First up, I describe this in detail in chapter four of my book, Rock Steady, so I highly recommend you take a read.
And second up, it’s both. So tinnitus can come from the ear system, from the outer ear, middle ear, or inner ear where there’s mechanical movements and there’s neural signals being processed and sent along our auditory nerve through the brain stem and to the brain auditory processing areas, the auditory cortex. And anywhere between the inner ear and the brain, we can have perception and tinnitus sounds that come and go. So it’s really happening through the body and through the brain. Anywhere that the nerves are firing.
My tinnitus sounds like a computer in my head. It’s hard to describe. It doesn’t sound like the descriptions I’ve heard. Could this still be tinnitus? MRI shows nothing wrong or abnormal.
First of all, and I explain this in my book, Rock Steady, every person could describe the sounds in their body differently and it’s all still tinnitus. Tinnitus describes any sound that nobody else can perceive but you. It’s sound coming from within your body. It’s sound that only you hear. So any description is a good description and it’s a little bit like describing wine. 100 people could describe a wine in 100 different ways, even though it’s the same wine. The way you describe it is your way and it’s perfectly fine. I’ve actually heard that tinnitus sounds like a computer sounds so there are other people out there who would describe it that way too and it’s all tinnitus. So, that’s the first thing.
Yes, sometimes it is hard to describe and that’s okay. And I wouldn’t get bogged down in trying to describe it because probably really what you want to do is to celebrate the fact that they’ve found nothing wrong with your brain, that sounds like you’ve got medical clearance. That there’s nothing wrong with you. So that’s good. We want to take an exhale and relax into that information. That’s where we want to prioritize. The sound can come and go, you can reverse the neural emphasis on it. And if you follow the Rock Steady path, you can retrain the maps of your brain to return back to or to really rebuild a whole new normal where tinnitus is no longer central. So I think it’s important to acknowledge what you’re hearing and also acknowledge that it’s safe. It’s allowed to be there. And it’s great that you’ve got a normal MRI.
My question is can one safely participate in choir orchestra, go to concerts or movies when they have tinnitus, hyperacusis, acoustic shock, or tonic tensor tympani syndrome, also referred to as TTTS?
So my first answer is I absolutely recommend that you safely participate in choirs, in music, in concerts, in orchestras, especially when it’s coming from a place of joy and engagement and loving connecting to your communities and enjoying being surrounded in that music and that sound scape. So sensory enrichment and reintroducing sounds that bring us pleasure and joy is hugely therapeutic for anyone with tinnitus. And for those of you with acoustic shock, hyperacusis, or TTTS, I think it’s absolutely recommended for you too. It’s beautiful to allow yourself to enjoy being flooded by these beautiful sounds that you are choosing to participate in.
But what I would say is pace yourself. Give yourself options to perhaps attend for five or 10 minutes and leave again. What else could you do? Give yourself opt outs, maybe take breaks so you might not want to be there the whole time. You might want to step in and out. You might want to bring a friend with you and let them know, “Hey, I’m very sensitive to loud sounds or even normal sounds. It really hurts my ears. I get stressed.” So what I would say if you’re feeling the anxiety, particularly with acoustic shock, hyperacusis, and TTTS, but honestly this is really relevant for tinnitus folks too because there’s an anxiety component of caring so much about ourselves and our hearing health that we don’t want to make it worse.
So what I would say is be resourced, have your self soothing tools. If you’ve got the Rock Steady program, look through the tools that are provided there that help you ground, that help you reclaim your safety, that help you self regulate, that help you find your steadiness and your center and use those tools before you go to the choir or the concert or the movies, use them while you’re in the movie or in the choir or in the concert and know when you’re feeling like you’ve had enough. You don’t have to get to the point of overwhelm and you don’t have to stay there. You have agency and choice. This is your body. You choose how much exposure you enjoy and feel safe for you in that day. And so because we’re building up, we’re teaching the brain that, “Oh, choir is safe,” and we’re teaching the brain the movies are safe, we need to build that trust. The brain’s learning, the brain’s going, “Oh, I’m not sure about this. This could hurt me.”
So especially around your tension, any tension around the head, shoulders, and neck, you want to have some strategies to release that muscular tension. I actually went to the movies recently and, being an audiologist, I had my watch measuring the decibel readings and I was feeling particularly sensitive that day and I was like, “This is really loud.” So I measured the volume and it was way over safe hearing levels. The audiologist in me was so angry that they would expose public to such loud sounds and I actually did go to complain and say, “This is not safe volume levels, I’m measuring it.” And anyway, so I think there is a little bit of public education to happen. So sometimes back yourself. It may be too loud and it is dangerously too loud.
But what happened was I went back in, I asked them to turn it down and whether they did or not was not in my control, but I went back into the movie and I was using my strategies. I was sometimes closing my eyes just to relieve some of the sensory input to my brain. I was body scanning. I was noticing if there was nervous tension or anxiety building up and I was meeting that with kindness and resolving it in real time. So it’s a little bit of if you don’t feel up for it, it’s okay to avoid it. You don’t have to expose yourself aggressively. You pace what you feel ready for. It’s all about remembering to connect into pleasure and joy because that’s what’s going to teach the brain and the ears that those sound pathways are healthy. They’re safe. They’re fine. From a physiological point of view, we want the signals coming from the sound collection in the ears that travels to the brain, we want the brain to tick all of those off as safe, healthy, and enjoyable.
