Tinnitus and the Nervous System

 

Calming the Nervous System
Hi, my name is Dr. Jennifer Gans, and I'm a clinical psychologist specializing in tinnitus.

And so, for today's talk, I am going to step away from what I usually talk about first, which is tinnitus education. In many ways, I see tinnitus as an education disorder.

Because, as we should know, tinnitus is a benign body sensation that the brain thinks is important to pay attention to when it can actually very safely place it into the background.

And so, today we're going to talk more about the nervous system and how, instead of education with tinnitus, today we're going to talk about calming the nervous system so that the person with bothersome tinnitus can shift their experience of tinnitus from the bothersome category into the non-bothersome category.

Now, I do want to say I talk an awful lot about education because humans are meaning-making creatures. When we understand things, we feel less anxious.

It doesn't matter what we're being educated about. It can be something really tough and hard to do. But when we understand what is happening, when our brain can really wrap its mind around what's in front of us, we can start plotting our path ahead.

And so the same goes for tinnitus.

We'll talk a little bit about the educational piece. I mean, we've already gotten started by explaining how it is a benign body sensation. But, you know, the brain—if we understand how the brain works, we can understand how it makes errors and why it would make errors, and then how to correct those errors.

And so, let's talk about the brain for a moment.

The Brain as a Prediction Machine
So, the human brain is a prediction machine. Let's call it, okay?

You know, this is evolution at its best—millions and millions and millions of years—and now we are left with this brain that predicts and it loves to fill in gaps.

Okay.

And so, we call it a prediction machine because it takes in information and it makes a best guess as to what's going on next.

Now, we also have to understand that the brain doesn't like to lose.

Okay?

And we'll talk about what happens when the brain loses something. What, you know, the lengths it will go to in order to fill things in.

And we all know that the brain fills in lots of things.

You know, we could be reading a book and, you know, we're not really reading each letter of each word. We're recognizing maybe the first word, maybe the last word, and the brain just kind of fills in the rest.

Another great example, actually, is the blind spot in our field of vision.

Okay, I'm trying to track it right now, but I've lost memory of how to track it.

But anyway, so the blind spot is where the retina hits the back of the eye.

And so, when we're born, we all have a blind spot, okay? It's a big hole in the middle of our vista, in our visual field.

And so, what does the brain do?

You know, the brain says, “You know what? I've always had this blind spot. It's not that interesting. And so, I'm just going to do Jennifer a favor, and I'm just going to fill it in because, you know, who wants to look out at the horizon and see a beautiful sunset with a big black spot in it?”

So, again, our brain just predicts that it has seen that spot before. It is really not that interesting. It's not going to make or break anything.

And so, yeah, I'll do Jennifer a favor, and I'll just fill in that black spot.

So, that's the blind spot.

The Five Senses and Phantom Sensations
Now, what happens? Let's talk about the senses.

Okay, we have five senses. Actually, we have many more than five, but the five top ones that we learn about in, you know, first grade or second grade are: touch, taste, smell, vision, and, last but not least, hearing.

Okay? We also have, you know, vestibular stuff, but that might be good for another video.

Anyway, so let's start with touch.

Okay, the brain again is that prediction machine, and it does not like to lose. It likes to fill things in because when it fills things in, it can, you know, it sees things as a whole and the brain feels less anxious.

When there is a break in that predicted sense, the brain says, “Alert, alert. There's a—there's a spot in this. There's a break in this. Let me see if I can figure out why and fill it in.”

So, let's go back to the senses.

So, we have the sense of touch.

All right. So, we all know that here is our hand, but our hand is actually really here. Our hand is, um—you know, this is where all the sensations come to. This is where all the commands come from, and this is where all the memories of my hand are, right here.

So, let's say, God forbid, I cut my hand off.

My brain says, “Wait a minute. That's weird. I've always had a hand. I was born with a hand. I use it all the time. Where is it?”

So, what does the brain do?

It doesn't like gaps.

So, what does it do?

It searches and searches and searches and searches and searches and searches.

And in that search, all the neural excitation—boom—creates the sensation as if the hand were still there.

