“Tinnitus relief is more than a hearing aid.”

In my book, Ringing in the Ear Tinnitus Relief, I write that a hearing aid is the best therapy for tinnitus. Yet, many patients complain of failure from simple or complex amplification to help their tinnitus.

The reason for this dissatisfaction is now clear from the research by Rilana Cima of 492 patients who were studied at the Maastricht Tinnitus clinic. This Lancet article demonstrates conclusively that cognitive therapy and reduction of stressors are important for tinnitus treatment success. They note stress is not a cause of tinnitus, but can worsen the symptoms because we humans inherit a system for fleeing from danger.

Cognitive

When someone breaks a finger, it is splinted, she takes an aspirin, and all is well. But in tinnitus, we are born with a reflex: when we hear a danger sound, we get a flee/fight response. This has nothing to do with whether a person is fat or thin, tall or short; the response is in our genetic makeup. This is why cognition is so important for tinnitus relief.

When you hear a scratching on your bedroom door at 4 a.m. you get this adrenaline response. When you are aware – cognition – that it is the family dog seeking your warm bed, you no longer get this response. This is the cognition that must be utilized in order to help reduce tinnitus. Without cognition, the prescribed hearing aid may not be enough.

This is the frequent scenario of the tinnitus patient:

Jim S lives on the second floor of an apartment in Manhattan. He is accustomed to nocturnal traffic and street noises. While driving to Chicago, he stops to sleep in a quiet motel. He is awakened by his tinnitus. He panics and rushes back to New York. After weeks of seeing his family doctor, the otolaryngologist, the audiologist and getting the MRI, he is finally told, “You have tinnitus. Learn to live with it.” This amplifies his anxiety, and is followed by trials of “Miracle Tinnitus Ear Drops” and “Miracle Tinnitus Pills.” All the time his stress is increasing his tinnitus symptoms.

This scenario can be avoided when you utilize the factors of:

• Cognition
• Stress Reduction
• Sleep Impairment
• Anxiety Reduction
• Masking and Distraction

All these factors need to be addressed, and can all be combined for successful therapy through the Whole Person Tinnitus Program, the combination of book and App.

Affect Change

The Ear Ringing Book explains cognition and gives known actions that reduce stress, anxiety and sleep problems. The patient learns what tinnitus is, and that it is not a “bad,” a danger, and is not a tiger.

In order to affect a change in the symptoms of tinnitus, daily repetition of measured breathing, mirror biofeedback, and cognition exercises are needed for several months.

Therefore an App: Ear Ringing Relief is added to the therapy. This simply reminds the patient to repeat the actions.

Instead of breathing rapidly as in stress, they count the breath: in four and out six. Since exhalation is longer than inhalation, you are in a relaxation (exhalation) mode longer than an inhalation mode. This signals the stress center that there is no danger. Thus, stress is reduced. Using the mirror as a biofeedback device, you practice relaxing face, jaw and shoulders. Since these muscles are now relaxed, any input from tight jaw or neck is reduced or eliminated.

In stress, you imagine the worst outcome: the scratching on the door is an intruder trying to come in. In this cognitive program you fully visualize using all five senses, not having these symptoms.

With this whole-person approach, any tinnitus patient will benefit when their tinnitus is masked by correcting their hearing loss with amplification. The effectiveness of this program is significantly enhanced when it is introduced by the audiologist.

The book, Ringing in the Ear Tinnitus Relief is available at Amazon in E book or print. The App, Ear Ringing Relief is available at iTunes for iPhone and iPad.

With these two parts of the program, an audiologist can present the Whole Person Tinnitus Relief program to their clients with assurance of benefit. With this program, no tinnitus patient need ever be told, “Nothing can be done for your tinnitus.”

References

1. Cima RF, Maes IH, Joor MA, et al. (2012). Specialized treatment based on cognitive behaviour therapy versus usual care for tinnitus. The Lancet. 379:1951-1959

Murray Grossan, MD, is a Los Angeles-based physician. Read more about the Ear Ringing Relief app at his website www.grossaninstitute.com