Habituation: No Action Required?

[MattK]

I've seen some who are habituated say that no action is required, even if the tinnitus becomes louder. How true is this?

Can someone who is habituated sit in a quiet room and read without turning on some type of environmental noise? If no, then it seems action is required. If yes, then how do we get to that point?

 

[Dr. Nagler]

Can someone who is habituated sit in a quiet room and read without turning on some type of environmental noise? If no, then it seems action is required. If yes, then how do we get to that point?

Speaking for myself, I love reading in a quiet room and never use sound in my bedroom at night to help with sleep. My wife and I spent this past weekend in a cabin in Northern Minnesota by the quiet shores of a still lake. And the only time my tinnitus came to mind was when I was answering questions on the Doctor's Corner. What I want to stress is that my tinnitus today is every bit as loud as it was when it all but incapacitated me. It is thunderous - like a cross between a jet turbine and a teakettle. I have changed; my tinnitus has not.

As to your second question - how do we get to that point - well, if you ask twenty different people who have indeed overcome their tinnitus as I have, you will likely get twenty different answers.

My message here is that it definitely can be done. And my prayer here is that all who truly suffer today as I once suffered will discover the path that is right for them ... and walk that path successfully.

Dr. Stephen Nagler

 

[MattK]

Just curious, Dr. Nagler, does your tinnitus ever seem to change in volume?

 

[Dr. Nagler]

Just curious, Dr. Nagler, does your tinnitus ever seem to change in volume?

Yes.

For instance, the spices in Thai food will predictably make my tinnitus absolutely scream. Not Indian food, Chinese, Japanese, Armenian, Greek, etc. Just Thai. Problem is ... I love Thai food. So my wife and I go out to our favorite Thai restaurant a couple of times a month. No way will I give up Thai food! Now if it was brussels sprouts that did it, I'd have no problem at all with the "sacrifice." But Thai food? Ain't gonna happen. And the next morning, my tinnitus is through the roof. Every time.

Dr. Stephen Nagler

 

[Bart]

Dr Nagler,

I read in the book by Dr Jastreboff that habituation of perception will automatically follow habituation of reaction.

Do you still hear your T most of the day or do you have days where you do not even hear it ?

Thanks

 

[ampumpkin]

Just like @Dr.Nagler I also am able to read in a quiet room and sleep without any masking at night.

From 2007 until May 2014, I always slept without masking and I fell asleep as soon as my head hit the pillow. In May, when my T increased (ototoxic meds), I had to start masking with a fan or AC because the T was too loud, unbearable and I couldn't sleep.

Since then, my T has gone down, my resentment towards it also... I feel much better and...

I am happy to tell you that for the past week, I have been falling asleep at night without any masking. I am really proud of that and it is a step forward in my new habituation process..

 

[MattK]

Yes.

For instance, the spices in Thai food will predictably make my tinnitus absolutely scream. Not Indian food, Chinese, Japanese, Armenian, Greek, etc. Just Thai. Problem is ... I love Thai food. So my wife and I go out to our favorite Thai restaurant a couple of times a month. No way will I give up Thai food! Now if it was brussels sprouts that did it, I'd have no problem at all with the "sacrifice." But Thai food? Ain't gonna happen. And the next morning, my tinnitus is through the roof. Every time.

Dr. Stephen Nagler

Good to know that even when your tinnitus gets louder, it doesn't stop you from enjoying life. And even when it does get louder, still no action required? That gives me hope.

 

[Mpt]

Yes.

For instance, the spices in Thai food will predictably make my tinnitus absolutely scream. Not Indian food, Chinese, Japanese, Armenian, Greek, etc. Just Thai. Problem is ... I love Thai food. So my wife and I go out to our favorite Thai restaurant a couple of times a month. No way will I give up Thai food! Now if it was brussels sprouts that did it, I'd have no problem at all with the "sacrifice." But Thai food? Ain't gonna happen. And the next morning, my tinnitus is through the roof. Every time.

Dr. Stephen Nagler

eat Thai food and wake up with screaming tinnitus, wow sign me up

 

[Dr. Nagler]

Good to know that even when your tinnitus gets louder, it doesn't stop you from enjoying life. And even when it does get louder, still no action required? That gives me hope.