Okay. We call that phantom limb sensation.

Okay.

So, let's move on to our other senses.

We have the sense of—we said taste.

So, people will report when they lose their sense of taste. They'll report sometimes to their doctor or just, you know, socially, or to a friend or somebody, you know, “It's so weird. I know I've lost my sense of taste, but I'm getting these weird, just really very real tastes in my mouth. What is that?”

Sometimes it's a metallic taste, sometimes it's, you know, whatever the case may be.

But anyway, so what's happening there?

The brain is like, “Wait a minute. I've always been able to taste. It has to be here.”

So, the brain searches for that sensation that it's not able to perceive. So, it searches harder and harder and harder, and boom, it creates a phantom sensation of taste.

Now, let's go to smell.

Same, same.

All right. When we lose our sense of smell, the brain will say, “Wait a minute. Where's that smell?”

And then we'll fill it in with a phantom smell.

And then we have vision.

So, when people lose vision, they'll report phantom visions in its place.

You can go look up Charles Bonnet syndrome. That's when people who have lost vision will actually create vision where it once was.

Okay.

Ah, so let's go to hearing, which is our favorite topic of today.

Let's go to hearing.

Hearing Loss and the Brain's Search
And for many of you that are watching today, you know that hearing loss is normal. Hearing loss is part of the aging process.

Okay? And hearing changes. We can get a cold and all of a sudden hearing is a little muffled. And then we recover, of course.

But any alteration in audition, any alteration in our brain's ability to pick up on a sensation of sound that it used to get, the brain says, “Huh, what's going on?”

And so, when we lose hearing, some people lose a lot of hearing. Other people, you can't even really measure their hearing. Or we could if we did an extended audiogram, but, you know, audiologists, when they're giving us tests, are testing us between 250 hertz to 8,000 hertz.

But humans hear well out beyond that to 20,000 hertz.

So, you know, people will come into my office all the time and say, “Well, you don't know what you're talking about because I have perfect hearing.”

And so I say to them, “Well, you know, congratulations. Go home. Celebrate that you've got amazing hearing. But if we took your audiogram out all the way towards 20,000, we might get up to 8,000, but then it goes down, down, down, down, down, down, down. That's the nature of living.”

We all have—it's even called presbycusis, hearing loss with age.

So, uh, where was I?

Ah, okay.

So, the human brain, when it loses hearing or there's a change in our ability to pick up on what the brain was expecting to pick up on, what does the brain do?

It says, “Huh? Where's that sound?”

So, it starts to search and search and search and search and search and search.

And in that search, boom, it creates a sensation that we all call tinnitus.

Okay?

So, this is my way of saying nothing's broken. There's actually nothing to fix. There's no pill, no procedure that, you know, needs to be done. It doesn't have to cost thousands of dollars.

But what has happened is the brain has misunderstood this benign signal that has come into our awareness.

The Three Ingredients of Bothersome Tinnitus
So, well, let me explain why somebody would be bothered by tinnitus.

Number one, as we mentioned before, you have to lose something in order to search for it.

So, I kind of jokingly say to people with tinnitus, I say, “You know, your silly brain is just searching for a sound that it's no longer able to perceive.”

Okay?

So, hearing loss is one of the necessary ingredients in tinnitus.

Okay? For some, it needs, you know, it needs to be looked at, and, you know, hearing aids can be wonderful if hearing loss is significant.

For others, you know, it's just a little bit of understanding and, you know, no hearing aids are necessary for some people.

But anyway, another thing that is—or another necessary ingredient for bothersome tinnitus—is stress, and we are going to talk a lot about that today.

And the third thing that is a necessary ingredient in the person with bothersome tinnitus is what I call an amazing personality.

Okay.

So, I want you for a moment to think about all of the wonderful people in your life that have tinnitus.

Maybe it's people that you work with. Maybe you are struggling with bothersome tinnitus. Maybe a loved one, a friend, what have you.

So, I say that everybody with bothersome tinnitus—now, non-bothersome tinnitus, I'm not going to talk about. I don't know much about those people because they don't come in to see me.

