Tinnitus is like a lock, you just have to find the right key that works for you...

[DebS]

I'm not sure where I read this (maybe even here on this site), it is part of a much larger article that I reread when I'm having a screechy day. It helps me:

'It is very reassuring to know that even though a person may always have tinnitus, they do not need to suffer from it, in fact they do not even need to hear it. Most people habituate over time by the effort of not reacting to it and this produces changes in the part of the brain concerned with suppressing or amplifying the signal. It may be obvious but obsessing over a sound is not the right way if you are trying to get your brain to ignore it. Anger and anxiety just draw attention to it and make it appear louder as your stress levels rise. Don't let this condition alter anything you do in life. Obviously take care with loud noise (as all people should) but try to live your life as if it is not there and this will aid natural habituation. Habituation of reaction is the primary goal and once that is even partially achieved, habituation of perception will automatically follow. Do not suppress the tinnitus sound as habituation cannot occur when the signal cannot be heard. It would be impossible to get over a phobia of spiders without facing the object of your fear and gradually feeling more at ease with it and this is the way to go with tinnitus. Don't focus on it but more importantly don't try to get away from it as you cannot habituate something that is not there! The best situation to be in is one where you hear the signal but remain calm and keep your reactions to a minimum. Even if this can only be done for 5 minutes this is a step in the right direction. Be kind to yourself and do whatever you can.'

 

[nills]

Nills, IMHO the one thing "happening in the world to get us out of this mess" is ourselves.

Ryan, if you ever reach the point where you feel suicidal and begin to seriously think of ways to make your passing look like an accident, rather than "giggle" about it, I hope you will take those feelings seriously, talk to a mental health professional, and do whatever it takes to get help.

Waiting for a cure can be a little like waiting for the woman of your dreams to magically appear on your doorstep. A cure for tinnitus would be lovely, but in the meantime, we have the choice to either let tinnitus happen to us or reclaim our lives by taking action. There are a number of ways to do that, and while most of them involve an investment of time and energy, some of them involve no or very little money.

here2help

You don`t even see how much more a giggle can do than psychotherapy ... when you take something like a thought srrious, you are in trouble ... and you end up on a couch ... when you laugh at it you are sronger than it and you are free ... but I don`t even want to start discussing this because it is too obvious IMHO.

 

[object16]

Hi, I also feel that I completely ruined my life. So my approach is now to not go anywhere near anything to do with noise. Gradually over the past 7 months, my tinnitus has been getting less intrusive, and much less noticeable. I believe the brain will rewire itself if it is given the correct opportunity to do so. By continuing to injure the auditory nerve with noise, does not let this happen. my approach is to just only have quiet normal sounds. all loud sounds are eliminated, I go to the extent of wearing a bose headset almost all the time, to prevent me from having to suddenly hear a Harley go by, or a truck back fire, or bad muffler. I can have nothing to do at all with power tools or anything like that. Luckily for me, my job is quiet, but even here I had the maintenance adjust the automatic door so the doors now all close super quiet, instead of the loud slam they were doing before. I use very quiet Enya music on constant play, all night, and all day I listen to very quiet enya music. this gives the brain the cue as to how to heal itself. I also use constant rain sound from a little machine, of CD of restful rain. it is a very long struggle, but my life has gone from a constant daily struggle, to being able to cope much better than before. also, I have started to exercise a bit more in the morning to improve my overall health. I agree TOTALLY with what "nills" above has to say - you are entitled to feel shitty, because the illness is shitty and has almost ruined my life. Luckily my job is quiet, so I did not have to go into early retirement, but 7 months ago, I thought for sure I would have to resign, and probably be dead very soon.

 

[here2help]

I respectfully disagree with Steve about the importance of mental dominance over tinnitus or the necessity of overcoming tinnitus-related anxiety preparatory to taking steps to begin to manage the condition. Instead of habituation being a case of mind of matter, it may be a case of mind over doesn't matter.

Managing tinnitus so it no longer affects us requires neither mental toughness, psychological stability, nor positive thinking. I don't think we have to be in a different psychological space before we start to adopt certain strategies. Rather, there are steps we can take to begin to manage the condition in spite of how overwhelmed or anxious we feel and no matter how loud or intrusive tinnitus is. With patient and consistent work, we may start to feel differently over time and eventually arrive at a different psychological space.

here2help

 

[Dr. Nagler]

I respectfully disagree with Steve about the importance of mental dominance over tinnitus

What I said was that habituation of tinnitus has nothing to do with mental dominance. I'll stand by that statement.

Stephen Nagler

Addendum - On re-reading, I think here2help was disagreeing with Steve and not with me. Here2help and I are pretty-much of the same mind on this issue. Apologies for any confusion.

 

[Steve]

I respectfully disagree with Steve about the importance of mental dominance over tinnitus or the necessity of overcoming tinnitus-related anxiety preparatory to taking steps to begin to manage the condition. Instead of habituation being a case of mind of matter, it may be a case of mind over doesn't matter.

