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Re: [AUDITORY] Responses to "listening to your tinnitus"

Hi Brian and Fatima,

I concur with the Fatima's opinion that "listening to your tinnitus" constitutes a kind of mindfulness.
There are many papers related to "tinnitus and mindfulness" (google scholar found 3,040 papers).

Quoting from https://doi.org/10.3389/fpsyg.2020.00483
"Changes [due to learning mindfulness based stress reduction training] involved recognizing how their existing coping strategies (of resistance and attempts to control tinnitus) paradoxically exacerbated their difficulties, whilst experimentation with allowing, accepting and turning toward tinnitus reduced their suffering."

Quoting from https://doi.org/10.1177/1073191107313003
"Previous research on assessment of mindfulness by self-report suggests that it [mindfulness] may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience."

Observing tinnitus with curiosity (as Brian did) can be described as non-judgmental observing and describing, which often suppress emotional reactivity and distress, leading to clinical effeictiveness.
"Judgment" in this context means emotional or value-related assessment, but does not include rational analysis of the sound.

Thus "listening to your tinnitus" and analyzing it can be described as in the mindful state.

From my clinical experience, however, few people can observe their tinnitus non-judgmentally and get relief, as listening to tinnitus often immediately evoke distress via the mechanism of classical conditioning unless its impact is reduced by partial masking.
Exposure therapy can extinguish classical conditioning, or the association between distress and tinnitus in this case, but full exposure without masking noise can be delivered only in the final stage.
Thus the effect of "listening to your tinnitus" cannot be fully attributable to the exposure therapy.
Though I do recommend mindfulness exercise to my tinnitus patients (I am an otolaryngologist), the rationale is to teach them to learn that diversion of attention from tinnitus reduces or even eliminates distress.
https://www.jstage.jst.go.jp/article/audiology/63/2/63_115/_article/-char/en (main text is in Japanese.)

Hope this gives some insight.
Koichi


Fatima Husain wrote on 2021/08/20 9:57:

Hi Brian
I will attempt to answer. What you are describing seems like the "sounds and thoughts" meditation, which is one of the mindfulness-based cognitive training (MBCT) exercises, where the individual meditates on their body's sounds & external sounds, including their tinnitus (if they have it). We conducted an MBCT intervention for adults with bothersome tinnitus and found that a great majority were helped by an 8-week MBCT course. When we were designing the experiment, we were worried if this particular exercise would exacerbate someone's tinnitus and we gave directions to the instructors accordingly. But, we found that no one complained about listening to or being intensely aware of their tinnitus in this context. There have been several published reports of MBCT being useful and if they all did the standard MBCT, then it would include this type of meditation. Other psychology-based treatments may also include such meditation exercises. No published report, to my knowledge, has weighed in on the relative merits of different aspects of MBCT or similar plans. 

Hope this helps,
Fatima

On Wed, Aug 18, 2021 at 11:57 PM Brian Gygi <bgygi@xxxxxxxxx <mailto:bgygi@xxxxxxxxx>> wrote:

    __
    Hello, I received several responses to my post on "listening to your tinnitus" in which I described a method I had found that seemed to alleviate my tinnitus.  Unfortunately, all of the posts described methods in which an acoustic signal is present to the ear with frequencies that match (or mask) the tinnitus, which is different from what I was talking about.

    The method I was describing involved actually focusing on the tinnitus, not an auditory stimulus.  I can hear out some of the individual tones in my tinnitus, and I find when I do this the tinnitus seems to lessen in severity.

    So, does anyone know of any work that that been done in this area?

    Thanks,
    Brian Gygi





--
MORI, Koichi, M.D., Ph.D.
National Rehabilitation Center for Persons with Disabilities (NRCD)
4-1 Namiki, Tokorozawa, Saitama 359-8555, Japan
mori-koichi@xxxxxxxxxxx / mori-koichi@xxxxxxxxxx
Tel:(+81)4-2995-3100, FAX:(+81)4-2995-3102