Back to Silence

I first got tinnitus from a loud sound event from a digital device while wearing earbuds. Like many if not most first timers with tinnitus, I freaked out totally. Could not sleep, could not concentrate, hyperacusis, suicidal ideation etc. Took me months to habituate to what I would call low level of tinnitus but it sure did not seem low in the beginning since tinnitus can and does in most cases in the beginning hijack the brain. At that time 12 years ago, there was not much on the internet on tinnitus that I could find. No Tinnitus Talk for instance.

Then about 4 or 5 years later I had a second loud sound event that took my tinnitus to what I consider moderate. That time it took me a few weeks to re-habituate. I did not freak out but I had much more in my habituation skill set and Back to Silence method to work with. As far as I know, there is no way to objectively measure the level of tinnitus. See this article though as maybe one is on the way:

Scientists Have Discovered a Way to Objectively Measure Tinnitus in the Brain

I don't consider my tinnitus severe, since the way people who say their tinnitus is severe describe it is not anything I would use to describe my tinnitus sounds. That said, there is a marked difference between the first tinnitus sound I habituated to and the second tinnitus sounds I habituated to, I can tell you that.

 

Hi, Henry.

I'm new to tinnitus and hyperacusis caused by an acoustic trauma (really loud gunshot). I saw that you mentioned having hyperacusis when you suffered your first loud noise event.

Do you remember how your hyperacusis felt at the time (I know it's been many years)? Did your hyperacusis resolve after the first loud noise event? How long did it take? Did it come back after the second loud noise event?

I have both and tinnitus is a piece of cake in comparison to my hyperacusis. Just looking for hope that it can go away.

Take care

 

Yes, the hyperacusis decreased as I habituated to the tinnitus the first time. That first time to habituation took about 6 months or so to get to level 4. The second time it took a month or two to get back to a level 4 of habituation with the sounds and hyperacusis. The hyperacusis issue for me now is about doing what anyone should do to protect their ears. See here for example:

Music-Induced Hearing Loss: Loud Concerts, Musicians and Hearing Loss Information for Audiologists

Now I have a decibel meter on my cell phone and, if my mind is wondering if something is too loud, I check the meter and most times it is well within the safe zone so my mind is making up danger when there is no danger. I don't want my mind to make up danger where there is none.

Hope this is useful.

 

This is the irritating and irrational part of this medical condition. Trying to separate what is really going on from what I think is going on. I'm very happy that habituation is working for you Henry. I vividly remember the time that a man kept staring at me from another table in a restaurant. I finally decided enough was enough, pushed my chair back to go ask him why the hell he was staring at me, when his waitress arrived w/ his food. She took his hand and brought it over to his plate because he was blind. He hadn't been staring at me, it just appeared that he was staring at me.

As someone who theoretically has a meditation practice (when I actually do it), this is a solid truth to life. Perception can be miles off from what actually is going on. Our own mind can lie to us. I think a lot of that is plain fear. Fear is now a factor in my life after getting tinnitus. I am a LOT more touchy, and am probably stressed much more than I think I am. It presents itself when I occasionally lose my temper over something that probably isn't worth the anger.

It helps me to try and deal w/ things as they happen. Otherwise my mind will make things out to be much worse than they actually are. Little things and resentments begin to stack up like cars in a traffic jam because I didn't deal w/ things immediately. I'm "in my head" at those times rather than being in the moment. But even sitting down to meditate for 15 minutes can be challenging.

Most people simply don't want to do it because when we do it, things pop up in our mind. Like most people, I find that it's by far a lot easier to try to escape or go into denial. But that only works for a while, sooner or later I have to deal w/ reality. Escaping is not helpful because, I don't know about others, but my tinnitus isn't something that I can escape from. It's there, like it or not. And like most things, the more I try to escape it or not acknowledge it, the worse everything becomes.

 

I also don't do meditation as often as would be best for me so I get that. I had to get to these two places in getting to habituation:

“God (or maybe “My Unconscious”, or “Universe” if God does not work for you), grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

Tinnitus is not something one can control. It is something that can be managed well or poorly. Learn to accept the tinnitus sounds is my motto. Even those with neurological, somatic or pulsatile type tinnitus at some point probably need to stop looking for a cure to make it go away and get on with working on habituation. Kind of goes back to the old saying often attributed falsely to the Buddha of "Pain is inevitable, suffering is optional."

