Managing Tinnitus

Managing Stress

It has now been proven that practising Mindfulness is a helpful technique to use to calm down your tinnitus and doing so on a regular basis is something that should be considered.   The aim is, not only to make peace with yourself but also to make peace with your tinnitus.  Once you have achieved this aim, your tinnitus will recede into the background as you learn to manage your emotions, anxieties and irrational thoughts and reactions.

 

Because stress is so closely linked to the emotional system, negative thoughts and feelings, along with worries and anxieties, will cause tinnitus to be intrusive so it is important to try to reduce stressful situations as much as possible.  Sometimes this may mean looking at your lifestyle and making some changes to minimise your stress.

Muscle Relaxation and Visualisation

Muscle relaxation is also very helpful.  If you lie on the bed and start from your toes, squeezing/tensing and then relaxing all your muscles right up to the top of your head, this helps to release tension in your body.

Visualisation is also a good idea.  Whilst relaxing and possibly, tensing and relaxing your muscles, visualise a place where you have either been, or maybe where you would like to go to (or even somewhere you imagine) – a place that is peaceful and relaxing.  This type of visualisation can also help to ease anxiety.

Do not shrink your lifestyle

It is very important not to shrink your lifestyle by thinking that you cannot enjoy all the things that you enjoyed before tinnitus.    Doing all the things that you enjoy (taking precautions where necessary when being exposed to extremely loud sounds) and enjoying your life to the full will certainly help you in distracting your thoughts from tinnitus.   Try to have as much daylight as possible, embrace nature, your garden and everything around you, and do a mindful breathing exercise.  Engage in a hobby, reading, writing poetry, journaling and anything that will engage your attention in something pleasant.

Music

Listening to music can stimulate a calmer emotional response and so it not only helps with relaxation but also allows your attention to focus elsewhere.  Classical music can have a beneficial effect by slowing the pulse and heart rate and decreasing the levels of stress hormones.

 

Perception and Tinnitus

Why do we react to Tinnitus? Why does it appear worse at some times than others?   

To answer this, we can look to some basic principles of the psychology of perception.    Our sensory systems provide vast amounts of information on the objects and events around us, but too much for us to utilise effectively.

To do that we need perception, the process by which we become aware of the information and make sense of the incoming data so as to allow us to interpret it in a meaningful way and act accordingly.

Perception

Sensation and perception are two separate processes that are closely intertwined.  Sensation represents the ‘input’ – in this case our tinnitus and the perception is the process by which the brain selects, organises and interprets these sensations.

Perception is a creation, it is our brains, mind and the neurons inside our heads creating the world for us.

When we hear a stimulus – our tinnitus – the first thing we do is attend to it – pay it attention.  We need to do this because we need to process it.  This is not the end of the process because then we need to recognise it.  As it is an internal sound and not one we are used to – it becomes frightening because we can’t recognise it.

However, perception also takes into consideration our prior experiences, the effect of memory, learning and previous encounters with a similar stimuli.

Think about your Tinnitus – what does it sound like?  

High pitched whistle – could it be like a warning – need to move to be safe

The sound of a pressure cooker – we need to react because it may boil dry

The sound of the television when it used to close down in the evening – we need to react, switch it off.    

To all of these sounds you need to take some action to stop it

Attention

We are continually bombarded by stimuli, but we are not always aware of it.  We don’t always feel the pants we are wearing unless we pay attention to them. One of the ways we manage tinnitus is by bringing in other stimuli for our senses. However, if we focus intently on our tinnitus we could miss the other stimuli (inattentional blindness).

In a famous study by Daniel Simons and Christopher Chabris (1999) participants watched a video of people dressed in black and white passing basketballs.  Participants were asked to count the number of times the team in white passed the ball.  During the video, a person dressed in a black gorilla costume walks among the teams.  You would notice a person dressed as a gorilla surely as it is so unusual?   Nearly half of the people who watched the video didn’t notice the gorilla at all.  They were so focused on the people passing the ball they completely tuned out other information.

