Tinnitus habituation might be described as the holy grail for tinnitus sufferers. For those in a traumatised state after the early onset of tinnitus it is a term which could be triggering and never have felt more out of reach. For those of us who have habituated to tinnitus it is a term we understand and a place we feel lucky to have reached but also understand why for some it is problematic. This article explores some of the pitfalls to tinnitus habituation, associated terms which are useful to know if you suffer from tinnitus and how you can take your first tentative steps towards habituation.
Tinnitus habituation explained?
The term tinnitus habituation means you become accustomed to a tinnitus experience. This means that you might still have tinnitus but you are no longer aware of it most of the time. When you do become aware of it you have a neutral response to it and it does not intrude on your life or bother you most of the time. You are no longer triggered by it.
A practical example that might help you understand the term better would be a couple who have just bought a new house. They are standing in the bedroom unpacking boxes and they hear a train pass by on the tracks behind the house. They start to worry that they have bought a house too close to the railway. Over the coming weeks they hear every train pass by and it annoys them and they start talking about options for moving somewhere else. They realise that this is an unrealistic option and try to accept their choice of new home. Several weeks pass and they notice the trains less. After a few months they realise they rarely notice them and if one passes by it no longer disturbs them.
What stops tinnitus habituation?
Before outlining the things which can help tinnitus habituation it is important to appreciate some of the things which can stand in the way or tinnitus habitation.
Trauma and tinnitus
Trauma is closely associated with tinnitus and tinnitus is closely associated with trauma. The common term used for tinnitus caused by trauma is trauma associated tinnitus. Examples of tinnitus caused by trauma might include head trauma sustained in an accident or physical attack or overwhelm caused by psychological abuse. Tinnitus not sustained as part of trauma can also cause a trauma response or post traumatic stress disorder (PTSD). PTSD and tinnitus conditions experienced together accentuate each other. This can cause someone a lot of difficulty and make each condition worse. It can also cause a big barrier to tinnitus habituation. The way to help someone with this difficulty is to address the PTSD first and then the tinnitus. You might be interested in EMDR Therapy For PTSD Therapy and EMDR Therapy For Tinnitus.
Fight or flight
When we experience a difficulty it can put a lot of stress on us. Our nervous system switches on to protect us from a perceived threat. We have reacted with the stress response of fight or flight to try and help the problem. We lock onto the problem and try and utilise our thinking function to come up with a solution. Whilst this can be helpful for some difficulties it is not necessarily helpful for tinnitus. Having a stress reaction to a tinnitus keeps the problematic tinnitus firmly in place and makes tinnitus habituation more difficult.
The wrong support
Getting the right support can be difficult if we do not know who can help us with tinnitus. The difficulty with tinnitus is that is requires an integrated approach which requires the expertise of different professionals. Most people might visit a doctor, audiologist or ENT surgeon. If you are told at this point that there is nothing you can do it can be very scary and you might feel alone with your difficulty. Reaching out to the internet has a mixture of advice which can be unhelpful. Friends or family who have not experienced tinnitus might struggle to support us.
There is other help out there which can be very effective. Tinnitus counselling, psychotherapy, somatic practitioners and thousands of people who live a life free from problematic tinnitus. You are not alone and can recover from tinnitus. You might feel as if there is no point getting help because it won’t get rid of the tinnitus. Support in the form of tinnitus retraining therapy can get tinnitus to back off and help you habituate to it.
Avoidance
A natural response to tinnitus is to try and avoid it. Some of the advice given by people who help with tinnitus is to avoid the quiet. Bed times can be notoriously difficult for tinnitus sufferers. This is because they are trying to switch off to sleep but are switched on as a result of their tinnitus. One way of avoiding tinnitus is through complete tinnitus masking. This means wearing a masker or listening to something that completely blocks a tinnitus sound.
This approach can be helpful in the early onset of tinnitus especially to reduce the stress tinnitus might cause. As a long term strategy to move toward tinnitus habituation it is not helpful. Complete tinnitus masking sets up a dynamic between you and the tinnitus which makes it more scary when you are not able to completely mask it. For some people complete tinnitus masking works as a long term strategy.
What helps tinnitus habituation?
Everyone’s tinnitus habitation journey is slightly different. Some people habituate to tinnitus very quickly whilst others struggle for a long time. Why some people struggle and others do not has a lot to do with what caused tinnitus in the first place, upbringing and attachments, perceived tinnitus sound level, whether tinnitus was caused by trauma or more natural causes, age of the person, historical trauma, mental health difficulties within the family and life circumstances. There a number of things that can improve the time it takes you to habituate to tinnitus.
Tinnitus counselling
One of the most important things you can do is to speak to a therapist who understands tinnitus or appreciates the difficulties which tinnitus can cause. Even better a therapist who has been on a tinnitus habituation journey. One of our first ports of call following a tinnitus experience should be a doctor or audiologist. These healthcare professionals can help rule out a medical cause of tinnitus, provide hearing aids or recommend a tinnitus counsellor. Conversations with medical professionals can be difficult especially if you are told that you won’t get rid of your tinnitus. This can set up a ‘nocebo’ affect. This is a negative expectation of future experience with tinnitus treatment or tinnitus counselling. It is important to speak to a supportive therapist who knows what you can do to help with tinnitus. It is possible for tinnitus to back off, reduce its perceived volume, habituate to tinnitus, manage tinnitus and in some cases for it to disappear altogether. This can be achieved by way of tinnitus retraining therapy, somatic work and a positive psychological approach.
Cranio-sacral therapy – (CST)
CST is a therapy which involves gentle body holding whilst you lay on a massage couch. It involves a holding of the cranium and sacrum as well as other parts of the body. t can help relieve stress, release trauma held in the body and assist with a number of medical conditions including tinnitus. It is gentle but also very powerful. It can help relieve some of the causes of tinnitus. These might include trauma release, TMJ tension release and calming the nervous system.
Tinnitus Retraining Therapy
Tinnitus Retraining Therapy (TRT) is a multidisciplinary approach to help with tinnitus habituation. The TRT I provide utilises sound therapy, tinnitus masking, cognitive behavioural therapy, somatic therapy and EMDR. Utilising these approaches gives you the information you need to habituate to tinnitus and live a life free from problematic tinnitus.
Partial tinnitus masking or sound therapy
Tinnitus becomes more noticeable for most people when we are in quiet environments. Complete tinnitus masking or partial tinnitus masking can help stave off tinnitus difficulties. Masking might involve listening to music, the radio or MP3 download on your phone or through an app. It might also involve wearing a tinnitus masker which can provide white noise or pink noise. Using a tinnitus masker for partial tinnitus masking as part of a tinnitus habituation strategy can be helpful in the short term. Long term avoidance and complete tinnitus masking can have you running scared of tinnitus making habituation difficult.
Somatic relaxation
Some people experience tinnitus as a result of stress or a traumatic event. Both tinnitus and trauma can cause our nervous system to stay too switched on. You are in a fight or flight response. Whilst being in a fight or flight response might be obvious in the short term many of us stay in this state for long periods of time. When this happens we are able to go about our business normally but the nervous system still has one eye open making it is difficult to relax leaving us feeling on edge. Finding a way of helping to calm the nervous system through a parasympathetic activity like yoga and reducing stressors in life can help to bring the body back into homeostasis.