Habituation and Tinnitus Treatments

Habituation And Tinnitus Treatments

Tinnitus joins a long list of medical ailments and conditions for which there is no cure at present. If you are new to tinnitus you may not be aware that it is very common and many people, learn to live with it after a while, and are able to carry on doing everything that they want to in life. Mention to a friend, family member or work colleague that you are experiencing ringing in your ears and it’s causing you some distress. You are likely to be told: “I get that but just ignore it”. “At night it bothers me but once asleep I’m fine. “Mine plays a tune, at first it was strange now I’m used to it". And so the story goes on.

The early stages of tinnitus can be particularly troublesome for some people and this can lead to sleepless nights. If you are affected see your doctor who may suggest a light sleeping draft, or prescribe something to help with any stress and anxiety you might be having. Please don’t be too alarmed as these symptoms are not unusual and usually improve with time. We are all different and each person that experiences tinnitus will be unique to them.

Some of you may have done a little research online before visiting in this forum, and concluded, it is awash with information. Some of it is good and much of it is bad, mainly due to a lot of ignorance and negativity that surrounds tinnitus. Unfortunately this is often mirrored at tinnitus support forums, although some are better than others. I am not referring to people that find their life is in turmoil and post the difficulties that they are going through and reaching out for help and support. I am talking about members whose main agenda is to impose their will on people and make them believe there is no light at the end of the tunnel for anyone that has tinnitus, and their life is now compelled to one of doom and gloom.

These people believe habituating to tinnitus does not reduce the noise and therefore, it’s a complete waste of time trying to achieve it. They are vehemently apposed to the words acceptance and positivity and won’t waste time listening to anyone that advocates counselling, TRT, CBT medication or the use of sound therapy to treat the condition. People that believe in such things should be ridiculed and therapists practicing them are often called charlatans and shills. Non believers first want to see scientific proof that a particular treatment is known to reduce the tinnitus noise. If this cannot be provided nothing else is acceptable to them as an effective form of tinnitus treatment.

I appreciate that everyone is entitled to their opinion and should air them if they want to. However, since you have come to this forum for help, I advise you to be careful and not read negative posts, that denounce recognised tinnitus treatments of the kind mentioned above, as not being effective because they are wrong. I know from whence I speak, having lived with tinnitus for twenty three years and had TRT treatment twice and used white noise generators for sound therapy that completely cured my severe hyperacusis in two years. The treatment with counselling helped reduce the tinnitus significantly, by taking away and demystifying the negative thinking that is often associated with the condition.

In 2008 I suffered a second noise trauma that resulted in a 2nd treatment of TRT lasting two years and it took a total of four years to habituate for the second time. If it wasn’t for the help and support of my Hearing Therapist, ENT consultant and medication perhaps I wouldn’t be here today. Those four years were the lowest points of my life and hope I never have to revisit them again.

Non believes in tinnitus treatment and habituation say, they don’t reduce the tinnitus noise. I beg to differ as I believe they do or at least one’s perception of it and quite significantly although this depends on the individual. Tinnitus is intrinsically linked to or mental and emotional wellbeing. Although tinnitus is often heard in the ears, the actual noise in generated in the brain. Stress makes tinnitus worse and tinnitus makes stress worse. Therefore, stress and anxiety needs to be managed and kept under control. This is particularly important for those new to the condition in the first few weeks and months as the brain tends to focus on it more.

Talking things over with your doctor how you feel can be beneficial, as I’ve mentioned something can be prescribed to make this process easier for you. As I have previously said, tinnitus is very common and people will often tell you they were once troubled by it but after a while it no longer bothered them. Many get so used to it they no longer hear it. The reason being they have all habituated.

Please accept whatever treatment you are able to get for your tinnitus particularly those mentioned above and if any of you are having recognised tinnitus treatment, my advice is to keep away from tinnitus forums for the duration.

