The Importance of NOT Focusing on your Tinnitus
The more a person focuses on their tinnitus, the louder it will seem, and the more distressed they will become. You must learn to shift your focus to other thoughts and activities so that gradually the periods where the brain is not focused on the sounds become more frequent and prolonged.
The brain cannot attend to two tasks at the same time and give full attention to both. As an example, when talking on the phone whilst watching TV - your brain will give priority to one or the other, but not both at the same time. In the same way, the brain cannot focus on tinnitus if tinnitus is not given priority. Take advantage of your brain's limitations - focus on something else.
In the early stages, shifting your focus is not always easy. It takes practice and Â perseverance.
When you become aware that you have not been listening to your tinnitus for a period, the brain has not been giving priority to the tinnitus.
These periods of not focusing on your tinnitus become longer and more frequent as you become more relaxed about your tinnitus.
Keep your brain active and avoid silence where possible by exposing yourself to low level background sounds such as a CD or radio playing softly in the background.
When your tinnitus is troublesome, remain active. Go for that walk, or better still, socialise with others. Avoid the temptation to hibernate in front of the TV.
It is more difficult to focus away from your tinnitus...
- In quiet environments
- During periods of mental and physical inactivity
- When you are tired and run down
- When it is the centre of attention - i.e. when you are talking, reading or thinking about your tinnitus
- Silence should be avoided where possible.
- Use sound distraction to refocus your attention away from the tinnitus
- Tinnitus thrives on boredom
Trying Too Hard
Ross McKeown, President of the Tinnitus Association of Victoria
I recently counselled a young man whose tinnitus was having a devastating effect upon his life. He had attended one of our Tinnitus Management Seminars but was finding it difficult to focus away from his tinnitus.
After listening to him describe his unsuccessful attempts, I suggested he was trying too hard to shift his focus from the tinnitus.
Paradoxically, the more we try to force our brain to focus on other things, the more it will remain fixed on our head noises.
We know that the brain cannot attend to two tasks at the same time and give full attention to both. As an example, when talking on the phone whilst watching television, your brain will give priority to one or the other, but not both at the same time.
In the same way, the brain cannot focus on tinnitus if tinnitus is not given priority.
By trying to force our brain to shift its focus we are in effect giving our tinnitus priority, reinforcing the idea that the tinnitus is important.
We will all have experienced a similar situation when we have had difficulty getting to sleep. The more you try to force yourself to fall asleep, and worry about it, the less chance you have of being successful.
However by relaxing, making yourself comfortable and thinking about pleasant memories or anticipating coming events, you do eventually catch a sleep wave and drift off to sleep. When you awake you will have no recollection of actually falling asleep.
Tinnitus is just the same. When we stop trying to force our brain away from the tinnitus, and simply go about our daily activities, our brain changes focus many times each day. And as we become more relaxed about our tinnitus these periods become longer and more frequent.
As when we fall asleep, we are not aware of our brain switching away from our tinnitus. Only when we hear it again do we realise we have not been listening to our tinnitus.
William Shatner, the American actor, said in an article he wrote for the American Tinnitus Association, "The moment you can divert your attention and don't hear your tinnitus, that's the moment you realise that all you have to do is occupy yourself, whether it's reading, work, play, love, family - any of these things, all of these things."
So if you are having one of those days or periods when your tinnitus seems louder than usual, and you are more aware of it than usual, that is precisely the time you must increase your physical and mental activity.
This will enable your brain to do what it does naturally - fi nd other things to focus on that are more interesting than your tinnitus.
Accepting Tinnitus: the Problem of Focusing and Attention
Dr Ross Dineen of Dineen and Westcott Audiology
Acknowledging 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 6 months it is unlikely that it will ever 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 tumour, that I'm going crazy, 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.
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 to environmental sounds, so that it seems to stand out from, and appears much louder than, other 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 of emotional excitation or arousal. We never 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, the drone of 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 which are useful to the activity which we are engaged in, 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 unusual 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 the 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.
Mental distraction from tinnitus
When we first notice tinnitus it may seem like an ever present intrusion, one from which we cannot get any relief. It constantly demands our attention. Yet even when it is at its most apparent we found that we are able to temporarily forget about it, if we are involved in a task which demands our full concentration.
