Can Sound Sensitive Tinnitus Be Treated?

Hi Doctor,

Thank you very much for your time and answering some of our questions on here.

I developed tinnitus almost a year ago. It started about a week after I went to a loud club for New Year's, so my guess is that is what caused it.

I immediately went to an ENT as the tinnitus I have is pretty intrusive (sounds a bit like yours from the earlier posts I’ve read on here). I did an MRI that came back clear, however my hearing test came back with mild hearing loss in the 6500-12000 + Hz region. I feel can hear perfectly well so I don’t think I need hearing aids.

My question is regarding the sensitivity part of my tinnitus as it reacts to other sounds. It’s usually at a volume of 4 or 5 in a quiet room, but will raise in a louder environment so I always hear it above most sounds. It especially reacts to white noise type sounds; hair dryer, clothes dryer, faucet,... Is there a way to treat the reactivity part of what I have or is it something I need to habituate to as well?
I just yesterday started sleeping with some pink noise at night (rain sounds on my iPad) played at low volume, not sure if it might help to sleep in a sound rich environment so to speak...

Thank you again.

Alex

 

Hi @alex1975 -

Your excellent question given me an opportunity to explain something about the nature of habituation, and I thank you for that.

This is how I have come to see it:

Habituation is 100% about reaction.

Now, just to be clear. When I say that habituation is all about reaction, I am not talking about what you are referring to as the "reactivity" of your tinnitus, but rather I am talking about your reaction to your tinnitus regardless of its reactivity, loudness, pitch, or timbre.

Perhaps look at it this way ...

If your tinnitus did not make you feel bad in some way or other - if your tinnitus did not distract you, worry you, depress you, affect your sleep, make you anxious, or bother you in any way - then while you would still have tinnitus, you would not have a problem. Now obviously you would prefer not to have tinnitus - we all would - and maybe someday research will make that possible. Or maybe your tinnitus will just go away on its own! But given that you do have tinnitus at this point in time, if your tinnitus did not in some way or other make you feel bad, then while you would still have tinnitus, you would not have a problem. Think about that for a moment, and if you disagree, please let me know.

But feeling bad falls under the umbrella of reaction to tinnitus! Tinnitus is the perception of a sound that is not associated with a sound wave, which is to say that tinnitus has mechanical energy. Thus, tinnitus has no power of its own (as opposed to, for example, cancer, arthritis, or a gunshot wound), In other words, if you did not react to your tinnitus, you could not possibly feel bad ... because feeling bad is a reaction. And just as importantly, if you reacted less to your tinnitus, you would feel less bad.

Well, habituation is the process whereby you react less and less to your tinnitus over time, which means that habituation is the process whereby your tinnitus makes you feel less and less bad over time. And thus, habituation is the process whereby tinnitus becomes less and less of a problem over time.

Back to your original question, then, Alex. "Is there a way to treat the reactivity part of what I have or is it something I need to habituate to as well?" The problem with your question for my perspective is that nobody needs to habituate to tinnitus. Habituation is an entirely passive process; it happens on its own. Everybody habituates to his or her tinnitus to some extent or other, regardless of its reactivity. The only thing you need to do is get out its way! (For more on the topic of getting out of its way, please see my article "Barriers to Habituation" that I will attach to this post later today.) As to whether or not you have to somehow "treat" the reactivity part of your tinnitus, to my way of thinking the farther along you travel on your habituation, the less the reactivity part of your tinnitus matters. And the harder you consciously try to treat the reactivity, well ... that's a barrier to habituation because it requires you to attend to your tinnitus more than is absolutely necessary. We necessarily attend to our tinnitus enough as is; unnecessarily attending to our tinnitus gives it far more power than it deserves, which is ZERO.

I realize that a lot of what I have written above will be foreign to many who are reading this post. Moreover, I suspect that many folks far more knowledgeable than I will disagree with it. And no one would take habituation over a cure. For sure, I wouldn't! But if we are going to talk about habituation at all, which is a term you raised in your question, I'd like be be clear on what that term means to me.

All the best -

Stephen M. Nagler, M.D.