 |
|||||
Tinnitus...The Series
This is the December 1995 installment of a series of articles I wrote
exclusively for Hearing Health Magazine.
by Kevin Hogan Ph.D., D.C.H.
Listening to the noises of tinnitus in the head, for many, is the
curse of a lifetime. Many of us have often wondered what great evil we
did to bring this upon ourselves. Of course, we know there was nothing
that we did, but knowing that seldom helps. What does help? Can
anything truly reduce the noise in our heads? The answer is yes. This
is the first in a series of three articles that will discuss how
tinnitus is most likely heard and how we can quiet the noise.
Tinnitus is noise that often begins in the middle or inner ear at
onset. Later the noise becomes thoroughly enmeshed in our nervous
system, and long after the stimulus for the noise has gone or healed,
the noise remains.
Why?
Remember the veterans of wars that once felt great pain in their limbs
and due to irreversible infection, had to have those limbs amputated?
Many still felt pain in a foot or knee or hand, long after the limb had
been removed. The phenomenon is known as phantom limb pain and is very
common. The brain was never "told"
that the limb had been removed and a
persisting loop of information told the brain that the limb still hurt
and that something needed to be done!
Long after Van Gogh cut off his ear, the noise continued. Long after
many thousands had surgeons cut the VIII nerve (the auditory nerve),
the noise of tinnitus persisted. In fact HALF of all patients having
the VIII nerve cut still have tinnitus. How could that possibly be if
tinnitus is in the ear? The answer of course is that is is only in the
ear in about half of patients. In the other half the noise is
persisting in the brain.
The brain is also well known as a chemical producing factory. The
improper mix of chemicals can cause stress and depression in the
individual. The inverse is also true. Coupling the notion of brain
chemistry with the fact that approximately 75% of tinnitus sufferers
had depression or anxiety before the onset of tinnitus has fascinating
ramifications. In theory, if we can successfully treat stress, anxiety,
and depression then we should be able to reduce the volume of tinnitus
as well if these three things actually pre-dispose tinnitus. In fact,
this is the case.
A simple example is that of stress and anxiety directly causing
temporomandibiluar joint disorder (TMJD). TMJD quite often is the
direct cause of tinnitus for numerous reasons. Once the TMJD is
properly treated the tinnitus often reduces or is eliminated. In
similar fashion, stress, anxiety and depression often cause an
alteration in the brain chemistry, that when ignited with a physical
stimulus (ototoxic drugs, a loud noise, TMJ, craniomandibular disorder
and so on...), tinnitus onsets.
Stress, depression, panic disorder, and anxiety are like fertilized
soil. The farmer planting the crops can be likened to the physical
stimulus that causes the tinnitus and makes it stay (grow) when in most
people, without the fertile soil, it only lasts a short period of
time.
Once the tinnitus is "planted" in the brain of the emotionally
hurting individual, it grows and soon plateaus in volume. The brain
initially becomes aware of this noise and initially does not like the
noise. Later, as the brain becomes accustomed to having the noise around,
it feels it is necessary for survival and goes looking for it immediately
when the conscious mind notices it is not there. (Have you ever awoken
from a nap only to have your tinnitus volume sky rocket? That is your
reticular activating system trying to keep you alive!) The brain does not
think the tinnitus is "good", it simply becomes a survival issue
and a "sound loop" is created in the neural pathways that keeps
the tinnitus there.
Long after the physical causes of tinnitus have healed in your ear, the
brain will continue to find the noise. This is what is meant when it is
said that tinnitus is psychosomatic in nature. The onset was physical
in nature, very real. However, the continuation of the noise is often
not necessary. Much like hearing voices and other auditory
hallucinations, tinnitus is simply a "replaying"
of "tapes" the brain
feels are necessary for survival.
The brain is an incredible piece of creation and tends to work
remarkably well. Like all sounds, tinnitus is processed and
"heard"
in
the brain. The ear, incredible as it is in it's own right is a sensory
organ that collects information and keeps our balance along with a few
other nice benefits. The ear does not hear though. The brain hears.
Sound is stored in the brain and can easily be remembered.
