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Hope
 #1 
Hi I am Hope and I am new to this forum. I am reading the threads on this forum. I can see you are a nice group of people..

I got tinnitus about three years ago and one of my great disappointments is I don't feel any more habituated now than I did then. The sound level of my tinnitus noise is about the same a normal TV audio. I've used audio processor to emulate the sound of my tinnitus. A pass band from 8kHz to 9kHz does the job pretty well. When I first got tinnitus I heard it in the ears and head now it is mainly in my ears.

I believe that people who get tinnitus from listening to loud music have damage to the cilia in the inner ear. Perhaps one day it will be possible to repair the cilia.

I believe people who have had tinnitus caused by stress or rapid withdrawal from benzodiazepine drugs (as I did ) are candidates for the brain case. During my withdrawal from Klonopin (Rivotril) I went from 4mg to zero in week. I got pins and needles, my sight became very sensitive and my hearing became very acute. I believe the high gain in my acoustic pathways and auditory cortex detected my brain's background noise and once latched on has not let go. The anxiety I continuously experience is making my life very unpleasant.

I do know I have to somehow stop being so anxious about the tinnitus but for me this has proven difficult. The adoption of a neutral attitude toward something I find loud and annoying just seems to go against my nature and yet I know there are a lot  of people suffering with tinnitus that live happy normal lives. I have somehow got to learn how to become one of these people.

To this date I am still anxious and have no idea how to habituate. Can any of you help me?

Thank you,

Hope
stringplayer
 #2 
Hope, I believe you may have asked the first question in Chip's proposed "Frequently Asked Questions" thread!

Folks, if I can rephrase Hope's question ...

What is habituation, and how do I go about accomplishing it?

I'm going to look at the responses in ths thread and then at the end try to consolidate them into a single response in the proposed new FAQ thread.  So have at it!

And welcome, Hope.  I am very sorry that you have a need to find this place, but I am glad that we can be here for you since you do!

sp
Murasaki53
 #3 

I used to think that 'habituation' was something that monks got up to when they thought that nobody was looking.

But then somebody pointed out to me that there was another word for that.

Since then I've learned that the term 'habituation' is a process whereby the brain gradually learns not to react emotionally and aversively to the sound(s) of tinnitus. When this happens, habituation of reaction can be said to have occurred.

Complementing and supplementing this is something called habituation of perception. Having learned to not to react to tinnitus, the brain no longer needs to monitor it as a perceived threat to one's inner harmony and the sound(s) of tinnitus drop from our conscious awareness. What perhaps is equally important is that when the tinnitus is heard (which is inevitable when it is loud and intrusive) it no longer provokes negative thinking and an emotional response, which again takes it quickly below the threshold of conscious perception.

Tinnitus Retraining Therapy and Cognitive Behaviour Therapy are two popular methods which may make us more receptive to the habituation process which itself is seen as being largely unconscious.

The speed of habituation varies from person to person but a majority achieve a state in which their tinnitus becomes less depressing and troublesome simply through the passing of time and allowing nature to take its course.

For those concerned about the effect of a possible future increase in the volume of tinnitus on this process (like me, for example), the good news is that habituation can actually be easier for those who have already previously experienced some degree of success in modulating their reaction to their tinnitus.

This is the best I can do for now. Hope some of what I've written proves to be useful and apologies for that bad joke at the beginning.

One thing I would say definitely needs to be included in the answer is the distinction between 'habituating' one's tinnitus and simply 'ignoring' it.

painterdude
 #4 

I don't think there is any difference between habituating and ignoring.  If you listen for it, especially when on a support board and it doesn't bother you emotionally you have habituated.  If it's there in the backround and you don't give it any reaction and sometimes if involved in another activity like living, you ignore it.  Same difference. pd

Tpeace
 #5 

I agree that different people will have different speed of habituation, particularily the habituation of reaction. Most people will improve though, given time. If you don't believe, just look back how shocked, deparate and lost we were when tinnitus first hit as compared to months later. We may still be anxious, perhaps depressed, but not to such degree as before. So there is some improvement there, and so some habituation has taken place.

