Tolerating Tinnitus

If you are afraid your Tinnitus will get worse if you go to a concert or the cinema, you are not the only one. This is a very usual problem: noise can increase the loudness of Tinnitus, as a matter of fact, even people who do not have persistent Tinnitus, can experience Tinnitus temporarily after they leave a music club or a concert. People who suffer from persistent, bothersome Tinnitus are understandably weary of any situations that can worsen their Tinnitus. However, avoiding social events such as meeting with friends in pubs can increase the sense of isolation, low mood and depression as you may be left with the sense of life passing by you.

Furthermore, no amount of avoidance can guarantee that your Tinnitus will remain the same. Most people with persistent Tinnitus experience some sort of variation: change of loudness, pitch or where you hear it etc. So you might give up a lot in life and still face with the challenge of changes.

During CBT for Tinnitus, we work together to guide you through the process of facing your fears and starting out on a path toward habituation (the ability to ignore the Tinnitus) . In this guide you can try some steps that are based on cognitive behavioural therapy to upskill yourself in your Tinnitus journey.

A bit of theory:

Normally our brain is perfectly capable to ignore internal bodily noises or neutral environmental sounds. However, if you feel annoyed or anxious when you hear your Tinnitus, your brain automatically focuses on it as a signal of importance. Our brain is geared toward focusing on unpleasant or threatening signals- this is a matter of self-preservation. The more it focuses on the ringing, the more difficult it becomes to ignore it and you will feel more and more agitated.  

Research tells us that depression among tinnitus sufferers does not directly related to the loudness of Tinnitus but to the effect of Tinnitus on their life. This means that if we can lessen the negative impact of Tinnitus on daily life, we can improve our mood even if the loudness of Tinnitus remains the same.

So, based on the theory of CBT, the aim is to change the emotion you associate with Tinnitus, then you will be more able to ignore it and therefore you can start living your life again and that will lift your mood.

Changing the emotion is no small feat. The method is to face your fears: gradually and repeatedly.

Here are the steps to follow:

1.        Be curious: you need a mindset that is open for experimenting. You are testing your limits and your capacity. In a sense, there is no failure here, you can learn something from any experiment.

2.        Choose your battle: what are the situation where you are willing to try and put up with your Tinnitus?

3.        Plan: how long will you do it? It needs to be gradual, so start with something feasible. Most important rule: you cannot use distractions during your experiment! So no white noise machine or TV as background noise, just You and your Tinnitus.

A simple experiment to try:

               Reading a book:

1.        Choose something you enjoy reading. Plan the experiment: decide how long you will be reading for without any background noise. You may start with 10 minutes. Plan the where and when as well.

2.        Execute your plan: sit down comfortable and start reading. You might find it difficult to focus at first because of the Tinnitus. Keep trying, don’t give up until the set time has ended.

3.        Analyse your experience: was it better or worse than you imagined? How did you feel during and after the experiment? How was you Tinnitus? How much you remember of what you have read?

4.        Learn and repeat: note down what went well and what was hard. Remember: there is no failure here, just experimenting. Keep repeating the experiment for a week.

5.        Raise your bar: habituation is about getting used to something. Gradually increase the time you spend with reading and keep repeating the experiment until the annoyance decrease to a mild level that does not impact your enjoyment of reading.

How to move forward:

               Create opportunities in your daily life for experimenting. Think about where else you could face your fears. Examples: sit in a noisy café for 10 minutes. Use the hoover without ear protection for 5 minutes. Go down to the pub for half an hour. Any situation can be turned into an opportunity to  experiment and increase your level of tolerance. Be consistent and you will notice the difference. The aim is to gain confidence: you can manage your Tinnitus, it is NOT a threat to you, it is harmless and your life is yours to live with or without Tinnitus.