This may be why you perceive your tinnitus even with the TV on or in a football match

Management Tip 

Try listening mindfully to your favourite piece of music or song.  Can you make out all the words?  Distract yourself from your tinnitus by concentrating on your other senses – sight, smell and touch.

Motivation

Motivation can also affect perception.  You may not want to be paying attention to your tinnitus but you are tuned into.  Motivation can be positive and negative.  It may be whilst waiting for an important call, you think you hear the phone ringing whilst in the shower.

It is the same effect when a mother sleeps through a thunder storm but hears the slightest cry of her baby, she has an emotional reaction to this sound and so reacts to it and not other stimuli.  Again, you perceive your tinnitus in a noisy environment because you are tuning in to it.

Contrast 

Contrast also affects our perception.  If someone’s mobile phone lights up in a dark theatre before a performance, you will most likely perceive it but if the same phone lights up in the well-lit bar in the interval, you will not notice it.

A number of our group members state they notice their tinnitus after being in the car and coming in the house.  This is the contrast between the noise of the engine and the quiet house.  Of course, tinnitus is most noticeable at night when you have had other stimuli around, maybe the TV, radio or your partner talking and then suddenly the quiet bedroom.

Management Tip

Try sleep Apps or under-pillow speakers. Pillow Speakers are available from the British Tinnitus Association.

https://www.tinnitus.org.uk/pages/shop/department/pillow-speakers-and-sleep-headphones

Conclusion

Perception is a complex process, we all have different beliefs, values and life experiences which affect our perception. Our experience of tinnitus is, therefore, affected by all these things.  However, understanding some of the basic psychological principles which affect perception can help us to make sense of our experience of tinnitus.

References: British Tinnitus Association – https://www.tinnitus.org.uk/

Future Learn

https://www.futurelearn.com/courses/sensation-perception/7/todo/72694?utm_campaign=sensation-perception-w

https://cnx.org/contents/Sr8Ev5Og@12.2:K-DZ-03P@12/5-1-Sensation-versus-Perception

 

 

 

 

 

 

 

 

 

 

Understanding Tinnitus

Tinnitus is the conscious awareness of a sound that is not due to an external source and affects about 1 in 8 of the population.

Understanding Tinnitus

However, tinnitus is closely associated with the emotional system (in particular the amygdala) which is part of the limbic system and is responsible for the “fight or flight” response.  When a threat is perceived (as in the onset of tinnitus), it impacts on how we process this new sound, causing survival changes in the body and mind which result in the fight/fright or freeze response.

Although we look very different to our ancestors (the caveman) we have not evolved (emotionally) since then, our brains still have basic primitive reactions. Thus, the sound of “tinnitus” elicits the same stressful response as it did to our ancestors as the noise heard by our ancestors may have been that of the sabre-toothed tiger.  But our stressors today are many and varied, from work related stresses, relationships, bereavement and many more.   Even though our modern-day stressors are very different to those of the caveman, our emotional reaction to stress and anxiety is still the same.

Hearing loss and tinnitus

Although noise can cause tinnitus there are other factors that can result in tinnitus, such as illness, some medications and injury.  Warning: never stop taking your prescribed medications – you must always speak to your GP.   For many people, stress and anxiety seem to be the trigger for their becoming aware of tinnitus, which is, of course, because of its close link with the emotional part of the brain.  However, hearing loss can also be a trigger for tinnitus as the brain searches to hear the missing sounds, tinnitus may be heard.  You may not always be aware that you have a hearing loss as, for many, it comes on gradually.

The first-line treatment at hospitals, for those who have hearing loss and tinnitus, tends to be fitting hearing aids which can be effective in reducing the perceived volume of the tinnitus as it allows you to hear external sounds more clearly and thus the brain doesn’t have to ‘search’ and strain to hear sound.

The sound of silence

There is no such thing as ‘silence’ and the following will explain this.  In a study carried out in the 1950s by two American researchers (Heller and Bergman) they placed 80 students who did not have tinnitus, one at a time, in a soundproof room.   Afterwards, approximately 94 per cent of those people experienced a sound sensation such as hissing, ringing or buzzing when listening to ‘silence’.

