Contributed by Marie Knight

Acknowledge the presence of tinnitus

The first step to accepting tinnitus is to acknowledge its presence, to stop avoiding or denying that it is present, and to acknowledge that it probably won’t go away. Unfortunately for most people who have had tinnitus for more than six months it is unlikely that it will go away completely. So, one of the first steps in coming to terms with tinnitus is to admit to yourself that the tinnitus does exist and that it will probably be part of you for the rest of your life.

The importance of getting informed

When you first become aware of your tinnitus you may find yourself constantly thinking about it, worrying about it. Why is it there? What has caused it? Does it mean I’ve got a brain tumor, that I’m going crazy, and that I’m going to go profoundly deaf? Will it ever go away? How can I ever learn to live with this thing? It will drive me crazy! The more you worry about tinnitus, the more overwhelming it seems.

Everyone asks these questions. These are a normal reaction and an important part of coming to terms with tinnitus. What is not reasonable is to constantly ask these same questions over and over again, without actively setting out to find the answers to the questions above.

Focusing on tinnitus

By constantly worrying about the significance of the tinnitus you keep it at the forefront of your attention, giving the tinnitus a significance in your health and well-being which is most likely unwarranted. This is an essential part of becoming a “tinnitus sufferer”.

By making tinnitus a focus of your attention you can highlight its persistence and amplify your sense of being plagued by the tinnitus. The more you listen to, or attend to your tinnitus, the louder and more overwhelming it seems to become

Attention and tinnitus

The process of attending to the tinnitus highlights it in relation toe environmental sounds.

We all live in a world full of noise. In most situations we are surrounded by a range of different noises and sounds that we can selectively listen to or ignore depending on the situation we are in at the time, the nature of the activity we are engaged in, and our level if emotional excitation or arousal.

We listen to all the sounds that we are capable of hearing in a given situation at the one time. To try and do so would be overwhelming. Typically we notice one thing after another - the sound of a door banging, the buzzing of a fly, and the drone of the air conditioning in the room. The rumble of traffic in the distance, all these sounds may be all present at the same time but typically we tend only to notice the sounds one at a time.

The process of attention is simply to bring something into our conscious mind, our attention system. We attend first to those things that occur in a surprising way. For example, if the door bangs, it arouses our attention, though if it happens frequently then the power of the sound to grab our attention tends to diminish over time.

Secondly, we attend to those things that are useful to the activity in which we are engaged. For example, the murmur of voices in the next room indicating that guests have arrived. If a sound is boring or repetitive or meaningless we tend to stop paying attention to it.

The ticking of a clock, the hum of air conditioning in a room, the sound of our own breathing, all become monotonous and no longer draw or catch our attention, unless for some reason our attention is drawn to the sound by it changing in some way.

In a similar way when we are engaged in a repetitive activity, like driving a car, our immediate attention can wander from the task. We can drive automatically though our mind may be miles away, but if anything occurs which potentially signals danger, like a flashing red light in the distance, our attention is drawn immediately back to the task at hand.

Tinnitus has been termed a disorder of attention. In most instances tinnitus is not a significant warning signal in terms of your physical or psychological survival. In most cases it is an annoying but benign symptom of changes that have occurred in our auditory functioning. It deserves to be treated like any other repetitive, boring sound in the immediate environment. We should be able to ignore it, to selectively focus our attention away from it, yet often when we first experience tinnitus we cannot stop thinking about it.

We worry it, like a dog worries a bone. Part of the process of adjusting to tinnitus is finding out about our tinnitus, about the significance that it has to our health and emotional well-being so that we can begin to treat it with the disdain that it so richly deserves.

If we see our tinnitus as just another boring, repetitive sound in the environment, we can choose to attend to it or ignore it as we see fit. Obviously if it changes in some way or gets louder, our attention will be drawn back to it.

But through an understanding of the factors which affect our perception of tinnitus, we can work out what has caused it to change, and through that process allow it to recede back into the general level of background sound.

Emotion regulation or emotion focused scoping strategies refer to attempts to reduce potentially dysfunctional or destructive emotional reactions, which are the results of exposure to stress. Strategies such as denial and wishful thinking are used to avoid directive confrontation with the source of the stress.

Some researchers into stress management and coping emphasise the positive adaptive value of problem solving mechanisms where the problem-focused approach facilitates mastery of the environment. Emotion-focused coping styles on the other hand, are viewed by some researchers as being less adaptive in comparison to problem-focused coping strategies.

Some examples of PROBLEM-SOLVING ACTIVITIES directed towards minimizing the impact of tinnitus are: