tin·ni·tus | ˈti-nə-təs , tə-ˈnī-təs
: a sensation of noise (such as a ringing or roaring) that is typically caused by a bodily condition (such as a disturbance of the auditory nerve or wax in the ear) and usually is of the subjective form which can only be heard by the one affected
The American Tinnitus Association estimates more than fifty million Americans experience tinnitus. Of those, twelve million have tinnitus severe enough to seek medical attention. Out of those twelve million, two million report it its ruining their lives. Don’t give up hope, however. It is in the more severe cases that hypnotherapy may offer the most hope.
Tinnitus, which can be emotionally devastating, may arise from a variety of issues ranging from normal hearing loss due to aging or a onetime exposure to a high intensity sound, to various medical issues. Regardless of the underlying cause, the relentless torture of the internal noise and dialogue can be likened to an ancient Chinese water torture. What can make it worse, is the lack of understanding by friends and family members.
As we begin to discuss, explain, and unwind this enigma, it’s important first that we understand that tinnitus is actually a symptom and not a disease. This distinction of semantics, however, makes the condition nonetheless scary. Those afflicted with tinnitus often live in fear that it will lead to deafness--though unlikely, that the noise will get so loud they will be able to hear nothing else, that it could be caused by a tumor—which is technically possible, but rare, or are continually told there is nothing physically wrong and they need to go home and learn to live with it. Unfortunately, this only increases the anxiety and fear which are closely intertwined and paired with tinnitus suffering.
Before we go too far down this path of doom, however, fear not. Clinical practice backed up by empirical and scholarly research has shown clinical hypnosis and hypnotherapy to offer help for those dealing with tinnitus. It should, however, be clearly stated at this point that while tinnitus can be related to a variety of benign issues it can also, in some cases, be triggered by physiological issues such as infections, vascular hypertension, calcium in the inner ear, or possibly even heavy metal poisoning, tumors or other medical issues. Therefore, it is imperative that if you or someone you know is plagued by tinnitus they consult a physician before seeking to turn it off with hypnosis.
Just keep in mind that tinnitus can in many ways be likened to pain, both in the way we manage it and in the way it should be viewed. Pain is often a warning signal or alarm that something is wrong. Now that doesn’t mean all pain is meaningful pain. Oftentimes, the gate gets left open so to speak. The injury has long since healed, yet the brain left the pain switch set in the on position. Again, tinnitus can be a result of the same type issue. In fact, Dr. James Sheehy of the House Ear Institute, one of the foremost authorities on tinnitus, reports that 99% of the time, there is no medical fix to be offered which is why the physician is placed in the frustrating position of telling the patient to go home, and learn to live with it. Even more frustrating for the patient is that they’re not told how they can accomplish that directive.
So back to the good news. Well, for a start, Dr. Sheehy said 99% of the time, there is no medical help available. That means that it’s only about 1% of the time that we’re dealing with causes such as heavy metal poisoning, acoustic neuromas, otosclerosis, infections, thyroid issues, vascular hypertension, etc. In that rare, 1% hypnotherapy may be a useful adjunctive treatment, but in that other ninety-nine percent, it is uniquely equipped to handle virtually every aspect of tinnitus habituation.
Consider this. Would it surprise you to know that everyone experiences tinnitus? In fact, most anyone can stop, quiet their mind and focus in on the sounds that plague a tinnitus sufferer. In fact, in a well-known study out of the University of Quebec, students were placed in a sound controlled environment known as an echo chamber and were told that a variety of sounds would be introduced at which time they were to log their interpretations of the sounds they encountered. However, no sounds were introduced, yet the students logged high pitched ringing, clicking, and various other sounds. The same types of sounds reported by tinnitus sufferers. How? Well, at this point, it’s important to realize that we don’t technically hear sounds with our ears, see with our eyes, or smell with our nose. While they are the sensory perception devices, they are doing little more than collecting data that is then interpreted in the brain, and it is the brain that takes that data and converts it to a perceived image, smell, or sound.
Before tinnitus was understood, there was in fact a barbaric treatment in which surgeons severed the auditory nerve, deafening the patient in an attempt to shut off the sound. Unfortunately, since the sound is being generated in the brain, not only did this treatment not work to terminate the tinnitus, it deafened the patient, so now there was no competing noise from the outside world to override the tinnitus noise. Therefore, the tinnitus was even worse, and the patient was deaf. On a side note, however, if you know someone who suffers from tinnitus, and have ever wondered why they make what you may perceive as such a big deal about it, the fact that a patient was willing to endure a procedure such as this is a testament to what a horrid condition this really is. To quote Dr. Billy Martin from the Oregon Health and Science University. "The load that tinnitus places on people is beyond what any human was designed to endure."
