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Tinnitus, TRT and Me
A Ray of Hope in a World of Noise
I first got tinnitus approximately a year ago. It came on quite suddenly. It’s a single tone high pitched squeal. I can only describe it as sounding similar to an automatic washing machine on its last, high speed cycle although thankfully not as loud. I first heard one morning in July. I awoke in my silent room to a ringing. Now id had this ringing before. Id done the usual, worked in engineering, rode motorcycles, listened to rock music, the usual. Well, when I first heard it I ignored it, went back to sleep only to wake and it was still there. At that moment it dawned on me this was not a good thing. I knew of tinnitus. Id heard it is a bad thing, people go mad, there’s no cure, it gets worse etc etc all the bad negative things we all think when we first hear it. Well it was at that point I was to learn later that not only was all my thinking on tinnitus wrong but that I had set up a negative aversive reaction, a phobic response. Because I had never heard this before, my brain had no memory of it, to match with my hearing it previously, matching it to a neutral, unimportant sound. Nice sounds we learn to ignore, dangerous ones we are always aware of like gunshots, car horns and creaking floorboards in the night. And so it began, a two month cycle of ups and downs, despair and elation. Happiness when I had a quiet day, sadness and panic when it was louder. Constant checking, is it louder, is it getting worse the dam thing was taking over a large slice of my life. Now coupled to this I must admit, I have had a thirty year battle with depression. Now don’t think im on a permanent downer, im not. Its just ive had episodes of deep depression of and on for a long time. Sometimes deeper than others. Well, as time went on the darkness fell on my moods. I didn’t know whether I could go on if this thing got worse, well it does, doesn’t it? (no). Sleep started to fall away as the anxiety kicked in. So where better than to look for answers than an ENT specialist. “You’ll have to live with it, there’s no cure” more sadness! Doctor, hell know “just take some anti depressants and maybe some benzos and learn to relax, there’s no cure. Even more sadness and later anger as they where totally wrong!
Next point of call, the internet, all the worlds answers are on there. Well yes as I found TRT and good people and bad because the place I found, a supposed support board was full of people who couldn’t handle tinnitus, had a strong phobia, where totally anti TRT, couldn’t understand it, did nothing but take lots of and claimed there tinnitus was worse than your tinnitus and seemed to adopt what we call in mental health (im a mental health social worker working with the most unwell), the patient role. No matter what people said to them, they would not listen, they where always right despite being given evidence of being wrong. A bad place, stay well away. Its at this point I must point out, such people are a very very small number approx %2. So don’t focus on being the %2 focus on being the %98!
Well at this point after listening to that lot I thought dam, ive got a lifetime of this, how can I go on like this. Then I met a fellow from England. He’d done this therapy called Tinnitus Retraining Therapy. He was a sound engineer and had very bad tinnitus. After 28 months he hardly ever heard his tinnitus. It was mostly now very low, he went weeks without hearing it and when he did hear it it quickly disappeared. So I visited the place at tinnitus.org that he suggested. I read and re read the stuff on the sight. At first I couldn’t believe it. “Tinnitus is a small noise usually caused by some damage to the auditory system that is amplified by the brains filter system…%85 of the people who have tinnitus don’t have a problem with it no matter how loud it is….all problem tinnitus is caused by an aversive reaction…everyone has tinnitus to some degree…..it can be cured (sort of)”. No can’t be true, must be a scam. Then I met more people, some had Hyperacausis too, that’s when all sound is magnified, and tinnitus both of which had all but gone. This place must be checked out. I called them, made an appointment and five weeks later travelled down to London to the home of TRT.
I met my therapist who actually helped develop the theories and the book. She explained that in an experiment on students by two audiologist Heller and Burgman 100 students with no hearing problems where put in a room which was totally silent. After five minutes they came out and all described hearing the noises just like tinnitus. It’s a natural thing we all have that only becomes a problem when our auditory system locks onto it and its amplified by the brains filters and our perception. She checked my hearing and it was fine. She said most people who get tinnitus have very good hearing. It’s not an ear thing it’s a brain thing. She actually believes it’s mainly brought on by stress and mood problems. No I thought, that’s me! Further tests revealed my ears functioned perfectly but I was phonophobic, overprotecting my hearing in the false assumption I damaged them. She explained how tinnitus becomes a problem, how it’s a new and unique sound which we react badly too so this is fixed in our subconscious as a bad thing. Our brain, doing its job will make us hear it as it’s a threat, that’s why we hear it so often. Our checking and getting worried over it only confirms to the brain, this is a bad thing so on it goes. The more anxious and depressed you get, the more important it appears to our subconscious so the more we hear it.