I wish you well
Michael

PS: Tinnitus will be experienced differently between people but many do learn to habituate. This can be achieved naturally without treatment sometimes, specialist treatment is required. I have covered habituation in more detail in my post: The habituation process in the link below.
People that experience spikes in their tinnitus are usually those that have noise induced tinnitus. The spikes are caused by oversensitivity to sound caused by hyperacusis and not what is believed by some to be Reactive Tinnitus. Reactive tinnitus, is a made-up term that has been used in tinnitus forums for the last ten years or so.

That is my belief and I stand by it. To people that believe otherwise I say: you are entitled to your opinion.

Hyperacusis can improve on its own but some people may need specialist treatment, in order for it to be brought under control. It can be cured for I am living proof of this. However, white noise generators need to be used under the care of a Hearing Therapist or Audiologist, that specialises in tinnitus and hyperacusis treatment. Counselling may also be required. If hypracusis does not improve on its own and treatment is not sought, spikes in tinnitus will be a recurring problem and could get worse and sometimes lead to additional problems that I have covered in my article: The complexities of tinnitus and hyperacusis.

https://www.tinnitustalk.com/threads/the-habituation-process.20767/
https://www.tinnitustalk.com/threads/the-complexities-of-tinnitus-and-hyperacusis.25733/

 

You’re completely ignoring the points people have made when it comes to why they're criticizing CBT and TRT.
First of all, people on here usually criticize the way CBT and TRT are being promoted and what they’re promising patients instead of CBT and TRT itself. Secondly, CBT and TRT are oftentimes based on misconceptions that don’t represent the whole tinnitus spectrum and further harm severe sufferers who don't benefit from these treatments.

Pawel Jastreboff himself has said that TRT is "good enough for tinnitus as a problem“ and has said that it works for everyone except for people who are negative and don’t want to get better or those who are on certain medications. There was absolutely no understanding or empathy in his words for severe sufferers. He is absolutely convinced that TRT is good enough.

Common misconceptions that CBT and TRT regularly perpetuate are:

• tinnitus loudness is never the predominating factor as to whether someone suffers from tinnitus or not
• the main reason as to whether someone sufferers from tinnitus or not is always their emotional reaction
• everyone can learn to tune out their tinnitus, the only people who struggle to do so are negative and don't want to accept their condition
• tinnitus can never be debilitating in itself, it's the emotional response to it that makes it debilitating
• "habituation of emotional reaction" will always lead to "habituation of perception"

Tinnitus loudness reduction is an absolutely normal treatment outcome measure that people should test for. If a tinnitus treatment cannot reduce loudness, it should not be called a tinnitus treatment but a tinnitus distress treatment. A treatment that can't actually reduce the symptoms should only be seen as a transitional coping mechanism until we find actual treatments.

An actual reduction in tinnitus loudness is not the same as being able to tune it out and these two things should not be confused with each other.

It's clear that pain-hyperacusis can currently not be cured in everyone, there are numerous stories of people who have had these conditions for years if not decades. Implying that they could cure their condition but are simply not taking the right steps to do so, is the same as saying everyone can learn to tune out tinnitus they're just not doing the right thing.

 

I completely disagree with you @Autumnly I know your stance on tinnitus. I have also corresponded with you at length in the past and found you quite nice and cordial to correspond with. I also know you have become more active with this forum and what goes on behind the scenes. Please don't let that change you into something you are not.

Goodbye and I wish you well
Michael

 

Do not listen to this man's disinformation. He will tell you habituation will lower the volume of your tinnitus.

His claim is that if you learn to not focus on it, your perception of it will diminish and that lowers the volume. It is a nonsensical lie.

 

If you are looking for a slanging match JohnAdams I will not entertain you. As you can see, I started a new thread as my post above is to help and encourage people that want to see a way forward with tinnitus. Although I could have posted this on MPP I didn't want to cause any disharmony or discord as I know your views on Habituation and tinnitus treatments. Please allow people visiting this forum to view threads such as mine, in the hope of finding positivity and not find us arguing amongst ourselves.

I read Hazel's post to you on MPP asking for you to show more civility and you couldn't even reply to her with respect and manners even when you disagree. You have no class that is abundantly clear.

