What Is Tinnitus Habituation Really?

Hi all ,as someone who copped for this 27 years ago I have strong views on Habituation.I truly believe it depends how loud it is .As I type I am watching the football on the TV loud,I have earphones on with sound therapy International tape playing and the jet engine noise is still in the fore front of what I can hear. 2 years ago an ear infection elevated the noise, a time when I had habituated because it just wasnt as loud then.

 

Habituation isn't a cure as some people make it out to be. But it certainly is a boost in life, your self esteem, your welfare. The first is the hardest, but as the slogan goes "Every one of us is a minor tragedy, most of us learn to cope."

 

Mario - A minor tragedy is a good way of putting it. Although at the time of onset it was major for me - still is.

How do you know when you have achieved habituation?

 

For me, habituation will mean no longer hearing my tinnitus. I know two people, both of whom acquired tinnitus as children, who no longer hear it--unless they are sick or under stress, and even then it is transitory.

Do adults loose the ability to silence their tinnitus? Or does that ability depend on other factors? Age is inversely correlated with neural plasticity; but so too is the duration of your tinnitus. What's the relationship between distress and tinnitus awareness? I no longer believe that distress affects awareness. Many people, myself included, are no longer distressed by their tinnitus; yet this has not resulted in an awareness reduction. Nor has the lack of distress reduced my loudness. (My tinnitus is quite variable, and this variability has nothing to do with stress or distress.)

TRT practitioners--or the various sound therapy practitioners--will all argue that habituation means not caring about your tinnitus and whether it is loud or not. If you know longer care, such practitioners believe, then your awareness will not be as acute or persistent. And this is true for some individuals with loud tinnitus. For myself, I do notice my tinnitus when it's spiking. It becomes intrusive and affects my ability to concentrate. I've never understood why scientists argue that annoyance, loudness, and intrusiveness are separate constructs. But perhaps that is because I am not habituated and thus am annoyed by loud, intrusive tinnitus.

 

Jazz - are you just "annoyed" or are you suffering? big difference I think

 

I totally agree.

Stress has never affected my tinnitus. When it's loud, it's loud. When it's quiet, it's quiet. And when it isn't there, it isn't there. My anxiety never made the tinnitus more extreme or me more aware of it.

Perhaps it is true for some people but I don't believe that, for me, not caring about my T will ever make it lessen. Having said that, it is lessening - or at least the number of bad days are. I just know it has nothing to do with how I feel about it.

 

Not sure that there is a huge difference... the annoyance can cause suffering. My T annoys me more than anything else. In fact I think it is the perfect word to describe the noise in my head... annoying. Extremely annoying. Incredibly and persistently annoying. And that annoyance makes me suffer.

 

Sorry to hear that yours is loud today Erik. Mine spiked after a walk today but only for about an hour. I am beginning to wonder if moving my head a lot affects it... keep remembering the hairdresser experience - that definitely spiked it. Perhaps I have mild brain damage - I did have concussion a few years ago...

I'm the same really. I hardly ever let T control what I do these days (although I still have a couple of days a month when I hide away... when it's really bad). But I believe that this is because of the anxiety decreasing rather than habituation. From what I have read, true habituation is when you cannot hear the tinnitus anymore (even when listening for it) because your brain has tuned it out. And then perhaps it comes back if you are ill but it goes away again.

 

Stan:

Has your noise been reduced? Or do you just notice it less? Does it vary in sound and/or intensity?

Regarding your comment, I am primarily annoyed. I no longer suffer much, though I did for several months. I went through several stages: panic and fear, suffering and annoyance, and now primarily annoyance. I attribute my annoyance--rather than suffering--to two factors: First, my tinnitus always resets in the morning so I wake up with a non-offensive whisper. It takes five or six hours to build--if it's going to be a bad day. Sometimes, the T stays low all day. Second, I understand the disease--as well as anyone does. Ignorance breeds fear; but knowledge, alas, does not lead to happiness! Not knowledge about tinnitus, that is.

If my tinnitus were to rage day after day, I would regress, undoubtedly. My annoyance would turn to fear, etc. You see this regression frequently on the board. People say, for example, "I habituated for ten years, then X happened. Now, my head is exploding, and I'm going crazy."

