Rewiring Tinnitus: Expectations v Reality – Glenn Schweitzer – #12

Glenn Schweitzer of Rewiring Tinnitus joins Dr. Ben Thompson for a discussion about neuroplasticity for tinnitus. We will discuss the expectations of neuroplasticity, as well as the reality of how to get better. Glenn habituated to tinnitus himself and he shares some insightful reflections with us today.

Ben Thompson, AuD

Hello and welcome to Episode 12 of the Pure Tinnitus and Hearing Podcast. Today we are with Glenn Schweitzer, founder of Rewiring Tinnitus. Today we are going to talk about habituation, Glenn’s personal experience with Meniere’s disease, hearing loss, tinnitus, and the tips and tricks that he has for working with clients to help them feel better and recover from their tinnitus.

Glenn Schweitzer

My name is Glenn Schweitzer. And I’ve been working with tinnitus patients now for about five or six years in a variety of capacities. I guess it all started with helping people primarily with Meniere’s disease, which is an inner ear disorder that I live with. A vestibular balance disorder that’s fairly nasty. And tinnitus is one of the primary symptoms and I wrote a book to help people with Meniere’s disease. And I started a blog and a website. And I had written like just a page or two in that first book about how I had kind of found some relief from the tinnitus. And that was it. And then over time, I got so much email and correspondence about this one or two pages in my book that I realized, there’s a much bigger problem here and a lot more people who are really suffering, and I kind of went back and I realized that this is something that deserved more of my time and energy.

Ben Thompson, AuD

Thank you so much. And as you were going on your own journey, and then decided you were in a position ready to serve others, what were some of the challenges that you had to overcome yourself before you felt ready to serve others in that way?

Glenn Schweitzer

That’s a good question. Well, it all sort of grew so organically in the beginning. When I was trying to think of what to write a book about, I just knew I wanted to do a writing project initially, before I got into any of this work. And I didn’t even occur to me that I was living well with Meniere’s disease, that this was something that I knew a lot about, it was just like one list item on a bunch of possible things I was considering writing about. The challenges have just sort of been, I guess the biggest challenges.

The biggest challenge, I guess, has been trying to reach people who are suffering so much with a health problem, and a medical system and a treatment environment where they’ve been let down a lot of times, and without having a medical background, sometimes it was initially hard for me to make that initial connection. But you know, a lot of these tinnitus patients have been let down over and over again, whether it was a doctor, or a specialist who told them, there’s nothing they can do or just have to live with it. I’ve never yet to work with a single person anywhere in the world who didn’t have at least you know, one story of a doctor who wasn’t helpful. And then you find all these different supplement companies.

And there’s all this sort of disingenuous kind of products and marketing online that paint a picture that like where, you know, some sort of false hope only to be, you know, have your hopes crushed again. And so you’re a target, it’s a demographic of people who are suffering greatly, who often have no hope and have been let down over and over again. And it was initially very hard to find ways to really reach out and make a meaningful connection with those people. But I’ve gotten better at that over time. And I feel that just being you know, the fact that I’ve been through it myself that I have been to very deep dark lows and depths with my own tinnitus and chronic illness. I think that that really helps my my message resonate. But that’s probably been the biggest challenge for me in doing this is trying to reach out and make a meaningful connection to a person who’s really suffering and has just been let down, left and right, like leading up to that point. That makes sense.

Ben Thompson, AuD

Yeah, a lot of what we do is building trust with people. 100%. It comes from us explaining our own experiences, our own stories, explaining research, how it supports these techniques, etc, etc. If I may go into your own medical history a bit: You have Meniere’s disease, which is typically a hearing and Balance condition on one ear, where there’s fluctuating hearing loss with tinnitus and fluctuating vertigo or balance disorder as well. So if I’m getting that correct, then let me ask you this question, which I think is important for our audience to understand here: Tinnitus can be caused by many different types of causes. You have a medical a physiological cause to tinnitus. Therefore, the treatment or the management is probably different than someone who has a stress-related tinnitus, or someone who has sudden onset tinnitus from a viral infection. When you’re working with your clients when you’re doing your tinnitus coaching, how do you counsel? How do you educate about the different causes and therefore the different management techniques?

And I went back and I ended up writing another book, to sort of document my story, and what I had been through and sort of the strategies and different techniques that I had used to habituate and find relief. And since then my work is sort of taken on sort of a life of its own. And I have my book out there. But I also work with a lot of people one on one in a health coaching kind of capacity. I’m not a medical professional like you. What I do is more considered, technically considered peer support, and I guess tinnitus focused health coaching. But over the last five or six years, I’ve been doing this work, and I’ve worked with hundreds of people all over the world.