Michael

 

Hi @JohnAdams.
I am 12 months into tinnitus so I am relatively new into this as compared to others.

Maybe habituation is a form a good nueroplasticity that the brain is able to at least diminish tinnitus perception, if not tune tinnitus out at all?

Warm regards,
Albert

 

You will improve @AlbertJ just stay positive and give it time....
All the best
Michael

 

It will still be there. That's my entire point. Also, some people's tinnitus is so severe or shrill that it is impossible to tune it out. Plus there is often hyperacusis clustered with tinnitus. The idea that tiniitus can be "tuned out" is very harmful for severe sufferers as well.

 

Thank you @Michael Leigh.
I appreciate it.


Warm regards,
Albert

 

Please read my post: The habituation process in the Link on my first post. It explains about habituation in much more detail. Even when tinnitus is severe as mine is, there is medication that can help. People that have severe really debilitating tinnitus, can't work and are on medication regularly. Unfortunately these people can't habituate. However, many people are not like this. My good friend @fishbone has 32 years experience with tinnitus. His tinnitus is quite intrusive. He will give you every assurance there is a way forward with tinnitus and it's not doom and gloom as some people would make you believe.

Take care
Michael

 

I currently have tinnitus + hyperacusis and recently, dysacusis that came out of nowhere.

My symptoms can be relatively called "mild to moderate" (1-3/10) but I experience spikes (5-8/10) every now and then - mainly brought about by stress and lack of sleep. So I am managing my stress as best as I could.

Tinnitus, hyperacusis, and dysacusis can be a triple whammy to a person and I have learned that severity is varied across sufferers. I just hope that a real cure will one day finally help us all.


Warm regards,
Albert

 

Thank you so much @Michael Leigh.
Reassurance is all what I need.


Warm regards,
Albert

 

HI @AlbertJ

You may find my post: Hyperacusis, As I see it helpful:
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

Habituation, if possible, is certainly a good thing, but do not let this person get your hopes up about its ability to lower the volume of your tinnitus.

 

The best thing that has helped me is a dietary supplement called curcumin. Several of the people that are members of this forum have reported an actual reduction in the volume of their tinnitus from using it daily, while others have not. I highly recommend buying a small bottle just to try it out and see if it works for you. It is a safe compound that is a derivative of the turmeric root. When and if you do try it, eat it at meals in large quantities like 3 or 4 or so grams and look for the effects to kick in by the next day.

 

@AlbertJ

Please read the post below which is a true story about a member of this forum. He visits this forum regularly now to help people with tinnitus.
Michael

From darkness into light.

Tinnitus is not an easy condition to live with when it is severe. So it always pleases me to hear when someone habituates and is able to put the passed behind them and look forwards to a brighter future. A forum member contacted me recently to express just that and has agreed for me to include some of his comments although his name has been changed. Anyone having difficulty habituating I hope they will find this post helpful.

Last year Marcus was in a distressed state and convinced he would never see light again at the end of the tunnel. He works as an electrician and while up a ladder one afternoon, suddenly heard a loud ringing coming from a fire alarm that was on a nearby wall. He didn’t pay it much attention and wasn’t concerned about his hearing as he believed it would soon stop. He continued working but this proved not to be a good idea as the alarm continued for another twenty minutes. When it finally stopped and there was complete silence he then noticed ringing in his ears. Over the following days and weeks it gradually became louder and more intrusive.

I remember his out pouring and condemning himself in this forum as if it were yesterday. He couldn’t believe he had done such a thing. Staying in that vicinity with no hearing protection and not coming down off that ladder had resulted in his whole life being turned upside down. With the benefit of hindsight one is often able to see mistakes that could have been easily avoided if they only knew. In his own words life as he once new it was completely over. Married with two young children he enjoyed regularly going out with the family but all that came to an abrupt end. I and other forum members tried to make Marcus look at the positive things in his life and not to give up hope but little of this was having any impact. The walls of negativity that he had built up to surround himself were just too great and it seemed no amount of good advice was able to get through.