More recently a similar study was replicated at Nottingham Hearing Biomedical Research Centre but with a twist.  They put people in a soundproof room and 83% reported hearing sound and then they put in a non-functioning speaker and the number of people who reported hearing sound went up to 92%.  These people did not have tinnitus and had normal hearing.  All of them heard some sort of sound when there was absence of any kind of input which indicated there is more to tinnitus than just the hearing of sound itself.  Attention or focusing on tinnitus plays a key role and I think everyone who has tinnitus will agree that they do tend to focus on their tinnitus.    But things do change and your brain does learn to filter out the sound once it becomes unimportant to you as you learn more about tinnitus and how to manage your emotional reactions.

Selective attention

There is evidence that our attention picks up tinnitus to focus on rather than other sounds and this can be heightened by monitoring to see if “it” is still there.  However, our ‘hearing brain’ has the capacity to filter out sounds that it considers unimportant.  We can help this process by using our other senses – sight, touch, taste, smell and choosing to do so will help in the process of “habituation”.

Habituation

This is a process by which any continuous stimulus (ie tinnitus) results in a process called habituation.  Once your reaction to tinnitus diminishes, there will be an automatic reduction in the perception of tinnitus.  However, should you notice it, your reaction will be somewhat diminished and so it will not trouble you.  One of the important things in life is to make peace with yourself, in doing so, you will make peace with your tinnitus.   However, in order to maintain habituation to tinnitus it is easier if it is heard from time to time so you can reinforce your beliefs that tinnitus is nothing to fear.

Patient Pathway

It is important to get a proper diagnosis so seek advice from your GP.  As there is now NICE Guidance for Tinnitus patients, there is an appropriate patient pathway that GPs should follow.  Depending on the diagnosis this may be a referral to ENT and/or to Audiology for further assessment.

https://www.nice.org.uk/guidance/ng155

Disclaimer

We are the Chesterfield and North Derbyshire Tinnitus Support Group.  We are not medically trained.  Our Lay Counsellor has experienced tinnitus since 1984 and, through making peace with her tinnitus, she has been able to live life to the full, in fact, she says, “experiencing tinnitus has helped me to manage, not only my tinnitus, but also all the other hurdles that you need to negotiate in life as well as making lots of friends along the way.”

 

 

 

 

 

 

New App for Tinnitus

Tinnibot App for Tinnitus

Tinnibot – all sounds a bit space age but during the pandemic we have been thrown into a world of technology.  Furthermore, Jodie Rogers, one of the Senior Specialist Audiologists at Chesterfield Royal Hospital said it is worth looking at.  The Tinnibot was introduced at the BTA conference at a talk Audrey and I were unable to attend because of other commitments.   However, the videos are available for some time so I went back to listen to it.

At the present time, whilst trials are underway, the Tinnibot is free – if you go to http://www.hearingpower.co/tinnibot you can register and receive a referral code to be able to open the Tinnibot app.  The App is available on iphone and android.

So, what is Tinnibot?

Tinnibot is a companion for Tinnitus relief.  Its aim is to:

  • Reduce stress
  • Enhance Wellbeing
  • Reduce anxiety
  • Help to sleep better
  • Give a greater sense of Self

The Tinnibot app was designed by a field of experts including input from tinnitus patients. It aims to offer personalised support in a safe way whilst complying with data protection regulations.

Tinnibot has an 8-week programme to follow and covers: 

  • Knowledge about Tinnitus
  • Changing perception using Cognitive Behavioural Therapy to re-frame your perception
  • Dealing with negative thoughts about tinnitus
  • Relaxation and meditation using mindfulness
  • Sleep better

There are also podcasts on the App as well as a transcript for anyone with hearing loss.

There is a calendar and journal to show your progress and create a gratitude journal if you wish.

There is also a chat function on Tinnibot – hence the idea that Tinnibot is your companion with tinnitus.  You can tell Tinnibot how you are feeling and what your worries are.  We were given a demonstration on the video and the presenter typed in that he was worried that with tinnitus he would not be able to live a normal life.  Tinnibot tries to understand how this is making you feel.  It will then provide a list of information that may help for example – Tinnibot may identify that this is catastrophising or give more understanding about how to identify negative thoughts and how to refrain your thoughts in a positive way.  These thoughts then can be added to your personal journal.  

