This is a question I received in my mailbag. There’s the simple answer: I choose not to hear it, and listen to something else instead.
But there is also a deeper level of understanding, because people who suffer with their tinnitus will not believe that it’s possible to just choose to listen to something else. For them, tinnitus is intrusive and makes itself heard whether they like it or not.
The same method of management would apply to all types of tinnitus, as they are all body noises that your brain can habituate (learn to stop hearing) to.
Redirecting your attention to something else, whenever you hear the tinnitus, is key. How you choose to do this is based on your preferences; maybe you would like to make a cup of tea, play some music, play with a fidget spinner or go for a walk. My personal method - and the one I teach my patients - is picking another sound from the environment and “tuning in” to that instead. You can pick multiple sounds, including your own breathing, and switch between them.
The more you redirect your attention, the easier it will be for your brain to learn that tinnitus is not important.
Your brain is constantly receiving sensory information, but it only presents you with sensory input it feels is important. If something touches your arm unexpectedly in the dark, your brain presents you with the sensation strongly, and you will react strongly to it! You might jump, your heart may start to race with adrenaline, you may breathe differently. You could become hyper focused on any touch sensation, all over your body. You find that you are primed and ready to feel the slightest movement.
If you were to gently touch your own arm with your body while using your mobile phone, your brain would barely register it. Maybe you’re doing it right now? For this sort of gentle touch, there would be no panic, no startle, no adrenaline; it would be forgotten as soon as it happened. The feeling of your clothes on your body, for instance is not registered much, once the clothes are on in the morning, you’re not constantly thinking “I’m wearing clothes! I can feel them!”. This is what I refer to as a “Beige Alert” situation in my clinic. Not a Red Alert, all hands on deck, panic! A Beige Alert, where absolutely nothing happens and you don’t respond after you notice something touching you, a sound, something you can see in the room.
Tinnitus is not a sound, but when it’s triggered the brain presents it to us as if it is. If we get in the habit of responding to it strongly (anxiety, aggravation, depressing thoughts, focusing in on it), it will be ‘heard’ prominently. In the same way that a light touch can be strongly felt (imagine a spider on the arm if you’re phobic) or barely felt (your shirt moving over your skin), a small stimulus like tinnitus can be heard loudly or softly. Or not at all.
People who have habituated to their tinnitus do not react to it when they hear it. Their brain is not saying “look at this!”. It may be there in the background, but we’re not paying attention to it and we’re not responding to it. It’s the aural equivalent of wearing a shirt all day - 95% of the time it’s not registered.
When you’ve fallen into the trap of listening to your tinnitus, the brain misdiagnoses it as important. Your brain can then work against you, highlighting the tinnitus signal, triggering adrenaline and anxiety, triggering negative thoughts, amplifying the signal. It becomes a self-sustaining process. Attention feeds the tinnitus, making it more prominent.
The path out of this negative doom-spiral is to redirect your attention, and keep doing that - day in, day out. Eventually your brain will not present the tinnitus signal to your conscious mind, and you will therefore be able to ignore it , just as you would be able to ignore a breeze on your skin. Redirecting your attention really works, but you need to keep up with it. You need to have a Beige Alert whenever the tinnitus appears, giving it absolutely no response whatsoever. If you accidentally give it some of your attention, you must quickly redirect your brain to something else.
Copyright: Sally Jackson BSc Hons (Audiology), RHAD, MSHAA. This information is part of my Active Habituation course of tinnitus treatment. If you wish to share this article with others, please keep it intact with this section included, so sufferers can find out about the whole course. Contact: sally@hearingandtinnitus.co.uk
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