Glenn Schweitzer

Sure, a couple of things just to clarify, with Meniere’s disease. Traditionally, it will arise in one ear, but having it bilaterally is also possible. So I have it in both ears. I also have had tinnitus, as long as I can remember, I may have been born with it, I just can’t remember a time without it. But when I was young, there was a time where I didn’t even know that the quiet sound that I could hear when or the small sound that I hear in quiet. I didn’t even know it wasn’t normal. I thought everybody could hear a sound when there was silence. It wasn’t until I was a little bit older and I would be at a loud party or a concert and it would just cause like a terrible spike for a day or a couple of days and then it would revert back. So I’ve always had some level of tinnitus as long as like remember.

Meniere’s disease just made it very loud. Meniere’s disease was the first time where I was confronted with very extremely loud intrusive, chronic tinnitus. And as I started to work to manage my symptoms, a lot of it has to do with taking a holistic approach of reducing stress, improving your diet, improving sleep, like all these sort of variables. I wasn’t having vertigo attacks anymore, the fullness and pressure in my ears was slowly diminishing, my hearing was a little bit better. But my tinnitus didn’t change. So like as my other Meniere’s symptoms got worse, my tinnitus remained the same. And it wasn’t until that happened, that it started to grab the full force of my attention and start to cause problems because prior to that, the vertigo attacks, and these other symptoms were so debilitating that I mean, it just wasn’t the most pressing concern.

It wasn’t until that was gone, where the tinnitus became very problematic. So in some ways, it is a different sort of tinnitus. I guess you can say but even to this day, my baseline tinnitus has changed permanently. For me, it’s a single tone about 3500 hertz, like constant loud tone. Now I’ve completely habituated like, I don’t hear it 99% of the time, I’m just not noticing it. If I do notice it, nothing happens, my attention can bounce off of it. But there are rare times where my Meniere’s symptoms flare up. And I’ll get weird spikes that required me to do some different techniques to to calm myself down. But as far as when I’m working with people one on one, what I generally tell people is that, there are certainly some types of tinnitus that seem much more challenging to work with, where habituation seems to take a lot longer, which would be like intermittent tinnitus. Also, like fluctuating tinnitus, if you’re hearing a different sound every day, or multiple sounds every day that change like you’re trying to hit a moving target in some sense.

Glenn Schweitzer

So that can take time. But when I’m working with people, what I generally say is, there are a lot of roads that lead to tinnitus, right, tinnitus is a symptom, it’s not necessarily a condition in itself, it’s a symptom of many different conditions. There are a lot of roads that lead to tinnitus. And some of these roads have underlying treatments that can actually address the underlying problem like hearing loss or a viral infection or you know, sometimes treating the viral infection, it’s not a guaranteed result that the tinnitus will will go away. But oftentimes, there is a way you can treat the underlying condition. But what I tell people is that even if you never figure it out, there’s still a way forward because you don’t even need to know how you got to that point where you’re having the tinnitus and it’s affecting your life negatively, to proactively work to habituate and to start change to pull the levers that are within your control to make the nervous system changes and the cognitive changes so that your nervous system and your brain can start to tune it out more and more over time.

So the strategies I teach are oftentimes very similar because I’m coming at this from an approach of a lot of different tools and techniques to calm the nervous system to help alleviate anxiety. Meditation techniques, different audio tools, different masking approaches. I’ve sort of, I would, you know, in my own experience, the meditation techniques that kind of helped me to habituate, I, I realized they would be difficult if I just put them out in the world for people to try, especially if you’ve never meditated before, and you’re dealing with very severe tinnitus. So I kind of want early on I made the decision, just anything that seems to help somebody cope and seems to help somebody calm the nervous system, find some relief in any way is on the table, like I’ve tried to really come at this from as wide of a spectrum of possible strategies and techniques, and I’m completely open to anything that might be helping a person.

Everybody’s coming at this with different personality traits, different levels of anxiety, and mental health issues and their background. So everybody and every case is unique. But I have found there’s a lot of commonalities as well and just getting the nervous system to calm down, first things first, seems to be an effective starting point, at the very least. So I always recommend, you know, seeking an audiologist or specialist to treat hearing loss or potentially underlying causes of your tinnitus if there are any, to be diagnosed and treated, but to also start working to habituate at the same time, because that’s something that I personally believe everybody has the power to start doing.