Also dive into this one a bit:

“What you resist not only persists, but will grow in size.” — Carl Jung

Read up about the above here:

‘’What we resist, persists, embrace it & will dissolve’’

I find tinnitus has been a great teacher, regardless if we wanted it or not... of course everyone did not.

 

The ATA should make a graph called "4 stages of embezzlement" that shows how they squander 99% of donations.

 

Same here, they are a complete 180 from each other. I was spoiled the first time with my old tinnitus, it was a walk in park compared to now.

 

I asked Dr. Hubbard what he thinks about the "Back to Silence" method. He basically dismissed it. It said it had some elements of what works (i.e. CBT), but it is "definitely not enough". Well, if it was, there would be no need for his services, would there be?

Myself, I tried to use this method in the beginning. That was before tinnitus completely overwhelmed my perception. It sort of worked. It was a time I was able to read a book. Maybe I should try again. But I'd have to be writing something like every minute. Sounds crazy, doesn't it?

 

In what you write I would first say to "it sort of worked" that if you moved the needle up in habituation, then it is a successful technique to cultivate. By moving the needle up in habituation, see here:

→ 4 Stages of Habituation

From what you wrote, I would say Dr. Hubbard is correct to a point. Back to Silence is not the whole and complete solution for many or maybe not most in the sense that it would lead to Stage 4 of habituation.

I like what @SDazzle wrote in post #446 on this thread. See here why he thinks Back to Silence works:

→ https://www.tinnitustalk.com/posts/640046/

Well, a few answers as to the underlying psychology of why it works for people, in my opinion as a retired psychotherapist. I don't think anyone knows for sure. I think it fits several models of psychotherapy approaches. Here are some in no particular order:

1. An old saying goes "what you resist, persists". Stop resisting it and it fades into the background. Resist it and that keeps it front and center. This method stops the resisting and focus on the tinnitus so it can fade into the background. I never cease to be amazed at how many people post in great detail on the sound(s) of their tinnitus and can't help but wonder if they are obsessed and doing exactly what keeps their tinnitus sound front and center in their lives. Now I am not putting anyone down saying that. I sure was obsessed and captured in the beginning as well. Seems to be the pattern for a lot of people at least in the beginning.

2. It could be it is as simple as the method allowing shifting of the brain that is trapped in the "fight or flight" mode, giving tinnitus a way out of that trap. The brain is taught via the method to opt-out of that trap and into a focus on the feelings instead.

3. The method is a sort of "mantra" or "pattern interruption" of the reaction of lower levels of the brain (this tinnitus sound is dangerous) so again it changes the focus so the brain is no longer in fear and focusing on the tinnitus (now using the higher logical levels of the brain) and instead using the cerebral cortex.

4. Human beings like to feel in control. Tinnitus sounds are uncontrollable. The method gives a person at least the illusion of being able to "do something about it" and feel like they are in control and not being run by the tinnitus, so they feel better or less threatened, which allows the brain to categorize the tinnitus as not dangerous and let it fade into the background. After all we can actually control our reactions to the tinnitus sounds so we do have some control over that aspect of having tinnitus. Additionally, with lower anxiety levels about the tinnitus sounds, the perception of the “loudness” of the tinnitus sound will decrease if not the tinnitus sounds themselves.

The bottom line of course is I really don't understand how electricity works but I sure know how to turn the lights on. If it works, I sure will use it regardless if I understand it or not. I still use Back to Silence today as one of my major means of staying in Stage 4 of habituation.

 

Well, I am kinda past the anxiety stage, I am too tired and depressed (well, my anxiety went up during hyperacusis spike). I can't find much to distract myself, so in effect yes, I am still monitoring the noise, which keeps me trapped I guess. I am not sure I attach a lot of emotion to the sound per se, either - I am just constantly sad, resigned and depressed that I have it. I can't find an escape, though.

 

Can Back to Silence work for high-pitched tinnitus that can be heard even while in the shower?

 

You're not alone. I feel the same. The only escape is distraction for me so far.