But I've now sat for thousands of hours with people with bothersome tinnitus. And so I'm here today to share with you what I've learned.

I mean, it's—that's—I've had years and years and years of experience.

And so I've noticed and learned some things about the group of people I'm working with, and I'm here to share that.

So, every single person in the bothersome group of tinnitus, people who are bothered and come to you for help, they have what I call an amazing personality.

The Vigilant Personality
Now, let me explain this personality.

And I want you to think of that person in your life with tinnitus, and I want you to, you know, think about if I'm right or wrong here.

Okay.

So, people with bothersome tinnitus are very vigilant.

Okay? If I could kind of put it in those terms, they're very vigilant people.

They see things, they smell things, they're alert and aware.

And if they spot a problem, they latch on to it and they have trouble letting it go until they figure it out.

Okay?

So, you know, think about those people in your life with tinnitus. Maybe think about yourself for a moment.

And so, this is a very vigilant personality, okay? They can get very locked into and stuck almost on something until they figure it out.

So, I keep going like this because inside of our mind, we have a lens.

Okay? I call it kind of like a camera lens.

When something is fearful, frustrating, or fascinating, the lens of the mind closes in, and boy, can it see what it's looking at with amazing clarity.

Can't see anything else, but boy, can it see what it's looking at.

Now, if we open up the aperture of the lens, what you're looking at is clearly still there, but it's within the context of everything else around it.

So, what's happening with a person with bothersome tinnitus is they pick up on this benign body sensation.

We'll talk a little bit about the brain, but, uh, pick up on this sensation. All of a sudden, the brain is searching for a sound that it's no longer able to perceive.

And in the subconscious amygdala, the amygdala picks up on it, puts it into the wrong category—the fear category—and all of a sudden, boom, the thalamus opens the gate and tinnitus goes from our subconscious limbic system area, the amygdala, into our conscious cortex, and prefrontal cortex to be exact.

And that's our conscious mind.

So, it goes from a place where we're unaware—it can be there, but we're just not aware of it—to the thalamus, which is the gateway to it opening up, and tinnitus goes into consciousness.

Now, what happens is a person who's very vigilant doesn't miss much. And if they spot this sensation, boom, they run the risk of locking on to it, saying, “Oh my God, what is this? Oh my God, could this be—oh no, is this tinnitus? Oh my God, could I have a brain tumor? Maybe I'm going to lose my hearing. Oh no, this is all my fault for all the music I listened to when I was a kid.”

So, what you see here is around the lens, around tinnitus, we've wrapped it up in story and this Gordian knot of actual—well, false information.

Okay? Tinnitus is not an indication that you're going to lose your hearing. It's not an indication that you have a brain tumor.

It's an indication that your brain is pretty vigilant, which, by the way, is an amazing quality if you think about it, and you run the risk of getting stuck.

So, I kind of joke about this, but tinnitus is kind of a stuck disorder.

And obviously, you can't bill for “stuck disorder.” I'm kind of saying this jokingly, but what's happened is the person has picked up on the signal, locked onto it, created a story around it that's keeping the lens like it's almost like taking glue and pouring it onto this beautiful lens.

And all of a sudden, oh no, they're stuck.

And so, our work as clinicians—or my work, certainly—is to help people get unstuck.

So, what we do is we unravel that story. We roll it—roll it the other way, get rid of all the junk around the lens so that they can open up the aperture and start to take in tinnitus in the, you know, as part of, you know, one among many benign body sensations that we have going on in our bodies at any given moment.

But we're not really aware of it because it's uninteresting, it's boring.

And so, you know, this is a critical piece.

If I was to say the type of work I do is I help people become bored with tinnitus, because that is what the brain can habituate.

We all are habituating.

Habituation in Everyday Life
Okay, if, uh, for those who are listening to this, maybe you're sitting in a chair now, take a moment and imagine the bottom of your foot on the floor.

Okay, so let's just all take a moment and give focus, all of our awareness, to the bottom of our foot resting on the floor.

Now, I'll speak for you, but I feel kind of a pressure, tingling, uh, kind of a warmth at the bottom of my foot.