Ben Thompson, AuD

That’s good. Those two simultaneous paths are very important immediately. Work on the holistic coping management, getting our system in check, sleep, health, nutrition, etc. Simultaneously, yes, pursue the medical path. Do not wait to start feeling better until you find a cure or a solution from a medical doctor because that may not come. And then in the moments, those can be times that you’re actually feeling better. You mentioned the nervous system, which is great. For example, tinnitus retraining therapy, one of the most followed protocols internationally, has a big emphasis on the fight or flight response and how it can start in the mind by hearing a sound and then transfer to the body. However, most clinics and most hospitals, don’t really teach someone how to calm the body in the nervous system through meditation through yoga, exercise, sleep, etc. For you, Glenn, how did you first learn about this relationship between tinnitus and the nervous system of your physical body?

Glenn Schweitzer

I stumbled into this blindly and by accident. It wasn’t until much later when I went back and actually started to write the book, and work on my blog, and put this project together that I kind of deconstructed and analyzed what actually happened to me. In hindsight, in the moment, it was completely accidental. I’ll just kind of walk you through it very quickly. So I had meditated for years leading up to this point when I was diagnosed with Meniere’s disease, and my tinnitus became very loud and intrusive. And that was such an important coping tool for me, I also had have struggled with anxiety and panic disorders, like earlier in life. So this was anxiety and panic, these are all like ongoing things. So I mean, I was predisposed, I guess, to have a very severely negative reaction to this. And meditation was one of the few things that actually had made a meaningful difference in my overall anxiety and stress levels.

It had a transformational effect on my quality of life. And when my tinnitus was becoming more and more intrusive, and causing more and more disruption and problems in my life, it was almost impossible to meditate like I would, I would sit down, I would try to I would sit down to focus on my breath. And I just couldn’t concentrate like as hard as I tried to ignore the ringing in my ears and just focus on the breath or mantra. I was doing like this sort of object oriented, concentration type meditation rather than the mindfulness but still, I just couldn’t focus, I couldn’t relax. And it was like, it was creating its own sort of vicious cycle. And I was laying in bed one night, trying to meditate and it’s suddenly this idea just sort of hit me and it’s like, not necessarily an original idea. I know like in Buddhism, there’s all sorts of other meditations schools, like you hear about this sort of thing. But I had this this idea was sort of like, I’m fighting so hard to ignore the sound of my tinnitus and meditate and I’m failing. I’m losing this battle every time and it just makes me want to rip my hair out.

What would happen if I just made the tinnitus sound the object of my meditation itself, focused on that instead. And it was this like crazy idea that seemed terrifying at first, but I was willing to do anything at this point. And so I tried it and a few things happened immediately, the first thing that happened was my mind started wandering. And which is a totally normal thing during meditation. It’s not about having like a perfect laser focus mind. Everybody thinks thoughts and, you know, their minds wander. It’s about getting better at noticing that you become distracted, and you begin again. But when my mind wandered, and then I noticed it and brought it back, it immediately occurred to me like, hmm, that was very interesting, my mind wandered away from the sound. And I was just daydreaming for a minute, and I wasn’t thinking about it at all. And so that was the first moment. And so I kept going, and I finished the meditation. For the first time, in like, months, I was feeling relaxed a little bit. Again, like I did this, I had not been able to relax in meditation in a long time. And, you know, in hindsight, it felt a little quieter. It wasn’t quieter, I’m confident of that. I wasn’t in such a state of anxiety anymore.

I was so much calmer that it wasn’t bothering me as much. I didn’t know what happened. I didn’t know the word habituation. I didn’t know any of this stuff. I just knew that something interesting had happened. And I shifted, and I was able to meditate again, and I shifted my meditation practice to this tinnitus focused meditation technique. And I was able to habituate relatively quickly, and I was. And I think it’s because I was getting back into the states of deep relaxation, and calm that had that escaped me for so long. And I know it’s I’m not the only person talking about meditation in this way. There’s other mindfulness programs for tinnitus that incorporates some tinnitus awareness. So it’s a little different than what I’m teaching, which is specifically making the tinnitus the object of your focus during meditation. But the way I’ve sort of come to understand it, or the way that I explain it generally, that helps people to understand how or why this crazy idea can be helpful. And how you know is that it boils down to this, because meditation is so calming and relaxing when you practice it and get better at it. And because anything can be used as the object of your meditation, there’s nothing magical or special about the breath or a mantra or part of the body when you’re doing this type of meditation. By choosing to focus instead on the sound of the tinnitus and then successfully achieving these very positive emotional states of calm and relaxation.