And what has been happening in the past is when we hear sounds, we’re associating it with pain and with tinnitus and with unwanted abnormal outcomes so the brain’s being vigilant and responding to it in more of a stressor way. So that’s what we’re doing is we’re teaching those sounds to come over into the brain as safe and pleasurable. And that could take time, it might be instant. Some of you will hear this, go straight to choir and just have fun. And for others of you, it will be a slow, incremental practice of learning to release that anxiety, self soothe, and re-expose your body and your ears and your brain, choose sounds in a really healthy way. And of course, I think as per the movie example, just note, if it feels too loud for you, it actually might be too loud for you. So just be really realistic and listen to your body because you know you best.
I’ve had high pitched tinnitus for three years now, and I’ve done a lot of changing, including changing my breathing, being more positive, being more mindful, going through times of joy, and more accepting of myself, yet through all of this, my tinnitus is so constant and steady. I know you’ve said it’s always changing, but mine doesn’t back off or lower in volume and it completely baffles me. I feel I’ve made such positive strides, but with no results and it’s very disheartening. Can you offer any insight?
So first of all, I want to say I feel like it’d be nice just to pause and celebrate where you are. And that really moves me directly into my response, which would be when we’re coming at things from a neuroplasticity point of view, it really is founded in non-judgment and meeting ourselves where we are bringing loving awareness to where we are. And if the tinnitus feels as though it’s not changing at all, which is honestly highly unlikely because it’s all about where our awareness is. If we think of our awareness as a torch in a dark room, I think saying that the tinnitus is unchanging and is constant and steady is like saying, “Well, the torch is not ever moving.” So if you learn how to move your conscious awareness around and start investigating your inner world and really getting in touch with your self head to toe and your feelings and your felt sense of the world, it will literally move allocation away from that tinnitus sound so the awareness is not so strongly pointed at the tinnitus sounds.
Therefore, just keeping it there and training yourself to get very curious and open and absorbed in other parts of you. Because there’s so much more to you than your tinnitus and the tinnitus is allowed to be there, absolutely. And we can bring a lot of loving awareness and loving kindness to supporting that and listening to that. But I think it’s also important to not get too bogged down and focused on whether it’s there or not. It’s there, okay. How can we honor it, acknowledge it, be loving toward it? So really remove that emotional loading of wanting to get rid of it and shift into navigating other parts of you. And the questions I would be asking is, “What brings you deep pleasure? What truly engages your attention and just so absorbs and immerses you that there’s no space for anything else?” And then you’ll begin to notice, “Oh, okay. So when I’m really focused on this conversation or when I’m really just loving the sense of sand against my toes, the tinnitus sound does change because more of my neural awareness is resource and allocated elsewhere over into that somatic sensory region where I’m feeling and sensing against my skin and that’s taking away that allotment over at the tinnitus areas of my brain.” So play with that and learn how to really move toward pleasure, joy, sensory enrichment.
And my second response would be just really notice if you’re being outcome focused, that somehow you want to change your tinnitus or you want to get rid of it. It’s there. It’s a part of you. It’s your body making sounds. It’s normal and healthy. You do not need to focus on it at all and trying to change it means you’re teaching the brain it’s important to you. Trying, putting any effort into the tinnitus is teaching the brain that you like it, you want it, you’re interested in it and is giving it more neural emphasis. So for example, if you’re changing your breathing for the purpose of changing your tinnitus, the motivation is keeping the tinnitus alive. If you’re trying to be more positive, whatever that means, so that you can try and change your tinnitus, again, A, viewing things as positive negative means you’re still coming from place of judgment, that things should be this way. So it’s not that things are positive or negative. Things just are as they are and we can learn to experience them and let life wash over us in a way that takes a much more allowing, we’re allowing, there’s an effortlessness of letting life wash over us however it comes and we’re not micromanaging the outcomes, we’re not premeditated about it.
And that’s essentially what mindfulness is. So some people use mindfulness in a way that I think is a bit skewed and is still aiming for an outcome, but true mindfulness means we’re unbiased, we’re nonjudgmental, and we’re completely open with a loving awareness and curiosity in the present moment. So if that means that tinnitus is there, that’s okay. It’s welcome. And if in the next moment the tinnitus is there, that’s okay. It’s welcome. But what else is there? My question would be, “How do we get mindful about other parts of you and how can you be really richly engaged and engrossed in learning about new parts of you?” Because perhaps if we’re used an analogy of doing a PhD, it almost sounds like maybe you’ve done a PhD in really focusing on your tinnitus and now it’s time to let that go and shift your awareness to deeply focus on other parts of you as a whole person.