 

I am sorry to say it is true that some people can't habituate. One does not have to be on forums like Tinnitus Talk to know that. Then it is a bit of a paradox. To escape, one has to stop trying to escape, get into acceptance that tinnitus is likely here to stay has been my experience personally and in my readings on the topic of getting to habituation.

In reading your post, I am reminded of what one philosopher type I read said something like the following... close quote: "Life is empty and meaningless and it does not mean anything that life is empty and meaningless." Human beings keep bringing some kind of meaning to life and the things in life including things like tinnitus. The founders of Cognitive Behavioral Therapy said feelings come from thoughts thus how you think about things drives how you feel and act. That reminds me of this quote as well:

“Whether you think you can or you think you can’t, your right.” — Henry Ford

Whenever my “self-talk” in my head says to me or I read “I can’t,” I always think of this quote. I really have to look at what my self-talk is saying to me.

Well, all the above is easy to write and much more difficult to implement to be sure. From reading what you write, it seems working with Dr. Hubbard is better than your status quo so if you can work with him I sure would go for it. I wish you well.

Sure it can. Of course it does not work for everyone. Also it depends on what you mean by "work for". If you have not read say the last 20 or 30 posts yet, I think you will have a better idea about what this approach is all about and why it can work for (depending on what you mean by work for) someone regardless of the type of tinnitus. If you have more questions, ask away as many want to be of help to you. Just follow the method and see what happens. You have nothing to lose I figure. See here:

The "Back to Silence" method calls for not measuring the sound(s), not to monitor the Tinnitus sound(s) or focus on it, do not describe the sound(s) or compare the sound(s).

Another way to think about it is to follow the four "don’ts" of the Back to Silence method:

1 - Don't measure it
2 - Don't monitor it
3 - Don't describe it
4 - Don't compare it

Do the following:

1 - STOP talking about tinnitus, measuring it, comparing it, describing it, and thinking about it.
2 - When you hear the sound(s), tell yourself, "I hear it, I feel .........." (insert your true emotion)
3 - Make a note of this incidence (just put a hash mark for instance and add them up daily... the total will go down over time) and each emotional response in a word or two on paper is best, review your paper weekly to see the change in your responses.

Once you get to less than 5 or 10 incidences per day, you can stop writing them down and only do it in your head since you do not have to speak it aloud to get the result. If you don’t want to write it down, that is OK, give it a try just verbally and see how it goes. If you do not notice a decrease in incidences over time, then begin to write them down to keep a count even if it is only a hash mark to keep the count.

 

Even if this is true (let's even agree it is), it's quite incomplete. Feelings come from experiences, too, damn it. When you experience a metal grinder in your head around the clock, it's, well, hard to feel good.

I am not working anymore with Dr. Hubbard. Two sessions were enough to realize he is another huckster taking advantage of tinnitus sufferers. He should be remembered for his description of the problem, quote: "It is just a fucking noise!".

 

Indeed you are in a tough spot. It is accurate some people just can not habituate so even getting into acceptance about that fact in your life might be useful in some way if you are not at that place now. I wish I could fix it for you and we know that is not possible. I do wish you well.

 

If you expected a miracle cure from Dr. Hubbard, you were mistaken because there is no such thing no matter what methods you might try. Your profile says that you have had tinnitus since 2023, which was not very long, a few months ago when you posted this. Dr. Hubbard is a very highly qualified NYC-based professional therapist who does not "take advantage" of anybody. He only added tinnitus therapy to his therapy practice after he got a very bad case of low-frequency tinnitus and hyperacusis in middle age, learned everything he could about it, and came up with ways of adapting CBT to help adjust to it. It was a tremendous help, for me. It is unfortunate that you didn't give it a chance, as even two sessions with somebody like him can be very worthwhile.

Good luck, I hope it is getting better for you.

 

I did two sessions. Glad it worked for you, I am envious. If it worked, money well spent. This was not my experience.

 

I used Back to Silence, as well.

The key to not letting tinnitus become bothersome is for the mind to not hear it, even though it can, and if it does, it is not a problem. This is what habituation is and it takes more or less time with different people. Many, if not most, who acquire tinnitus can do this immediately, and will never experience anxiety or worse, from their tinnitus. For those of us who are not so lucky in this regard, it will eventually happen for the vast majority of them, over time.

