Tinnitus Trifecta

 

We're now going to talk about why a person would be bothered by tinnitus, or essentially, what are the causes of bothersome tinnitus.

And so today we're going to talk about the Tinnitus Triad, or the Tinnitus Trifecta, as I call it.

There are really three ingredients, I call them, that go into making a person feel bothered by tinnitus.

Now, if I was to bake a cake or any kind of recipe, there are certain things that need to be in that recipe in order to make it into what it is.

Now, you can certainly add in other things, but it has to have the basic ingredients.

And so here with tinnitus, you know, every person is, of course, individual, and they bring many things to the table.

But people with bothersome tinnitus always have three ingredients in common.

And I think it's important to understand what those three ingredients are so that we can start to find ways to manage around these three ingredients.

And also, understanding what puts us into the bothersome category for tinnitus can give us a lot of answers as to how to get out of that category.

So, three things are necessary.

Okay?

Now, again, let me go back to the demographics that we've spoken about before.

For now, 50 million Americans experience tinnitus.

But that doesn't really give us a ton of information because not everybody in that group is bothered by tinnitus.

So, 20 million of that 50 million—and this is just the United States—20 million are bothered enough by tinnitus to go to their doctor and say, "Oh my God, this is not okay. Something is terribly wrong."

So that we will call the bothersome category.

And so if we do the math together, that leaves us 30 million Americans that are walking the streets of this country with tinnitus, and they don't care.

So our work together, or the work that I do with patients or clients, is helping them not necessarily get rid of tinnitus because, to be honest, I don't know that that's something that I can control.

And certainly, we don't know if that's what the person can control.

And so I'm not in the business of working on things that I can't affect.

However, I 100% know that anybody can shift from the bothersome category of 20 million to the 30 million non-bothersome category.

And I ask my clients, you know, if you have a benign body sensation for the rest of your life and it doesn't bother you, could you be okay with that?

And invariably they say, "Yes."

And so there's your effective cure right there.

So, going back to what puts people into the 20 million category.

Now, again, I don't know much about the 30 million category because those people don't come in to see me.

But I've now sat for thousands of hours with people with bothersome tinnitus.

And so it would be irresponsible of me not to share what I've learned.

And so, again, going back to these ingredients, there are three things that—100%, not 20% of the time, not 83% of the time, but 100% of the time—the people that fall into the bothersome tinnitus category, there are three ingredients that they always have in common.

And so the first category, or the first quality, I guess you could say, the first is hearing loss.

Okay?

That is a necessary ingredient for bothersome—or for maybe tinnitus in general—but certainly for bothersome tinnitus.

Now, many people come into my office and they say, "Oh, but you don't know what you're talking about because I went to my audiologist and they said my hearing was just fine."

And yes, you know, when you go to your audiologist, they're measuring from 250 Hz to 8,000 Hz.

That's the range that they're looking at.

And I don't know if many of you know this, but humans hear out to 20,000 Hz.

So when we're going to our audiologist's office and we're going into a soundproof booth and we're having our hearing tested, they're most interested in 250 to 8,000.

Why?

Because this is really where our hearing world occurs.

Okay?

This is where voices, this is where speech sounds are, this is where environmental noises are, this is where alarms are, this is where the birds chirping, music—all those things fall between 250 and 8,000 Hz.

And so, you know, while I'm sure they'd love to know how you're hearing out to 20,000, that's just—you know, we usually measure between 250 and 8,000.

And so if you looked at your audiogram, it could be normal between 250 and 8,000.

But if you did a test further out towards 20,000, what I think you'd see—or what I know you'd see after a certain age—is that all of a sudden it shows that you lose some hearing.

Kind of, they call it kind of a ski slope:

Normal, normal, normal, and then at the higher frequencies it starts to go down.

So we'll talk a little bit about the individual with hearing loss and why that would cause tinnitus.

But let's get back to our Tinnitus Trifecta.