Right, no action required when it gets louder.

I wouldn't give my tinnitus the satisfaction of compromising in any way no matter how it decides to behave on a given day.

Dr. Stephen Nagler

 

[Dr. Nagler]

Dr Nagler,

I read in the book by Dr Jastreboff that habituation of perception will automatically follow habituation of reaction.

Do you still hear your T most of the day or do you have days where you do not even hear it ?

Thanks

My tinnitus is incredibly loud, @Bart. I can always hear it in any environment (even in the "Maid of the Mist" boat at the foot of Niagara Falls) if I purposely listen for it. But in general I don't purposely listen for it (why would I?) So your question might be better phrased what percentage of the time that I am awake do I happen to be aware of my tinnitus when I am not purposely seeking it? And I'd say it's gone from 99% in 1994 to less than 5% now. It can sometimes really catch me off guard. It can distract me temporarily (good thing I'm not a neurosurgeon, huh?) But since I do not react to it, it soon fades from consciousness. Unless, of course, I check. Which as noted above, I don't.

Dr. Stephen Nagler

 

[Martin69]

My tinnitus is incredibly loud, @Bart. I can always hear it in any environment (even in the "Maid of the Mist" boat at the foot of Niagara Falls) if I purposely listen for it. But in general I don't purposely listen for it (why would I?) So your question might be better phrased what percentage of the time that I am awake do I happen to be aware of my tinnitus when I am not purposely seeking it? And I'd say it's gone from 99% in 1994 to less than 5% now. It can sometimes really catch me off guard. It can distract me temporarily (good thing I'm not a neurosurgeon, huh?) But since I do not react to it, it soon fades from consciousness. Unless, of course, I check. Which as noted above, I don't.

Dr. Stephen Nagler

Still unbelievable for me, but it gives me always hope reading this.

 

[Mark McDill]

I've seen some who are habituated say that no action is required, even if the tinnitus becomes louder. How true is this?

Can someone who is habituated sit in a quiet room and read without turning on some type of environmental noise? If no, then it seems action is required. If yes, then how do we get to that point?

Matt
I'm largely habituated but I still use the white noise generators in my hearing aids; however, I can sit in a quiet room and read a book (without white noise) no problem -- even though I can hear my T over almost everything all the time. If my T is real loud at that time (and I notice it) I may say 'gosh, that's loud' but have no real visceral reaction beyond that. I consider the lack of a significant reaction the key indicator of habituation; also, it doesn't stop me from doing anything I want to do and it no longer consumes a significant amount of my mental and emotional resources.

I never thought I would be to this point, but I thank God I am.

How did I get to this point? I not only had to accept my situation (or plight) and objectively understand it as a noise that can't hurt me (that took about 2-3 months) then I had to finally accept the 'idea' of T and its permanence in my life; I found that to be a very difficult challenge indeed -- I HATED the idea of T (that I could do nothing about it, how it affected me, etc.). All during this time (of acceptance) I did the 'one foot in front of the other' routine wherein I slowly took my life back and started doing the things I wanted to do (T and all). How this process works precisely, I don't know; however, after about a year (plus) I simply pressed forward and slowly proved to myself that T is not the boss of me. It took time and consistency. Had someone told me this at the onset of my T I would not have believed them; I would have told them they had no idea what I was suffering, but now I'm living it.

At one point in time I had to make a choice.

Either T was going to be in charge (and have its way with me) or I was going to do as I please (T and all) -- with some adjustments. Although it was a very clear (binary) decision, I must admit that within the first couple months of the onset of T I did not think it was a decision within my reach (I was so overwhelmed and unable to think clearly). That is understandable; however, I believe every T sufferer comes to a decision point at one time in their life. Furthermore, I believe every T sufferer can make the decision to take their life back anytime they choose.

I'm not saying it is purely an act of the will; but the choice must be made before the process can start...


Mark

 

[MattK]

eat Thai food and wake up with screaming tinnitus, wow sign me up

lol... I definitely understand your frustration, mpt. Believe me, I'm suffering once again. I would like nothing better than a genuine cure. The problem is, there isn't one as far as I know. So the only thing I can do is habituate. But believe me, if there was a genuine cure without any absurd side-effects, I'd be taking it right now assuming that I could afford it.

