by Neil Bauman, Ph.D.
If your tinnitus is bothering you, maybe you should try Cognitive Behavior Therapy (CBT). CBT is just a fancy way of saying that how you think about something reflects how you will react physically and emotionally to it.
Thousands of years ago, wise King Solomon wrote, “As a man thinks in his heart, so is he (or so he becomes)” (Proverbs 23:7). This was true back in Solomon’s time, and it is just as true today. Therefore, it should come as no surprise that it is also just as true in regards to how we think about our tinnitus.
Although about 50 million Americans have tinnitus (I’m one of them), only about 12 million are bothered by it.
Why is it that roughly 75% of the people with tinnitus are not distressed by their tinnitus? Just as importantly, why is it that the other 25% are bothered by their tinnitus?
For most people with tinnitus,
after an initial stress reaction, they simply stop reacting to the same boring tinnitus sound and become largely unaware of their tinnitus for most of the time. This process is called habituation. It occurs naturally as long as the person regards the tinnitus as meaningless.
In contrast, generally the people who suffer from tinnitus perceive their tinnitus as a threat to their physical and mental well-being. Their thoughts
reflect despair, persecution, hopelessness, loss of enjoyment, a desire for peace and quiet and a belief that others do not understand. Other common themes are resentment about persistent tinnitus, a wish to escape it and worries about health and sanity.
They often complain of “feeling depressed, sad, irritated, anxious, frightened, panicky, agitated, angry or ashamed.” In addition, they may become restless or withdrawn; they can’t sleep and have difficulty functioning; they feel the need for antidepressants, sleeping pills or other tranquilizers.
You see, it is the psychological processes, not just the audiological ones, that make the real difference in whether or not a person habituates to their tinnitus, or is distressed by it.
Distress due to tinnitus involves a lot of worry, or overly negative thinking, and a high level of stress, anxiety or tension.
In fact, those that suffer from tinnitus often either get tinnitus in the first place, or notice their existing tinnitus getting worse during or after a period of high stress.
Furthermore, people who suffer from tinnitus think about it much more than people who have tinnitus but do not complain about it. Therefore, if you are constantly worrying about your tinnitus with thoughts such as:
I will have a nervous breakdown if this tinnitus keeps up
- I will ruin my physical health
- I won’t get any peace and quiet ever again
- I can’t enjoy my life now
- I can’t do normal things anymore
- I must avoid loud sounds and/or silence
Don’t be surprised if these thoughts become a self-fulfilling prophecy.
All these negative thoughts increase your anxiety. This increased anxiety not only makes you tense, but also causes you to focus ever more narrowly on your tinnitus, which you perceive to be a threat to you. As a result, you begin to focus your attention on your tinnitus to the exclusion of other things. This makes your tinnitus seem much louder and more intrusive.
Therefore, if you are distressed by your tinnitus, probably the largest key to reducing that distress is changing how you think about your tinnitus.
If you carefully examine your thoughts and beliefs about tinnitus, you will realize that the above thoughts are obviously not true since the vast majority of people with tinnitus are not distressed by their tinnitus.
Tinnitus is important—not because it exists, but because of what you believe it does, or will do, to you. As we have seen, these ideas you harbor are seldom accurate. Thus, if you change these ideas, you change your reaction to your tinnitus. The result will be that it becomes less intrusive in your life.
That’s Cognitive Behavior Therapy in a nutshell. (Adapted from the article “Changing Reactions to Tinnitus” as reported in Hearing Review, 2007 (http://www.hearingreview.com/issues/articles/2007-08_01.asp?).
You can learn about Cognitive Behavior Therapy and many other ways to help yourself control your tinnitus in our book “Take Control of Your Tinnitus—Here’s How“.