That's why I believe volume does matter for most people. I believe it correlates with intrusiveness, but I know many studies indicate otherwise. To those researchers, I'd like to see their methodology: What are they measuring? How do they define annoyance? How do they define loud noise? Do they look at masking issues, etc. Tinnitus is such an understudied disease. I'm always amazed, for example, why researchers don't look at the correlation between tinnitus severity and tinnitus types--since tinnitus is a symptom, rather than a disease, rooted in audiological dysfunction.


clik:

I agree that habituation enables you to function somewhat normally, even when the T is loud. And you're right that this functioning is rooted in reduced anxiety. But there are limits as you know! Annoyance does become suffering when loud, intrusive noise just won't remit, and your head feels like fuzzy. There's a study I need to find that looks at how intellectual performance is affected by tinnitus. Now, one wants to think about this, of course, for we all need our brains. The idea that neural noise--which is one way to define tinnitus--affects our ability to concentrate on complex problems is disconcerting but nonetheless a fact for many people. It is truly a fact for me, though I function quite well intellectually when my T is low.

erik:

You're correct! I've heard about habituation occurring whether or not you can hear your noise. It seems counterintuitive, but I know it happens. Still, it must be easier to habituate when the noise is low to nearly silent.

 

Hi Erik... hopefully it just takes a little longer. I think we should give it 2 years & hope that we will eventually tune it out completely

 

Jazz - No my T noise has not reduced and I notice it all the time. A high freq pitch goes up and down in volume during the course. of the day.

 

When I read about tinnitus habituation is seems so undefined and general, almost like another word for learning to deal with it, which sounds alot like ENT talk. But in some terms I read that the habituation and/or the process of habituation is something more, like something scientific, specially in context of TRT etc.

Isn't habituation just another word for getting to terms with the T or is it actually the brain producing more neuron pathways so that we get to lower the volume cause of the brains ability to change?

 

Habituation is really just a fancy term for 'you will get used to it. ENT talk is a good way to describe it. Sort of like an Anatomist telling someone to initiate the supine position when everyone else just tells you to start lying on your back.

 

I sometimes don't hear it when im busy, or rather I'm unaware of it, and if I am it is not much of a problem. But it never reduced in volume.

 

A great question, which I have pondered. It's almost a philosophical question about what constitutes our thinking process and how much can we control our own thoughts.

I think that habituation means that you no longer consciously listen to the sound. Instead of continually checking on it, you train yourself to stop checking on it. If your conscious thoughts no longer react to it, it's no longer a factor.

But if we continually monitor the sound, then we reinforce a habit that will defeat our goal. It's tricky. A person almost needs to have a "willing suspension of disbelief".

My audiologist has had tinnitus for 10 years. I asked her if she can she still hear it, and she needs to actively search for it. I can see she isn't acting when she's "looking for it" in her head. Sometimes it still bugs her in certain situations.

I think it requires discipline - perhaps a TRT coach - but habituation can occur naturally. Jastreboff says that it's hard to habituate if someone is taking benzo's, because those drugs make it difficult for the brain to learn. Habituation is a learning process, where the brain restructures itself (neuroplasticity), changing neural circuitry to avoid the negative thoughts.

 

Habituation is a state of mind. You aren't bothered by it if you don't care about it. A profoundly deaf woman I work with has told me has had tinnitus since she started hearing it while baby sitting one night when she was 17. She's in her late 50's now. She says she's had it so long it simply is of no concern to her. Her annoyance with tinnitus is that it gets in the way of her speech understanding, as she tells me.

Understanding that tinnitus habituation is a state of mind gives you some forecast as to what you can expect. You can lose the habituation if the sound changes and you are a person prone to anxiety. The one thing your brain will never forget is the negative association it once had with tinnitus. It can all come flooding back quicker than you can imagine. It has happened to me a couple times. But every time, I have more or less become habituated again. That is why although you don't care about your tinnitus any longer, you need to maintain vigilance about protecting your ears. Don't put yourself through the suffering again if you don't have to.

 

Wow, having an audiologist with T seems like a dream situation if you ask me, as I have stated before, to understand T you need to have T. But Karl, when you say "listening to the sound" or "checking on it" I must admit I really don't get it. I don't need to check or listen to it to realize it's there because it just is! It's so freaking loud it's impossible not noticing it. I mean, it's like a very high pitched dentist drill, a jet engine in neutral gear or a billion crickets playing a never ending anthem of loud T. In addition to this more sounds are introduced, like equally loud constant tones on lower frequencies. So when I read about habituating my T I never seem to get the part where I'm supposed to "forget my T or avoid listening for it". I understand it's wise to avoid focusing on it, that's the same as when my mother used to say "Oh, don't think about it and it will get better" when I had scratches on my knee after falling off my bike, but loud T is so much more a part of me than any conflicted damage to the skin so I'm finding it so hard to grasp onto the theory that not listening to it is the answer to habituating - I'm not searching for my T, I don't sit down with a cup of coffee to "search for my T" cause I don't need to. It's like having a knife in my eyeball, it's kinda hard to avoid noticing it if you know what I mean.