 

[MattK]

Matt
I'm largely habituated but I still use the white noise generators in my hearing aids; however, I can sit in a quiet room and read a book (without white noise) no problem -- even though I can hear my T over almost everything all the time. If my T is real loud at that time (and I notice it) I may say 'gosh, that's loud' but have no real visceral reaction beyond that. I consider the lack of a significant reaction the key indicator of habituation; also, it doesn't stop me from doing anything I want to do and it no longer consumes a significant amount of my mental and emotional resources.

I never thought I would be to this point, but I thank God I am.

How did I get to this point? I not only had to accept my situation (or plight) and objectively understand it as a noise that can't hurt me (that took about 2-3 months) then I had to finally accept the 'idea' of T and its permanence in my life; I found that to be a very difficult challenge indeed -- I HATED the idea of T (that I could do nothing about it, how it affected me, etc.). All during this time (of acceptance) I did the 'one foot in front of the other' routine wherein I slowly took my life back and started doing the things I wanted to do (T and all). How this process works precisely, I don't know; however, after about a year (plus) I simply pressed forward and slowly proved to myself that T is not the boss of me. It took time and consistency. Had someone told me this at the onset of my T I would not have believed them; I would have told them they had no idea what I was suffering, but now I'm living it.

At one point in time I had to make a choice.

Either T was going to be in charge (and have its way with me) or I was going to do as I please (T and all) -- with some adjustments. Although it was a very clear (binary) decision, I must admit that within the first couple months of the onset of T I did not think it was a decision within my reach (I was so overwhelmed and unable to think clearly). That is understandable; however, I believe every T sufferer comes to a decision point at one time in their life. Furthermore, I believe every T sufferer can make the decision to take their life back anytime they choose.

I'm not saying it is purely an act of the will; but the choice must be made before the process can start...


Mark

I'm really glad to hear that Mark. I have given up on finding a cure; I just don't have the energy for that anymore. My T actually went away for a while, only to show up every-once-in-a-while. But then it would disappear again. When it did come back, it didn't really bother me that much, though it may have been annoying.

Since last Thursday, it seems like it is here to stay with me once again. The anxiety levels have increased and I've gotten depressed... not like I had when I first originally got it, but still. With all of this said, I am hoping to just habituate now. I want to be ok with it even if it doesn't go away. I want to replace the "what if it doesn't go away" with "even if it doesn't go away, it will be ok".

Reading testimonies like yours and Dr Nagler's has gives me hope.

 

[ampumpkin]

@Mark McDill I loved your post... I went throught the same process... I had to make a choice and I decided that T was NOT gonna get the best of me!! F*** T!!

That being said, I still have bad days but it's nothing like what it was in May/June.

 

[bwspot]

My tinnitus is incredibly loud, @Bart. I can always hear it in any environment (even in the "Maid of the Mist" boat at the foot of Niagara Falls) if I purposely listen for it. But in general I don't purposely listen for it (why would I?) So your question might be better phrased what percentage of the time that I am awake do I happen to be aware of my tinnitus when I am not purposely seeking it? And I'd say it's gone from 99% in 1994 to less than 5% now. It can sometimes really catch me off guard. It can distract me temporarily (good thing I'm not a neurosurgeon, huh?) But since I do not react to it, it soon fades from consciousness. Unless, of course, I check. Which as noted above, I don't.

Dr. Stephen Nagler

This amazes me. Lets says I turn some sound very loud at home, let it be note A, there is no way i can disconnect from it. It is interesting that you can do it especially that it is very loud. Is it like it is there but it just does not bug you?

 

[Dr. Nagler]

This amazes me. Lets says I turn some sound very loud at home, let it be note A, there is no way i can disconnect from it. It is interesting that you can do it especially that it is very loud. Is it like it is there but it just does not bug you?

People live near railroad tracks, but are largely unaware of the trains going by every few minutes, right?

My trains are constant and internal rather than intermittent and external. But a sound is a sound.

Dr. Nagler

 

[rachelfaye]

I can't add much to what people have said. What would make it worse is changing my life around it. I have to put up with T - but then give up what I enjoy also? Ack. That said -- I do sometimes change my environment during times it's really intrusive - maybe white noise or a walk. And I do have days where it's difficult.