Recall the voice of someone you love very much. (If you have been deaf
for your entire life follow along anyway as this pertains to everyone!)
You were easily able to do that weren't you? Even if you are profoundly
deaf today, you are still able to remember the voice of a relative or
friend. The memory of sound is the brain stored. Long after a person
becomes deaf, they continue to hear sounds in their dreams. The memory
of sound is stored in the brain. When you feel a certain way or have
certain important decisions to make you may hear the voice of a parent
or friend who is long dead in your head. Some people hear these voices
all day long. The brain is working perfectly well. It simply needs a
bit of reprogramming!
The implications for those people who listen to tinnitus are profound.
The sound is another memory in the brain. Like anything else in the
brain, it can be altered through pharmacology or altering states of
conscious in natural ways including but not limited to meditation,
yoga, hypnosis, biofeedback, visualization and various other mental
"technologies" like neurolinguistic programming.
When considering tinnitus as a problem we must subdivide the problem
into two areas. First there is the level of the volume of the tinnitus.
Second, there is the level of suffering the tinnitus causes. Therefore,
we are looking for two solutions. One is to reduce the volume as much
possible. The other is to reduce the negative emotional impact we have
toward the noises in the head. They are very different things aren't
they? The sound of a baby crying to some is the sound of a child
trying to communicate and is looked upon as a sound of joy. To others,
the sound of crying is hyperacoustic in nature. It can be the most
annoying and frustrating of sounds!
Because tinnitus is a noise that is "heard" in the conscious
portion of our brain, we can always alter at least one of the two problems.
We can always change our interpretation of the sound we here. In most cases
we can reduce the volume of the tinnitus and in some cases eliminate it
completely. We can, through various means, which will be discussed in an
upcoming issue, move from, "This noise is driving me insane," to,
"This noise is annoying." That is a VERY big step to make
and it is not as simple as saying, "you'll have to learn to live with
it."
Let us begin with a worst case scenario. An individual has tinnitus
which is in no way related to psychosomatic cause. The person was
standing next to a fog horn when it went off, had no protection and has
had tinnitus from that exact moment on. Another situation along these
lines would be someone with a cholosteotoma that is causing the
tinnitus. (This cause by the way, is the best reason to get an MRI one
needs. Though fairly rare, early treatment is absolutely critical.)
This person's tinnitus is NOT caused by anything that had to do with
emotional state of mind.
In situations where a specific physical cause is diagnosable and certain,
reducing the volume is a greater challenge, but reducing the emotional
impact is far easier BECAUSE the individual was emotionally happy
before onset. These people tend to be annoyed by tinnitus but do not tend
to "suffer" with tinnitus. They would prefer it be gone, but
generally feel no major negative emotions.
For people who have tinnitus that is exacerbated by TMJD, stress, poor
posture, and so on, the opposite is normally true. Here it is easier to
reduce the volume but more challenging to reduce the emotional impact
of the tinnitus! The reason for the inverse relationship is that stress
is the root cause of TMJD. Other negative emotions have a direct impact
on our immune system and our body in general. By correcting the
emotional aspect of ourselves, we will gradually reduce the volume of
the tinnitus. Unfortunately, once that negative emotional belief system
has interpreted the tinnitus as a curse or a cause for suicide, even
reducing the depression and stress often doesn't alter the
interpretation even though volume reduces dramatically.
The positive aspect is that for a person whose tinnitus was born in
depression or anxiety, with the physical stimulus, this person is also
likely to have significant improvement given time, a good medical plan
with an M.D. and many lifestyle changes that will discussed in the next
issue of Hearing Health.
Kevin Hogan received his doctorate in clinical hypnotherapy from the
American Institute of Hypnotherapy in Irvine, Ca. Dr. Hogan once had
tinnitus that varied from the 50-80 dB level persistently. Through various
medications and lifestyle alterations Dr. Hogan normally does not hear any
tinnitus and when he does it is in the 10-20 dB level. Dr. Hogan is the
author of The Tinnitus Reduction Program.
Feel free to write or email
Dr. Hogan.
The next article in the series: The Noise Can Go
Away .
|
|||||