Empower Your Journey

The Role of Self-Compassion in Managing Tinnitus

By: Emily Hensarling, AuD

Imagine being at your son’s wedding, an event you’ve been looking forward to celebrating for many months. The bride and groom are blissful. The party after the ceremony is jubilant and loud. Unexpectedly, you find yourself seated near one of the DJ’s speakers, where it is so loud that not only does it cause some permanent hearing loss but also leaves you with permanent tinnitus. This is the story of one of my patients, who, like many patients, was engulfed in self-blame and regret about the circumstances around their tinnitus. We’ve heard the statements before: “I should be able to deal with this,” “I wish I had…”

My patient, whom I’ll call Dan, was filled with self-blame, shame, and regret for not speaking up for himself, not taking action that could have prevented his tinnitus and hearing loss. Like many patients, Dan spent a lot of time googling “how to make tinnitus stop” and watching YouTube videos on tinnitus. He continued to blame himself for his tinnitus and questioned his ability to live with it. He was unrelentingly hard on himself.

This made me wonder if how we speak to ourselves when experiencing something hard, as tinnitus very often is, affects our ability to cope? If yes, what should the patient do? How can the healthcare provider help a patient break this negative cycle that often stands as a barrier to making progress?

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According to the Merriam-Webster’s dictionary, self-criticism is “the act of or capacity for criticizing one’s own faults or shortcomings.” The emotional cycle of self-criticism works like this: You experience a stressful situation or negative thought that triggers a fight-or-flight response. Next, you criticize yourself for the situation or your response to it. The stress response is activated, which affects your physical, emotional, and behavioral response.

Let’s use this cycle to view my patient. Dan attends the wedding, which is spectacular, but finds himself seated next to a loudspeaker at the party that follows. He’s left with hearing loss and tinnitus in his left ear. Emotionally, he’s angry and regrets his choice not to move. Behaviorally, he looks for solutions on the internet, none of which work. Physically, he’s tense, tired from lack of sleep, and withdrawn from his family. The self-criticism gathers force as he ruminates about that fateful party, his inability to

find tinnitus solutions on the internet, and his difficulty coping with the sound. He sees himself as weak and helpless. Whenever he thinks about the tinnitus and/or the wedding, the cycle begins anew. So how do you break this vicious and destructive cycle of self-criticism? With self-compassion. 

We’re often unaware that we talk to ourselves in such a negative, unforgiving way when we would never speak to another person like that. Hence, we don’t realize the harm that these thought patterns can have on our ability to cope and be resilient. In fact, some people view self-criticism as beneficial because it can mean that you’re being “tough” and pushing yourself to excel. It’s a tool for continuous improvement.

People may also view self-compassion negatively, seeing it as self-indulgent, weak, lazy, selfish, or complacent.

So, what is self-compassion? Kristen Neff, author of Self-Compassion: The Power of Being Kind to Yourself, and Chris Germer, author of The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions, have done extensive research and writing on self-compassion. Germer describes self-compassion as “basic kindness, with a deep awareness of the suffering of oneself and of other living things, coupled with the wish and effort to relieve it.” In self-compassion, one needs to have awareness of the suffering that is occurring; a normalization period, when one realizes that experiencing pain and discomfort are normal; kindness, care and concern toward oneself and the pain itself; and focused energy on alleviation of the discomfort. Alleviation of suffering may include having a helpful perspective or shift in mindset around the troubling issue or having the courage to take the action needed to address the problem.

Self-compassion is not simply giving yourself a mantra to repeat in the mirror or wishing the situation would go away. It is an active thought and behavioral process that can be useful to deal with self-critical talk.

Awareness is the first step in learning to rein in self-critical thinking. Once we become aware of our thoughts, it is easier to explore them more fully by being intentional and nonjudgmental. With experience, we can begin to choose how to respond to these thoughts instead of allowing the fight-or-flight system to hijack our feelings, emotions, and behaviors.

Normalizing the idea that all of us experience pain and suffering daily can make us more aware that we are not alone in our experience. Approaching pain and suffering with a compassionate mindset, the way we would with a loved one in a similar situation, allows us to learn how to “be” with a challenging situation without trying to change it, fight it, or avoid it. By becoming more aware of self-critical thoughts, bringing more compassion to one’s own situation, and recognizing that we are not alone, we can begin the journey of learning how to ease suffering.

My client Dan and I had several long conversations about his experience at the wedding and how his tinnitus experience was shaping and affecting his quality of life. He realized how angry he was with himself. By leaning into a mindfulness practice, Dan learned to separate these negative thoughts and emotions from the tinnitus.

As Dan practiced mindfulness, his resiliency strengthened, which enabled him to be less harsh on himself. He recognized that his tinnitus was wrapped up in anger and a sense of helplessness. By allowing himself to sit with that discomfort and explore his reactions to it, he discovered how to untangle his emotions from the tinnitus itself. He discovered he was capable of handling it and getting back to living fully despite its presence. Dan was no longer suffering because of tinnitus. He also addressed the hearing loss with a hearing aid, which provided masking when needed.

Using self-compassion techniques, such as developing awareness of his thought patterns and normalizing his response, Dan was brave enough to sit with his tinnitus and create a kinder inner dialogue and compassionate mindset. Self-compassion allowed him to move forward in his life and enjoy the things he was grateful for, even though he still experienced his tinnitus. Self-compassion provided Dan with both hope and a tool to live unburdened by the sound of tinnitus.


EmilyHensarling

Emily Hensarling, AuD, has over twenty years of clinical practice experience, with a strong focus on supporting and caring for tinnitus patients using best practices. Throughout her career, Dr. Hensarling has taken on various roles, including training other staff members and leading a team of audiologists in developing and implementing an online class for tinnitus patients. She is a Certificate Holder in Tinnitus Management (CH-TM) through the American Board of Audiology. Additionally, she owns Seeds of Insight Coaching and serves on the Board of the Colorado Academy of Audiology.

References 

Marks, E., Smith, P., & McKenna, L. (2020). “I Wasn’t at War With the Noise: How Mindfulness Based Cognitive Therapy Changes Patients’ Experiences of Tinnitus.” Frontiers in Psychology, 11, 483. https://doi.org/10.3389/ fpsyg.2020.00483

Neff, K. D. (2022). Self-compassion: Theory, method, research, and intervention. Annual Review in Psychology, 74, 193–218. https://doi.org/10.1146/ annurev-psych-032420-031047

Perry, B. D., & Winfrey, O. (2021). What happened to you? Conversations on trauma, resilience, and healing. Flatiron Books.

Saulsman, L., Campbell, B., & Sng, A. (2017). Building self-compassion: From self-criticism to self-kindness. Center for Clinical Interventions (Perth, Western Australia).