His symptoms will be familiar to those that have suffered noise trauma to their auditory system. Intrusive tinnitus with hyperacusis, that can vary considerably especially in the early onset of the conditions. I understood his distress at not being able to enjoy listening to music even as a form of distraction from the noise. Everything sounded distorted to him as if it is coming out of a broken speaker and his ears would hurt when certain sounds were heard. His appointment at ENT was some time away which is often the case when tinnitus is not accompanied by dizziness, balance problems and impaired hearing or continuous pain in the ears.

Contrary to what some believe, the best treatment for tinnitus in the early stages and when there are no additional symptoms, as mentioned above is to leave it alone. The ears and auditory system are very delicate and often right themselves when left alone. Many people habituate to tinnitus within the first six months sometimes a little longer and the condition has been known to go away completely. Marcus had taken time of work, as he just wasn’t in a good place and couldn’t function properly. One good thing is that he was under the care of his GP and taking medication to help cope with his moods. Tinnitus can be such an emotional roller coaster in the early days so often no two days are the same. An antidepressant often helps a person from becoming too down so acts as a safety net when those low points arrive.

Marcus became a frequent visitor to this forum and I believe it helped him, although his outlook on recovery was quite bleak and negative. Perhaps knowing there were people around him in this virtual world of cyberspace, gave him the support and sanctuary that he needed to vent his frustrations which at times I believe were overwhelming. I hadn’t seen him for quite a while but got an acknowledgement from him recently by private messenger. I have omitted my comments.

It changes a lot over time doesn't it. Not just one’s perception of it but the tone itself.
For me it ranges from a jet engine noise to hum, I used to hear it all the time but now I only hear it in silence.

Just past the 1 year mark for me. Feeling much better now. It sure does take time.
How's things with you? I really appreciate the help and advice you have offered to me over this time, and the help from other people in the forum.

It's a terrible condition. I did go too see Guns n Roses last weekend at Slane castle. Used professional ear plugs, was a great show and no negative consequences apart from a crazy two day hangover lol

The fact the concert was outdoors made it possible, it still peeked at over 115db at times.
I still haven’t been seen at ent yet, did bother chasing up the appointment. No point really. I will take your advice and chase up ent and see if I can get an appointment. Just to do the tests.

Yes, I'm much much better now, I was in a very dark place. It was a terrible time. Things have improved, the distortion in music has gone and things sound normal again. I can even setup an eq system hear the different frequencies, when I first suffered this I couldn't hear bass, everything sounded flat, really was a bad time, I'm surprised I survived it to be honest.

I now have a new appreciation for sound and music. I just wish I understood this before. I still have slight balance issues but mostly I am happy my hearing has improved, It is very difficult too accept when it happens as I am sure you know.
I will always use hearing protection at loud events, concerts etc. The guns n roses concert felt fine with my pro plugs in and I noticed many others using plugs too. Good to see.

I’m back at work and able to spend time with my family. Thanks Michael for your advice (even at those times when I didn't believe it)

Marcus

 

Thank you @JohnAdams.

I will try it out. Few months ago, I bought a small jar of turmeric tea (very popular now here in the Philippines) but has not touched it yet. I'll look for curcumin supplements at GNC or some health shops.


Warm regards,
Albert

 

Yes, the tea will not deliver a high enough dose. The key is taking a large dose. The best foods to take it with are ones high in fat as curcumin is not water soluble but is lipid soluble.

 

Thanks a lot @Michael Leigh.
I really appreciate it.

I have read through your article on hyperacusis and the story of Marcus.

Very informative and practical and it really means a lot to a new sufferer like me.

I am now seeing a neuro-otologist (after a third ENT doctor) for my dysacusis. As my audiogram and speech discrimination test are normal, he now wants to rule out TMD and advised me to look for a TMJ specialist. So I feel that I am not out of the woods yet but I am believing there is light out of this tunnel.


Warm regards,
Albert

 

Do you know anyone who has very loud tinnitus (which you can hear over TV and conversations) and has fully habituated?