Now, I would hope that while you're listening to my lecture that you would find what I'm saying a lot more interesting than the boring bottom of your foot.

So, what does your brain do?

Your brain says, “Oh yeah, that sensation at the bottom of your foot—boring. I, you know, mind you, it's there. And if you bring your attention to it, you can obviously focus on it. But I would venture to say that not many of you are focused on the bottom of your foot while we're giving this lecture.”

Unless I had—obviously, I just brought your attention to it.

But your brain just knows how to habituate to predictable, boring, and just nonrelevant body sensations.

And so tinnitus is one of those sensations.

Again, I want to put this in, you know—I mean this with compassion—but a person with bothersome tinnitus, their silly brain is searching for a sound that they're no longer able to perceive.

The Silent Room Experiment
Okay? You know, I'm going to share with you actually a—it might go a little bit off time, but I think it's interesting.

So, Heller and Bergman in 1953, I believe it was 1953, did a study, and I want to share with you the results of their study.

So, these two researchers were curious what happens to people who go into an anechoic chamber, or a soundproof booth.

Okay.

So, they took 100—or 104, I believe—but anyway, we'll just, for round numbers, we'll say 100 people with normal hearing, and they asked them to go into a soundproof booth for five minutes and come out and report what they experience.

Well, the results of this study are that they found that 94%, which I don't know about you, but when you're doing research, 94% is basically 100%.

But basically, people would come out and they would report something like this, you know:

“Yeah, I was sitting there for the first few minutes, and I don't know, I didn't really notice anything, but then I don't know, it was—I don't know, I just, after a few minutes, I started to kind of hear these sounds.”

Okay.

So, what that study shows us is that in the absence of sound, the brain creates sound.

Okay?

Our ears, they start working, you know, from the very beginning of our life and they go to the very end of our life, and they're working 24/7.

They're constantly taking in waves of air that bring us the sensation of sound.

And so, when you're putting somebody in a strange situation, which, of course, an anechoic chamber is—I don't even know if that exists in nature, in the world—but we put them in a soundproof booth because we want pure tone results from hearing tests.

But it is a strange environment for the brain.

The brain can no longer make predictions because it's so used to taking in these waves of air that give us sense of sound, and they can't perceive those waves of air and they're not hearing anything.

Their frequencies are just not giving them the information they were expecting.

So, the brain does its hard work to look for it, and boom, it creates tinnitus.

Accurate Education Comes First
So, let's switch our talk today to what I really want to talk about, which is our nervous system.

So, we—I said I wasn't going to talk about education, but I really spent an awful lot of time just clarifying what tinnitus is and what it isn't.

But that education piece, it is critical.

When I talk about the care that we give to people with bothersome tinnitus, I say it's on a scale from one to 100.

Now, one is education.

If you don't have—excuse me, let me restate that. One is accurate education.

If we don't have one, we don't get to pass Go. We don't get to try the other hundred because we need to start with accurate education.

Why?

Because we need to use our prefrontal cortex, our knowing, logical brain, to help chill out the fear center of our brain, the amygdala, which is subconscious, and chill it out and say, “You know what? I just learned that tinnitus is benign. I just learned that it's a paper tiger. I just learned that it's just really not that relevant.”

Okay.

Now, that isn't to say that it isn't incredibly bothersome.

And I do understand that anybody listening to this can maybe feel as though I'm being very easy-breezy about it.

You know, it's a benign body sensation. Oh, it's a paper tiger. Oh, you know, it's boring. Whatever.

But I probably should have prefaced this talk by saying it is not lost on me that tinnitus is devastating for millions of people around the world.

So, but with all due respect, after thousands of hours of sitting with people with bothersome tinnitus, as a clinician, it's very hard for me to get excited about a benign body sensation.

So, you can see from the way I talk about it, it is—I don't want to rev up anybody's nervous system.

I want to dampen down everybody's nervous system around tinnitus through education and then nervous system regulation.

Okay.

And that's where we're going to go now.

The Fire Beneath Tinnitus
So, tinnitus now is here.