As for the last comment by Mura, I have a question for the T veterans too. If choosing to ignore T is the best approach, then is masking T bad for this goal. By masking T, don't we try to attend to it and therefore implying that we are worrying about its volume or distraction? In fact anything we do to minimize/appease T, shouldn't it be considered as attending to it, and therefore may bring more worries or emotional ups and downs, making it harder to habituate?

I am leaning on not masking T, especially when T is not in sharp spike, so that I will go on with living my life normally and ignore T at all times despite what it can throw at me. The spikes are hard to ignore, but with time, perhaps one can train the brain to ignore even the spikes without masking. On the other hand, TRT is so effective by % of success and it seems to use masking or sound enrichment a lot of time. I am a bit unsure what is the better approach. What do SP and Rob think about this?

Painterdude raises a good point I always wonder myself. People say the only way to forget about T is ignoring it and get away from anything to do with T, including visiting support forum. Yet we see SP & Rob doing well living with T and have daily reminder of T by being the host/admin for this board. I appreciate their sacrifice in the noble cause to help others. Any wisdom to share with us, SP and/or Rob?

By the way, welcome Hope. I like your name. Hope and Peace. I like what they imply.



DrChip
 #6 
I found an excellent article on habituation at:
 

It is considered to be the simplest form of learning,neurologically based and well documented. 

http://www.animalbehavioronline.com/habituation.html

Now open to discussion!   c
Rob_in_Denver
 #7 
Hello Hope (what a great name!)

Please don't be discouraged.  Three years is still not very long.  How long habituation takes varies quite a bit from one person to the next.  And it is a process, rather than an event.  The kind of process that can't be observed, so don't try to monitor how well you are habituating.  And understand that everyone is different.

I know of people who have habituated in a matter of months, and some who took two years and some who took longer.  The end result is always the same: At some point you find that while the tinnitus is still there, it does not bother you and you are less and less aware of it and certainly no longer very much distressed by it, if you are distressed at all.

It is all part of a natural process that occurs every day.  Do you notice the pressure on your body created by your clothing? Now that I have mentioned it, you may notice it.  But in general you don't.  Because your nervous system has habituated the stimulus of your clothing pressing against your body.  In fact, we are all bombarded by so many sensory inputs constantly that unless the brain had the ability to tune out most of it, we could never be able to pay attention to anything.

So your nervous system is prewired to gate out meaningless and unimportant stimuli.  Tinnitus is no different.  Well, of course it is different.  Because a loud, constant inescapable noise is a novel stimulus and when it elicits the perfectly natural response of concern and anxiety (where is that sound coming from, why won't it go away), then the nervous system will tend to NOT ignore it. 

All of the information in the other posts is relevant here, especially Mura's excellent expanation of the process of habituation.  The bottom line is that there are many ways you can counteract this reaction and as you do (and it can be a slow process), you will start moving down the road to habituation.

I thought I would never habituate. I thought my tinnitus was louder and more intrusive than what others suffered.  I tried all kinds of things - ginkgo, Neuromonics, sound therapy, masking, avoiding coffee and wine. etc., etc.  It was only when I gave up trying to find something that would make the noise go away and focused instead on changing my reaction to the noise that I started to make progress. Slowly, imperceptibly at first (with many ups and downs) the tinnitus started shrinking.  Until what once was an 800 foot fire-breathing dragon that threatened to destroy me, I came to see as a harmless dragonfly.  Once in a while I hear it buzz, and I swat it away.

That is what you can expect. Time is on your side.  It may take you a bit longer, but you will get there.  One of these days.

Just live your life.  Fill your time with things you enjoy.  Tell yourself when you feel the tinnitus creating distress "OK, I am feeling badly now, but I won't always feel this way."  And that day will come.

Rob in Denver


Murasaki53
 #8 
Rob in Denver wrote (in yet another great post):

Do you notice the pressure on your body created by your clothing? Now that I have mentioned it, you may notice it.  But in general you don't.  Because your nervous system has habituated the stimulus of your clothing pressing against your body. 
 
This is what I meant by 'habituating' as opposed to 'ignoring' tinnitus (which perhaps implies more conscious effort).

