A Year Without Silence: A Reflection on my Experience with Tinnitus
If you’ve never heard of Tinnitus, you're not alone. I had never heard of it until a year ago, as I frantically tried to figure out why my ears wouldn't stop ringing. Like most people, I had experienced ringing in my ears after leaving loud venues, like a concert, loud party, or noisy restaurant. This time, however, the ringing was exceptionally loud — and persistent.
I had just left a party where I had been standing close to a speaker, and on the way home my ears were ringing so loudly that I was having trouble hearing people in the car with me. As I settled into the relative quiet of my apartment, it sounded like there was an ambulance blaring directly outside the front door. I asked my partner whether she could hear it as well, but she only looked back at me with a mixture of confusion and concern. Impulsively, I tried to plug my ears to stop the onslaught of noise. However, this only blocked out ambient noise, and the ringing ratcheted up even higher.
Even at this point, I assumed the sensation would dissipate over the next few hours. Unfortunately, that didn't end up being the case. A few days into it, I was at my lowest point. My mind was so fixated on the ringing that I couldn't focus on anything else for more than a few minutes at a time. It started to affect my work and relationships, as I could feel a baseline irritability set in — a common refrain in the stories of Tinnitus I had read online.
Sleeping proved to be the biggest challenge. As soon as I closed my eyes, the ringing would flood my bedroom. With no other sensory inputs to occupy myself with, the ringing became the sole object of my attention. Instead of trying to fall asleep, I would actively try to cultivate trains of thought and engrossing narratives to distract myself from the sound. And no matter how much I tossed around in bed or instinctively covered my ears with pillows, there it was, clinging to me like a shadow that I desperately wanted to escape.
The only relief, ironically, came from listening to music loud enough that it would overwhelm the ringing. Unfortunately, as you might expect, this only made the ringing even louder afterwards. It was like binge drinking to drown out the withdrawal symptoms of alcohol addiction. Clearly, I needed a new strategy that didn’t perpetuate the problem.
Fast forward one year, and I can still hear the ringing if I tune into it. My relationship to it, however, has changed dramatically. Despite being a constant companion, it occupies almost zero of my attention on a given day. Even when my head hits the pillow and the ringing starts to permeate my bedroom, it only momentarily captures my attention before my mind wanders off or drifts into sleep.
So what has changed? And what is there to learn from the experience that could help others deal with tinnitus and other chronic conditions?
For me, the first step was understanding the mechanism behind the ringing. Though our scientific understanding of Tinnitus is still incomplete, the current interpretation is that our brains are trying to compensate for hearing loss by constantly producing the tone at which our hearing was damaged (similar to the sensations associated with Phantom Limb syndrome). Unfortunately, we don’t currently have a way to reverse this process, so Tinnitus is incurable.
Once I learned this, the next step was learning how to effectively manage the condition. In my experience thus far, the most effective tools for doing so have been practicing mindfulness meditation and applying Buddhist philosophy. At a meditation retreat last Spring, I was introduced to a Buddhist principle that spoke directly to my experience with Tinnitus:
Suffering = Pain x Resistance.
Reflecting on this simple equation, I realized that most of my discomfort did not come from the physical sensation of the ringing itself. It came from my emotional response — my resistance — to it. The suffering I was experiencing was rooted in the anger, frustration, and anguish that I felt, not anything intrinsic to the sound itself. By developing an awareness of my emotional reaction and shifting the way in which I responded to it, I could effectively remove the negative valence associated with the raw sensation of the ringing. The sound – the pain – would be there, but my resistance to it, and consequently my own suffering, was under my control.
In addition to training my response to the sound, I also needed to train my attention. William James, widely considered the father of modern psychology, once said, “My experience is what I agree to attend to.” Attention can be thought of as a spotlight, and with any sensory experience, our brain attributes importance to what we actively direct our attention toward. Thus, your brain will amplify sensations that you are actively focusing on, similar to how the taste of food becomes more intense if you actively focus on the flavors on your tongue. On the flip side, if you pay less attention to a stimulus, over time your brain will dampen the subjective intensity of those same sensations.
