A Few Questions on Habituation

Hello all,

My original tinnitus which i had for 10 years was mild, and I never had to mask it or use sound enrichment of any sort. I almost never gave the tinnitus any thought and it wasn't a problem to be in a quiet environment plus sleeping was all good.

My - seemingly permanent - spike from January has changed that whole ball game. Now I have a way louder T and also now in both ears. It's been 6 months since the onset of the spike.

Habituation is not there yet. I do have periods where I manage better than others. I haven't yet had a day where I didn't give T any thought. That tells me that I'm not habituated. Even though my original T was mild, I could hear it if I looked for it, but it was not a real problem. I miss to be able to be in a somewhat silent environment. Obviously that was possible because I habituated 100 % to my original T. I can say that with high confidence. But it's another thing now...

Firstly, how can you habituate to a T that you get reminded of on a daily basis since you hear it so often? From what I understand from various posts, the habituation happens pretty much on it's own.

Some of the following questions may be selfexplanatory, but none the less, I'd like to put some focus on them for the sake of my own process.

1) Do people habituate to T even though they can hear it throughout the day?

2) If you habituate to a T that is often hearable, will you also be able to ignore it in quiet environments?

3) Will you be able to sleep without sound enrichment when you've fully habituated?

4) If you reach habituation, will you be careless on the days where it seems louder?

5) To the lot of you who has habituated to moderate T, do you just continue with life each day without being annoyed by it? Or do you still get setbacks and down periods?

I better point out, that my T at this point probably ain't extremely intrusive. It has gone from 2/10 to 6-7/10. But I can hear it outside, in the car, when shopping. It does sometimes feels like the head is about to explode when I enter a silent environment.

I can't hear it in the shower.

Sometimes it does get masked by only having the fridge to turn on it's compressor while im in the kitchen. The same with the water faucet running.

I probably forgot some questions...I may add a few later on.

 

This sounds similar to mine. I use pink noise to mask it alot although I am finding I can have periods of time without masking sounds on, of course this I hear the t but because its a kind of soft white noise sound it is not really distressing. Sometimes when i am tired and i hear the T it will annoy me so masking is essential for those times but if I am relaxed like on a weekend or a day off from work like today then I am generally okay without masking.

 

Hey bellafjelle, I'm in a similar situation. Just like you, I had T that was very mild and never bothered me for years. It got worse about two months ago, and I haven't become fully habituated to it yet, but I've had some interesting experiences.
I've been having a spike for the last four days, but before that I had an entire week when I just couldn't hear it, even though my T is fairly loud (at least compared to how it had been before). It was definitely there, but I felt as if my brain had learned to filter it out. Just to give an example, one day I woke up and had the impression that it had completely vanished! My T had been, until then, the first thing I noticed when I woke up. But on that day, it was like ambient noise, almost like it was just the sound of the world. (I sometimes like to think of my T as the sound of the earth spinning, if that makes any sense lol)
I don't know when I'm going to feel that way again, or what provoked this spike. I think it was maybe a combination of stress and bad sleeping habits. Also, it might be of relevance that I had been very busy during that week when I didn't hear it, so I was just very focused on the things I had to do. So it might be good to try to keep busy.

I hope you feel better soon! Wishing you luck

 

I'm in a similar situation, tinnitus for about 3 years first habituation took about two months the second spike that started this February is now about over and I'm functioning 100%.

To answer all your questions I would say YES to all of them. If you're experiencing brief good periods I would say you're well on your way to habituation, that's how my latest habituation started, little by little I would notice good times. Of course there were some periods of setback but don't be discouraged.

I wish I could tell you there's a magic formula, but for me, it just seems to happen. And believe me, when my tinnitus was at it's worst I wanted to end it all and for me that's the gold standard of who has intrusive debilitating tinnitus. When all you can think about is ending it, you've got it bad.

I think you're on your way to peace. Yes I still hear it, especially when i first wake up but after a shower and I get moving around it's no longer a thought. I do wear hearing aids and they are also a big help.

