Looking for Tips for Getting Over the Habituation Hump

I am almost 2 years into my tinnitus journey and in many ways I am much better at dealing with this condition, but I find that I have reached at least temporary plateau in my recovery. I have 24/7, high pitched, unmaskable tinnitus, but it doesn't drive me to despair anymore. I'm largely back to full functionality. There are times, and I am sure this aligns with the severity of the symptoms on a given day, that I can largely push it from my mind, and when I do I can truly enjoy life.

My problem, the thing that I am stuck on, is

1) When it is worse, it is still hard to ignore and it will dominate my consciousness.

2) Although the sound doesn't drive me mad when it is cranked up, I still at times perceive it as an annoyance/painful/negative sound rather than just a neutral noise. I feel like I've been stuck at this stage for a while and wonder if anyone has any tips.

For those who are in a similar stage or have gotten beyond it what are your favorite strategies you have used to get over that last hump?

 

This is pretty much where I'm at nowadays. This IS habituation. Its not a cure, its an accommodation that allows life to go on. You are on the path.

 

Hi AfroSnowman

I agree with PaulB that you are describing habituation and I believe you will continue to make improvement. This will happen but takes time. Please read my post the Habituation Process in the link below. It explains the various levels of habituation and how it can affect people differently. You may remember I recently posted on your profile page that you are showing all the right signs and have every confidence that you will succeed. My comments were not merely to give you comfort or tell you what you might want to hear. You are still just two years in, so give it time and try not to be too hard on yourself.

I think the wearing of one or two white noise generators, worn as described in my posts on TRT on my started threads, will assist you further on the habituation path since your tinnitus is variable at the moment. The white noise generator(s) will help desensitize any oversensitivity within your auditory system and further help the brain to habituate to the tinnitus. Setting the white noise slightly below the tinnitus (not masking it) the brain will habituate to the white noise and slowly push to tinnitus further into the background making its perception less noticeable. In short, the white noise generators will be providing sound enrichment continuously throughout the day. At night use a sound machine by the bedside. I don't think you require counselling which is normally recommended when wearing white noise generator(s)

The white noise generator is expensive but is the avenue I am advising you to pursue. I have been using them for over 20 years so have a lot of experience with this type of sound therapy. It can be very effective when used correctly and one is patient and not looking for quick results. If you don't want to use BTE (Behind The Ear) white noise generators(s) you can opt for the smaller and more discreet in-ear type. I have both kinds. The MM10 is the smallest in-ear white noise generators. I will paste a like below showing you various WNGs models available. You will have to see what's available in your part of the world.

In addition, I recommend try and bring as much positivity into your life as possible, as this will help take your mind off the tinnitus. For instance take up a new hobby to keep you occupied. How about setting up a topical freshwater aquarium? It can be challenging and immensely rewarding and doesn't have to be large. There are plenty of videos on YouTube to walk you through the process of starting one up as a newbie through to advanced.

If you do start wearing white noise generator(s) I recommend you stop visiting tinnitus forums for at least three months.

All the best
Michael

The Habituation Process | Tinnitus Talk Support Forum
Tinnitus Relief - Puretone Ltd

 

Thanks for taking the time for a thoughtful response. And yes I did see your response to my post, I appreciated it, I've also read your other posts. I have WNG/hearing aids fitted and set for my tinnitus, I've used them on and off. When I first got them I was religious about it for the first few months, but I don't like them and I didn't feel that the treatment was doing anything positive for me so I've largely stopped wearing them.

I have ultra high pitch tinnitus, along with mild-moderate hearing loss in the 12-16 kHz range, so the WNG can't overlap at all with the tinnitus. It is more sound adjacent than overlapping in any way, so there is soothing effect. The overall effect when I use them is generally neutral to negative, it just adds more noise to an already noisy environment, particularly when I am in a period where I am still being challenged. Alternatively when I am in a cycle where I am doing better at handling it, I'd rather enjoy not having the additional input.

Assuming I give it another go, what is the minimal amount of daily use that you think could be worthwhile. I understand the concept behind using them, but as I find it unpleasant and therefor less likely to use what do you think the minimal daily usage should be to get any benefit.

I completely agree with your advice on positive thinking, I try to keep myself in that positive mindset and actively pursue yoga, mindfulness, meditation, and clean living. I also acknowledge that even though I stay more or less exclusively on the research pages here, the act of checking in continuously helps train the mind towards giving tinnitus a prominent position in my thoughts. I think after the FX-322 results come out I'll take your advice and try to take a break from it.