I think people who say they have habituated have a mild tinnitus and not a very loud intrusive tinnitus.

 

HI @Sean

Yes I do know such a person and that is yours truly. Habituation means to live with. If you haven't read my post: The habituation process in the link above, please read it as it explains habituation in detail.

If you have any more questions please ask
Michael

 

Thank you for replying. I will create a poll when I can. I really want to know how many members have a truly loud tinnitus and don’t care much about it.

Sometimes you can hear mild tinnitus over conversations. I really want to know if a truly loud tinnitus can be habituated to.

I have had spike where it was loud for 3-4 months and I remember it was impossible to live a normal life.

 

@Sean

HI Sean,

Create a poll if you wish and if you think it'll help. As I have mentioned in my post: The habituation process. People can have loud tinnitus this doesn't mean they can ignore it and go about their daily affairs as if they are not affected. My tinnitus can reach very severe levels where I can't read and don't have any interest in watching tv. When it's like I take clonazepam to help lower the intensity. Usually one dose is enough: 2x 0.5mg it will reduce over 12hrs to a more manageable level. However, this doesn't mean I haven't habituated I assure you that I have. When my tinnitus is mild or moderate it's of no problem at all.

Now, to your spike. If you are experiencing spikes this is usually caused by hyperacusis or some oversensitivity to your auditory system caused by Noise trauma. In this case you need treatment. Please see a Hearing Therapist or Audiologist that specialises in tinnitus and hyperacusis management and treatment.

All the best
Michael

 

@Fifth Business

HI Fifth,
I no longer post on MPP and hoped you would have seen my message there. Although I listen to classical music I'm not a connoisseur of it either. I am an Audiophile and strive to hear the best sound quality from my recordings, whether it's classical or opera. American Jazz fusion is also a passion of mine: Bob James, Michael Franks, Fourplay, Lee Ritenour, Diane Schuur etc.

As you know Herbert Von Karajan was a conductor and I do have some of his recordings on CDs but not on vinyl records. Modern recordings featuring the English conductor Simon Rattle, are quite superb so you might want to check him out. It all depends what you want regarding sound quality? Whether you like classical, baroque, or opera? I particularly like baroque and my favourite composers in this genre are: Handel, JS Bach, Scarlatti. Favourite classical composers are: Mozart, Haydn and Beethoven.

If you have a good HI-FI system then you will appreciate modern classical recordings especially SACD recordings which stand for Super Audio CDs. They are recorded at a higher resolution and if you have a SACD player you will hear much higher sound quality than ordinary CDs. Many classical CDs are recorded in SACD.

Hope this helps
Michael ​

 

Hi Michael, if you can’t read or watch TV then how can you be habituated? Wouldn’t habituated mean you can carry on with your activities without taking meds?

If meds are needed to function then how can you consider as you being habituated. Not arguing here with you but my definition of getting habituated means you can go on without taking meds. If you are taking meds just to function when you have a spike then there is a serious problem. Please clarify.

There are gotta be people who have loud and intrusive tinnitus but they just don’t care and do their thing... anyone on this board?

 

HI Sean,

I said when my tinnitus reaches severe levels I am unable to read or watch tv in comfort. This does not mean I haven't habituated. Habituation means a person accepts tinnitus whether it is mild, moderate or severe. I will ask @fishbone to also comment on this and hopefully he will. Fishbone has quite loud and intrusive tinnitus and has habituated. He has had tinnitus for over 30 years.

No, habituation does not mean that, habituation is about accepting your tinnitus. It is your mind-set and to be positive thinking even in the downtimes when tinnitus is intrusive.

As I have explained in my previous post to you: I only take medication when my tinnitus reaches severe levels. Perhaps once or twice a month. Again, it's a person's mindset and their outlook on life which will determine whether they have habituated.

I don't have tinnitus spikes. Spikes in tinnitus are usually a result of oversensitivity to sound caused by Noise trauma. Therefore, I suspect you have hyperacusis and this needs to be treated as I have mentioned in my post: Hyperacusis, As I see it.