But generally it's notice the T -- and then move on.

I agree with the responses that say - it's the attitude and acceptance that brought habituation (if that's what this is).

 

[Karen]

I agree with the others, who are now able to sit in a quiet room and read a book. I'm able to do that now, too, in spite of the fact that I have both tinnitus and pulsatile tinnitus. I've also stopped using any background sounds to fall asleep by, because I actually prefer the quiet when I'm going to sleep.

It has take me longer this time around (I was habituated before this latest round of severe tinnitus), but now I can truly say that things are much improved! One thing that really helps me is distraction; although I'm retired, I've gone back to work part-time, and that has really helped keep my mind off the tinnitus.

So -- yes, no real action required. Just keep a positive attitude, refuse to let the tinnitus rule your thoughts, and find lots of ways to keep active and keep your mind occupied. It may take time, but eventually things will improve for you, too!!

 

[bwspot]

People live near railroad tracks, but are largely unaware of the trains going by every few minutes, right?

My trains are constant and internal rather than intermittent and external. But a sound is a sound.

Dr. Nagler

I actually live by the train station. I do hear the train every few minutes or so. Basically it is a sound that at some point I start hearing and it slowly gets louder and then it slowly fades away. I do hear it but for me it is a little different that my T. Train comes and goes , T stays with me. For me the train will be always there unless I fall in sleep. For now I am at the point where I can continue doing stuff while T is ringing, but it never goes away unless it does which only happened once. I want to believe that at some point my brain gets reprogrammed in such a way that T becomes silence. Probably I am too naive and still dont get the idea behind the habituation, but that is my dream habituation that I will try to achieve.

 

[Dr. Nagler]

@bwspot, are you consciously aware of every single train that goes by when you are home? If not, what percentage of train that go by would you say do not capture your attention?

Have you ever lived in a house with a grandfather clock or cuckoo clock. Most folks who do are hardly ever aware of the racket they make ... or else they'd throw the damned things out, no?

Dr. Stephen Nagler

 

[bwspot]

@bwspot, are you consciously aware of every single train that goes by when you are home? If not, what percentage of train that go by would you say do not capture your attention?

Have you ever lived in a house with a grandfather clock or cuckoo clock. Most folks who do are hardly ever aware of the racket they make ... or else they'd throw the damned things out, no?

Dr. Stephen Nagler

Good point, I guess at times when i read or do stuff I probably am not aware of the train, although because the train comes and goes I might be hearing it every time
The clock is better example. I always hated the ticking of the clock when I was falling into sleep. The clock that would barely made any sound for me was always very loud and distracting. But, only after I started to hear it. So probably that time when I did not hear it was the time when I was disconnected from that clock. Does the habitation works the same?

 

[Mark McDill]

@Mark McDill I loved your post... I went throught the same process... I had to make a choice and I decided that T was NOT gonna get the best of me!! F*** T!!

That being said, I still have bad days but it's nothing like what it was in May/June.

ampumpkin
Awesome!! T BE GONE (or at least go to your corner)!! I love it

Mark

 

[Karen]

@bwspot,

Yes, habituation does work that way. Dr. Nagler's analogy is very good; when you've habituated, you still hear the sound, but it's like background noise that doesn't phase you any more. For each person, it's probably a little bit different, and it may take some people longer than others (I'm a good example of that!), but it can be done.

 

[Mpt]

@bwspot, are you consciously aware of every single train that goes by when you are home? If not, what percentage of train that go by would you say do not capture your attention?

Have you ever lived in a house with a grandfather clock or cuckoo clock. Most folks who do are hardly ever aware of the racket they make ... or else they'd throw the damned things out, no?

Dr. Stephen Nagler

its 2014 and this is the widely accepted "gold standard" therapy (at least the "counselling" module of it) for tinnitus, comparisons to trains going by with tinnitus...really, so ridiculous, so funny and yet so sad... I'm going on vacation for the next 3 weeks, I just hope their aren't too many people who buy into this nonsense... question motives and keep your thinking caps on in the midst of your suffering

 

[jimH]

At one point in time I had to make a choice.
Either T was going to be in charge (and have its way with me) or I was going to do as I please (T and all) -- with some adjustments. Mark

Roger that!....I've had T for more than 30 years. Although, I have had times when it was so severe that I didn't care if I lived anymore, I always some how found the strength to press on and live my life as though I didn't have it.
I still ride a Harley (only with ear plugs now), shoot handguns and ski. I include skiing because of the wind buffeting. I don't wear ear plugs when skiing because it's important to know when someone is coming up behind you so that you don't suddenly change your "line" at that time which would make a collision much more likely.

