Write-up from February 21st support group meeting

If you are reading a book and you are wearing glasses, you have large rims around your area of vision. Are you distracted by those glasses frames? So severely that you can’t read? No – because your brain has habituated to them. You focus on the words on the page, and the rims fade into the background. This is one of the ways psycho-therapist Virginia Lindahl illustrates to her tinnitus patients the goal of habituating to the sound they hear in their heads. 

Dr. Lindahl addressed our support group on February 21st. Years ago, she explained, she developed hearing loss and tinnitus herself. Her doctors told her they could treat her hearing loss. But the ringing? No. “I wasn’t happy with that answer,” she related. “The doctors said – you’re a psycho-therapist, so use the tools you know.” Dr. Lindahl settled on CBT (Cognitive Behavior Therapy) and treated herself. This is still her main tool for her tinnitus patients. “To habituate, we have to get out of our own way,” she told us. “The ringing is a false alarm, and the more we pay attention to it, the more our brain thinks it’s important. We need to convince the brain that the opposite is true.” Negative emotional responses only raise anxiety and worsen our symptoms.

Make no mistake – CBT is an incremental healing process, and re-training ourselves from the inside out is no mean feat. “We are hard-wired to react to sudden noises,” Dr. Lindahl said. “For our ancestors living in trees, it could have meant life or death.” Some of her tinnitus patients arrive severely distressed, and may require referrals to specialists to get on medications (for pain or anxiety). She might work with patients for months to relieve their panic attacks, insomnia, related depression, and other issues. On the other hand, some tinnitus patients are less distressed and may only need a couple of sessions to internalize that: A) they are not going crazy, and B) they can improve their symptoms with CBT methods in her office or at home.

She finds hyperacusis to be the other side of the tinnitus coin. Whether distressing sounds are coming from without or from within, for those in a state of hyper-vigilance, the way out is de-sensitization, which CBT promotes. She helps her patients challenge their catastrophic thinking, so they can turn around avoidance-type behaviors. If a patient thinks she will be fired from her job if she doesn’t sleep tonight – is that really true? If a patient is terrified that engaging in some former activity will make his tinnitus get worse, is that a fact? What small step can he take to try it again? With CBT, Dr. Lindahl helps her tinnitus patients to make steady progress toward habituation.