Now, let’s return to our students from the echo chamber. As they focused in during the quiet of their mind, they were able to hear the tinnitus sounds, yet they don’t go through life dealing with it. In fact, after the study, most likely never thought much about the sounds again. This is because of that term mentioned earlier. Habituation. Their brain had no warning or danger attached to the sound. It was “habituated.”
To further add credence to this research, we need to look no further than to the work of Dr. Pawel Jasterboff, the premier scientist in the study of tinnitus who postulates that, “The non-auditory systems, particularly the limbic system, and the autonomic nervous system, which controls all bodily functions and triggers the 'fight or flight' reaction, are an essential part of each case of troublesome tinnitus. The auditory pathways play a secondary role.” This again, gives us parallels between tinnitus and chronic pain. Consider phantom limb pain. An amputee feels pain in a limb that is no longer there. Clearly the limb is gone, yet the brain still feels the pain as if it were still attached. Now recall that when the auditory nerve was severed, the noise continued, even though there was no hearing mechanism left to sense the noise.
What this has taught us is that if we can reduce the emotional disturbance and activation of fight flight associated to the tinnitus, we can then encourage the natural process of habituation to occur. These are the areas where clinical hypnosis and hypnotherapy excel and can be a Godsend to the tinnitus sufferer.
If you or someone you know is suffering from tinnitus, contact us online, or call the office at 469-225-9040. Dr. Carpenter is certified by the American Hypnosis Association in the specialty of tinnitus.
|Dr. Carpenter is designated as a Certified Specialist in Hypnosis and Tinnitus from the American Hypnosis Association.
The following articles are recommended by the American Hypnosis Association for further education on Tinnitus management via hypnosis:
“Comparison between Self-Hypnosis, Masking and Attentiveness for Alleviation of Chronic Tinnitus”
Notes: “The efficacy of self-hypnosis (SH), masking (MA) and attentiveness to the patient's complaints (AT) in the alleviation of tinnitus was evaluated. Forty-five male patients close in age with chronic tinnitus related to acoustic trauma were assigned to three matched subgroups: SH, AT or MA. The therapeutic stimuli in the SH and MA sessions, recorded on audio cassettes, were given to the patients for use when needed.” (Attias et al., 1993)
“Ericksonian hypnosis in tinnitus therapy”
Notes: "The goal was to evaluate the effect of Ericksonian therapy on tinnitus in a non-randomised, prospective longitudinal study. A total of 49 patients underwent hypnosis therapy. Fourteen patients failed to finish the therapy (drop-out rate: 35%). Of the 35" patients who completed the therapy, 20 were male and 15 female. The average age was 46.3 years (range 17-78). The hypnotic treatment was based on the principles and approaches of Ericksonian hypnosis. The first session was mainly dedicated to the evaluation of the impact of tinnitus on the patient's life and to an explanation of hypnosis therapy. The next sessions were "learning sessions" based on relaxation and mental imaging. Exercises were first based on all senses other than hearing. Then they focused on hearing, teaching patients how to modulate sound intensity, and finally how to modulate tinnitus intensity. Patients also learned self-hypnosis." (Maudoux, Bonnet, Lhonneux-Ledous, & Lefebvre, 2007)
“The Effectiveness of Hypnotherapy In The Treatment Of Subjective Tinnitus”
Notes: This study aimed to investigate the effectiveness of hypnotherapy in the treatment of subjective tinnitus. Twenty people suffering from tinnitus were divided equally into two groups. They completed tinnitus clinical questionnaires before and after the test --and the severity of their tinnitus was recorded by a number from one to ten. One experimental group had 10 sessions of hypnotherapy. The control group did not receive hypnosis or any other psychological treatment. (Moghtaderi, and Bahrami, 2012)
“Effectiveness of Ericksonian hypnosis in tinnitus therapy: preliminary results”
Notes: The present study was performed to evaluate the efficacy of Ericksonian hypnosis in reducing the impact of tinnitus on patients' quality of life. A controlled prospective longitudinal study was designed. The severity of tinnitus was assessed with Tinnitus Handicap Inventory (THI) before hypnotherapy and then 1 week, 1 month, 3 months, and 6 months after therapy. Health Survey SF-36 was used to assess health-related quality of life before and after hypnotherapy. Thirty-nine patients with severe idiopathic subjective tinnitus were enrolled in the study. (Yazici, et al., 2012 )
“An Alternative Method of Treating Tinnitus: Relaxation-Hypnotherapy Primarily Through the Home Use of a Recorded Audio Cassette”
Notes: 32 patients, variously diagnosed as suffering from tinnitus, were treated with hypnosis. Treatment consisted of a 1-hour consultation with the physician followed by 4 weeks of daily home practice while listening to an audio-tape recording of approximately
15 minutes duration. (Gunilla, 1983)
“Client-centered hypnotherapy for tinnitus: who is likely to benefit?”
Notes: This study analyzed 41 patients, 15 females and 26 males with a mean age of 54, who underwent three sessions of client-centered hypnotherapy for their tinnitus. (Mason, and Rogerson, 1995)
"Role of hypnotherapy in the treatment of debilitating tinnitus”
Notes: Hypnotherapy is currently used for tinnitus therapy in the researchers’ university hospital. The aim of this study was to evaluate its efficacy. This study was performed on 110 patients suffering from distressing tinnitus. They were treated during five sessions with hypnotherapy, supplemented by instruction on self-hypnotherapy. A subjective evaluation was done by the practitioner at the end of the sessions of hypnotherapy. Then a questionnaire on psychological distress (Wilson 1991) was sent retrospectively to the patients. (Gajan, et. al, 2011)
"A controlled trial of hypnotherapy in tinnitus”
Notes: A group of 14 patients with unilateral tinnitus were selected because of the constant nature of their tinnitus, and its resistance to all other forms of therapy. They were subjected to hypnosis in three forms in random order. The induction of a trance state
alone formed the control arm of the trial. Compared to this were the effects of 'ego boosting' and active suppression of tinnitus whilst in a trance state. (Marks, Karl, and Onisiphorou, 1985)
American Hypnosis Association. (2016). Hypnosis & Tinnitus. Tarzana,CA: Panorama Publishing.
Attias J, Shemesh Z, Sohmer H, Gold S, Shoham C, Faraggi D. Comparison between self-hypnosis, masking and attentiveness for alleviation of chronic tinnitus. Audiology. 1993;32(3):205-212. doi:10.3109/00206099309072936
Gajan F, Pannetier B, Cordier A, Amstutz-Montadert I, Dehesdin D, Marie JP. Intérêt de l'hypnose dans le traitement des acouphènes invalidants [Role of hypnotherapy in the treatment of debilitating tinnitus]. Rev Laryngol Otol Rhinol (Bord). 2011;132(3):147-51. French. PMID: 22533067.
Gunilla Brattberg (1983) An Alternative Method of Treating Tinnitus: Relaxation-Hypnotherapy Primarily Through the Home Use of a Recorded Audio Cassette, International Journal of Clinical and Experimental Hypnosis, 31:2, 90-97, DOI: 10.1080/00207148308406596
Marks, N. J., Karl, H., & Onisiphorou, C. (1985). A controlled trial of hypnotherapy in tinnitus. Clinical otolaryngology and allied sciences, 10(1), 43–46. https://doi.org/10.1111/j.1365-2273.1985.tb01163.x
Mason, J., & Rogerson, D. (1995). Client-centered hypnotherapy for tinnitus: who is likely to benefit?. The American journal of clinical hypnosis, 37(4), 294–299. https://doi.org/10.1080/00029157.1995.10403158
Maudoux, A., Bonnet, S., Lhonneux-Ledoux, F., & Lefebvre, P. (2007). Ericksonian hypnosis in tinnitus therapy. B-ENT, 3 Suppl 7, 75–77.
Moghtaderi, Shirin and Bahrami, Hadi, Dept. of Psychology, Isamlic Azad University, Science and Research Branch, Tehran, Iran, Seyed-Mahmoud Mirzamani, Dept. of Counseling, Educaiton and Counseling Faculty, Islanic Azad University, Islamshshahr Branch, Iran Audiol. 2012: 21(4): 60-67
Yazici, Z. M., Gökkus, I., Alatas, E., Kaya, H., Kayhan, Bakirköy Education and Training Hospital, Clinic of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey, B-ENT. 2012;8(1):7-12