Treating Tinnitus using the Model of Treating Trauma
Working with people distressed by tinnitus for 30 years now - with what for many of them was devastating tinnitus - NOT ONE ONLY had “tinnitus”. On the contrary, there is layer upon layer of additional issues (as in the Autonomic Ladder explanation) surrounding “the noises in their ears/head” that has given rise to something much more complex. They rarely glimpse the BLUE ZONE, spending most of their time in the RED and GREY zones
Compare that complexity with those that hear a tinnitus noise but it doesn’t trouble them, get on with their lives, rarely NOTICE it and even when their attention to it gets caught in their mind, nothing is holding it there so they simply forget it again. The research shows that this is true for 85% of the 1 in 8 people that have tinnitus.
The remaining 15% are those with the complex layers, living in the RED and GREY zones.
Tinnitus Trauma
Treating tinnitus encompassing the model of treating trauma makes sense.
Look at these statements about trauma from NICABM (National Institute for Cognitive and Behavioural Medicine):
- "By its very nature, trauma can disrupt our clients’ internal systems. And when THAT happens, it can become very easy for some clients to fall into near-constant cycles of reactivity, hypervigilance, or fear."
- "That’s why it can be critical for practitioners to know how to employ the kind of interventions that can help clients short-circuit old patterns of reactivity, ground in the present, learn to tolerate their feelings and bodily sensations, and learn how to self-regulate."
- "Treating trauma is about helping people find a way to tolerate what they’re feeling, what they’re experiencing in their body, about people finding a way of getting along with their own internal systems."
- "So while it’s certainly true that trauma can be devastating, it shouldn’t be the way you define the rest of your life." (NICABM)
Now substitute “tinnitus” in place of “trauma”:
- By its very nature, tinnitus can disrupt our clients’ internal systems. And when THAT happens, it can become very easy for some clients to fall into near-constant cycles of reactivity, hypervigilance, or fear.
- That’s why it can be critical for practitioners to know how to employ the kind of interventions that can help clients short-circuit old patterns of reactivity, ground in the present, learn to tolerate their feelings and bodily sensations, and learn how to self-regulate.
- Treating tinnitus is about helping people find a way to tolerate what they’re feeling, what they’re experiencing in their body, about people finding a way of getting along with their own internal systems.
- So while it’s certainly true that tinnitus can be devastating, it shouldn’t be the way you define the rest of your life.
The corrolation is clear, as are the outcomes of the work I do with people that come to me: initially, they are SO distressed, and SO overwhelmed by what's happened and IS happening to them, they are filled with dread about their future. When we think of "a noise as a noise", without attaching meaning and feelings to it, we don't notice it; there is no reason we should listen to it let alone monitor it. This is what happens for those that "habituate" to tinnitus.
It's when we attach negative, threatening, fearful or worrying meaning to the noise, it becomes a whole different scenario. Many of the 15% have in fact become traumatised by the tinnitus, and trauma has PHYSICAL effects on our physiology; it is not all "psychological". As the Autonomic Ladder teaches us, the effect of trauma is one of dysregulation of the nervous systems in the body.
Most of us are in and out of dysregulation often, just in our everyday lives (see Autonomic Ladder), but when we get stuck, it feels like there's no way out - just like "John" in scenario 3 of the Autonomic Ladder.
Here's something that may help you to check on the sort of "thoughts" you have about tinnitus: Tinnitus Cognitions Questionnaire