And this is where I would hope to be one day, where the loud spike that I'm experiencing right now becomes of no greater significance than the sensation at the tip of my finger as I type these words.


pt
 #9 
Sorry but I don't think the clothing example is a good one. The pressure of clothing is noticeable but not unpleasant, unless it is too tight, or chafing, or something else odd. A better example is a pebble in your shoe or too-tight armholes or itchy fabrics or twisted hose.

For the guys among us who don't understand the hose example, imagine a pair of vertically striped hose. But they are put on twisted so the stripes do a half spiral or even a full spiral around your leg.

Here is a fun picture:
http://fashionupdate.wordpress.com/2008/07/03/patterned-tights/
On the leg to the right, the vertical stripes are starting to twist toward the outside. Imagine if this were a half or even full twist around your leg. It pulls weirdly. It is maddening! This easily happens when you put on hose without a designated heel and are not careful.
Interestingly, though, I see plenty of people wearing hose twisted in this manner! Maybe those are the ones tinnitus wouldn't bother.
Maccy
 #10 
Hello Hope, welcome.

I am very new to T (march this year) and at first I was so scared, so anxious etc but gradually these feelings have reduced. This board has helped me a lot in the last few weeks and if you stay with us I'm sure you'll feel the same.

I am still a bit confused about "Habituation" and I think it can mean different things for different people. I want to get to a place where it doesn't bother me. That to me will be fine. It may never disappear completely so I want to try and forget about it as much as I can. Trying to ignore it is almost impossible. You cannot ignore something you are focused on ignoring. Does that make sense?...So you have to get busy. When I am totally engrossed in doing something else thats when I don't hear it. When your brain is concentrating on something totally...thats when habituation occurs. (I think).

I was out shopping the other day and searching for the perfect gift. I was so absorbed in doing this that it wasn't until afterwards that I realised I hadn't thought about or heard my T for a couple of hours. Now I know we can't go shopping all day everyday (oh what a life) but it's just an example that shows me it's possible to get to that point.

Take care Hope, Peace has added his name to yours and I'd also like to add Courage to that group as well.

stringplayer
 #11 
Mura posted [in part]:

And this is where I would hope to be one day, where the loud spike that I'm experiencing right now becomes of no greater significance than the sensation at the tip of my finger as I type these words.

...........

I can honestly tell you that I am not at that point, yet my life is quite wonderful ... and indeed much better than in my "pre-tinnitus days."

Mura, let's say that a year or two from now you have achieved 75% of what you state above you hope to one day achieve.  Would you at that point consider your effort to be a success or a failure?

sp

stringplayer
 #12 
Mandy wrote:

I am still a bit confused about "Habituation" and I think it can mean different things for different people.

.........

Many people are just as confused as you - and the word does mean different things to different people.  Which really makes talking about it quite a challenge, no?

Maybe we should look at it from a historical perspective to try to arrive at a definition we can all pretty much live with.  The word "habituation" has been around for quite a while ... but who introduced the term specifically to the tinnitus lexicon, and how did he or she define it with regard to tinnitus?

sp
Murasaki53
 #13 
sp asked:

Mura, let's say that a year or two from now you have achieved 75% of what you state above you hope to one day achieve.  Would you at that point consider your effort to be a success or a failure?

It would be a success. It just looks like I might have overestimated what can be achieved with spikes in terms of habituation in that statement I made above.

sp said:

I can honestly tell you that I am not at that point, yet my life is quite wonderful.
 
So what would you say has changed about your attitude to spikes/loud ear days since your pre-tinnitus days? Do you just tell yourself that 'this too will pass', for example. Or is there more to it than that?

I must admit that I find spikes very distracting. So I'm left wondering whether - in time - sedate activities like reading or watching tv can be enjoyed in the midst of one.





stringplayer
 #14 
Mura, I used a phrase when you and I met for breakfast in Maida Vale late last December.  I'll say it again now.  My tinnitus is occasionally distracting, but no longer distressing.  So I guess the process of habituation of reaction was at play. 

But in terms of my life's being better now than it was in my pre-tinnitus years, I guess it's also a process, one whereby over time you being not to view the world in terms of your tinnitus, but rather view your tinnitus in terms of the world.

sp
Rob_in_Denver
 #15 
Mura asked:

I must admit that I find spikes very distracting. So I'm left wondering whether - in time - sedate activities like reading or watching tv can be enjoyed in the midst of one.
 