Now at this point you may be sceptical and not understand the brains filters or subconscious so ill explain. Do you put your clothes on a morning? I should hope so you dirty little ! Your body is covered in nerves but you never feel your clothes (until now when I reminded you). Why? Put on scent or aftershave? Yes, but why do you never smell it during the day? Ever got a new refrigerator or lived near a busy road? After a week or two you don’t hear it? Why? It still makes the same noise. Driven to work with the radio on? Bet you can’t recall everything on the radio? Why, it was playing all the time. It’s because as we developed as humans we developed a filter system which filters out all unnecessary feelings, noise, smells etc to prevent sensory overload. It only passes on things to the brain on a need to know basis. Now this is the main point of TRT, the directive counselling. If you understand what ive just said then you’re well on you’re way. Again, say I had a dog and you visit me. You stroke and pet my dog and it wanders over to the corner. You soon pay it no attention. I say it’s never ripped anyone’s throat out for days and you would instantly notice it and pay it lots of attention. Just like tinnitus. You don’t like it so you pay it lots of attention. You’re whole body and subconscious makes you, it’s designed too, to protect you from harm. If I placed a box on a table you wouldn’t give it much attention. Strap a bomb to it and you would. Just like the emotions you attach to tinnitus.
So what to do? Easy (it isn’t at first) re-train the brain to stop monitoring it by lowering you’re reactions. Instead of “o my it’s my tinnitus” think “who cares its only noise, I don’t out when a car passes or a plane fly’s over so why stress”. Remember, tinnitus isn’t anything more than a noise, the noise of the brain at work. Be glad you have a brain. Mines smaller than most but I love it all the same. Remember, tinnitus can’t hurt you, only your reaction hurts you. You’re favourite cd makes noise but you don’t out over that do you. She told me to live in a world of noise, to sleep with a nature sound in the background but above all avoid silence as tinnitus sounds louder in silence. It isn’t, it just sounds like it is.
So with this new knowledge I ventured out, full of hope. For three days it lasted. Then the first time it appeared to jump, down went the mood. Dam. I e-mailed my therapist. “Stop looking for change, stop monitoring it, exist side by side with it, work on lowering you’re aversive reaction, bit by bit. I was then measured for my white noise generators. They give you a constant level of white noise which comes in handy in quiet places as the tinnitus doesn’t seem as loud and it helps the brain to re-learn not to dislike noise, it helps to habituate the noise. That’s what the %85 did naturally. The tinnitus signal is unimportant to them so is blocked by the brains filter system so never reaches the brain so isn’t converted to sound, they don’t hear it. Well the months flew over. At times it seemed easy at times impossible and remote. The quiet days easy the louder days remote. I kept in touch with friends who did TRT and they advised me, avoid stressing just let go, get on with life. The tinnitus still seemed to fluctuate for no reason. It had a life of its own. No matter what I did it did its own thing. Frustration, despair with elation and happiness. A real roller coaster. Would this ever work?
Well yes, it did start too. What helped was listening to the download on the tinnitus.org web site. The therapist is one of TRT’s founders Jonathan Hazel. It re-in forced all what my therapist said. I avoided the phobic’s on the internet. I learned the TRT stuff inside out and focused on understanding tinnitus. It’s just a noise like any other, lower my reactions. When I heard it, which was a lot, I began to just not care. I got on with life, did the things I loved. If anything tinnitus was for me a good thing (WHAT ARE YOU MAD!!!!) It actually made me look at myself and my life. I realised im human. I am mortal, life is for living. So I began to live life. To travel, to love, to live. For the first time in 30 years of fighting depression I got on with life. That’s the important thing, you live with tinnitus, and you don’t let tinnitus control you. I met people with tinnitus which was loud but it didn’t bother them so they didn’t hear it much and when they did it quickly disappeared as it was unimportant to them. Hard as it was I started slowly to stop monitoring it. It had become almost a habit. I knew places which where silent and stopped checking myself there. I knew places that had a lot of noise such as traffic, I stopped avoiding them. I re-gained control over my life. Sure I had bad days, lots of them but slowly they began to get less. My depression lifted and flew away. I had gone from listening and talking about it 24/7 to a far nicer place. I just lived with it and began to care less. It’s hard at first. It takes time and patience and practice but it began to work. The tinnitus didn’t change much but I began to. TRT knowledge was moving me from the %15 with a problem to the %85 who don’t care.