Okay. It's a benign body sensation right here.

But there's a fire below it.

And the fire below it is anxiety.

Okay?

We talked about this vigilance.

You could call it hypervigilance. You could call it somatic vigilance.

You know, you're very alert, aware of your body. You're very alert, aware of your environment.

And, you know, this can be something you're born with. This can be something that the environment encourages.

You know, there's, um, you know, warfare and military, and, you know, these—you can create a very vigilant person.

You know, also people are born with just proclivities to higher levels of anxiety.

And so, what we're seeing is tinnitus in and of itself is benign.

So, we can push it to the side.

But what we're left with, what we're left with, is the fire of anxiety.

So, this is what we really need to be talking about.

You know, people come in thinking that we're going to spend all of our time talking about tinnitus.

And once we educate about it and move it over slightly to the side, we start talking about what really matters.

And what really matters is the fire that's keeping tinnitus burning, which is anxiety.

And so, let's talk about anxiety and nervous system regulation.

Finding Balance in the Nervous System
So, again, a lot of people are born with just a more suggestible amygdala, which is—the amygdala being the fear center inside the limbic system, the second part of the brain to develop, very subconscious, but it's really a fear center that kind of helps to keep us alive.

It's very small but mighty.

The amygdala's job is to take in information from the external world and take in information from the internal world and make a decision.

Now, the decision that the amygdala makes is: Is this sensation a credible danger, or I don't know what it is, so I better keep my eye on it? Or is this sensation not that interesting, not relevant right now, just irrelevant, so I can push it into the background?

Well, the person with bothersome tinnitus, the error that was made was the amygdala put it into the wrong category.

And the amygdala is like, “Alert, alert, alert. We have an issue. We better let the conscious mind know about it.”

So, what happens is, again, the gateway—the thalamus opens.

Tinnitus goes from the subconscious, where it should have stayed, into our conscious mind.

And so, by changing our nervous system, by changing—not getting rid of anxiety or not getting rid of stress, because we need a little bit of stress in our lives.

I mean, stress is what gets us out of bed in the morning.

But we don't want to have so much stress that we can't get out of bed in the morning.

So, we have to find that beautiful balance, that nervous system balance.

Okay.

And so, what I have found—again, I talk from one to 100 as far as what we can do to help ourselves with tinnitus.

So, one obviously is education, and then everything after that follows a pattern.

The pattern is that anything that stresses you out will likely make tinnitus more bothersome, and anything that relaxes you will more likely make it less bothersome.

So, of all the things after that, anything that we choose to help ourselves, our nervous system, with tinnitus is—we want to make sure that it doesn't increase stress, that it actually helps to relax us.

Meditation as Awareness Building
Okay. And so, let's start with the lowest-hanging fruit.

Let's start with meditation.

Okay.

Now, meditation has, you know, just means so much to so many people, and so I might actually change the wording I use around meditation and call it awareness building.

Okay? So, that's essentially what meditation is.

Meditation is an awareness-building exercise.

Now, it's a human capacity.

So, you know, I hear people say, “Oh no, I can't meditate. My mind wanders.”

Well, I kind of chuckle when I hear that because, of course, your mind wanders.

That's what the brain is designed to do.

And thank goodness, because some of the greatest ideas have come up from mind wandering.

So, it's not a defective brain. It's a brain that needs a little bit of training.

Kind of like if we went to the gym to strengthen, you know, a muscle, we would do reps, right?

So, with meditation, or awareness building, we place our attention on anything, really.

We tend to use the breath.

Why?

Because everybody has one.

It's—we usually don't put a lot of emotion or judgment on it.

I'm not saying, “Gee, she breathes better than I do,” or whatever, or “I used to breathe better than I do now.”

You know, there's not a lot of stories locked into the breath, of course, unless you have a breathing issue.

So, I do have to put in that caveat.

But anyway, we bring our attention to the breath, and the mind leaves the breath because minds do that.

The mind wanders, and that's okay.

That's okay.

But the practice here is to note where the mind goes.

Because the problem is not the mind wandering. It's the obliviousness, or the lack of knowing: Where is our mind at any given moment?