Without going too much further into it, some form of hearing loss is 100% necessary as far as the three ingredients that go into bothersome tinnitus.

But we're not going to talk about that.

All right.

So the second ingredient that is 100% necessary is stress.

And, you know, stress is not always a bad thing.

But when we have too much stress, it can overwhelm the system and we start to misunderstand our environment because we're so tight.

We're not able to see things clearly when we're super stressed.

So this is a necessary ingredient.

And number three is an amazing personality.

So 100% of the people that I work with in my practice, and the people that fall into the bothersome category, have this amazing personality.

And I do say that is amazing because in many ways it is.

You know, it's what makes people—a person with bothersome tinnitus—it's what makes them good at what they do.

It's what makes them really effective in this world.

It's what people love about them.

It's what their employer certainly loves about them.

It's what they have used to make them who they are.

So this is not—this really is an amazing quality.

However, this amazing personality has an underbelly.

And the underbelly can really be pulling a person down into experiencing bothersome tinnitus.

And so I'm going to describe this personality, and you think about either yourself or somebody that you know with bothersome tinnitus—a colleague, a friend, a family member.

Perhaps you work with people with bothersome tinnitus.

But think about their personality for a moment, and as I describe their amazing personality.

So the people that fall into this category, they are the kind of people that are very alert and aware, and they take things in.

They're really alive and on this Earth.

And, for example, they'll walk into a room, they scan the room, and if they spot a problem, they latch onto it and they have trouble letting it go until they figure it out.

Okay?

So I don't always mean this by way of diagnosis at all, but there's almost an obsessive-compulsive quality to the way they go about certain things.

Okay?

So, you know, think about the people that you know with bothersome tinnitus, and perhaps this is their amazing personality.

The kind of person that spots a problem, latches on, and has trouble letting go until they figure it out.

And so this Tinnitus Trifecta is important to understand because there's nothing broken here.

There's nothing that needs to be fixed necessarily about their personality.

But what has happened is their brain has picked up on a benign body sensation and put it into the wrong category.

It has connected tinnitus with fear.

And we all know that when we experience something fearful, boom, the lens of our mind gets locked and loaded on whatever it's fearing because it better pay attention to it because it could mean their life.

But the problem is, when you are misunderstanding a benign body sensation like tinnitus and you link it to fear, the mind stays locked and loaded and gets wrapped around it and starts to create this story around it.

Like, "Oh my God, you know, what is this? Oh God, this is terrible. Maybe I have a brain tumor."

Or, "Oh no, this is all my fault for all the music I listened to when I was a kid."

Or, "Oh my God, does this mean I'm going to lose my hearing?"

Or, "What if this gets worse? How will I do my job?"

And so all of a sudden what you see is we've taken this benign body sensation and we've wrapped it up in a fear story, in a riddle, in a Gordian knot of terror, so to speak.

And so essentially what's happening is the brain is having trouble letting go of this body sensation, which should be pushed into the background where other benign body sensations that we experience go.

So, again, that is kind of an introduction to the person behind tinnitus, or the psychology of the person behind tinnitus.

We need to start looking at that Tinnitus Trifecta.

If there's significant hearing loss, your audiologist can certainly help you with hearing aids, or if there's severe and profound hearing loss, perhaps a cochlear implant, what have you.

Stress—this needs to be addressed.

Okay?

And we have many kinds of stress: internal stress, health stress, work stress, relationship stress.

And these all need to be addressed.

And then, of course, paying attention to this amazing personality and seeing if there's a way that you can know when, where, and how much to really create some space between yourself and whatever is going on, whether it's a problem or anything, any kind of body sensation.

And give yourself a little bit of space to reassess and get information on whether or not, "Is this really something my brain needs to stay focused on, or is this something that can safely go into the background?"

Okay?

Which is often much more easily said than done.

But we'll talk about in other videos about this link between tinnitus and fear, and how to unlink these two so that the experience or the sensation of tinnitus can really go where it belongs: into the background.