Managing tinnitus so it no longer affects us requires neither mental toughness, psychological stability, nor positive thinking. I don't think we have to be in a different psychological space before we start to adopt certain strategies. Rather, there are steps we can take to begin to manage the condition in spite of how overwhelmed or anxious we feel and no matter how loud or intrusive tinnitus is. With patient and consistent work, we may start to feel differently over time and eventually arrive at a different psychological space.

here2help

So do you believe that we can habituate to tinnitus without overcoming the anxiety? That arrival at a different psychological space is surely achieved by managing the anxiety response, the fight or flight reaction, and being able to overcome it - at least in some way? Or do you see other elements at play here?

I would say that without positivity and the ability to stabilise our response we do not have the right tools to begin habituating. From my experience, we begin to get better when we learn to accept it and accept that we can carry on living life (with some restrictions).

I think the phrase 'mental dominance' was not a good one. What I was referring to is the process that you have to engage to overcome anxiety, telling yourself that you will not react, that you can control it. That slow, difficult process, using all the tools that you find can work for you.

 

[Dr. Nagler]

So do you believe that we can habituate to tinnitus without overcoming the anxiety? ...

Steve, thank you for bringing to focus here back where it belongs: on tinnitus.

I look forward to here2help's response, but would you mind stating exactly what you mean when you refer to "habituating" so we can all be on the same page. The word means different things to different people. Thanks.

Stephen Nagler

 

[Steve]

Steve, thank you for bringing to focus here back where it belongs: on tinnitus.

I look forward to here2help's response, but would you mind stating exactly what you mean when you refer to "habituating" so we can all be on the same page. The word means different things to different people. Thanks.

Stephen Nagler

Well, I mean the state where we have accepted the noise and have learned to move our focus away from it. So that it is no longer a threat or source of anxiety, we've just stopped responding to it or giving it attention.

 

[Dr. Nagler]

Well, I mean the state where we have accepted the noise and have learned to move our focus away from it. So that it is no longer a threat or source of anxiety, we've just stopped responding to it or giving it attention.

I guess we look at habituation differently then - because from a neurophysiological standpoint you do not have to "accept" your tinnitus in order to stop responding to it. I know I sure as hell will never accept mine!

You also mentioned in an earlier post about "telling yourself not to react." I do not know how you can do that successfully. It's like telling yourself not to think about a pink elephant.

So I think the issue here is one of definition.

It will be interesting to see here2help's take on it.

Best regards -

Stephen Nagler

 

[Steve]

I know where you're coming from with the pink elephant reference and I totally agree with it, but that isn't quite what I mean.

I'm referring to managing the response. When you have an anxious reaction that is getting of control, you can reinforce your reaction to it. This is a long and slow process of course.

So acceptance for me is the act of positive reinforcement, using a variety of techniques to change your perception to the sound and therefore habituate.

I guess that the thing with tinnitus is that there isn't a single approach, no panacea. We all have our own way of managing it and have found, or are finding, our own techniques to carry on with life. I used to accept the sound as a companion, but over the years my view has changed to treat it as unwelcome and ignore it.

It's all about perception. A treatment can be amazing to one person, rubbish to the next.

 

[Dr. Nagler]

I guess that the thing with tinnitus is that there isn't a single approach, no panacea.

I fully agree. That's why I post in terms of generalities and not specifics.

Under the assumption that the aim is overcoming one's tinnitus, I have come to believe in a universal formula with four elements:

Strategy
Determination
Flexibility
Insight

The Strategy is the "approach" to which you refer in your post above. You select a Strategy that makes sense to you and that is consistent with your goals and philosophy.
Determination is tougher. Determination is following through on that Strategy - not giving up at the first (inevitable) bump in the road. Or the second. Or the third.
Flexibility is tougher still. Flexibility means that on occasion you may have to change Strategy regardless of how vested you might be in that Strategy if in spite of your Determination your Strategy is not getting you anywhere, all the while staying consistent with your goals and philosophy.
Insight? Insight is the toughest of all. Insight means that at some point in time you may have to come to the realization that the problem lies not in the Strategy, but in the goals and philosophy. And in such cases you may need to totally reboot.

That's how I have come to see it anyway.

Stephen Nagler

 

[here2help]

Steve, earlier in the thread, you wrote that other "processes" take over "and they have to be overcome before you can progress." I see these things – anxiety, distress, fear, torment – as responses, rather than processes. Specifically, they are responses to tinnitus, and they can occur to people who have been suffering from tinnitus for a short time or for years.

The anxiety response changes over time as a result of a using good approach to manage tinnitus, rather than preparatory to it. It isn't necessary to feel less anxious in order to pursue a tinnitus management strategy. Feeling less anxiety, distress, fear, and despair can be a by-product of using a good strategy to manage tinnitus, making changes to the strategy where necessary, and keeping at it. Over time, and with a good approach, the anxiety response is gradually replaced with a different set of responses.

I'm not sure most people can overcome or control anxiety by telling themselves to not react to what they are feeling. Trying to control a response is like trying to put a lampshade on the sunrise.

If by positivity you mean "positive thinking" is necessary to manage tinnitus, we see this differently. I'm upbeat about people's chances for turning the table on tinnitus, but I don't believe we have to use positive thinking to get there.