For the first two years or so I found it very difficult to read in a quiet room.  But now I have no problem.  Even during a spike.  It just takes time.  I know it can be hard to believe, but your nervous system is powerful, and that power over time -- the same power that keeps your attention on the tinnitus at the beginning -- will start working to your advantage.

Rob in Denver


Murasaki53
 #16 

Thanks Rob in Denver.

You always seem to somehow address issues that are on my mind with just the right words at just the right time and it's very much appreciated I can tell you.

Even today, I'm not having such a bad day : just picked up a huge crab for less than $5.00 (!) in the local Chinese supermarket that I'm going to prepare with a Thai dressing and then eat together with a bottle of La Biere Du Demon which is, apparently, 'the most alcoholic pale ale in the world' a bit later on.

Just wish I could share this feast with a few of you guys out there in cyberspace as seafood cookery is a hobby and I know that some of you like to fish.

Anyway, that should put tinnitus in its place!

dustie
 #17 
Quote:
Originally Posted by Rob_in_Denver
Mura asked:

I must admit that I find spikes very distracting. So I'm left wondering whether - in time - sedate activities like reading or watching tv can be enjoyed in the midst of one.
 
For the first two years or so I found it very difficult to read in a quiet room.  But now I have no problem.  Even during a spike.  It just takes time.  I know it can be hard to believe, but your nervous system is powerful, and that power over time -- the same power that keeps your attention on the tinnitus at the beginning -- will start working to your advantage.

Rob in Denver



this is good to hear, rob in denver.   like mura, it hasn't been easy for me to read since the tinnitus arrived.   i don't get upset by it, but it's distracting enough that i have trouble absorbing what i'm reading.   i read sentences and whole paragraphs two or three times because of this.   reading seems to be the only thing affected in this way for me at this point -- so hearing that you used to be distracted from reading but now have no trouble with it is very good news.   (here's a topical example:  i never hit the "post message" button on this board until i've read my post at least two or three times, sometimes even more!)

on another note, tpeace wondered somewhere in this thread if masking is a barrier to habituation.   i wouldn't want to make a blanket statement about it because i know some people feel helped by it, but right from the beginning i found that masking wasn't going to work for me.   it kept my attention on the tinnitus -- the "can i hear it now?"  "can i hear it now?" syndrome.   of course, i could hear it over everything anyway, so it seemed like a useless battle, but even if i could have successfully masked it, i believe the "can i hear it now" question still would have kept me too attached to the tinnitus.

dustie


Tpeace
 #18 

Thank you dustsie for your comment. I am on the same wave length. I do use masking with natural sounds at times when spike is on. Since I have panic attack symptoms all my life, if the spike lingers, the panic reaction can surface. That is the time I like to mask it for a short time, just to satisfy the nervous brain that all is well and that there is an answer to the spike and that I don't have to take it on cold turkey if I don't want to. But I do prefer no masking and no earplug as a way to get on with life.

Hope
 #19 
Thank you everybody for your kind words and explanations. I appreciate you sharing your personal experiences with me.

I think the main reason why I am taking so long to habituate to tinnitus is that I have had a phobia about developing it since I first read about it as a child. I was one of those kids that liked reading technical books and I stumbled across this condition called tinnitus when I was about 10. The description of the symptoms scared me and I dreaded ever getting it myself. When I first developed the symptoms my anxiety just went into overdrive.

I can see this is a caring community. I feel better for being here.

 #20 
Hope,
 
Working through powerful feelings that we develop when we're very young is tough, but I'll bet you can do it.  When you were ten, the description you read about the symptoms of tinnitus scared you, and now that you have tinnitus, it plays into those old and established feelings you developed as a child.  Perhaps it might help you to counter what you learned about tinnitus as a child by learning about it in a new way as an adult.  Understanding some of the basics of tinnitus can help to make it less of a concern, and it is often a very good first step to take in the habituation process.  For example, tinnitus is a neutral signal that can't hurt us and, in most cases, isn't indicative of an associated, more serious health challenge.
 
Rob
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