UNDERSTANDING TINNITUS – Part 1


This week is Tinnitus Awareness Week in the UK.  Coincidentally, I’ve spent much of January working on a CD to help tinnitus sufferers deal with the sometimes devastating impact of being aware of loud noises coming from inside their heads 24/7.  This blog is drawn from the introduction to the CD and is designed to help those suffering from its effects, or those with a friend or relative who suffers from the problem, to understand it causes.  

Having several friends who suffer from Tinnitus, I have made a particular study of how it works and how hypnotherapy might help sufferers accept it and reduce its impact on their day to day lives.

This blog divides into two parts – the first is a fairly detailed description of the mechanisms which drive Tinnitus.  I’ve found in my researches that it’s quite difficult to get a simple but comprehensive description of how Tinnitus sounds are generated and why they are so different for different people.  If you know about this already, please just skip down to the second part which deals with the ways in which hypnotherapy can help you live with Tinnitus more comfortably.

How Tinnitus Sounds Are Generated

When a sound reaches the human ear, it enters as a pressure wave of vibrating air. This wave is converted into mechanical vibration by the eardrum and then amplified by the hammer/anvil/stirrup structure of the Middle Ear. It then passes into the fluid filled space of the Inner Ear.

Inside this space lie the semi-circular canals which control our balance, together with the complex structure of the Cochlear. It is here that the mechanical vibration of the sound is converted into chemical and electrical energy by a part of the Cochlear called the Organ of Corti. This identifies the pitch of the vibrations passing through it and also, their volume.  This is then converted into a signal which is passed to the temporal lobe of the brain – the part which controls our hearing. Only at this point does our conscious mind becomes aware of the sound for the first time.

Tinnitus occurs because of  a mechanical malfunction inside the Organ of Corti.   Inside the organ is a highly specialised structure containing up to 20,000 receptors, each one with its own tiny hair cell attached.  Each hair is responsible for detecting sound at a set frequency and measuring its volume. This information is then passed directly to its parent nerve receptor (one of the 20,000 mentioned above) and then on to the brain.

These hairs are very sensitive to damage from aging, exposure to overly loud sounds or to certain ototoxic drugs and once they are damaged they do not regenerate.   However, the loss of particular hairs does not mean that we stop hearing sounds at those frequencies.  Instead, the nerve receptor which is attached to a dead hair switches to a default setting which amplifies the sound being sent to the brain.  So it doesn’t matter if the sound is soft or really loud in the real world; it will just be amplified to the one and only high level of volume that the nerve receptor can deliver to the brain.

As a consequence, as hair cells become damaged, certain  frequencies of noise will become unnaturally loud and the brain will become much more aware of them.

You probably already know that your body is not a silent place. You can sometimes hear your own heart beating when your head is resting on a pillow in a quiet room. Sometime you can hear rushing noises in your ears as a result of blood flow, or the movement of air in your ear canals. And it can become even more noticeable if you get anxious. As your heart rate increases, your blood pounds round your body faster and the sounds it produces become more noticeable. Even the hairs in the Organ of Corti itself produce noise as they move around.

This is why Tinnitus noise is a very individual experience. It can be heard in different parts of the head by different people and can range from a high pitched whine to loud thuddings and bangings or low groanings. And the same sounds persist day after day after day.

The Psychological Effects of Tinnitus

As a result of the above, Tinnitus can create strong psychological stress which is caused  by the way our brains evaluate and respond to sounds.  The ability to recognise sound is a vital primitive instinct – it helps us distinguish between the threatening growl of a tiger and the comforting purr of a cat. When we identify a sound, our body responds according to the level of threat the noise seems to represent.

The tiger’s growl behind us, for instance, triggers our “fight or flight” mechanism. It immediately prepares us to either fight the tiger or to run away from it. Consequently our Autonomic Nervous System (ANS) pours adrenalin and stimulating hormones into our bodies, dries up our digestive juices, dilates our pupils and opens the pores on our skin so that we can sweat and cool ourselves more easily as we run etc. In modern life, this response translates into high levels of stress and anxiety.

The kitten’s purr on the other hand, makes us smile and relax. So it does the reverse of the tiger’s growl. It triggers relaxation, and so the ANS pours pleasure-hormones into our body, calming us, slowing our heart rate and relaxing our muscles and minds.

So, every sound we hear get labelled and, if repeated often enough, creates a “conditioned reflex” according to the feelings we associate with it.   This reflex is very sensitive and sophisticated. For instance, even though a mother might sleep through a thunderstorm, she will wake up the moment her child begins to cry.

So, awake or asleep, our minds and bodies are conditioned to respond to the sounds we hear – consciously or unconsciously.

In addition, the way we think of a sound is as flexible as our response to it. For instance, loud music might be really enjoyable at a party, but a hellish din when heard through a thin wall at 2 o’clock in the morning. So the label we put on a particular sound depends on the context in which we hear it and the level of excitement/relaxation it causes.

Because Tinnitus sounds are inside the head, can’t be escaped and are more or less continuous, the mind’s response to the sounds is that they are unpleasant, threatening, unwanted and something to fear and feel angry and sad about – and who can blame it?

The problem it creates however, is that developing the habit of always being unhappy and distressed by the Tinnitus noise becomes a vicious circle. This learned response creates an ever-strengthening cycle of negative responses – starting with a feeling of annoyance and irritation and rapidly progressing to fear, anger and a desire to escape – all of which  makes the sensitisation to the Tinnitus sounds even greater.

In additon, to becoming a reflex response, Tinnitus also creates a self-reinforcing vocabulary of internal self-talk –  “I can’t stand it, it’s driving me mad, I can’t shut it out” etc – every time it’s heard.  This negative language once again alerts the ANS to something bad and so the unhappy feeling just get worse.

Finally, on top of all this, many GP’s will tell their patients that there is no cure for Tinnitus – which is medically correct, but leaves no hope of finding ways of alleviating the symptoms or learning to live in peace with the sounds.

How Hypnotherapy Can Help you Live with Tinnitus

We’ve seen from the discussion above that there are three elements involved in the experience of Tinnitus –  i)  the noise itself and the seeming inability to escape it  ii)  the emotions generated every time the noise is heard and iii)  the apparent lack of control and helplessness which sufferers feel.

As we’ve seen, it’s true that there is no literal way of escaping the noise of Tinnitus.  However, it is possible to change your response to the sound of Tinnitus, to  retrain your hearing to make the sound less intrusive ( a process called by audiologists Habituation) and in doing so, change your body’s emotional response to it.   Thus, by using a variety of techniques, it is possible to learn to live at relative peace with the noises – by learning to be less disturbed by them, to be able to forget about them for longer (if you think about, you probably do experience times during the day when the sounds are less troublesome or not even noticed) and to change your response to them when you do notice them.

Hypnotherapy can help you  learn to make the sound of Tinnitus less threatening, to make the use of masking sounds (Pink Noise) more effective and to help you extend the periods in which you don’t notice, or notice the sounds less  – in the way that sound of air conditioning will gradually fades from your consciousness the more time you spend with it.

Therapy for Tinnitus  begins with a thorough review of your own Tinnitus experience and the words you use to describe it.   At your first session you will be given a CD designed to help you relax your nervous system right down to a pleasant state of relaxation.  The CD will also train you to listen to Pink Noise, which will help mask your Tinnitus sounds and help retrain your auditory memory/awareness networks (the basics of Tinnitus Masking techniques).  It will also help you to ignore the sounds more easily and to be focussed instead on all those times when you just don’t remember hearing the noise. Finally it has a Pink Noise track which you can copy onto a mobile phone or mp3 player to use whenever you are out and about or in bed and want to supress your Tinnitus sounds.

Subsequent sessions  focus on your own particular issues, thoughts and feelings and are designed give you the means of putting you in control of your Tinnitus and help in creating a more positive and optimistic attitude towards your future.

If you or a relative suffer from Tinnitus and would lke to discuss how hypnotherapy can help,  please feel free to give me a call for a free, no obligation, consultation.  See my website www.keithjeffordhypnotherapy.co.uk  for more details.

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Obesity, weight loss & why Gastric Bands fail


I am often asked if I offer hypnotic Gastric Band therapy and the answer is always “Yes, but…”.  The reason that I am loathe to offer an immediate gastric band fix is that it runs the risk of leaving the real underlying reason for weight problems unresolved and can therefore be doomed to failure.

Cummerspeck (literally grief bacon) is a German word which describes the mindless eating  which leads to weight problems and obesity in those with untreated emotional trauma.

GPs in the UK are often faced with patients who are desperate to become “normal” and demand quick-fix gastric band or bypass surgery to solve their problems.

Yet having a physical gastric band fitted means making major changes to diet (for instance having to avoid anything with oil or fat in it or else experience vomiting immediately after eating) and having to accept a death rate risk of 1 in 2,000 operations (the most common cause of death being pulmonary embolism) plus the risk of being one of the 1 in 10  patients who will need a further operation at some time due to slippage, erosion, leakage or infection involving the band.

But of more concern perhaps, is the fact that although the patient may lose weight and reduce the risk of heart and endocrine disorders there is mounting evidence that they may suffer ADDED psychological pressure due to loss of their mechanism for dealing with stress, leading to  issues of low self-esteem, relationship problems, dissatisfaction with  body image and ultimately, depression.

The same psychological problems can obviously attach themselves to use of a hypnotic gastric band.  As a result, I always insist that anyone wanting this therapy also does the first three sessions of my standard weight-loss course.  In this way, they have the opportunity to relearn the basic rules of good eating and to come forward with any underlying problems of grief, loss etc which might be driving their behaviour.  Having dealt with those things first and cleared or controlled psychological blockages, the chances of a hypnotic gastric band working are greatly enhanced.

In my view, hypnotherapy should provide support for overweight or obese clients in  a variety of ways:-

•   Firstly, by identifying and dealing with the underlying causes of their obesity – both emotional  (grief, fear, abuse etc) and practical (being unable to read/write, dyslexia, lack of social training etc) – thus providing a combination of therapy and practical help.
•   Secondly, by offering reinforcement – especially if they’ve already had advice from an NHS dietician.  New ways of eating and thinking about food can be reinforced through the creation of hypnotic suggestions based on an individuals eating plan and the breaking of addictions to unhealthy foods like chocolate, fried foods etc.  I find that teaching people to eat like thin people eat, often makes a major difference to their ability to lose weight.
•   Thirdly, through the creation of tailor-made CD’s – designed to reinforce therapy between sessions and provide constant reminders of what to eat, how to eat and all the benefits which weight loss brings, combined with ego-boosting suggestions and encouragement.
•   And finally, but very importantly – Resolution of problems arising –  providing an on-call resource for dealing with practical or emotional problems immediately they arise.

Five things that people regret on their deathbeds


Later on this year I plan to write a blog article on death, fear of it and coping with it.

However, for those of you who wonder what regrets you might have when your turn comes take a look at this brief article on the five greatest regrets express by people with only a few days of life left.

After reading the article, take a few moments to consider how, armed with that knowledge and insight, you might change your own life to avoid having the same regrets.

http://m.guardian.co.uk/lifeandstyle/2012/feb/01/top-five-regrets-of-the-dying?cat=lifeandstyle&type=article