So I hope I’ve answered your question. And I think part of… You’re definitely on the journey, I can see that in your question and so it’ll be really tweaking it to shift away from that focal point of tinnitus, which it sounds like it’s coming back to, “Well, it’s still there. It’s still there. It’s unchanging. It’s still there. I’m doing this, but it’s still there.” Well, what I would say to you is, A, read my book or, B, try my rock steady program if you haven’t already, because this question demonstrates to me that you’re just trying to get rid of it and that doesn’t work. That will keep the brain locked in firing the tinnitus signal because it’s all coming back to whether the tinnitus is there or whether it’s changing. And we need to really let go of that agenda and surrender, allow and have an effortless approach to experiencing life as it is. I hope that helps answer your question.
A really big yes, is my answer to this question. So, so, so many of my private clients over the years have been women going through menopause, or perimenopause, and really facing changes within themselves, and within their body. And I think where neuroplasticity helps is when we use conscious neuroplasticity and the Rock Steady process, the Rock Steady program, the path is to pause and listen to the body with a sense of reverence and grace and loving awareness. And we’re listening in order to respond in a supportive way to the body. And that’s not just going to impact the vertigo and tinnitus symptoms or sensations, it impacts us as a whole person. So it impacts us with how we set our boundaries, and how we prioritize giving time to ourselves. It can help really nurture and nourish relationships in our family, and with our intimate partners. It can help us stand up at work and speak up for ourselves. So there’s been so many ways that these skills and tools help our behavior and help us understand our body and what we are wanting and needing as this new chapter in life is upon us.
I think what happens without neuroplasticity conscious awareness and without the Rock Steady skills and tools, my clients are often really burdened with old patterns and habits that may have worked okay and served them 10 years ago, but now they’ve outgrown them. It’s not working anymore. Their capacity and resources are feeling stretched. They’re no longer happy and perhaps they need to negotiate new agreements with themselves and with the people they’re living and sharing their lives with. So, it is a new chapter — we’re rebirthing into a new person. It’s a very exciting and beautiful time, especially if we give ourselves the space to listen, to pause, to respond, to support ourselves and above all, to bring a sense of loving kindness in, as we feel through those changes.
And that’s where we have a direct impact on our nervous system and the nervous system is impacting the release of hormones. So the more we can move away from the stress responses, the more we can get healthy, balanced hormones acting on our behalf while we rest, repair, digest, and investigate more of those pleasure pathways — which is a really big part of Module 4 in the Rock Steady program — the better off we’ll be in navigating these changes. So, it’s a pretty long answer. But as our body is changing during menopause, our nervous system is changing alongside it. Our hormones are changing — that definitely goes hand in hand with increases in all forms of symptoms, not just menopausal symptoms, but also anxiety, depression, chronic pain, tinnitus, vertigo — whatever’s lying there in the background is likely to amplify. Using the Rock Steady skills and tools to lovingly listen, respond, and support ourselves helps to tone down the nervous system, balance out the hormones, and help us think more clearly as we navigate a more graceful transition through menopause.
Here is a question from a community member, about tinnitus:
My tinnitus is very inconsistent, it varies in intensity and loudness, I take the no big deal approach but my question is, I wonder, will it ever completely leave my conscious mind, return to my auditory brain and quietly store away for eternity?
First of all, great job that you’re taking the no big deal approach. That is a really the core, the most important rock steady skill and tool to remove that emotional loading of your tinnitus. It’s totally normal that it’s inconsistent, that it comes and goes, that it changes intensity and loudness because all of that will change depending on what you’re doing, your circumstances, your situation, your mood, even what you’ve eaten or how much you’ve slept. There will be many biological factors that change the quality of the sounds we hear in our body.
The piece about your comment that I feel like is perhaps unhelpful for you, so I’ll bring it to your attention, is this ‘for eternity’ piece. What we see when people heal and recover from tinnitus using neuroplasticity, is that rather than the tinnitus sounds being locked in the front of their attention and their awareness, and them being present all the time, is that they learn to distract the brain and teach their brain to filter the tinnitus sounds out. And while technically the tinnitus sounds might still be firing in the background, it’s not in the awareness so they’re not hearing them — they’re not perceiving the sounds. And I think more and more moments of that will come to people who use these Rock Steady tools to resolve their tinnitus. But it doesn’t mean it will never, ever come back ever again.
So, this idea of eternity or needing rigid certainty that the tinnitus sounds won’t ever come back, it almost, to me, feels like saying, “Well, will I start my car one day and I just won’t hear the idle sound?” Well, when you start your car, there is sound. It’s like fighting reality. The body does make sound and it’s okay to hear that sound from time to time, but what we want is that hearing these body sounds is coming in and out of our awareness at a really healthy pace and that we’re not getting upset if it pops in, when of course it’s welcome and it’s normal. But we then want it to just as easily pop out again of our awareness. So, I think the overall answer to your question, I think, is yes, we can have a situation where it does leave our consciousness, it leaves our perception, it leaves our awareness, but it’s also okay if it comes back again. It doesn’t need to be for an eternity. It’s actually really healthy and normal to hear our body sounds from time to time.