If you are interested why not try it out, at the moment it is free.

On registering you will be asked a few questions about how bothersome your tinnitus is and will establish tinnitus goals with you. 

Online Tinnitus Support Group meetings

Online Support

We would like to welcome you to our online support group meeting.  

As a result of Covid-19 restrictions and social distancing measures, our group are introducing online tinnitus support group meetings. Our meetings will offer flexible support, an opportunity to meet       existing members who are managing the  condition, all from the   comfort of your own home.

Meeting dates

    Tuesday 2nd February 1.30pm – Speaker Nic Wray from the British Tinnitus Association – Research round-up and how to get involved

    Tuesday 2nd March – 1.30pm – coffee and chat

    Tuesday  6th April 1.30pm – Chair based exercise

     

The meetings will be via zoom -To get the login information please contact us at mail@tinnitussupport.org.uk or by phoning the group on 01246 380415

Login and bring a brew

You will need a computer able to access zoom and a webcam or built in camera.

Perception and Tinnitus

UNDERSTANDING TINNITUS

The BTA state “Tinnitus is the perception of noises in the head and/or ear which have no external source. It derives from the latin word for ringing and those living with the condition may have to endure a ringing, buzzing, hissing, whistling or other noise. The sensation can be constant or intermittent.”

Why do we react to Tinnitus? Why does it appear worse at some times than others?   

To answer this, we can look to some basic principles of the psychology of perception.    Our sensory systems provide vast amounts of information on the objects and events around us, but too much for us to utilise effectively. 

To do that we need perception, the process by which we become aware of the information and make sense of the incoming data so as to allow us to interpret it in a meaningful way and act accordingly. 

Perception

Sensation and perception are two separate processes that are closely intertwined.  Sensation represents the ‘input’ – in this case our tinnitus and the perception is the process by which the brain selects, organises and interprets these sensations.

Perception is a creation, it is our brains, mind and the neurons inside our heads creating the world for us.  

When we hear a stimulus – our tinnitus – the first thing we do is attend to it – pay it attention.  We need to do this because we need to process it.  This is not the end of the process because then we need to recognise it.  As it is an internal sound and not one we are used to – it becomes frightening because we can’t recognise it.  

However, perception also takes into consideration our prior experiences, the effect of memory, learning and previous encounters with a similar stimuli.

Think about your Tinnitus – what does it sound like?  

High pitched whistle – could it be like a warning – need to move to be safe

The sound of a pressure cooker – we need to react because it may boil dry

The sound of the television when it used to close down in the evening – we need to react, switch it off. 

To all of these sounds you need to take some action to stop it

Attention

We are continually bombarded by stimuli, but we are not always aware of it.  We don’t always feel the pants we are wearing unless we pay attention to them. One of the ways we manage tinnitus is by bringing in other stimuli for our senses. However, if we focus intently on our tinnitus we could miss the other stimuli (inattentional blindness). 

If you have been to one of our workshops we may have shown you the famous study by Daniel Simons and Christopher Chabris (1999).  In this study participants watched a video of people dressed in black and white passing basketballs.  Participants were asked to count the number of times the team in white passed the ball.  During the video, a person dressed in a black gorilla costume walks among the teams.  You would notice a person dressed as a gorilla surely as it is so unusual?   Nearly half of the people who watched the video didn’t notice the gorilla at all.  They were so focused on the people passing the ball they completely tuned out other information.  

This may be why you perceive your tinnitus even with the TV on or in a football match

Audrey has often told the story where she was chatting to a friend but never heard what the friend was saying, she was only paying attention to her tinnitus.  

Management Tip 

Try listening mindfully to your favourite piece of music or song.  Can you make out all the words?  Distract yourself from your tinnitus by concentrating on your other senses – sight, smell and touch.