 

HI AfroSnowman

Thank you for your reply and for the additional information and think I will be able to help you further, if you are willing to try my suggestions long term. Unfortunately I do not agree with much of your post, that is not to say I am right I'm just giving my opinion.

Hearing loss can often cause or make tinnitus worse and is well documented in the medical field. Since you were issued with hearing aids means your hearing isn't what it should be. Therefore, you are not helping yourself by not using the device. This is probably the reason your tinnitus is still problematic and likely to continue unless you address the problem. It is important that your hearing is at its optimum otherwise your brain will struggle to hear sounds from the outside environment. To compensate for any deficiency in hearing, the brain will increase it's internal gain, rather like a volume control on a radio to hear sounds from the outside environment. However, at the same time the tinnitus will be increased too which is not what you want.

People that acquired tinnitus because of hearing loss notice, once fitted with a hearing aid(s) the tinnitus decreases over time and in many cases disappears or they habituate to a level that it's rarely heard. Therefore, I advise you see your Audiologist and get your hearing checked and the hearing aid(s) set at the correct level. Don't use the white noise generators. Allow your ears and auditory system to get used to the hearing aids and you may find that you don't need to use the white noise. However, you could slowly introduce the white noise following the procedure I have detailed in my TRT posts if required.

I held back from what I really wanted to say to you in my previous post but will be more candid, since you have given me more information. I do not think it's a good idea for you to visiting this forum or any other tinnitus forum too often and reading research into tinnitus. I hinted this to you by saying, try to bring more positivity into your life and take up a hobby. This will help take your focus off the tinnitus. What I really mean, if you want to help yourself keep away from tinnitus forums. Constantly visiting them your thoughts are continuously focused on tinnitus and this isn't such a good thing. Tinnitus is an integral part of our thoughts and emotions and cannot be separated from it. You need to project your mind and thoughts onto other things and not tinnitus and I'm sure you will see improvement. Start by getting your hearing checked and wear your hearing aid(s) without using white noise. When you are used to them after three months or so, you can slowly introduce white noise if you need it.

All the best
Michael

 

The audiologist fitted me with hearing aid only for the masking capacity as my insurance would cover it, as opposed to WNG which would not be covered. She as well as the other number of audiologists and ENTs I've gone to have all agreed that aside from the tinnitus therapy (i.e. WNG) hearing aids as a hearing augmentation device would not be otherwise indicated. My hearing loss is only significant at the ranges beyond which a hearing aid can help.


Thanks again for your advice and insight.

 

Hearing aids are not white noise generators and are the wrong devices to treat tinnitus and hyperacusis if present. I wish some Audiologists would stop doing this because it's wrong. If the hearing aid is fitted with a white noise generator within the same unit, these devices are called dual purpose and can be used independently. If the device you have is just a hearing aid then this will not help you. You need a white noise generator in my opinion. Either one or two and use it in the way described in my TRT posts.

All the best
Michael

 

My understanding is that these are indeed supposed to be dual purpose units, they are Widex Moments if it means anything to you. The audiologist I work with is specifically focused on treating tinnitus and hyperacusis and this model was the specific type she said that I had to get for tinnitus therapy tools. She spent a good bit of time over a couple of visits designing a sounds of my tinnitus profile.

Of course I don't know the specifics of one hearing aid WNG vs a different one, at a certain point we trust the people we work with as being capable and she certainly appeared to be.

For what it is worth the only TRT provider I could find in my state (10 hours away by car so no thank you) also said that she would use hearing aid as WNG, she suggested that that was pretty much all they use any more. I don't know which brand she intended to use.

 

I have heard of Widex devices but never used them. If the hearing aid can be turned off completely and just use the white noise then I suggest you try this. Hopefully the white noise volume can be adjusted and should be set slightly below the tinnitus. If you want to proceed then follow my advice in my previous posts. Try to reduce your visits to tinnitus forums and direct your attention to other things so you're not focused on tinnitus. It's just a suggestion but think this will help you, best of luck.

 

I find this to be excellent advice; however, it's kind of contradictory to what you're saying in this thread?

 

Please explain how I am being contradictory, bearing in mind I was not corresponding with you?

 

In this thread you say "Hearing aids are not white noise generators and are the wrong devices to treat tinnitus and hyperacusis if present. I wish some Audiologists would stop doing this because it's wrong"... and in the other thread you go on to explain precisely how hearing aids help tinnitus.

