Practical Steps to Support Your Loved One With Tinnitus
By Bruce Hubbard, PhD
If you don’t have tinnitus yourself, it may be hard to understand what your loved one with tinnitus is going through. Take it from me—a board-certified cognitive behavioral psychologist who’s helped close to 1,500 people with tinnitus get their lives back, and like your friend, partner, or family member, one of hundreds of millions of people worldwide living with the persistent internal sound of tinnitus—tinnitus can be awful!
The first six months following my tinnitus onset were among the worst of my life. At that time, it seemed impossible that I would ever be well again. That was 2005. I am grateful to report that, although my tinnitus hasn’t changed, I rarely notice it, and when I do, it’s no more upsetting than the hum of a fridge. I’ve gone on to enjoy the same full life I had prior to my tinnitus journey.
Not everyone achieves full relief, but for the vast majority of people, having tinnitus does get easier over time, often a lot easier. It’s likely that if your loved one can hang on, be patient, and get the right help, then over the next few weeks and months, they too will see that having tinnitus can get easier. To instill hope, let’s review some facts about tinnitus and propose an actionable plan for your loved one’s recovery.
Tinnitus Versus Tinnitus Distress
First, it’s important to distinguish between tinnitus and tinnitus distress. Tinnitus is the sound we hear. A hard fact that can be both terrifying and maddening is that, at present, there is no cure for tinnitus.
In contrast, tinnitus distress is the emotional reaction to the tinnitus sound, and how it impacts our sleep, concentration, and ability to be at peace. Chances are it’s the distress, as much or more than the tinnitus sound itself, that is causing your loved one to suffer. It may be comforting, then, to know that, though there’s no cure for tinnitus, there are effective treatments for tinnitus distress.
Cognitive Behavioral Therapy (CBT)
The most proven treatment for tinnitus distress is cognitive behavioral therapy, better known as CBT. CBT is a common treatment for stress, trauma, anxiety, depression, and insomnia. And more than a dozen carefully controlled studies have found CBT to significantly reduce tinnitus distress.
In CBT we learn practical skills to cope better with tinnitus, to reduce distress and improve functioning (sleep, concentration, leisure). CBT skills involve changing our psychological response to tinnitus— how we think about, pay attention to, and act in relation to tinnitus. I think of CBT as physical therapy for the brain, a set of exercises that become automatic with practice. When done correctly, you can expect your emotional reaction and attention to tinnitus to gradually improve. A well-rounded CBT clinician will also be an expert in treating the anxiety, depression, and insomnia that are so typical of tinnitus distress.
Adding a soothing background sound at the times tinnitus is most distressing can help soften your loved one’s perception of tinnitus. This can make it easier to let go of tinnitus and redirect attention back to the important stuff of life.
Sound therapy can be self-guided or audiologist guided. Self-guided sound therapy is much less expensive and can be very effective. The Progressive Tinnitus Management manual, accessible through the ATA’s website, has an excellent chapter on the topic. And the Spring 2022 Tinnitus Today article on open earbuds and bone conduction headphones highlights low-cost Bluetooth streaming devices that can be used to access ear-level sound therapy inexpensively.
Information about audiologist-guided sound therapy can be found on the ATA website (ATA.org) and using the list of providers starting on page 50. The evidence supporting audiologist-guided sound therapies is mixed. Nevertheless, for many people, this is an important intervention for tinnitus distress.
Hearing aids may be helpful for those with hearing loss because they raise the level of natural background sound and improve the quality of hearing in a manner that sometimes reduces tinnitus perception and distress. Although there is limited research on hearing aids for tinnitus, many people report them to be beneficial.
Hope Through Habituation
If a medical doctor has told your loved one “For your tinnitus, there’s no treatment, but you’ll get used to it,” what they mean is “It may not go away, but you’ll habituate.” Habituation is a natural process through which the brain gradually reduces its automatic “alarm reaction” as it learns tinnitus is not important.
Habituation is the most important form of tinnitus neuroplasticity. Through habituation, tinnitus doesn’t change, but the emotional reaction and attention to tinnitus gradually diminish, making it much easier to live with the sound. At full habituation (my state for the past 16 years), you rarely notice your tinnitus, and when you do, it’s not upsetting and you forget about it quickly.
Like many forms of healing, tinnitus habituation is a gradual process that occurs over months and years. Surveys indicate that, at any given time, roughly 95 percent of people with tinnitus have achieved some level of habituation, with 50 percent in full habituation. When done correctly, tinnitus distress treatments promote habituation. With the right guidance, your loved one can make significant improvement over the first few weeks and months. Make sure that any tinnitus professional helping your loved one understands tinnitus habituation and teaches them how to promote it. Learn more about tinnitus habituation in the Spring 2018 Tinnitus Today magazine, which focused on this topic.
Take Heart. It Can Get Easier!
For the vast majority of people, even when the tinnitus sound itself does not improve, living with the sound does get easier over time. And there are effective strategies available to reduce distress, improve functioning, and promote habituation and recovery.
I encourage you and your loved one to be patient and to seek the right help. Take some time to research effective treatments for anxiety and insomnia. Learn about tinnitus habituation and how to promote it. Read habituation success stories, readily available through an internet search. And take heart. It can get easier to live with tinnitus!
After developing tinnitus distress in 2005, Bruce Hubbard, an experienced clinical psychologist, utilized cognitive behavioral therapy, which is globally recognized as the most effective, research-based treatment for tinnitus. Following his recovery, he founded CBT for Tinnitus, LLC, to provide online training and coaching for people bothered by tinnitus, and tinnitus education for professionals.
Dr. Hubbard has published numerous articles and podcasts on CBT, mindfulness, and tinnitus. His webinar, Cognitive-Behavior Therapy for Tinnitus, sponsored by the Anxiety & Depression Association of America (ADAA), has received close to 350,000 views.
Dr. Hubbard is a visiting scholar at Columbia University, Teachers College, a past president of the New York City Cognitive Behavior Therapy Association (2016–2018), and founder and director of CBT for Tinnitus, LLC. He is certified in Cognitive and Behavioral Psychology through the American Board of Professional Psychology (ABPP).