I so want to habituate and learn the tips & tricks of the T trade, but each time I read about that "you need to shut it out" theory I get depressed. I guess I wished habituating was more something like the alteration of the physical neuron pathways in the brain or something cause that would at least carry some potential. Having said all this I'm not doubting anyone who has improved their situation trough habituation and I'm glad to read any happy recovering story. I guess this only emphasizes the individuality of T. To me the T loudness is the key factor, if I could only decrease that damn volume I would be on my way accepting my situation. I think I would be willing to risk my life for it, thus meaning very toxic trial medication or something like that. So there's nothing wrong with the will to get better, many times I feel like TRT theoretics think that people that don't get better from their therapy are somewhat unwilling to better their T or something meaningless like that.

Ps: If Benzo's make it harder to habituate, what about sleep med.? I've been taking'em every day since the 17th of June this year to get just 3-4 hours of poor sleep. with no med. I'm a zombie with zero minutes of sleep. Getting off them would most surely provoke anxiety and pain.

 

Per -
All I can say is what I have read in "Tinnitus Retraining Therapy" by Jastreboff and Hazell. They explain the logic of what they call the "Neurophysiolgical Model". If you haven't read it, I suggest you purchase this. It will demistify tinnitus so that you can come to grips with it.

I'm sorry that you are suffering so much. My T is not loud, however it was awful when I first got it. There are no "bragging rights" about this awful thing. But in almost 2 years, mine is much more tolerable.
- Karl

 

Hi every one,

My heart goes out to every one. I can feel your pain since T has changed my life. I have one big passion in my life- Silent meditation! T took that away from me! I dont think there is such thing as getting used to the loud noise ..in my opinion we can just mask it. I dont know t what would i do if i didnt have whitenoise. I dont think i can survive without white noise. I would go nuts!.
If there is a whitenoise around then i dont hear T at all and there is no difference between me and some one else who doesnt have T- except i have to hear the whitenoise in the background. what do you guys have to say about this? Does Whitenoise help you guys as much it has helped me?

 

I know I'm habituated to wearing pants because I don't recall if I had a good or bad pants day today. I know I'm wearing them, but they don't register beyond that. But I don't know how the brain works and if there is any volume limit for habituation.

I saw this video today: http://www.ted.com/talks/andres_loz..._and_the_switch_that_might_turn_them_off.html and I know that Michal J. Fox did something similar but less invasive, ultrasounds instead electrodes. I think it's on the HIFU thread. I'd say they will find a solution once they understand how the areas of the brain relate to each other. I have my money on the US BRAIN project.

 

Thanks for sharing frohike! That video was amazing, I hope geniuses like that live to be 150 years old cause we sure need them here. At least I hope they store their science and trials in very safe places cause it carries great potential. If theyre able to affect over active brain sections and neurons like that then T should be on the test list. The brain is the source of so much, their been focusing too much on the local areas so far I think. Doesn't help to work on the trembling arm if it's caused by Parkinsons in the brain. Doesn't help to focus on the inner ear to treat tinnitus when the phantom noise is created in the auditory cortex in the brain either.

 

I think habituation is influenced by the volume of tinnitus we all have. Worrying if it will get louder after all the horror stories that we read/youtube on the web. Maybe if I didn't have the internet my tinnitus would be gone by now, hard to say... but whatever the volume of your tinnitus is whether it be "mild" or "severe 24/7" we all get in quiet situations and it's just difficult not to "look for it" and "tune-in" which makes it distressing to say the least, people that say they hear their tinnitus 24/7 are they just looking for it subconsciously somehow 24/7? More than other people with or without T would?

 

Straight forward logic dictates it's easier for people with mild T to adjust than people with louder. It depends a lot of the person too. Their mentality towards the issue, what they do most days/the level of noise they surround themselves in, and I say they because while I consider my tinnitus to sometimes be problematic and bothering, I know there's people out there going through an even more hellish experience compared to my myself.

 

OTOH without internet I wouldn't know it tends to get better with time. No doctor told me that. As for the loudness of T, if it is masked by certain amount of environmental sound you can not hear it even when you look for it, it's not a matter of perception in that case.

 

Sorry to say my when mine is loud which is the norm, I can't mask it. Aware 24/7.

 

Wanted to add, this forum had comforted me as well educated.

 

Is everybody capable of habituating to their T? Or are there some people who are just doomed to suffer forever?

 

I am afraid of the answer. I have been sensitive to sounds all my life, even before T, so this habituating idea is a tough concept for me.