So, like you, I decided not to allow it to dictate how I would live my life or stop me from doing the things that I love.

 

[Mark McDill]

This amazes me. Lets says I turn some sound very loud at home, let it be note A, there is no way i can disconnect from it. It is interesting that you can do it especially that it is very loud. Is it like it is there but it just does not bug you?

bwspot
I know what you mean, it seems to defy logic; but it's real. I think it analogous to when you drive your car on the freeway; there is no way you can NOT hear the rushing wind, the roar of the tires, and all other related sounds; it's just that they don't entirely register with you and what little does register (is perceived) is no longer given a strong emotional tag by your limbic system (it goes in the whatev bucket).

The frustrating part is that we cannot 'will' our way into this state; we can only exercise our will to make the choice to change our attitude and outlook about it -- post that, it's really a matter of time before our brain simply stops reacting to it (how much time is very individual).

I firmly believe there is an involuntary aspect to this wherein our brain is simply reacting (with anxiety) and there is very little we can do about it except manage until our brain calms down. At least that's what I went through at the onset -- I so hated it. Again, I think this is only one aspect (not the total picture). I just know that my brain zeroed in on it so much that I could hear it over everything (I had a machine shop in my head); even now, I can hear it over everything but my brain no longer reacts as much and for most of the day it simply doesn't register. I find myself saying 'oh yeah, I have T' and then just pressing on. But that took me a long time and wasn't an act of the will.

None of that happened until I made peace with the 'idea' that I have T (permanent T) and that an act of the will was only relevant in that I made a choice and, therefore, since fighting it is nothing but an act of the will, then fighting it is pointless (and actually counter-productive); that was the hardest part for me.

Mark

 

[Mark McDill]

I'm really glad to hear that Mark. I have given up on finding a cure; I just don't have the energy for that anymore. My T actually went away for a while, only to show up every-once-in-a-while. But then it would disappear again. When it did come back, it didn't really bother me that much, though it may have been annoying.

Since last Thursday, it seems like it is here to stay with me once again. The anxiety levels have increased and I've gotten depressed... not like I had when I first originally got it, but still. With all of this said, I am hoping to just habituate now. I want to be ok with it even if it doesn't go away. I want to replace the "what if it doesn't go away" with "even if it doesn't go away, it will be ok".

Reading testimonies like yours and Dr Nagler's has gives me hope.

MattK
I can totally relate, I have cyclic T (I get days off) and it really made habituation take a lot longer. During days off I would think I was out of the woods and during days on I would be afraid it would never stop. The emotional roller coaster really made habituation take so much longer and I must admit it really took its toll on me. I love roller coaster rides but I hated this one.

After about a year, I unwittingly adopted a 'come what may' attitude -- and it worked. I calmed down, stopped fighting it. I must admit it felt like giving up and giving in (and maybe it was giving up) but it worked. My anxiety came down, my focus was much better; I just felt better, it was my ticket off the roller coaster. Not too long after that I considered myself basically habituated.

Granted, if in some other dimension my T presented itself as a living creature I would likely beat it with a baseball bat and burn it with a flame-thrower !

The point being, I don't like it, I just live with it (like bad neighbors -- don't make eye contact, they'll invite themselves over for dinner again).

Mark

 

[Lisa88]

I've seen some who are habituated say that no action is required, even if the tinnitus becomes louder. How true is this?

Can someone who is habituated sit in a quiet room and read without turning on some type of environmental noise? If no, then it seems action is required. If yes, then how do we get to that point?

I have heard of this too, Matt. I guess that is the power of the brain to habituate without even trying, and rings true for all senses. Like we are now accustomed to our clothing, as opposed to someone wearing it for the first time, and feeling every part of it against their skin.

 

[ampumpkin]

love your attitude @Mark McDill