When the Brain Turns Up the Volume: Understanding Hyperacusis and Predictive Failure

By Jennifer J. Gans, Psy.D.

Most people can tune out ordinary sounds—a humming refrigerator, footsteps, or the buzz of a light. The brain’s sensory system filters these background noises automatically, allowing us to focus on what matters. But for those with hyperacusis, this natural filtering process malfunctions. Everyday sounds feel unbearably loud or even painful.

At its core, hyperacusis is not a problem of the ears—it’s a problem of prediction. The brain has turned up the volume because its internal 'cancellation system' has failed.

The Brain’s Predictive Model

The brain operates as a prediction machine. It constantly compares incoming sensory input to internal expectations built from past experience. When the sound it receives matches what it expects, the brain cancels it out—it fades into the background.

For example, you don’t notice the sound of your own breathing, or the clothes on your skin after a few moments, because the brain predicts these sensations and efficiently filters them away. This predictive 'cancellation system' keeps us from being overwhelmed by familiar, harmless input. Our brain does us a favor and simply cancels out sounds that are of no import.

When the System Fails

In hyperacusis, this predictive system misfires. Trauma (usually including a loud-painful sound), fear that can accompany hearing damage, tinnitus onset, or chronic stress puts the brain on high alert. When under stress, the brain is more likely to make a prediction error. The brain stops recognizing familiar sounds as safe. Instead, it flags them as new, unfamiliar, or threatening.

This failure to predict correctly means the sounds are not cancelled out—they’re amplified. The nervous system overreacts, releasing stress hormones and tightening auditory attention. Over time, even moderately loud sounds can evoke discomfort, startle, or panic. The more this occurs, the more sensitized the system becomes, reinforcing the problem.

Turning Down the Brain’s Volume

The good news is that the same neuroplasticity that causes this problem can also undo it. With education, disconnecting of fear from sound, reducing anxiety, the brain can relearn which sounds are safe. This process involves:

• Education, to shift the interpretation of sound from 'threat' to 'neutral.'
• Mindfulness-based strategies found at MindfulTinnitusRelief.com, which help calm the body’s fear response.
• Taking measures to calm the anxiety-fear response networks (Cognitive Behavior Therapy CBT; medication if indicated for anxiety).

When the nervous system relaxes, fear and sound are no longer linked, the brain’s predictive filters begin to function normally again—turning the 'volume knob' back down.

From Error to Balance

Hyperacusis is best understood not as ear damage, but as a predictive failure of the brain— a temporary breakdown in how sensory information is categorized. The sound itself is unchanged, but the meaning assigned to it is distorted.

By restoring trust in sound and calming the neural alarm system, individuals can retrain their auditory networks to once again recognize safe, familiar input. The brain, given the right conditions, knows how to cancel the noise.

Dr. Jennifer Gans, Psy.D.

Clinical Psychologist | Founder, MindfulTinnitusRelief.com

Creator of the Mindfulness-Based Tinnitus Stress Reduction (MBTSR) Program