WHAT YOU SHOULD KNOW ABOUT TINNITUS BEFORE ACCEPTING TINNITUS CLIENTS
by Claire de la Varre, PhD, CH, CI
Overview:
Tinnitus is a common, complex, and troublesome issue. It can sometimes be caused by organic
changes in the brain such as damage to the ear, or even a tumor. However, for many people,
no specific cause can be identified although a majority of cases have some degree of hearing
loss. For a small percentage of people with tinnitus, it becomes such a problem that it
interferes with daily life, causes depression, and has driven some to suicide.
Many doctors will tell patients there is no cure for tinnitus, because they are not aware of the
current options or recent research. There is certainly NO quick fix. The aim of any tinnitus
treatment program is to turn an annoying, bothersome noise into a neutral, background noise
to which the client no longer pays attention. Treatment will often require the help of a variety
healthcare and medical practitioners and may take months or even more than a year.
Hypnosis can be a valuable part of a holistic approach to tinnitus. However, it is not simply a
case of turning down the volume or flipping an off switch. Particularly helpful are regression
and parts therapy.
This presentation will give you a solid grasp of the facts about tinnitus and its treatment, the
characteristics of people who tend to suffer from tinnitus, and what you need to tell any client
that inquires about hypnosis for treating tinnitus.
What is tinnitus:
Tinnitus (pronounced either “tin-uh-tus” or “tin-eye-tus,” both are correct) is experienced
as sounds in one or both ears or in the head – often a ringing noise, but sometimes
described as chirping, clicking, popping, humming, roaring, screeching, buzzing, or whining.
All of us have experienced it temporarily, lasting a few seconds or more. It is part of the
normal human experience.
Tinnitus is estimated to affect 10-15% of the population worldwide, with an estimated 4550 million Americans experiencing chronic tinnitus. Prevalence is higher in certain
population e.g. 30% of returning veterans.
Tinnitus is a complex condition that can last for years and causes significant distress in
about one quarter of the people who have it. People with tinnitus may describe it as
"driving them crazy" so it certainly has a considerable emotional component. It has even
driven some people to suicide. Because loud tinnitus can interfere with the ability to hear
normal conversations, sufferers may withdraw from social interaction and experience
increased loneliness or isolation. The loudness of tinnitus can be measured by an
audiologist.
Many people who experience tinnitus have associated hearing loss. With normal hearing,
external sounds mask the internal sounds of our body (which include background electrical
activity of our neurological system, blood circulation, heartbeat, popping or clicking of
joints in the head or neck, noises when yawning or blinking etc.) but with hearing loss we
are more likely to hear our own internal sounds. As the brain is adaptive it may try to
compensate for hearing loss by turning up sensitivity to sounds. Tinnitus is not a disease; it
is simply the ability to hear the compensatory sounds generated by the auditory system,
and therefore part of its normal function. Tinnitus only becomes a problem when it causes
distress. Turning up the sensitivity to sound increases the sensitivity to internal sounds as
well, and so turns up the volume of tinnitus. This hypersensitivity can also lead to
hyperacusis, an abnormal intolerance of (or attention to) everyday sounds in the
environment. 40% of people with tinnitus also have hyperacusis.
As there are multiple possible physical or physiological causes, and some medications can
cause or worsen tinnitus (e.g. aspirin), it is very important to take a multi-faceted approach
to treatment.
Many people have tinnitus, but (importantly) most of them learn to adapt to it and are not
bothered by it, regardless of how loud they perceive the sound to be. So it may be possible
to learn to ignore it (habituation) over time. Ask your client if they have noticed that the
tinnitus comes and goes, depending on whether they are concentrating intensely on
something or distracted by an absorbing activity.
Tinnitus sufferers often have a profile that includes greater incidence of depression and/or
anxiety than the general population – this is known as "Type D" personality (D for distress).
Such people are often sensitive, anxious, shy, and pessimistic. Kevin Hogan, refers to this
combination of characteristics as SPADES (stress, panic, anxiety, depression, emotional
difficulties). About 30% of returning veterans report having tinnitus. Not only have they
been in very loud environments but they are chronically stresses and often have PTSD.
Clients should have whatever tests are available to them from their primary care physician,
or ENT specialist, to determine, if possible, what is causing the tinnitus. Often there is no
identifiable cause, and while it is good to rule out possible malignancies or other
pathologies, it can add to the frustration sufferers feel.