 

Thank you for your reply. I ask that you please read my comments again. In addition, please do some research in the benefits of hearing aids and tinnitus.

Hearing aids are not white noise generators and I've explained this many times in this forum. It is for this reason dual purpose hearing aids are made that incorporate white noise generators and hearing aids within the same device. My white noise generators are dual-purpose as they have hearing aids fitted. However, because I have no hearing loss, my Audiologist disabled the hearing aids via computer when I was being fitted, so they only function as white noise generators but also have pink-noise and can select between the two.

Hearing aids treat hearing loss, that is their primary purpose. When tinnitus develops as a result of hearing loss, as mentioned in my previous posts, the fitting of hearing aid(s) increase hearing and thus, the brain over time lowers its internal activity, at the same time tinnitus is lowered making it less noticeable. Although many people perceive tinnitus in the ears, the sound is generated in the brain, as is the auditory centre for hearing.

So to clarify: Hearing aids treat hearing loss (not tinnitus) and by doing so the brain no longer has to struggle to hear sounds from the outside environment, so it lowers its internal gain at the same time tinnitus is lowered. This is the reason at night it's advisable for people with tinnitus not to sleep in a quiet room; for when the brain hears silence it will increase its internal activity and this will increase the tinnitus. Sound enrichment supplies the brain with sound, helping to prevent it increasing internal activity and keeping tinnitus low.

Michael

 

Hi Michael,

First of all thanks for all your great answers to the members - I really enjoy reading them.

I have been dealing with tinnitus for 15 years - and have had several spikes which eventually went back to some sort of baseline (whatever that is after 15 years).
At the moment I am in the middle of a BAD spike (think it is from stress - work stress and the loss of my mother).

I would like to try white noise generators which I have had all these years but never used. Do you think I can benefit from them after all these years and if yes, do you any tips for me?

Best Regards,
Troels

 

Hi Megatron,

I like the sound of your name and thank you for your kind comments.

You are a veteran to tinnitus so will not attempt to tell you how to suck eggs. Various things can cause tinnitus to spike, stress and the loss of someone close. Please accept my condolences on the passing of your mother, I know how it feels for you right now but with time it does get easier. Tomorrow will be 15 years that my mother died and think about her every day. I have little choice as she made all my short sleeve shirts that amass to over one hundred. Each one is unique as there isn't another like it in the world. The compliments I receive from people are too many to count but always appreciated.

If you have been using headphones, earbuds, headsets or AirPods even at low volume this can cause the tinnitus to spike too. As well as working in a noisy environment or listening to music through speakers at high volume. If stress is the cause, then this needs to be managed so advise you talk to your family doctor. Please click on the links below and read my posts.

White noise generators can be helpful and I use them regularly. However, it's important to find out what has caused the spike, whether it's stress or exposure to sound from the sources I have mentioned. White noise generators should be used alongside counselling with an Audiologist or Hearing Therapist that's trained in tinnitus and hyperacusis management. Please go to my started threads and read my posts on TRT.

As a veteran you may not need counselling so if you decide to go ahead the following procedure is what I advise.

White noise generators should be introduced to the ears and auditory system slowly and not used continuously as some therapists tell patients, as this can cause irritation and possibly spike the tinnitus and hyperacusis. Therefore, set the volume of the WNG below the level of the tinnitus and wear them for just 1 or 2 hours then remove them for the same duration. After the elapsed time put them on again setting the volume below the tinnitus and wear them for another 1 or 2 hours. If you notice any irritation reduce the wearing time again.

Continue doing this on day one, two and throughout the week. Continue this process for week two and so on, then gradually increase the wearing time. The goal is to achieve a total wearing time of 6 to 10 hours and many people achieve this. At night white noise generators shouldn't be worn while asleep. Instead use a sound machine by the bedside setting the volume slightly below the tinnitus.

Over time the white noise generators will help to desensitize the auditory system so it becomes less sensitive to sound and thus hyperacusis will reduce. At the same time the tinnitus is treated as the brain will habituate to the white noise generators and slowly push the tinnitus into the background so it becomes less noticeable. This treatment can take up to 18 months and ideally, the patient should have regular counselling with their Hearing Therapist or Audiologist. Counselling helps to remove demystifies the negative thinking that is often associated with tinnitus and hyperacusis. Contrary to some beliefs, hyperacusis can be completely cured using white noise generators or reduced considerably. The same can be achieved naturally without WNG or using self help as described in my post: Hyperacusis, As I See It, on my started threads.