Many people when they first get tinnitus actively seek tasks which demand such concentration, as when absorbing ourselves into a favourite hobby, or doing cross-words or mental tasks, as a way of giving ourselves some relief from the constant awareness of the tinnitus. This approach works quite well during the day, but becomes more of a problem at night when we are trying to relax or trying to get to sleep, or if we wake-up during the night, as there is less noise and activity around us to distract us from the tinnitus.
When we start to listen to the tinnitus, it seems to get louder and louder and more overwhelming. The more that we focus on it, the louder it seems to get.
Activities which previously allowed us some temporary relief from the pressures of the world, such as day-dreaming or sleeping, can become another source of distress and frustration because of the intrusion of tinnitus. This situation shows tinnitus at its most annoying stage as, by disturbing our ability to rest and relax, it starts to undermine our perception of our ability to cope with life in general and our sense of health and well-being.
Distraction as an aid to sleeping
Nearly everyone who experiences a distressing level of tinnitus experiences a period of sleep disturbance.
Part of the process of coming to terms with tinnitus is developing a range of strategies to minimize the awareness of tinnitus when trying to sleep or relax. These techniques are intended to enable you to switch your focus of attention away from the tinnitus, without stimulating you to the point where relaxation or sleep becomes impossible.
Refocusing strategies can be either cognitive, that is using the mind or mental activity to distract you from focusing on the tinnitus, or behavioural in that they involve physical activity or sound, to aid switching your focus of attention away from the tinnitus. Nearly all the management techniques or coping strategies that we use to deal with periods of heightened awareness of the tinnitus are a form of distraction or refocusing technique.
Coping strategies and tinnitus
Coping strategies which we use to manage periods of crisis can be divided into two main types of behaviour, these are problem-solving and emotion regulation.
Problem solving or problem-focused coping strategies are activities directed towards modifying, avoiding or minimizing the impact of stress, or mental activities that lead to the belief that a source of stress can be controlled.
Emotion regulation or emotion-focused coping strategies refers to attempts to reduce potentially dysfunctional or destructive emotional reactions, which are the result of exposure to stress. Strategies such as denial and wishful thinking are used to avoid direct 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 of the impact of the tinnitus are:
- Seeking information about the significance of tinnitus in your overall health, rather than just worrying about it.
- Getting and using a hearing-aid if you also have hearing problems.
- Finding out about how you can use sound to overwhelm your awareness of the tinnitus, to give you temporary relief from focusing on the tinnitus.
Some examples of emotion-regulation activities that avoid direct confrontation with the emotional reactions elicited by the tinnitus are:
- Denying that you have a problem or pretending that it's not happening (denial can be useful in managing short-term crisis, but if the problem persists denial can be destructive as you can end up ill prepared to cope with a long-term problem)
- Wishful thinking, such as hoping that it will just go away, or trying to think about something else which is more pleasant than listening to your tinnitus
- Learning and regularly using relaxation and stress management techniques that reduce the level of emotional response to stressful situations.
Accepting the Fluctuations of Your Tinnitus
Ross McKeown, President of the Tinnitus Association of Victoria
There are many reasons why we experience temporary increases in our tinnitus. Whether the loudness has increased or we are simply listening to it more than usual, the result is the same. We know that we are focusing on our tinnitus more than usual and we find ourselves becoming preoccupied with our tinnitus.
We know there are many factors that can cause these fluctuations; stress, anxiety, poor health, tiredness, certain foods and drinks, medications etc...
In the early stages of tinnitus many people become anxious and even fearful of sudden increases in their tinnitus, believing that the increase might be permanent. However, in time you begin to realise that the tinnitus usually settles down to its normal level.
As you gain more knowledge about your own tinnitus you become more relaxed about the fluctuations.
I now know the different foods, drinks and other factors that increase the level of my tinnitus, but as most of them are things that I enjoy, I consider a short-term increase in my tinnitus a small price to pay.
If you find that your tinnitus has been louder than normal for an extended period then it is important to examine your lifestyle.
Ask yourself :
- Have I become tired and run-down?
- Am I working too hard?
- Are there things I am particularly worried about at the moment?
- Am I getting enough exercise and relaxation?
- Are there unresolved problems preying on my mind?
Any of the above could be responsible for the increase.
In fact you can actually turn your tinnitus into a positive. If it has been louder than normal for a while you know it is time to reflect on your lifestyle and make the necessary changes.
Remember, gain a deeper understanding of your tinnitus and begin to accept the fluctuations as normal.
You will be far more relaxed about your tinnitus when you do.