Psychology of Tinnitus

True silence is rare, especially in urban environments where background noise is almost constant. When we do find ourselves in a quiet place, the effect on our ears can be profound. The absence of external sound allows our auditory system to become more sensitive, sometimes picking up the faintest noises that would normally go unnoticed. This increased sensitivity can make us more aware of our own bodily sounds, such as the hum of blood flowing or the ringing of tinnitus.

Physiological Effects on the Ears

Our ears are designed to process sound, constantly adjusting to the environment. In silence, the tiny hair cells in the inner ear have no external vibrations to process, which can lead the brain to amplify internal noises.

Silence and Mental Wellbeing

The impact of silence is not limited to our ears. Studies suggest that quiet environments can help reduce stress, improve concentration and promote relaxation. However, complete silence can also be unsettling for some, as it removes the comforting layer of background noise that many people are accustomed to. This can heighten the sense of solitude or make normal bodily sounds seem unnaturally loud. 

I would suggest a moderate amount of silence, possibly to read or have a quiet moment, but if that feels uncomfortable, then allow yourself to experience sound in a way that is calming for you, such as music for instance. However, it is important that you do not try to drown out the tinnitus and so the level of music should be below the level of your tinnitus in order to habituate to it.  

The Sound of Silence

In a study carried out in the 1950s by two American researchers (Heller and Bergman) they placed 80 students who did not have tinnitus, one at a time, in a soundproof room. Afterwards, approximately 94 per cent of those people experienced a sound sensation such as hissing, ringing or buzzing when listening to ‘silence’. 

More recently a similar study was replicated at Nottingham Hearing Biomedical Research Centre but with a twist.  They put people in a soundproof room and 83% reported hearing sound and then they put in a non-functioning speaker and the number of people who reported hearing sound went up to 92%.  These people did not have tinnitus and had normal hearing. All of them heard some sort of sound when there was absence of any kind of input which indicated there is more to tinnitus than just the hearing of sound itself.  Attention or focusing on tinnitus plays a key role and I think everyone who has tinnitus will agree that they do tend to focus on their tinnitus.  But things do change and your brain does learn to filter out the sound once it becomes unimportant to you as you learn more about tinnitus and how to manage your emotional reactions.

Selective attention

There is evidence that our attention picks up tinnitus to focus on rather than other sounds and this can be heightened by monitoring to see if “it” is still there.  However, our ‘hearing brain’ has the capacity to filter out sounds that it considers unimportant.  We can help this process by using our other senses – sight, touch, taste, smell and choosing to do so will help in the process of “habituation”.

Perception

Sensation and perception are two separate processes that are closely intertwined. Sensation represents the ‘input’ – in this case our tinnitus and the perception is the process by which the brain selects, organises and interprets these sensations.

Perception is a creation, it is our brains, mind and the neurons inside our heads creating the world for us.

When we hear a stimulus – our tinnitus – the first thing we do is attend to it – pay it attention.  We need to do this because we need to process it. This is not the end of the process because then we need to recognise it.  As it is an internal sound and not one we are used to – it becomes frightening because we can’t recognise it.  However, perception also takes into consideration our prior experiences, the effect of memory, learning and previous encounters with a similar stimuli.

Attention

We are continually bombarded by stimuli, but we are not always aware of it. We don’t always feel the clothes we are wearing unless we pay attention to them. One of the ways we manage tinnitus is by bringing in other stimuli for our senses. However, if we focus intently on our tinnitus, we could miss the other stimuli (inattentional blindness).

In a famous study by Daniel Simons and Christopher Chabris (1999) participants watched a video of people dressed in black and white passing basketballs. Participants were asked to count the number of times the team in white passed the ball. During the video, a person dressed in a black gorilla costume walks among the teams. You would notice a person dressed as a gorilla surely as it is so unusual? Nearly half of the people who watched the video didn’t notice the gorilla at all. They were so focused on the people passing the ball they completely tuned out other information. This may be why you perceive your tinnitus even with the TV on or at a football match.

Contrast 

Contrast also affects our perception. If someone’s mobile phone lights up in a dark theatre before a performance, you will most likely perceive it but if the same phone lights up in the well-lit bar in the interval, you will not notice it.

A number of our group members state they notice their tinnitus after being in the car and coming in the house. This is the contrast between the noise of the engine and the quiet house. 

Of course, tinnitus is most noticeable at night when you have had other stimuli around, maybe the TV, radio or your partner talking and then suddenly the quiet bedroom.

Habituation

Over time the brain will become habituated to tinnitus as it does to any other frequently repeated stimulus. Effectively the brain learns to accept tinnitus as another bodily function and thus learns to ignore it as it learns to filter out the sound as being ‘unimportant’. For example, if you lived close to a railway line, over time your brain would habituate to the constant noise of the trains passing your home and consequently filter out the sound.

Habituation is a natural process by which the brain becomes less responsive to a repeated or constant stimulus over time. In everyday life, this process allows us to tune out unimportant background noises, such as the ticking of a clock or traffic sounds, so we can focus on more meaningful stimuli. Habituation is an essential mechanism for filtering sensory information and preventing sensory overload.

Habituation is a key concept in helping people manage tinnitus. By understanding and supporting the brain’s natural ability to adapt, individuals can reduce the distress caused by tinnitus and regain control over their quality of life. While tinnitus may not always disappear, habituation offers hope that it can become a background noise – barely noticeable and rarely bothersome.