All the best
Michael

Can Tinnitus Counselling Help? | Tinnitus Talk Support Forum
Will My Tinnitus Get Worse? | Tinnitus Talk Support Forum

 

Hi Michael,

Again - thank you so much for taking your time to answer me and thank you for your condolences.

I will try to find a doctor here in Denmark to help me with the WNG.

Like I told you I am in the middle of a bad spike (3 weeks so far) and the worst part is that I am experiencing new sounds, very different from my normal sounds. I have a few. They are harder to mask this time.

Again - I have had bad spikes before but this i really bothersome and I feel that I haven’t learnt anything all these years since I am out of control like this.
I am back to the dark thoughts of this being the new normal once again.

P.S. I have not used earbuds or anything like that. I went and got my hearing checked and everything was ok.

Maybe I am relapsing again?

Have a wonderful day.

Best,
Troels

 

HI Troels,

Something causes tinnitus to spike. You have had your hearing checked and assume the rest of your auditory system has been tested. If exposure to sound hasn't caused it and you don't have hyperacusis, then stress could be the cause. I don't recommend trying white noise generators as the moment. Have a talk with your GP and see if something can be prescribed to help lower stress. If you are able to get some compassionate leave from work due to your mother's recent passing, I think this will help. White noise generators at this time might not be a good idea.

All the best
Michael

 

Hi Michael,

I have hyperacusis. It has also spiked again.
I don’t think I have been exposed to more noise than anybody else lately. I live a quiet life, no loud music, use special ear protection etc etc. Really trying to do all the right things.

Can it be the hyperacusis that are causing it? I have also a burning feeling inside my ear canals (it comes and goes).

Best,
Troels

 

Hi Troels,

A person can habituate to tinnitus but if hyperacusis is present and hasn't been treated, spikes will be a recurring problem. In your first post you haven't said what the original cause of the tinnitus was but seems to me it was noise induced. Hyperacusis often accompanies noise induced tinnitus. Therefore, if you have had this for 15 years or experiencing it for over two years, without seeking professional treatment as mentioned in my post: Hyperacusis, As I See It, then I advise you to do so.

The main reasons for spikes in tinnitus are exposure to certain sounds especially when hyperacusis is present and using any type of headphones. Unfortunately living a quiet life as you've been doing and using hearing protection perhaps more than you should, is not doing the right thing and has probably lowered the noise floor of your auditory system and made it more sensitive to sound. A lot of people do not realize this. They think keeping away from normal everyday sounds, using hearing protection often to excess is the right thing to do but it's not.

Quiet surroundings for people with tinnitus, starves the brain and auditory system from outside audio input and therefore, forces the brain to increase its internal activity which will also increase the tinnitus. Having hyperacusis exacerbates the problem and one enters cycle of recurring spikes that can get progressively worse with time. It can cause other problems that I have mentioned in my post: The Complexities of Tinnitus and Hyperacusis. You need to slowly introduce more sound into your environment and suggest that you start using a sound machine by your bedside at night and use sound enrichment during the day. More is explained in my article: Tinnitus, A Personal View, on my started threads. Please read the Habituation Process.

You may need to see an Audiologist that is trained in tinnitus and hyperacusis management and recommend, white noise generators with counselling. Please read all the articles mentioned including those on TRT. Print and refer to them often as this will help to reinforce positive thinking.

I wish you well and all the best
Michael

The Complexities of Tinnitus and Hyperacusis | Tinnitus Talk Support Forum
Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

I am trialing three different dual purpose hearing aids/WNG for my tinnitus. The first is an Oticon which goes up to 8 kHz. The second is a Phonak which goes up to 9.6 kHz, and the third is a Signia which goes up to 12 kHz. My tinnitus is around 12 kHz but have not been able to pinpoint a closer frequency.

With both the Oticon and Signia, as I understand, you can turn off amplification and just use the WNG. From what I understand, with the Phonak you cannot.

My pricing is the Oticon is cheapest, then the Phonak, then the Signia.

 

Hi Michael,

I saw that you either currently use or have used the PureTone MM10.

I was curious, did it seem to block sound? I only need the masking feature. I'm worried that it will block some of my hearing and then potentially make tinnitus worse.