An interesting perspective. Reminds me of the famous scene in Lawrence of Arabia, where Lawrence lets a match burn down in his fingers without flinching. One of his men tries to do the same thing and burns himself and lets out a yelp of pain exclaiming "it hurts!". Upon being asked "what's the trick sir" Lawrence replies: "The trick William Potter is in not minding that it hurts"
Is it the same with tinnitus? If I don't mind it being there is it there for all extents and purposes?
Consider this: you're most likely reading this sat down, let me call attention to the sensation on the bottom of your forearms, are they resting on something hard or something soft? Are they warm or cold? Now that I have called attention to them you can answer. But...that sensation was always there, you had to pay attention to it to answer the question.
Do we have forums for people with constant forearm stimulation constantly opining : "This forearm sensation is always there all day; it's driving me crazy" of course not. The reason why is there is no emotional salience to how your forearm is feeling; it's no big deal. Your limbic system is scanning your sensory inputs from sensory receptors in your arm but the signals reaching are of no concern, it's no big deal.
However...suppose I were to throw a black widow spider in Dr Charlies tuxedo and off it scurried inside. Would a constant sensation in his sleeve bother him? Most certainly, his brain would find any sensory input from inside his jacket as annoying. The limbic system would have gone on alert and found anything different as a threat and constantly send signals to his Dorsal Anterior Cingulate Cortex* telling him to find it distressing.
[* The dACC is a fascinating part of the brain, one of it's purposes is to tell you to find pain distressing, patients with lesions to it or after operations called "Cingulotomies" can experience terrific chronic pain prior to the operation but afterwards still feel the pain but will now say it doesn't bother them at all, maybe habituation is the dACC realising that all this neural traffic from the limbic system is serving no purpose and moving on to more important matters?]
So....what's the "spider in the tuxedo" for tinnitus? My own personal view is it's the caring about the loss of silence.
Most losses in the body such as hearing, sight, etc come with age; they're gradual and happen so slowly they don't trigger any anxiety, tinnitus as a rule appears in a short period of time and knocks the brain's cognitive homeostasis of kilter. Your limbic system is obliged to forward the traffic to the dACC. Once that happens you begin to focus on it and another part of the brain becomes annoyed by the fact that it's there but also that the silence is gone forever.
It's not as if prior to T we used to sit in quiet rooms all day savouring it (although that sounds great now!)
As humans we feel loss worse in a relative sense, being sufferers of T ourselves we look at people without it and feel envy, it makes us care more about having it ourselves.
Here's a thought experiment for you: Suppose the earths core started vibrating at frequency. Scientists investigated and found out it was a natural event and totally harmless. However...it gave everyone on the planet tinnitus. From the the president of the USA to an innuit fisherman in Alaska...see those people on the bus? They all have it, the crowd at a football match on TV yup all of them too. Would you feel better about yours now that "we're all in it together". Most likely yes, in fact we might feel a bit privileged and superior because we've "been there done that, you'll get used to it buddy" I suspect we would put tinnitus to bed and turn the light out, we would stop caring. But hold on! Has out T got better? Is it getting quieter? Ah....actually no it hasn't, we're just thinking about it differently. It's a hell of a difference though.
"The trick dear reader is in not minding that you have tinnitus...it's not as if we have had our arm chopped off"
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