 

YES to questions 1, 2 and 3, NO to question 4 (I'm never careless about my hearing now), and YES to question 5 (although once in a while I miss experiencing complete silence and I'm occasionally concerned that the tinnitus is starting to mask sounds that I want to hear).

About 18 months ago I made the conscious decision to habituate and began a mindfulness meditation practice to make that happen. My life is so much better in so many ways as a result, and I'm almost to the point of thinking that tinnitus is a small price to pay for the serenity I've found. Regular meditation allows me to "push" the tinnitus to a different part of my brain, so that I kinda hear it and don't hear it at the sane time. It also taught me to let go of things that I can't do anything about, which is a useful life skill for anyone. I'm hearing the tinnitus right now, and it's OK - it doesn't affect my life whether I hear it or not.

There are different paths to habituation. For many it seems to happen spontaneously; the brain figures out that the sound isn't a threat and it starts to ignore it. Some need to give themselves a push; I was one of them. Personal opinion: it's better to be in the second group, since habituation is a skill that you've had to develop, rather than something that just happened.

I also think that habituation isn't necessarily a one-time thing. Tinnitus is a changeable beast, with new sounds appearing occasionally; a number of people on this site have talked about having to re-habituate. Two things that I keep in mind: 1) I know how to habituate, I can do it again if I have to; and 2) I don't consider new or louder sounds to be setbacks, just tinnitus showing off its inventiveness. I think this last point is important psychologically. If you think it's a setback, you're adding more stress and hampering your ability to deal with it. If you look at a spike as just business as usual, it's much easier to shrug it off.

 

Something has caused your tinnitus to become more severe and the usual cause is "sound" providing there is no underlying medical condition responsible. Do you listen to music through headphones regularly? Attend places where music is played loud? Do you work in a noisy environment? Any of these things can cause tinnitus to increase. It is possible to habituate to tinnitus for a second time. Please read the post below that you mind find helpful. Additional information tinnitus is available by clicking on the links below.

Michael

The habituation process.

Habituation is frequently talked about in tinnitus forums and probably comes in at second place to the popular question: when will a cure be found? It seems some people have become quite taken with this word and believe it is the most important thing to strive for when dealing with this condition. Everyone wants to habituate as soon as possible and carry on living their life doing everything that they want to and putting tinnitus firmly behind them.

I can honestly say that I see nothing wrong with that, but wanting something in the speed that we would like it isn’t always achievable, especially with something like tinnitus. A few people that have had tinnitus for a while, have contacted me to discuss just that. They have concerns about the length of time it’s taking to habituate. Similarly, I have heard from those new to this condition that want the habitation process to start as quickly as possible. Both groups tell me they are doing all the right things but it seems patience is giving way to despondency and despair and some are starting to believe habituation might never happen for them.

It is of little comfort to these people when they hear family and friends say, tinnitus is just a minor irritant and something that can easily be ignored. Occasionally, it might be intrusive but this is never more than temporary and they are still able to carry on with their life unperturbed. I often sense the frustration a person is under when they are relaying this to me. Whether I’m talking to them on the telephone, private messenger or answering an email. It is then that I’m often asked: why is it that the habituation process doesn’t seem to be happening for them?

Answering such a question isn’t easy because there is no single answer that I can provide but I will say this. Tinnitus is a common condition that comes in many forms and intensities and no two people experience it the same. It can be very troublesome especially in the early stages of onset, but gradually this gives way and the condition settles down and in time many manage to cope with it when it’s mild or moderate. Sometimes this may involve treatment via a hearing therapist or a person achieves this naturally without being referred to a clinic.