Then I got ill. Sure enough the tinnitus appeared louder, my mood dropped. I e-mailed the therapist again. I got more advice, “you’re ill, just remembering what you learned, it will get better”. It did. I just kept on with TRT and after the virus I was back to normal. I took the knock backs as a lesson to be learned for next time. If I became ill the tinnitus may go up a bit or appear to but who cares it’s only a noise. A further visit to the therapist revealed more information. If you measure you’re tinnitus on a day it sounds loud and a day it sounds quiet, it will measure the same. Tinnitus loudness never changes, ever! Everyone’s tinnitus measure the same it’s just our ever changing perceptions. Things like stress, the big bad one, affect our perceptions as does monitoring tinnitus, sleep deprivation, depression, and a whole host of things. I gathered all this information, read it then put it all away. The more you read on it, focus on it the more it is important, the more you’re subconscious makes you hear it.
So things where still up and down but as the months moved on I suddenly noticed how my sleep was now fine as I wasn’t anxious anymore. I had no depression that gradually lifted. The emotional part of the brain, the limbic system and the body’s survival mechanism, both designed to keep us alive play the central part in prolonging problem tinnitus. They are mood and anxiety central so to speak. I was talking about it less (boy was my wife happy about that) I stopped looking on the internet for answers, avoided the “support” board and just lived life with tinnitus hard as it was. Months rolled by and I slowly noticed that what ever the tinnitus did I started to not care. I started to hear it less often. When stressed I heard it a little more but when it sounded louder I knew it wasn’t, it was just me, my perceptions changing, a little stressed, who cares its just noise. I could watch a movie and not hear it, go for a walk and not be bothered. Small things that all added up. My fluctuations weren’t real fluctuations, just me, my filters and my perception. I had begun to let go. I kept busy too, doing things I love and as I said, lived life. I attended a British Tinnitus Association conference and listened to a top ENT specialist, one of the countries leading thinkers on tinnitus who spoke of TRT, how it worked and how the brain would stop hearing it if tinnitus became as unimportant as a fridge. So each time I heard it I thought of it as a fridge. Each time I left a loud environment to a quiet one the tinnitus appeared to jump. It didn’t, it was just the contrast between quiet and loud, more information to file away so if it happened again I thought who cares! They explained how all tinnitus was though to be approximately 1to 15db, very quiet. The only thing that changes is how much we focus on it, our perception, and how perceptions can change! The less we focus on it the less we are aware of it, the quieter and less intrusive it is. They said how humans are the most adaptive of creatures, how time helps as we adapt to this new noise.
So hear I am. A year in, six months into TRT. I still have tinnitus but then again everyone has. It’s much the same BUT, it is early days. I hear it less, I don’t care much what it does. I sleep well, I have no depression or much anxiety. Just think how ill be in two years! So in summary:
The sound of tinnitus is generated in the brain.
It is thought to be very quiet, unlikely to ever get worse and is only affected by us, not coffee, salt, tea, exercise, whatever, only us and our reactions.
The perceived loudness, how loud we think it is and how much it bothers us varies dependant on how much we focus on it, what is going on in our lives and our emotional state at the time.
Perceptions can change and they are ours to control.
Its all down to a phobic reaction and all phobias can be overcome.
There is no cure but if you have an illness, it wont kill you, you aren’t bothered by it and aren’t aware of it much, isn’t that as close to a cure as makes no difference (TRT)
Ask not how your tinnitus affects you rather how you affect you’re tinnitus
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Mick
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05 Jul 2008 22:52
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So it's at this point that I've decided to take some serious remedial action and TRT, from all that I've heard/read seems to be as good a place as any to start 
))