Hypnosis can help teach more appropriate responses to stress, but while hypnosis is often
a quick fix for issues like phobias and smoking, that is NOT the case with tinnitus. It may
take months and perhaps even more than a year to gain some relief from tinnitus. It
requires commitment to making significant lifestyle changes, and lots of patience.
To summarize, a person suffering from tinnitus should take a multi-faceted approach to
treatment, first seeing a primary care physician and having a scan to rule out any
malignancy in the brain and review current medications for side effects that may include
tinnitus. A psychiatrist can prescribe Xanax, Zoloft, or Klonipin to help with anxiety and/or
depression and, but these may not be appropriate for clients with history of alcoholism or
other addictive behaviors.
Clients may want to see an ENT specialist, and possibly audiologist, as well as a clinical
psychologist for CBT (cognitive behavioral therapy) and a hypnotist for stress reduction
and other management techniques.
What you can tell your clients:
Do NOT spend much time talking with other people about tinnitus e.g. online, or in support
groups. Focusing on the problem makes it worse.
Tinnitus clients should avoid very loud environments (over 85dB). The chart below gives
you an idea of the loudness of everyday sounds:
Painful (120-150 dB)
Jet plane takeoff, siren, jackhammer, firearms, fireworks (immediate vicinity)
Very Loud (90-110dB)
Subway train, passing motorcycle, hand drill, pneumatic drill, gas lawn mower, snow
blower, maximum output of some MP3 players, model airplane, chain saw
Loud (70-90dB)
Busy traffic, vacuum cleaner, alarm clock, hair dryer, kitchen blender, food processor
Moderate (40-60dB)
Quiet room, moderate rainfall, typical conversation, dishwasher, clothes dryer
However clients should absolutely not spend time in silence because that only increases
awareness of the tinnitus. They should immerse themselves in a sound enriched
environment as often as possible by always having background music, or the TV or radio
playing, or a white noise/ambient sounds machine, even at night while sleeping. Do not
turn the volume any louder than the level of the tinnitus noise, as it will compete and may
end up even louder. It is also important that the background sounds are not too intrusive
or stimulating so if using TV or radio choose the program or channel wisely.
Tinnitus Retraining Therapy (TRT) uses counseling plus sound therapy and has two aims:
to reduce the anxiety and emotional distress associated with tinnitus, and to reclassify the
annoying tinnitus sounds as neutral so that the brain no longer pays attention and the
person no longer gets upset.
What can we do as hypnotists?
Kevin Hogan (“Turning down the Volume”) suggests that parts therapy and age regression
are both very useful for tinnitus:
 Parts therapy for speaking with the part that has something important to say and is
using the tinnitus to get the attention of the client (because nothing else has
worked). The message is often one of reducing stress and workload, and listening to
the self and others. Only when the lifestyle changes are put into place and adhered
to will the tinnitus begin to shift.
 Age regression takes the client back to a time before the tinnitus started. Age
progression can also be useful here – taking the client forward in time to when
he/she has already experienced significant relief from tinnitus.
 Clients can be regressed to describe incidents where tinnitus volume is loud or
distressing, and will typically experience increased tinnitus and distress. Upon going
through these incidents many times in trance, their anxiety and helplessness
reduces (the client habituates) and eventually they will experience little or no
anxiety to loud tinnitus while in trance.
 Teach a variety of stress reduction and relaxation skills e.g. deep breathing,
anchoring, affirmations, self-hypnosis, relaxation imagery, NLP techniques.
 Have the client come up with a symbolic representation of the tinnitus (e.g. object,
shape, color, texture, temperature etc.) and then alter it so it becomes a pleasant
feeling.
 Address any anger, or other strong unpleasant emotions, the client may have
towards self or others.
 Use David Quigley’s technique of entering the room of the disease or condition and
see who and what is in there. Ask who hired the disease and for what purpose.
 Teach insomnia techniques. Tinnitus sufferers often report sleep problems.
 If you are trained in energy modalities e.g. EFT (Emotional Freedom Techniques),
TAT (Tapas Acupressure Technique), AIT (Advanced Integrative Therapy) etc. then
use those techniques too.
Affirmations or statements for use with energy work for tinnitus:
“Even though I have tinnitus, I deeply and completely love and accept myself.”
“Although I may continue to hear the tinnitus, I will no longer give it my attention.”
“I listen to what my body is saying to me. I listen to my heart. I take good care of myself.”