Motivation

Motivation can also affect perception.  You may not want to be paying attention to your tinnitus but you are tuned into.  Motivation can be positive and negative.  It may be whilst waiting for an important call, you think you hear the phone ringing whilst in the shower. 

It is the same effect when a mother sleeps through a thunder storm but hears the slightest cry of her baby, she has an emotional reaction to this sound and so reacts to it and not other stimuli.  Again, you perceive your tinnitus in a noisy environment because you are tuning in to it.

Contrast 

Contrast also affects our perception.  If someone’s mobile phone lights up in a dark theatre before a performance, you will most likely perceive it but if the same phone lights up in the well-lit bar in the interval, you will not notice it.    

A number of our group members state they notice their tinnitus after being in the car and coming in the house.  This is the contrast between the noise of the engine and the quiet house.  Of course, tinnitus is most noticeable at night when you have had other stimuli around, maybe the TV, radio or your partner talking and then suddenly the quiet bedroom.

Management Tip

Try sleep Apps or under-pillow speakers. Pillow Speakers are available from the British Tinnitus Association. See below for website address.

Conclusion

Perception is a complex process, we all have different beliefs, values and life experiences which affect our perception. Our experience of tinnitus is, therefore, affected by all these things.  However, understanding some of the basic psychological principles which affect perception can help us to make sense of our experience of tinnitus. 

References: British Tinnitus Association – https://www.tinnitus.org.uk/

Future Learnhttps://www.futurelearn.com/courses/sensation-perception/7/todo/72694?utm_campaign=sensation-perception-w

Tips for staying positive

Helen Jeffery first came to know about the group in 2012 when she started with Tinnitus. Helen is also a professional career life coach and trainer and we asked her to put some tips together for staying positive over this very different and difficult time. Helen has put together a fantastic presentation and video which contains some useful tips for us all. https://www.youtube.com/watch?v=RUcc5HIZVPg&feature=youtu.be&fbclid=IwAR31ZQw_nx08jdgQwKTp4Imne-ZwUqsg8UcQQAtxEVR9dkxfyeCeQYN87hY

Getting a Good Night’s Sleep

In a survey by the British Tinnitus Association 6 out of 10 people reported difficulty sleeping with Tinnitus. We are pleased to announce thanks to Chesterfield Health and Wellbeing Small grants scheme we have a wealth of resources, books and information to loan and share to help get a Good Night’s Sleep with Tinnitus. To find out more come along to our event on 6th April at Monkey Park, Brampton Chesterfield 1pm – 3pm

Members Poetry Books for sale

The Poetry Buzz book has arrived! A compilation of poems written by group members, with the theme of wellbeing and mindfulness, has now been printed thanks to the support of Thompsons Solicitors. We will be selling the books at future events at the bargain price of £2 – all proceeds will go to the support group. If you can’t make it to an event but would like us to post one, please send a cheque for £2.50 (the extra 50p to cover postage) payable to Chesterfield Tinnitus Support to 34 Glumangate, Chesterfield, S40 1TX. Alternatively, you can call in at the office and pick one up – call 01246 380415 to check that we are here.

Stress and Tinnitus

Can you be involved with a research study?

Tinnitus and stress Stress is known to have an impact on health, and is linked to tinnitus. For example, people who have more severe tinnitus report a higher level of stress and more stress symptoms than those who had milder tinnitus. Some people also link the start of their tinnitus with the occurrence of a stressful event. But it is not clear whether tinnitus acts as a stressor, or stress leads to or makes tinnitus worse. At the NIHR Nottingham BRC (University of Nottingham), PhD student Asma Elarbed is conducting research to answer this question. She is measuring “cortisol” which is an important human hormone that is released by the “adrenal gland” in response to stress. She is comparing the level of cortisol (from hair sample) in people who have tinnitus with those who do not have tinnitus, and before and after tinnitus starts. This will tell us more about the biology of tinnitus. She is also looking at issues that relate to stress and tinnitus, namely depression, anxiety, memory, and attention, to determine how all these factors relate to each other. If you would like to participate or to know more, contact Asma Elarbed at this email: asma.elarbed@nottingham.ac.uk