Today my tinnitus has been quite intrusive higher than moderate I would say and I wasn't troubled in the slightest. I have been watching TV and reading. As I type it has calmed down as it sometimes does and perhaps tomorrow It might be very low or completely silent.

As I have mentioned in my post: The habituation process, habituation is different for everyone and some people may need specialist treatment to achieve this. Some people cannot habituate as I have described in my post.

Michael

 

@ajc
I wish @Michael Leigh offered Skype consulting sessions for £100/hour like Julian Cowan Hill does.

I no longer post on MPP so please do not tag me there. I counsel people by telephone those that wish to contact me and I do not charge.

Michael

 

All of us want to habituate to our tinnitus. Some have mild, some have moderate, some have bad/intrusive level(me). It can be quite a task for us to achieve habituation, everyone is different.

Habituation is something that requires lots of work. It's not easy and it's not an overnight ordeal either. The first thing is to accept that yes, our ears ring and this is how it is. Now, if you are a newcomer then your ringing might fade or possibly go away.

If your tinnitus is not going away, then it's time to make a plan to face our tinnitus. Facing it should not be in a negative manner. Tinnitus can possibly put stress on our minds and body. The last thing that we should do is to be negative about it. It's not an easy thing, but in my 31 years I have learned that fighting tinnitus is not going to help at all.

Instead we need to plan and come up with ways to manage and live with our tinnitus. Accepting, gaining support and taking baby steps to push forward are the ways I have habituated. All of these components have taken lots of effort, lots of patience and lots of planning.

Some will ask, "does habituation mean that I will not hear my tinnitus anymore?" Habituation simply means that the stimuli (tinnitus) is not affecting our lives in a negative manner. I still hear my beyond loud ringing, but I will not get emotional about it.

In regards to meds, some use it and some don't. It's a personal choice and more power to it. Some may use meds to push forward and not get affected by the ringing. Some do not use meds and push forward. Meds can be helpful to some people and other folks will not take them.

@Michael Leigh and myself always say, that having a good mindset when approaching our tinnitus goals is vital. Habituation, coping, adapting, moving forward can happen if we don't look at tinnitus as a foe. I am not over joyed that my ears ring in an intrusive way, but I will not let it get a rise out of my emotions.

I have accepted that this noise is part of me and my life and I accept that I need to adjust, plan and try to live a life with tinnitus. I use to not accept it in the early years and it DID NOT help at all. It just held my back and slowed down my progress to live a life with the tinging.

All of this take TIME, EFFORT, PATIENCE and lots of self love. Tinnitus is a horrible condition and it has impacted my life and changed me. It has also show me just how much courage I have, how resilient we can be.

People like @Michael Leigh give so much to this forum, it's a gift to have mentor care so much and help people out.

Bless.......

 

That's usually not how habituation is described in articles or defined by people offering CBT or TRT for tinnitus.

Another issue with the concept of habituation is that it's usually described as the person with tinnitus reaching "habituation of emotional reaction" and therefor reaching "habituation of perception" where they are rarely aware of their tinnitus and if they are it doesn't bother them. This is, for example, explained in an article by Dr. Hubbard in the ATA's magazine Tinnitus Today where he discusses the four stages of habituation without mentioning that there are people who, unfortunately, won't be able to tune out their tinnitus for most of the time.

Even in the European guideline, it says "Habituation theory [29] proposes that the negative interpretation of the tinnitus signal, and related heightened autonomic arousal levels, leads to dysfunctional cognitive processing and thereby distress.", making it clear that this model doesn't take loudness, reactiveness or hyperacusis into account. Whether you suffer or not is your fault.

Also, you can whole-heartedly accept a health issue and still be negatively affected by it. Acceptance itself won't lessen the impact of tinnitus on everyone's life to a point where they don't feel severely limited.

The concept of habituation has harmed tinnitus sufferers and there are many valid reasons to criticize it. It's a discussion worth having.

 

So habituation is just accepting tinnitus? Damn! I thought it was being able to 'not hear it' by it somehow getting 'tuned out' into the background. I feel completely deflated by this.