 

This is a very interesting thread, so much good information here. We are all different. I am in a similar situation to @DebInAustralia. I've had tinnitus for almost 12 years. After the awful first year I habituated to level 3, sometimes level 4.

Then, 8 months ago, due to stress and/or COVID-19, I felt like I'd just got tinnitus again. I couldn't believe it or handle it and it has sent me into a deep depression, which has taken on a life of its own. This time around I am older, now 62, kids just left home. I am barely able to work, battling to figure out how to deal with the situation. My energy levels are a lot lower than when I first got tinnitus. I also deal with T1 diabetes. 8 months later I'm still traumatized by what happened after many years of thinking 'I got this'. Bugger, eh?

 

When you describe what you feel, is it what you feel towards the tinnitus or how you feel at the current time?

Like right now I would feel:

A) Towards the tinnitus I’m mildly annoyed.
B) Mood currently optimistic, ready for the new week.

So both feelings are different.

I hear tinnitus, I feel... A or B?

 

I just observed my response to the tinnitus. I don't think that I tied my mood into it, but that's fine if it works. As habituation progressed, I heard it less and less and any responses were closer to objective observations without any emotion attached. I hear it for a few seconds once in a while but I know through experience that it won't last long once my mind is on something else. I notice it when I think about it, like right now, but I don't care. Habituation is a natural process, which happens for virtually everybody with tinnitus distress.

 

Would Back to Silence even work if you are an avid earplug wearer? I mean, even with attenuated musician's earplugs in, I can barely hear anything else besides my tinnitus. And I'm not talking about wearing them at home in silent environments. I'm talking about in the car on the highway, at a restaurant or at the store. Hell it's even front and center while I'm flying in a commercial airliner and that is a pretty loud environment. It's definitely not going to fade into the background in these situations.

 

I have two thoughts in reading your post. First where you write "...It's definitely not going to fade into the background in these situations." I am reminded of this:

“Whether you think you can or you think you can’t, you’re right.” — Henry Ford

Whenever my “self-talk” in my head says to me or I read “I can’t” I always think of this quote. I really have to look at what my self-talk is saying to me. You might want to read this article on this quote and see what the research says:

Mental health: new study finds simply believing you can do something to improve it is linked with higher wellbeing

I am a meditator. That means my tinnitus sounds come up in my meditation of course so I note them using the Back to Silence method and before you know it the sounds have disappeared for me with my "monkey mind" jumping around to some other thoughts that are streaming in my head and sure enough I don't "hear" my tinnitus sounds any longer. I can also tell you that when I flew regularly for 5 years with my tinnitus due to work I would always wear ear plugs and sure I would hear my tinnitus at times so I just noted it using the method and sure enough before too long my attention would move to something else and I would not "hear" my tinnitus any longer. Thus, maybe you are the exception that proves the rule that most everyone can habituate to tinnitus. Now, that said there is no question some people can't habituate to tinnitus so there is more work to be done to find a way to help those folks reach habituation.

A second concern that comes up for me is are you wearing the earplugs everywhere due to hyperacusis issues? Hyperacusis goes along with tinnitus with many. It did for me. If that is the case, you might want to look into getting treatment for hyperacusis with an audiologists and or CBT for it.

This is what comes up in my head to share with you. I figure you benefit from Back to Silence. It is just like learning anything else in your life. If you work at it, the odds are extremely high that you can figure it out.

 

I have had sensitivity to sound since my tinnitus increased. I don't know if it's very mild hyperacusis or just recruitment. Higher frequency sounds cause me a lot of discomfort even at very low volume, so I've just considered it recruitment.

I've been wearing earplugs to try and mitigate any worsening of my tinnitus, since it seems to increase very easily. I try to wear earplugs around anything above 70 dB, and try to avoid anything over 80 dB even in double protection. I had a serious spike from an 82 dB vacuum cleaner despite 37 dB NRR double protection.

I'll admit now that after using earplugs so much, when I remove them in environments where I regularly wear them, things sound very uncomfortable to me. My car's engine sounds enormous without earplugs.

With earplugs in, the enormity of my tinnitus blocks most other sounds in my environment. There is a wall of static and hissing that drowns everything out, with various pitches of pure tone ringing that can become so loud I can no longer hear even the static/hissing. I have a difficult enough time ignoring it when I don't have any hearing protection in, let alone when I am wearing it and am completely isolated with my tinnitus.