Because when our mind wanders, and it can wander to some old stories—

“Ah, tinnitus is the worst thing in the world. This is going to kill me. Or I'm never going to be able to concentrate again. Or, you know, nobody can help me. The doctor just told me to go home and live with it. What am I supposed to do now? And the internet and blah, blah, blah, blah, blah, blah, blah, blah.”

So, but if we are aware of where our mind is, we can say, “Uh-uh-uh. I caught you. That is an old story. I can let that go and gently come back to the breath.”

And so, why I call meditation, or awareness building, low-hanging fruit is because you don't need a doctor's prescription for it.

You don't need money to practice awareness building.

You don't, you know, you can use it at 3:00 in the afternoon and you can use it at 3:00 in the morning.

So, it goes with you everywhere.

And what we find is by improving our ability to bring awareness to where we choose it to go, or meditation, awareness building, we find that other areas of our lives improve.

Okay?

So, you know, as a clinical psychologist, sure, I'm interested in helping people with bothersome tinnitus feel non-bothered by it, but I'm also interested in their life as a whole.

And what I have found is that people that have a consistent meditation practice, all of a sudden, their relationships start to be clearer. They tend not to be as overly vigilant as they were.

Reduction of anxiety, reduction of depression, reduction of sleep difficulty.

I mean, these are the top three complaints of people with bothersome tinnitus: anxiety, depression, and sleep difficulty.

Anxiety, as we mentioned before, is really primary.

You know, if you're anxious for a really long time, it can be very depressing, and who can sleep when they're anxious and depressed?

So, you know, it really is a—it starts with anxiety.

Tuning the Orchestra
So, meditation also—another great analogy I can make is, if you can see up here, I can move—this, we have some instruments on the wall here.

So, I'll talk about a violin for a moment.

And you're probably wondering, why is she talking about a violin?

Well, because the brain is like—well, let me start with a symphony.

The brain is like a symphony.

Okay.

I have a young daughter who asked me, you know, “Mom, can you tell me something about the brain?”

So, what did I do?

I went to Google and I pulled up a picture of the brain, and I looked at it and it was color-coded.

And I looked at it and I was like, “Oh my God, that's kind of like a symphony.”

It just kind of looked like a symphony.

We had the occipital lobe in pink. We had the parietal lobe in green. We had the medulla in red. We had the amygdala in purple. Whatever.

You know, all these different sections of the brain here.

And they were all color-coded.

And in and of themselves, each part of this—of our beautiful brain is miraculous, wonderful.

But they don't work in isolation.

They have to blend with all the other beautiful parts of the brain in order to make a life, in order to make a symphony.

And so, if you think about our brain, you know, when—if we go to a symphony, we would expect a concertmaster to tune the orchestra.

Well, if the violin section is playing in the key of F and everybody else is playing in the key of A, let's say, well, I don't care how great your instruments are, it's not going to sound like Beethoven, right?

But if the concertmaster gets up there, stops for a moment, pauses, listens very carefully, makes small adjustments—not too much, not too little, just right—gets every instrument into perfect balance, all of a sudden, you know, Beethoven can happen.

So, that's also how I think about the human brain.

Okay?

Like, I'll use a violin.

For those who know about violins, they have four pegs.

And let's say I take this beautiful instrument and I crank up those four pegs really, really tight so that the instrument is just about to pop.

And I start to play it, and oof, it sounds sharp. Sounds horrible.

Okay.

Now, do I throw out the instrument because it's playing sharp?

No.

I simply loosen the strings a little into balance. Not too much, but just right, so that the person is playing in tune.

And then the beautiful violin can do what it does.

So, when I'm working with people with bothersome tinnitus, I feel like I'm sitting in a room with a beautiful Stradivarius, a beautiful violin.

And there's nothing broken. There's actually nothing to fix, but they are playing out of tune. They're playing sharp.

And anxiety, I think of being too—you know, when I think of anxiety, I think of too tight.

When I think of depression, I think of as too loose.