As a result, that gives your brain almost like a new experience to associate with the sound of the tinnitus. And it’s an experience that you don’t really have any other way. A person who’s really struggling with their tinnitus, like actively suffering. There’s generally one of two experiences, which is they’re thinking about it and it’s bothering them and it’s in their awareness and their the perception is intense, or they’re not thinking about it, and they’re distracted. Right? And there’s no third option where you’re engaging with the sound in some way and experiencing anything, you know, closely resembling, like a positive emotional state, right? And it’s never just like all habituation , you know, it’s not an every day is better than the day before process. It’s up and down. And then that can be very confusing. But this is the strategy that enabled me to habituate.

This is sort of at the center of the strategy I teach, although it incorporates everything else. I’ve had a lot of my clients doing TRT as well, doing other habituation strategies. One nice thing about meditation is it’s not really mutually exclusive from anything else that’s helping you. And so yeah, I’ve had a lot of success with that approach. I know, it’s a very difficult sounding thing, though, to anyone who’s listening right now I know the idea of focusing on the sound of your tinnitus and then expecting to achieve like any sort of state of relaxation, and doing so is a sort of a tall order. But there’s a lot of ways you can make it easier. And just to give like a tip, if there’s any meditators out there who want to try this, like, you can just put on some background noise, you can lower the perceived volume that makes it a little less intense, right? That’s just to give one example, or you can do other things to try to relax first, and then you meditate once you’re already calm. So there’s all sorts of different tools and techniques. I also incorporate a lot of other audio tools that can help promote relaxation, as well.

Ben Thompson, AuD

Glen, we’re big into meditation here with Pure Tinnitus. Personally, meditation has been a part of my life for the last five years. And I created a seven day meditation series for tinnitus individuals. I’m with you 100% on that. Even if you have or have not tried meditation, I would say that if we can just adjust the angle that we relate to our tinnitus slightly, psychologically, that can have a calming effect in the mind and In the body, which can help the nervous system and that reduce the fight-or-flight feeling that is so often tied with tinnitus, stress and anxiety. So maybe it’s not meditation if you’re watching or listening, but maybe it’s something else.

So over the years of you being involved in this community, what do you see as the the most common hurdles, the most common barriers that stopp people from getting better? Let’s assume we’re working with someone who has a baseline tinnitus. But then they went through a period of high stress, high anxiety in their life, and then their tinnitus got a lot louder. What do you see as the most common the barriers that are stopping someone from getting better?

Glenn Schweitzer

It’s a great question. And, you know, it’s a very relevant question to the pandemic, right, like, you couldn’t have asked for a more perfect storm of suffering circumstances to promote and amplify suffering in a person with tinnitus, right? To talk about a high stress period of time, right.

Everything I do is just to try to get better at explaining it, explaining tinnitus using the options available in a way that completely fosters a sense of hope and empowerment in a person because when you’re stuck in the middle of it, it feels like you’re powerless, because nothing you can do just magically turns the sound down. But you’re not powerless, you just don’t have a good understanding of where your power lies and how to express that power and what to work on. To try to get better. It’s not a quick fix. But then again, a lot of things in life are not quick fixes.

Habituation, I tell people, it’s a lot more like dealing with physically rehabbing an injury in physical therapy than it is solving, like a health typical health problem, right? It’s not every day is a little better than the day before. Sometimes you overdo it, and then you know. I’m in physical therapy right now for a shoulder injury, like sometimes I overdo it, and my pain comes back, but that doesn’t mean that like my injury got worse, I just overdid it. And then I back off a little bit. And I get back on track. And it’s sort of trying to separate yourself allowing for day to day fluctuations, you know, focusing on coping tools, but hope is behind all of it. And so I’ve made a real effort to construct all of my work, all of my messaging around that, like core fundamental idea, because that is to me, the biggest obstacle in not having any hope, is the thing that prevents a lot of people from getting to a mindset where they will start taking where they can learn and start taking the actions that might help them.

Ben Thompson, AuD

Yeah, and with that hope, with that message of hope comes responsibility, right? For anyone who’s working in the tinnitus world, as a professional, if we’re giving hope, we have to really follow through on that to the best of our abilities, with the use of the best research possible. And I liked what you said about painting a picture that things might be okay. That change in mindset leads to increased motivation, which is really necessary to make the lifestyle changes that are required to habituate. Would you agree?

Glenn Schweitzer

Yes, I would agree completely. Um, you know, I what I found, when I’m meeting someone for the first time, if I can make that connection, where it resonates, like, to their emotional core, like that’s, of course, like, I can tell that, like, they’re going to do the work, right. But I, I found that that’s not even necessarily it. It doesn’t need to be there, because people can can still be skeptical, right? As long as they can understand it intellectually, like if you can get through to somebody intellectually, and explain the nature of the problem in a way that at least intellectually makes sense, like, okay, it’s not what I thought it was, there are various paths ahead of me, there are things I can do.

