Tinnitus, a condition in which a person hears a phantom sound, is incredibly common. An estimated 30% of people worldwide will experience tinnitus at some point in their lives.
But, this doesn’t mean they have to simply accept their fates. While pervasive, tinnitus isn’t a hopeless condition. There are several courses of highly effective treatment options currently available. Habituation is one approach that works well for many.
In this post, we’ll:
- Define and explain tinnitus habituation
- Explore how habituation differs from reinforcement
- Discuss tinnitus habituation techniques
What is Habituation?
Ever wonder about how someone can live under a major flight path yet the loud commotion of the airport doesn’t even seem to register to them? It’s no mystery — they’ve habituated!
Habituation Defined
Habituation is what happens when you become familiar with a place, situation, condition, etc. It’s a term used a lot in the realm of psychology, especially in reference to learning and behavior.
However, when psychologists speak of habituation, they usually also incorporate an element — known as a stimulus or stimuli — into the conversation. You can think of the stimulus as a trigger. The stimulus sparks your brain into responding, and when your mind-body reacts to a stimulus, it isn’t habituated to that trigger.
At a deeper level, habituation results in the neurons in the brain learning to ignore or absorb the stimulus. The stimulus sort of blends into the background as if it’s nothing out of the ordinary.
Let’s put it all together in the context of tinnitus. For people with tinnitus, sound is the stimulus. Habituation, then, occurs when the tinnitus noise no longer spikes a reaction. The brain essentially becomes desensitized to the ringing, buzzing, whooshing, and so on.
History of Habituation
In the early days, habituation was referred to as “inhibition and adaptation.” The study of this process began in the first part of the 20th century. By the mid-1960s, the concept had evolved to be called “habituation” and thought of as a learning model. Nuanced versions of habituation surfaced in the late 1970s.
Over the years, various theories have expanded and contracted the meaning and mechanisms of habituation. But they all basically boil down to your brain — at the neuronal level — being able to suppress stimuli so they don’t instigate a reaction or downstream effects.
Basic Properties & Processes of Habituation
You can train your brain to become habituated to a stimulus. With a rudimentary understanding of what habituation is in your cap, let’s take a look at some of the key underpinnings of habituation and habituation training with some examples.
Achieving Habituation
First, let’s assume that a patient’s tinnitus manifests as a shrill tone (the stimulus) and that elicits a particular response (tinnitus side effects like headaches). In this scenario, to habituate, repeated applications of that stimulus — the shrill tone — is replicated and administered to the patient. This is a form of sound therapy.
As a result of the treatment, the stimulus begins to trigger less of a response (habituation). The drop in response is usually exponentially related to the number of times the patient is exposed to the stimulus. This simply means that there’s a snowball-like effect — the more the patient is presented with the tone via sound therapy, the greater the rate at which habituation occurs.
Maintaining Habituation
Unfortunately, habitation isn’t a one-and-done kind of thing — it’s not permanent. If the therapeutic version of the stimulus is withheld, the original response tends to resume over time. This response return is called spontaneous recovery.
Patients generally require periodic habituation “tune-ups.” Most need to repeat their habituation training from time to time. The good news is that habituation becomes successively more rapid with each cycle of sound therapy.
A neat thing about habituation training is that it can be cumulative. You can actually “store up” its effects, building a reserve of sorts. What this means is that if a patient continues with the sound therapy after their response to the stimulus is neutralized, the patient accrues additional benefits:
- Onset of spontaneous recovery may be delayed, slower progressing, and less severe.
- Future rounds of habituation training may produce results faster.
Maintaining habituation can be tricky when another (usually strong) stimulus is introduced. The new stimulus (e.g., roaring) can undo a patient’s habituation to the initial stimulus (shrill tone). This is called dishabituation — the roaring is causing spontaneous recovery of the response to the shrill tone. This can be addressed by habituation training for the dishabitutory stimulus (roaring).
Some Habituation Caveats
A patient with a weaker stimulus might experience habituation more quickly and/or in a more pronounced way than a patient with a stronger stimulus. And, it’s important to note that sometimes strong stimuli yield no significant habituation.
Other things being equal, the more rapid the frequency of stimulation, the more rapid and/or marked habituation may be. So, if a patient’s tinnitus exhibits itself as 60 clicks per minute, habituation might be more noticeable than if the patient’s clicks were paced at 20 per minute.
Habituation to one stimulus can result in a patient becoming somewhat habituated to other stimuli as well. For example, a patient who — using sound therapy — becomes habituated to the incessant hissing of their tinnitus might also become desensitized to the sizzling sounds they also hear.
Habituation vs Reinforcement
People often wonder what the distinction is between habituation and reinforcement. Both are mechanisms for learning — so how do they differ and why does it matter for tinnitus patients?
