There are several kinds of doctors you’d call if something were wrong with your ears. Maybe you’d start with a family doctor to check into your overall health. Maybe you’d find an ENT to treat any pain you may be experiencing. Or maybe you’d reach out to an audiologist to evaluate you for hearing loss.
But a Psychologist?
Yes, it may seem unusual. But for millions of Americans who suffer from tinnitus, a psychologist or other kind of talk therapist may be the perfect provider to deliver relief.
What Is Tinnitus?
Tinnitus is sound in your head that doesn’t have an external source. While many people describe it as a ringing sound, others experience it as whistling, buzzing, chirping, hissing, humming, or roaring. It can be loud or soft, occasional or constant, a mild annoyance or a debilitating chronic condition. Tinnitus can present itself after noise-induced hearing loss.
Why Can’t A Pill Make My Tinnitus Go Away?
Over 50 million Americans experience tinnitus—but it is notoriously hard to treat. That’s because, rather than a stand-alone medical condition, tinnitus is a symptom—a signal to you and your doctor that something else is going on in your body. That “something” could be anything from inner-ear damage, to stress, to ear wax, to Meniere’s disease.
Because there are so many causes for tinnitus, there is no one easy treatment. With some detective work into the cause and careful management of your condition, you may see your symptoms dissipate or disappear altogether—but some people with tinnitus may find it to be a lifelong condition.
How Does Tinnitus Affect The Mind?
You may think that chronic tinnitus would be characterized by the sound the patient hears—how loud it is, how high-pitched, how frequent. But study after study has shown that the severity of tinnitus is not determined by the quality of the sound, but by how the patient reacts to it.
Some people have the good fortune of being completely unperturbed by their tinnitus. They experience it as non-threatening background noise—easily ignored or forgotten.
But for others, tinnitus triggers a vicious stress loop. Consciously or unconsciously, these patients’ brains perceive the sounds of tinnitus as a threat.
The sounds distract, annoy or anger the patient, or lead them to think something is very wrong. This can cause body tension and other biological stress responses—more signals to your brain that danger is present. And, because stress exacerbates tinnitus, the responses can lead to the patient experiencing tinnitus even more intensely, triggering the stress loop all over again.
This can affect the emotional well-being of an individual greatly. The patient can go round and round in circles of frustration, anger, and desperation—which can eventually lead to depression, anxiety, insomnia and even suicidal thoughts or actions.
Related: 5 Surprising Causes of Tinnitus
How Can Psychology Help My Tinnitus?
Tinnitus sufferers—especially those who perceive their tinnitus to be severe—need help removing themselves from the stress loop. Psychological help, or talk therapy, is a tinnitus management option.
Tinnitus suffers learn how to break the vicious cycle by reframing how they understand their tinnitus so their brain no longer perceives it as a threat. This can help lessen the symptoms and greatly improve patients’ quality of life.
I’m Worried About Therapy
Many people are intimidated by the idea of starting talk therapy. Let’s look at some common concerns and ways to move past them:
- I’m worried about being judged; therapy is just for “crazy” people: nobody would judge you for seeking help if your kidneys aren’t functioning properly or your appendix were causing you pain. Just like the kidneys and the appendix, the brain is an organ in your body, and if it temporarily misfires, it deserves a doctors’ care.
- I don’t know how to find a therapist: there are several ways to get an appointment. You can ask your family doctor for a referral to someone they trust. (This is especially important if you are covered by an HMO plan.) You can do an internet search, look for therapists near you who have received positive reviews and call the office yourself to set up the appointment. (Your insurance company may even keep quality scores for their in-network providers.) Or, you can see a therapist online via video chat on your smartphone or tablet. Doctor On Demand, Talkspace, BetterHelp and 7 Cups of Tea are all respected online therapy providers.
- I don’t know how to choose a therapist: there are two important things to consider when choosing your therapist: personal chemistry and expertise. First, chemistry. You want a therapist you can connect with and trust. You want to feel like they understand you, they listen to you and they provide insight that’s meaningful to you. When you are narrowing down possible therapists, don’t hesitate to ask to speak to a few on the phone or to schedule some introductory visits until you find the one that fits you best. Second, expertise. You want a qualified psychiatrist, therapist or social worker who has experience dealing with your concerns. During your introductory discussions, ask your therapist finalists what experience they have treating people struggling with chronic conditions like tinnitus.
- I don’t know what to say: that’s okay! The therapist is there to guide you. Just be as honest and open with your therapist as possible. The more open you are, the more likely your therapy is going to work.
- I’m worried about what’s going to happen at the appointment: movies and TV shows give us a distorted view of what actually happens in talk therapy. You won’t lie down on a couch or dissect your most recent dreams. Rather, you and your therapist will sit in comfy chairs and talk about what’s on your mind. They’ll then give you coping strategies or things to work on before your next appointment. How your therapist addresses your concerns may depend on the types of therapy they specialize in. These could include:
- Cognitive Behavioral Therapy: a therapy that emphasizes challenging negative beliefs and self-talk and finding new ways to think about what’s causing you distress.
- Mindfulness-Based Stress Reduction: emphasizes “mindfulness”—non-judgmental awareness and acceptance.
- Acceptance and Commitment Therapy: teaches patients to stop avoiding tinnitus and fully experience thoughts, perceptions, and emotions in non-judgmental way.
- Tinnitus Activities Treatment: a variation of cognitive behavioral therapy that focuses specifically on the management of tinnitus. TAT explores four areas impacted by tinnitus: thoughts and emotions, hearing and communication, sleep and concentration.
- Tinnitus Retraining Therapy: combines cognitive behavioral therapy with supplemental sound masking to get patients used to the sound of tinnitus and lessen their stress response.
- Progressive Tinnitus Management: developed by the U.S. Veterans Administration, PTM involves patient education, behavioral therapy, and supplemental sound therapy.
- This isn’t going to work: talk therapy has been shown to improve the symptoms of tinnitus in 95% of patients who commit to the process—but it is a commitment, and it is a process. It takes time for your subconscious brain to unlearn a deeply ingrained stress response. That’s why it’s important to stick with your therapy—and to faithfully do the work your therapist assigns outside of your sessions—for several months. In the end, you’ll have the tools you need to find the relief you are looking for.