Habituation is a term that is used to describe the positive changes that undergo while recovering from tinnitus. The length of time varies greatly by the individual. For some it can take a few weeks, while for others it can take over a year. In this article, you will learn how you can habituate to tinnitus as quickly as possible. 

My name is Dr. Ben Thompson. I’m an audiologist and tinnitus specialist in California. Let’s talk about tinnitus habituation. Reducing your actual tinnitus perception, or the “loudness” of your tinnitus, is not as important as reducing and working on the negative emotional reactions to the tinnitus.

Tinnitus Retraining Therapy: Habituation

One of the most commonly used methods for tinnitus treatment is called tinnitus retraining therapy. It’s something that I was trained very specifically on, and one of the modalities that I use. With the right guidance and commitment to tinnitus retraining therapy, 80% of patients can habituate to the emotional reactions toward their tinnitus within 12 months. In other words, for most people that habituation period is less than one year if they’re putting in the work and they know how to do it. 

I will use what’s called the neuro-physiological model to describe two feedback loops inside your body that impact tinnitus. The upper feedback loop involves the auditory perception of tinnitus coming from your auditory brain, and your mental concentration or focus on that perception. The upper feedback loop is dominant in the acute stage of tinnitus, which is usually in the first weeks to months of having it.

The lower feedback loop involves the limbic system, the emotional brain, and the autonomic nervous system. The limbic system helps regulate your fight or flight response. If you’re bothered by tinnitus, it typically means that your limbic system and that response are on high alert.

The autonomic nervous system helps regulate homeostasis in our bodies. If tinnitus is bothering you, it’s likely that your autonomic nervous system is intensified. That causes an increased heart rate, increase in breathing, and other physiological responses that make it hard to calm down and let tinnitus become less of a problem. That lower feedback loop is most commonly dominant for chronic tinnitus when you’ve had it for months to years, and it’s been a bothersome problem in your life.

So that negative reaction to tinnitus comes from a few places: the limbic system in the emotional centers of our brain, and the autonomic nervous system, which increases our body’s physiological response to tinnitus. That covers some of the basics of the neurophysiological model.

There are a few reasons why someone like yourself could have a negative response to tinnitus. Number one could be what’s called negative counseling. A common example of negative counseling is when you go to your primary doctor or an EMT doctor, and they say, “There’s nothing that can be done about your tinnitus, you’re just going to have to learn how to live with it.” When you’re given that kind of harsh response, it increases the intensity of the feedback loop. It doesn’t give you hope that things are going to change. It makes your tinnitus louder, and it makes your emotional reaction to it stronger.

Another reason why you could have a negative reaction to tinnitus is because there was some pre-existing emotional response in your body that tinnitus spiked. The pre-existing condition may involve anxiety, depression, chronic fear or worrying, or stress.

Tinnitus habituation occurs when the upper and lower feedback loops are both ended. Ending the feedback loops means that you discontinue this constant back and forth intensification between the factors of each one. When you fully understand what’s happening in the upper and lower feedback loops, then you can take direct action and regain some control over how the tinnitus affects your experience.

Dr. Thompson explains how long it takes to habituate to tinnitus.

Is Tinnitus Habituation Real?

Yes, tinnitus habituation is real. For the upper feedback loop of tinnitus habituation, I’ll share one thing you can do, which is try not to be mentally hyper-focused on your tinnitus. Here’s a common way for this to show through. Say John Smith has ringing in the ears, and over the next two weeks, he spends many hours a day researching on the internet about what he can do to fix his tinnitus. I would categorize that as mentally hyper-focusing on tinnitus in the upper feedback loop.

Doing this only intensifies the tinnitus and makes it louder, which causes John Smith to hyper-focus even more, because he feels like if he doesn’t figure this out now, it’s only going to get worse. That creates a heightened sense of stress and anxiety, which does not help stop the upper feedback loop. In fact, it causes it to directly impact the lower feedback loop. This is part of the autonomic nervous system.

To combat this, we want to target and welcome the parasympathetic nervous system, which is part of your nervous system that comes out through deep relaxation and peaceful practices. This could be mind/body practices like guided breathing, guided meditation, yoga, taking a warm bath, or having a ritual or a practice every night before you go to sleep. Anything that grounds you, calms you down, puts you in a good headspace, and relaxes you into your body is going to activate the parasympathetic nervous system. And that’s one way to have some direct control and get out of that feedback loop.

In the lower system, there are techniques that work well for some people and not for others. We’re all individuals. So I encourage you to really do your homework, look at what is out there. Since we have both the upper feedback loop and the lower feedback loop, you can try some techniques to work on either of these systems. If you put in the time, if you’re motivated and have the right guidance, you will see progress related to your quality of life and the emotional reactions or stress you have from the tinnitus.

When you can limit your hyper-focusing on the tinnitus in the upper feedback loop, and increase the parasympathetic nervous system response in your lower feedback loop, then habituation is already happening. Habituation to the sound of tinnitus occurs naturally; you cannot force it.

Remember that there’s no way to push through to tinnitus habituation. It only happens when you ease into it by addressing the upper system and lower systems. That is the key for you to habituate to the negative emotional reaction of your tinnitus over time. Remember, this can take a period of weeks, months, or sometimes over a year. So please be patient. Keep at it, have a dedicated practice, and find some good guidance because with the right guidance, you can certainly get through this.

To learn what may help you manage your tinnitus, please download our free 10-page e-book, The Ultimate Guide to Tinnitus Relief.

Dr. Ben Thompson, Au.D.

Dr. Ben Thompson, Au.D.

Dr. Ben Thompson is an audiologist in California and founder of Pure Tinnitus. Dr. Thompson has a comprehensive knowledge of tinnitus management. He completed his residency at University of California at San Francisco (UCSF) and is a past board member of the California Academy of Audiology. Via telehealth, Dr. Thompson provides services to patients with hearing loss and tinnitus.

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