as much a part of me as the ache in my back.
This is what habituation looks like for me. Acceptance. Not ‘checking in’ with your tinnitus. Having no strong feelings about it. Knowing the triggers and, even when they’re there and unavoidable like anxiety, knowing that it’s frustrating today but it will be better the next day, maybe even in the next hour. Never dwelling, because you know you’re only hurting yourself and making it worse, like poking a bruise.
I hope this helps someone. I know it might frustrate someone who can’t see themselves in this place yet. But remember I do have constant tinnitus. I wasn’t lucky to get it in my twenties, but I’m sure glad I can consider myself lucky, because that has helped me accept my body for what it is, ringing and all.