We also feel differently about the role of acceptance in habituation. I see habituation as a process rather than an end state. In any case, I don't believe it is necessary to learn to accept tinnitus before we can move our focus away from tinnitus so it is no longer a threat. To accept tinnitus is to give tinnitus a status it doesn't deserve.

here2help

 

[Dr. Nagler]

To accept tinnitus is to give tinnitus a status it doesn't deserve.
here2help

I love this!!!

Stephen Nagler

 

[I who love music]

OK, you said you suspect some jaw problems.
You said you still go out around loud music.
Stop the loud music. Is it worth it? No.
Many of us clench our teeth at night and grind too. We don't know we do it. The jaw problem and the T is a giveaway.
Sleep on your back with a stiff rolled up towel or something under your neck with your mouth open.
Don't listen to your T. Instead, gauge your RESPONSE to it. Say to yourself, "I feel like shit hearing this again today." And pretty soon something starts to change.
40 years living with this. It'll get better. But please take some action. And stay away from loud music, buddy.

 

[Magpie]

To accept tinnitus is to give tinnitus a status it doesn't deserve.

I accepted my tinnitus but it has no status. I've heard you say you laugh at your tinnitus here2help and if that helps make it a non issue in your life why isn't somebody saying they accepted their tinnitus equally as valid?
Often we seem to place importance on words or a phrase which in the end is meaningless if you are winning the battle or have won the battle.

 

[Steve]

Steve, earlier in the thread, you wrote that other "processes" take over "and they have to be overcome before you can progress." I see these things – anxiety, distress, fear, torment – as responses, rather than processes. Specifically, they are responses to tinnitus, and they can occur to people who have been suffering from tinnitus for a short time or for years.

The anxiety response changes over time as a result of a using good approach to manage tinnitus, rather than preparatory to it. It isn't necessary to feel less anxious in order to pursue a tinnitus management strategy. Feeling less anxiety, distress, fear, and despair can be a by-product of using a good strategy to manage tinnitus, making changes to the strategy where necessary, and keeping at it. Over time, and with a good approach, the anxiety response is gradually replaced with a different set of responses.

I'm not sure most people can overcome or control anxiety by telling themselves to not react to what they are feeling. Trying to control a response is like trying to put a lampshade on the sunrise.

If by positivity you mean "positive thinking" is necessary to manage tinnitus, we see this differently. I'm upbeat about people's chances for turning the table on tinnitus, but I don't believe we have to use positive thinking to get there.

We also feel differently about the role of acceptance in habituation. I see habituation as a process rather than an end state. In any case, I don't believe it is necessary to learn to accept tinnitus before we can move our focus away from tinnitus so it is no longer a threat. To accept tinnitus is to give tinnitus a status it doesn't deserve.

here2help

As I said before, there is no single management strategy, no single way of getting better. There is no magical text book that we can all read and get relief.

If either my or your opinion was 100% correct we would be the leading authority on tinnitus.

It's different for everybody and we all have our own way of dealing with it, TRT to CBT and everything in between, each approach is valid to the right individual.

 

[Dr. Nagler]

It's different for everybody and we all have our own way of dealing with it, TRT to CBT and everything in between, each approach is valid to the right individual.

Would you agree that even though there are some significant differences among us, there are some things we all have in common?

For instance, consider the following:

The problem for all who suffer from tinnitus lies in the fact that their brains do not classify their tinnitus as a neutral stimulus. If their brains did classify their tinnitus as a neutral stimulus, while they would still have tinnitus, they would no longer suffer from it.​

Would you say that even though tinnitus is different for everybody, what I have just written is true for everybody?

Stephen Nagler

 

[Steve]

Would you agree that even though there are some significant differences among us, there are some things we all have in common?

For instance, consider the following:

The problem for all who suffer from tinnitus lies in the fact that their brains do not classify their tinnitus as a neutral stimulus. If their brains did classify their tinnitus as a neutral stimulus, while they would still have tinnitus, they would no longer suffer from it.​

Would you say that even though tinnitus is different for everybody, what I have just written is true for everybody?

Stephen Nagler

I do. I try and see things from all angles and take in all viewpoints, I don't disagree with what you say, I firmly believe in looking at all theories and approaches and finding what works for the individual. I have my personal opinion based on what works for me of course.

Anxiety response for me is an inherent thing - I am fairly strong and resolute as a person, I know my mind etc. but I also know that I am pretty susceptible to anxiety. I have to manage that, I do it by checking myself when I react to something, positively reinforcing, or by trying to be logical. It doesn't always work in the moment but over time it does. I've struggled with it more than once and I've come through it.

And I believe that managing that response, that mode or process, is part of the key in properly managing tinnitus. If you don't do that then I believe you are going to have difficulty in keeping any state of habituation. Because the smallest of setbacks will be perceived as crushing and put you back by so much.

I hate to use the word holistic, as it gets a bad rep from the many quacks that use it, but my feeling is that we need to look at everything to get better, to use tinnitus as a catalyst for change. Anxiety is just a part of that.