I feel that even if I was able to use Back to Silence to habituate, wearing earplugs would completely hinder the process, but I refuse to not wear protection.

In just a few months I will be at 3 years with tinnitus, so I am not new to it.

 

I am certain that the Back to Silence method works.

Two things we "must" achieve to move on from tinnitus suffering is "acceptance" and "calmness".

When you accept tinnitus as your new normal, you can move ahead. It is the first step. You cannot get better if you keep fighting it and refusing to accept it. Stop waiting for it to go away or get better, just accept it as a part of your life without regret.

We must also remember that being calm and being quiet are two separate experiences. You can be completely calm with your ears screaming. You can achieve mental peace with tinnitus, 100%. You achieve this by not attaching any emotion to your tinnitus. You don't think of it as an infliction and you don't try to run away from it.

There is also a difference between hearing and listening. Hearing tinnitus isn't a problem, but listening to it is. You listen when you pay attention. When you pay attention, your mind focuses on it and you become aware of it. Eventually, your mind wants to help you listen to it better and starts amplifying the sound and you'd think the volume has increased.

All in all, the fundamental idea behind Back to Silence is pretty solid. As long as you can distract your mind away from tinnitus and stop paying attention to it, it will eventually stop bothering you. Don't be hasty. It takes time. You will manage to distract yourself for 5 minutes, then 15 minutes, then 1 hour and eventually you'll go weeks without noticing your tinnitus. It will get better, just have faith and never lose hope.

G'day.

YES.

It works for tinnitus with 10/10 scale as well. Our mind is a very capable instrument, we just need to learn how to use it effectively.

You must also understand that very often the loudness of our tinnitus is based on how much we notice and react to it. I am not denying that your tinnitus is loud, I am just speaking from my experience. My tinnitus peaks when I post on this forum, every single time, because I am very aware of it. It proves that thinking about it does influence the volume, by a big margin.

10 days ago, I was miserable and couldn't imagine how life could go on with this annoying infliction.

Today, I can hear it, loud and clear, I just don't care. Life is far too important.

Attitude matters.

G'day.

 

Well, with all due respect and a little tough love, I get the "I can't" in what you write.

Your thinking is justifying why you can't in your post. That would need to change I figure to open up the possibility of change. The "I refuse to not wear earplugs" issue probably means you will spend you life that way since my understanding in reading of how hyperacusis treatment works is usually a gradual increase in times when earplugs are not worn until reaching a point of few appropriate times to wear earplugs is reached.

In terms of applying the Back to Silence method to your situation, you can wear your earplugs all the time and still use the Back to Silence method. One can attend or not attend to the sound(s) of tinnitus with earplugs on or not.

I do wish you well.

 

I've been trying to understand and practice the Back to Silence method, and I'm afraid it's making me feel worse, not better. Every time I focus on my emotions (not the sound of the tinnitus), all I can think of is how suicidal I feel.

The same thing happened when I tried a highly touted chronic-pain management technique called "expressive writing," where you're supposed to write down your deepest, darkest emotions and then tear the paper up or shred it or burn it so that nobody sees it. In theory, if you have any subconscious fears that have no safe outlet for expression, expressive writing is supposed to help you put those fears into words so they can be safely released, resulting in a reduction of chronic pain. But for me, expressive writing only makes me feel more hopeless. It makes the depression and suicidal ideation dig an even deeper ditch into my brain.

What am I doing wrong with these exercises?

 

Thanks for your thoughtful reply. I hope I didn't come across as too negative or combative. I generally wanted your opinion and advice and was trying to lay out my current thoughts. Concentrating and writing was already difficult for me before tinnitus, and is just that much more difficult now.

 

When I felt suicidal, I've been instructed by a psychiatrist (who also has tinnitus) to talk about my tinnitus as if it were a friend. I even gave it a name and it worked somewhat for a while! Now, I just try and stay busy enough to where "I don't hear it." When I do, I still distract myself as much as I can and try and make myself feel normal as if I didn't have tinnitus. When I get overwhelmed with it, I cry. And I cry. And I cry. And then, I get up and do the next thing.

 

Don't you just love psychiatrists. So you have a friend who follows you all day and blows a football whistle in your ear - some friend eh.