Reinforcement is a learning system based on reward and punishment. An action is taken or a behavior is exhibited. It’s met with a “prize” or a “penalty.” Actions or behaviors that produce favorable responses (rewards) are promoted and perpetuated. Those that inflicted undesirable effects (punishments) are demoted and deterred.
Over time, reinforcement intensifies the response to the stimulus. This is why eating sweets fuels your sweet tooth or getting another cavity filled fills you with dread the next time you have to go to the dentist!
Perhaps you’ve heard the saying, “The opposite of love isn’t hate, it’s indifference.” Habituation is that third point on the triangle, the disassociation or detachment. Instead of encouraging or discouraging a learned action or response with a trick or a treat — it strives for neutrality.
Whereas the response to a stimulus builds with reinforcement over time, it fades away with habituation.
Tinnitus Habituation Success — Proven Techniques
Several methods to reach habituation exist. Three popular approaches are sound therapy, cognitive behavioral therapy (CBT), and mindfulness practices. Many people incorporate one or more techniques into their plan of action.
Sound Therapy
Habituation via sound therapy is near and dear to our hearts — it’s what we do! This method leverages externally-produced sounds to counter the noises in your head.
For instance, an audiologist or hearing specialist calibrates the Levo System to exactly match what you hear. As you use the system while sleeping, your brain gradually becomes accustomed to the natural and artificial stimuli, eventually learning to be indifferent to them.
Cognitive Behavioral Therapy
Cognitive and behavioral therapies aim to reprogram your response to a stimulus.
A slew of CBT treatments are helpful for tinnitus habituation. Among these are mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), tinnitus activities treatment (TAT), tinnitus retraining therapy (TRT), and progressive tinnitus management (PTM). These are frequently combined with other habituation techniques, like sound therapy.
Mindfulness Practices
Examples of this include meditation, yoga, breathing exercises, and body scanning.
Mindfulness practices can help you manage both your response to the tinnitus stimulus as well as side effects you have from your condition. (They’re proven to bust stress and boost sleep!) These modalities also pair fantastically with other habituation and self-care techniques.
4 Stages of Habituation for Tinnitus Patients
Every patient’s habituation journey is unique. It’s dependent on numerous factors, like the type of tinnitus, the nature and magnitude of the symptom, etc. Plus, habituation is a gradual process. How long it takes to habituate and the ebbs and flows of progress will be different for each person.
Still, here are some common milestones or phases you might experience along the road to habituation.
Stage 1
- You’re still acutely aware of your tinnitus if you’re not sleeping or masking it, though it’s getting less intrusive and more tolerable.
- You often have anxiety or feel depressed about your condition, though it may be less severe than prior to beginning treatment.
- It’s hard for you to maintain focus for any length of time.
- Even highly-engaging activities don’t really distract you from your tinnitus.
- You may have intense or debilitative sleep disturbance.
- Your quality of life is still suffering but improving.
- Relief is inconsistent or not significant.
Stage 2
- Your awareness of your tinnitus is sporadic.
- The sounds you hear seem quieter and less bothersome.
- Your symptoms and side effects are no longer all-consuming — they’re vastly more tolerable.
- Your cognitive abilities are starting to rebound, making concentration and memory easier.
- You’re able to sleep better.
- Your mental state and quality of life are improving.
- Relief still has crests and troughs but is more predictable and even.
Stage 3
- Generally, you only notice your tinnitus when you’re tired or stressed.
- Your brain has made great strides in learning to disregard your stimuli.
- Tinnitus sounds rarely interrupt your concentration or memory.
- The noises, while irritating, aren’t distressing and are very manageable.
- Relief is getting evermore robust and regular.
Stage 4
- In normal, everyday life, you hardly notice your tinnitus, if at all.
- Your life is undisturbed by sounds or side effects.
- You’re emotionally detached from the noises — you don’t internalize them as good or bad.
- Your brain has learned to modulate the stimuli to the point it seems like your tinnitus is gone.
Life After Tinnitus Habituation — What to Expect
You’ve attained habituation — awesome! But, now what?
The reality is there’s no cure for tinnitus, so you’ll probably notice it again on occasion. This is common when in a really quiet space or life is throwing you curveballs.
On a positive note, because you put in the hard work to habituate yourself, the stimulus you hear likely won’t spur a drastic response. It’ll be more of a background noise or annoyance.
However, it’s recommended to have a plan in place to deal with the possibility of spontaneous recovery or dishabituation. (Remember — we mentioned revisiting your sound therapy regimen periodically?)
Levo Medical, Innovating Tinnitus Habituation for Greater Success
We’re experts in tinnitus and innovators in its treatment. Because of this, the Levo System can be an extraordinarily effective tool for you.
Using repeated sound therapy, the Levo System is proven to reduce your sensitivity to stimuli and minimize your response. The result is that — because you experience fewer and less severe tinnitus symptoms — your quality of life goes up.
Don’t learn to live with your tinnitus. Contact Levo Medical today to learn how to alleviate your tinnitus.