So, the patients, or the people that I work with, with bothersome tinnitus are very, very vigilant, and they're very, very alert.

And certainly after tinnitus, their mind is on fire.

They're simply playing with their instrument too tight, their violin.

And so, what do we do together?

We loosen the strings.

And meditation, a meditation practice, mindfulness practice, is again like the concertmaster that gets up and stops—stops for a moment, stops everything, pauses, and pays very close attention to where is my mind at any given moment.

What thoughts am I thinking?

Because if I'm thinking a stress thought, maybe I would choose to not hold on to it and just let it go and come back to this moment.

And then boom, the mind pops off again.

But then we let it go and come back to this moment, to what is.

And so, what I find is that a meditation practice turns a reaction into a response.

Creating Space Between Stimulus and Response
Okay.

So, Viktor Frankl was a Holocaust survivor, and he then went on to become a psychiatrist, and he wrote a book called Man's Search for Meaning.

And in his book—and I'm not going to quote him exactly—but he said that between every stimulus and response is a space, and within this space lies our freedom and our choice.

So, between every stimulus and response is a space, and within this space lies our freedom and our choice.

Okay?

So, when I'm working with people with bothersome tinnitus, they come into my office and they are tinnitus reaction, tinnitus reaction, tinnitus reaction, tinnitus reaction.

There's no space. There's no freedom. There's no choice.

And so, what meditation does is it does just that.

It relaxes the system. It relaxes your autonomic nervous system, and it ends up creating space, and now tinnitus—you can start responding to.

Okay?

So, with that choice and freedom, you can say, “You know what? I used to react to tinnitus with fear. But now that I'm educated and I know that tinnitus is just my silly brain searching for a sound that it's no longer able to perceive, I think I can choose to just treat it like a paper tiger.

“It looks scary, but it's made of paper.

“Or, you know what? I don't have to be wrecked by it. It's bothersome in this moment, but let me ask myself, how can I help myself in this moment?”

Okay?

That's a very important question to ask:

How can I help myself in this moment?

Because then we go back to that scale, and anything that reduces anxiety will likely make tinnitus less bothersome.

So, in any given moment, you could take a shower, you could go for a walk, you can, uh, you know, pull back from work and take a bit of a, you know, a vacation if possible.

You can meditate.

You can push back and just, you know, be in nature.

You can push back and remind your brain that you're safe.

And you can also move into tinnitus.

If tinnitus is there and it feels really big for you, you can just meditate on tinnitus.

You know, it's—you know, you don't have to like it, but there's no reason, you know, to, you know, to get upset about it.

You can simply be there with it, but without the judgment, without the fear, without the erroneous—or these stories that we wrap around it.

By just being with the bare sensation, we realize, okay, I don't have to like it in this moment, and it is here, but it's not always going to be here.

Disengaging Tinnitus From Fear
Okay.

So, there's many different approaches that we can take to tinnitus.

And so, I think that this is a very critical point to be aware of: that we have to disengage tinnitus from fear.

Okay?

And we can use fear language like, “Oh God, this is horrible.”

Well, your brain hears the word “horrible,” and it says, “Huh? Huh? What's horrible? What's horrible?”

Or, “God, this is never going to go away.”

“Oh, what's never going to go away? What? What? There clearly is a present danger.”

And so, by simply changing the words that we use to relate to tinnitus in our thoughts, we can, over time, disengage tinnitus from fear.

And with that, we can start taking a deep breath and responding to tinnitus in more helpful ways.

The Real Punchline
And here's the real punchline of all of this before we end for today:

It was never about tinnitus.

Tinnitus is a benign body sensation.

It was never about tinnitus.

But what we find through working with tinnitus and shifting it from bothersome to non-bothersome is we realize that we have lots of forms of, quote-unquote, tinnitus in our lives.

Anything that's bothering us and we just—God, we're holding on to it so tightly, we just can't let it go.

We can get stuck.

And so, if we can start to become aware of the brain's proclivity to get stuck on things that were never yours to own, we start generalizing that to other areas of our lives and start to live with more choice and freedom.

And so, I'm going to end with that today.

Thank you all for listening.