In the case of Tinnitus, focusing on the ringing tells your brain that the noise is important and must be attended to, which amplifies your experience of the sound. However, if you direct your attention elsewhere, you tell your brain that the sound is unimportant and that you are impartial to it. As a result, the brain will start to interpret the ringing as ambient background noise, which is processed differently in the brain. This kicks off a positive flywheel whereby the sound itself is actually perceived as quieter. Now that it's quieter, it tends to demand less of your attention, thus further training your brain to interpret it as background noise, and so on.
So how do you kick off this process by training yourself to pay less attention to the ringing?
For me, meditation provided a blueprint. Meditation is a practice in which you repeatedly notice thoughts, sensations, and emotions arising, let go of them, and redirect your focus on the breath. The popular meditation guidebook The Mind Illuminated explains it this way:
A helpful phrase to remember when dealing with distractions of any kind is, let it come, let it be, let it go. Don’t try to suppress it, just let it come into peripheral awareness. Don’t engage the distraction or focus attention on it, simply disregard it and let it be in the background. Then, let it go away by itself.
By repeating these steps, you start to notice when you're jumping into a new train of thought, which creates the opportunity to either dismiss the thought outright or approach it with greater mindfulness and intention. For instance, as the memory of a recent argument arises, you can simply let go of that train of thought before getting engrossed in an emotional narrative about it.
This is precisely the relationship that I wanted to foster with my tinnitus. Whenever my attention started to focus on the ringing, I wanted to be able to: recognize my attention had shifted; not label the sound as positive or negative, and then redirect my attention elsewhere. Ironically, the quiet of meditation itself was when the ringing was most noticeable (aside from falling asleep), so it proved a challenging but rewarding testing ground for cultivating a new attitude towards my Tinnitus. After a few weeks of effortful and often frustrating meditation sessions, the practice began to pay off. These were the first nights where sleep came easily, and the ringing became just a momentary object of attention among many others.
At risk of overpromising the benefits of meditation for dealing with Tinnitus, I have experienced a few moments in deep meditation where the sound dissipates altogether, albeit temporarily. These occurrences have been rare, I've only had three of them in the past year, but they have been incredibly meaningful. Being reunited with silence, if only for a minute or so, has been like being reunited with a long-lost friend that I had previously taken for granted. Two of these instances happened while I was meditating in the quiet of nature. In those brief moments of silence, I heard the world as I had remembered it, and I was struck by the beauty and ease in that negative space. I quickly found myself wiping away tears, deeply grateful for the momentary reunion.
In addition to changing my underlying relationship with Tinnitus, I also made a few practical changes that drastically helped manage the condition.
Take care of your ears! I wear earplugs to everything from concerts to workout classes now. I've found these to work quite well. This goes for people without Tinnitus as well. Take it from me — your ears are more fragile than you might think!
Buy an ambient noise-maker for your bedroom. This will help mitigate the intensity of the noise, especially in the early days when it's still at the forefront of your attention.
Finally, the physiology behind Tinnitus is fascinating, and learning about the mechanism behind the ringing can help reduce the initial fear of the symptoms and reclaim a sense of power over it.
For those of you dealing with Tinnitus, I hope this article provides a bit of inspiration to guide you in managing your condition. And for those not dealing with Tinnitus, I have found that the principles and lessons outlined above can be applied to a broad range of obstacles in life.
When I was first frantically searching the internet for stories about Tinnitus, I was struck by the discouraging, and often frightening, tone in many of the articles. This article, I hope, provides just the opposite: a blueprint to overcoming the condition by fostering a new relationship with it. And though I wouldn’t wish Tinnitus on anyone, it has become a teacher of sorts. It has deepened my sense of gratitude for small things that I used to take for granted; it has challenged me to apply buddhist practice to one of the greatest challenges in my life thus far, and it has taught me that the way I react to the world can directly affect my perception of it. Most importantly, I’ve learned that, if we listen closely enough, our moments of greatest adversity can be our biggest opportunities for personal growth.
Thanks for reading,
Mark