Cultivating Attentional Control

[jazz]

Hi Dr. Hubbard,

Attentional control is important to cultivate as a tool to help habituate. But how to do this? Should you practice mindfulness, or are there other things you can do? For example, my own tinnitus cycles. It's gotten much better, and on my low days I hardly notice it. But one to two days a week it's loud and intrusive. I don't respond emotionally to it, and I continue to do everything normally. Yet my mind still notices the noise. It's there, even if I'm engaged in something stimulating. Obviously, I don't like my tinnitus when it's loud, but I do consciously treat it as a neutral event.

Any advice would be greatly appreciated!

 

[Dr. Hubbard]

You're right Jazz, habituation is about attention, but also the quality of attention you bring to tinnitus sounds. Mindfulness characterizes this quality, and is best understood as the "relationship" you have with tinnitus. What works best for promoting habituation is an open, accepting, relationship, one in which you are allowing the tinnitus to be present as part of your soundscape. Even if you're not attending directly to the tinnitus, when you do notice it you'll want to catch yourself responding with anxious, angry, hopeless thoughts, and coach yourself in being more open, accepting, and trusting that habituation will eventually occur. This takes patient effort over time. Though I don't know of any research to back this up, it's been my experience with my patients that it's easier to habituate to a constant signal. You can definitely habituate to a fluctuating signal, but it may take longer. Your brain will become familiar with the range of fluctuations, so that the fluctuations themselves are no longer viewed by your brain as interesting or important, and will stop paying attention, stop sounding the anxiety alarm.

Hope that helps!

 

[jazz]

Thank you! I have been slowing trying to embrace my tinnitus as opposed to treating it as neutral. I must say embracing it is significantly more difficult. That said, I will follow what you've suggested, and perhaps I will eventually not notice it at all. That's the goal, after all!

Thanks again!