It should be noted that tinnitus can be a complex condition, depending on how loud and intrusive it is for the individual? So what I’ve just outlined won’t apply to everyone. There are other factors that also come into play. A person’s make-up or rather their outlook on life. Whether they are positive or negative thinking can help or delay the habitation process. In addition to this, stress and anxiety are often associated with tinnitus and a person might be taking medication such as an antidepressant to help cope with it. There are a myriad of scenarios that I could relay to you on how tinnitus can affect someone’s quality of life, their well-being and the habituation process. For now I will say this:

When a person habituates to tinnitus it means they are able cope with it but this doesn’t mean they will never hear it. Although some people habituate to a level where the tinnitus is rarely heard or stays at a very low level. Whether the tinnitus is silent for periods of time or remains low, mild, moderate or is occasionally intrusive, it doesn’t really matter, because it all means the same thing. When habituation is reached a person will know, because whatever the level it will not bother you. However, like everything there are exceptions and tinnitus is no different. I believe there are some limitations to habituation. As I have previously said the condition comes in many forms and intensities. Some people have variable tinnitus that can fluctuate from silent, mild, moderate and severe. When it is loud and intrusive (severe) and this level is sustained for long periods it can become very debilitating and a person might have to take medication to cope with it, which is usually supplied by their doctor. This level of sustained intrusiveness shouldn’t be confused with a tinnitus spike, which usually returns to baseline within a short period of time.

I want to say that I believe habituation is achievable for most people with time. In some instances a person might need the professional help of a Hearing Therapist or Audiologist, as there are a variety of treatment options available to help one in the habituation process. One should also try to be realistic. There are some people that will accept nothing less than a complete cure from their tinnitus and this is unfortunate, because they could waste a lot of time being miserable.

I have corresponded with people that have said, their tinnitus is very low and is only heard occasionally or in a quiet room, at night for instance. Yet these people are not satisfied because they want a complete cure and will deliberately seek out quiet surroundings to monitor their tinnitus, checking to see if it has increased or not. It’s as if they have become obsessed with this condition and to the point where is starts to affect their relationship with those that are close to them, and I don’t think this is healthy.

In summing up I want to say one last thing. Those that are having treatment with a Hearing Therapist, Audiologist, or finding that their tinnitus is becoming less intrusive and they are in the habituation process. Try not to read negative posts or associate with negative thinking people who are not in the same place that you are, as their beliefs can prevent your advancement, if you are not careful.

I wish you well
Michael

PS: further reading on habituation:
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/answers-to-hyperacusis-and-habituation.12058/

 

This is exactly what I needed to read today. Love your quote, too. I feel like the more I accept tinnitus as just a part of me and not something I need to escape, the less it bothers me.

 

Thank you very much for your inputs. Much appreciated! Nice to also get some uplifting comments.

@Michael:

Here's an explanation and story behind the spike: https://www.tinnitustalk.com/threads/6-months-update-spike-—-some-thoughts.22589/

I really don't think spike is due to exposure to sound although I can't say for certain. Regarding use of headphones, well I on rare occassions used them before this spike, but there would go months between the use of them and since I also had T before, I've always been very careful with the volume level.

However, after all this spike going on, I decided at the onset to totally stop the use of head phones. Also, when I do listen to music, which I do a lot by the way, I constantly use my dB meter to measure my environment. I aim to listen to music only at 45-60 dB. The same goes for watching movies.

 

Hi @bellafjelle

I read your post and thanks for the link.

I don't think "sound" is responsible for your tinnitus increase as it seems you have been careful. As I previously mentioned, something usually causes tinnitus to increase after a long duration of habituation. I believe it is a combination of things that could caused it, "stress" which is quite understandable. The medical procedures that you refer to and the dental implants in particular as you noticed an increase in the tinnitus soon after this work was carried out. Perhaps some tinnitus counselling with a Hearing Therapist or Audiologist trained in this field might help you.

I advise you to use sound enrichment at night. Keeping the sound level slightly lower than the tinnitus and not masking it.

All the best
Michael

 

Thank you!

I do use sound erichment at night now, and it has changed my sleeping pattern to the better. I like it very much and my girlfriend luckily also like it. I use both a bedside masker under the pillow and a normal bluetooth speaker with same sound.

I hope it aids habituation.