This is what relief might look like, this is, you know, it’s gonna take time, it’s not every day is better than the day before. There’s all sorts of other tools we can work with to support your efforts in the meantime, to help you, you know, like more masking, more relaxation techniques, but at the center of it, like, intellectually understanding that there’s hope. I don’t even think it needs to, you don’t need to hit somebody, it doesn’t need to resonate to like the the core of a person’s being.

Ben Thompson, AuD

I have found that just making that connection, where being able to explain it, where somebody can wrap their head around it intellectually is enough of a motivation to start trying some new things. “Does that make sense?” “That totally makes sense.” I think of a musician or an engineer, someone who’s very system-oriented. When they reach out to me and I’m working with them. I’m approaching it more from a systems model of here’s what’s wrong. Here’s how to get inputs into the system to improve and feel better. And here’s what you can’t control because we can’t turn the dial of the tinnitus directly. There’s no input that will directly do that. So it’s an indirect pathway. And that’s a lot of the things you and I teach to people is really how to bio-hack tinnitus in a way, and engineering minds, system-oriented people intellectually can follow that.

Glenn Schweitzer

100% agree. Yeah. And, you know, it’s interesting, like something you just said about, like, indirect control. So like, one thing I always tell people is like, that, I think it’s helpful to understand within habituation, remember, it’s not just something that tinnitus sufferers are concerned with, right? It’s simply the name of the mental process by which the brain is able to ignore all kinds of sensory perceptions, right. But the thing that most people don’t always get is that it’s, it’s not a conscious thing you’re doing. It’s an unconscious thing that happens automatically as a consequence of just being able to focus your attention. So like, when you’re in a restaurant eating with friends, pre-COVID times, you’re not making an effort to ignore the sound of other people talking around you, your brain just does that automatically. Or if you’re watching TV, and the air conditioner turns on, you know, you’ll notice the sound is there, and then your attention will kind of bounce off of it. And you can just go back to watching TV.

So, it’s an unconscious process. So with tinnitus, habituation is not something you’re consciously doing in the moment. It feels what it feels like, what I always tell people is like, everyone’s had the experience of being distracted from the sound for like a brief moment, or maybe a little longer, depending. But that’s what it feels like to habituate. It just feels like that all the time. It doesn’t require you to be very incredibly engaged to get there. But for me, like so I mentioned earlier, I have this constant baseline tone, and I just generally don’t focus on it. And I can hear that it’s loud. But I didn’t hear it at all, out of my awareness as we were just talking a minute ago. But in the times where Meniere’s flares up a bit, and I do have a weird spike, I’ll get new sounds, louder baseline like all sorts of weird things can happen. Like when it rises to the level where it crosses that threshold where it does start to activate my nervous system again, and I feel my self reacting in a negative way. And I feel like an anxiety response building, even in that moment, despite the fact that I have habituated so thoroughly that I can do this work and talk about it every day and not trigger myself.

But in that moment, I can’t just like flex my brain in a certain way and push it away. It’s indirect, but that indirectly, as you were saying, I can use a variety of techniques to like, kind of cognitively frame what’s happening to calm myself very quickly. And in doing so I can kind of get back to the place where my brain will just automatically lose it again after a little bit of time has passed. But it’s still like an indirect level of control. And I think that’s an important thing. You mentioned that it’s not something that’s talked about a lot is like if you tell somebody to ignore something, like if you say don’t think about elephants, what’s he thinking about? And that effect is amplified exponentially when the thing is actively bothering you. Right? Like if you, if you tell yourself to ignore something that’s bothering you, you’re only giving it more attention. And so that’s not trying to fight yourself to ignore the sound isn’t always even a good strategy in the moment. So I think that indirect control is an important thing to stress on.

Ben Thompson, AuD

Yeah, so important. And that’s where most of the power lies in this. So this is Episode 12 of the Pure Tinnitus and Hearing Podcast, we have Glenn Schweitzer, who has given us a lot of knowledge, a lot of wisdom from his life experience personally. Glenn, tell us where someone can find you.

Glenn Schweitzer

Yeah, so you can find all of my work at my website, RewiringTinnitus.com. I write a lot of blogs and I make a lot of videos like Dr. Ben does. Feel free to reach out to me directly if anyone wants to connect. I’m always happy to meet new people answer questions and connect with people.

Ben Thompson, AuD

Amazing. Thanks, Glenn. Thank you for being here. It’s been a pleasure and we hope to talk to you real soon. Hope to have you on the podcast again sometime in the future.

Glenn Schweitzer

Thank you so much, Ben.

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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