Tinnitus and negative thinking
Tinnitus is a noise (often ringing, swishing, buzzing or whistling) that is heard in the ears or head. While the perception of the noise is real, there is no actual external physical noise present. It is very easy to fall into the trap of negative thinking when you are coping with a chronic stressor like tinnitus.  As tinnitus is often made worse by stress, watch your thoughts and check you are not adding to the distress with negative thoughts about it. The more stressed you are by tinnitus, the more aware you will be of it, leading to more irritation and distress.

Psychological Treatment for Tinnitus
There are psychological strategies to assist with getting out of these negative cycles.  Cognitive Behaviour Therapy (CBT) has been found to reduce the distress from tinnitus. More recently, Acceptance and Commitment therapy (ACT) has also been used as treatment for tinnitus. Of the two therapies – and I practice both of them – I think that ACT has probably more to offer for this particular problem. This is because the very essence of ACT is learning ways of managing troubling thoughts, feelings and chronic conditions so they do not stop you from leading a rewarding and meaningful life.   

Clean and dirty distress
ACT makes a distinction between “clean distress” and “dirty distress” when dealing with chronic conditions. The essence of clean distress is that you are just experiencing the pure distress (I’m sad, this is unpleasant) without muddying the waters by adding in further negative thoughts like judgements (I should be able to cope better), assumptions (this is my fault) or predictions (I’ll never be able to cope with this). It also refers to additional feelings about your feelings (e.g. sad about being sad, angry about feeling anxious). So feeling irritated about your sadness over how silence is no longer a peaceful experience for you is “dirty” distress. Judging yourself for being sad would also be “dirty” distress. The sadness itself is “clean” distress.

Stop struggling
Coping with tinnitus also means coming to terms with the fact that it is a chronic condition. This means you need to give up struggling with trying to get rid of it. Instead, the key is to work out how to live around it. While you can shift your attention from it and focus on other things (sounds, people, and activities) in your present environment, it may always be there in the background. 

Trying to get rid of something that you cannot control is also “dirty” distress. ACT teaches you ways of acknowledging and accepting “clean” distress and ways of managing and letting go of the “dirty” distress that could pull you into a downward spiral of further distress. 

Enjoy life around it
Fortunately, you live in a world where this challenging problem can now be managed much more effectively than a few years ago. The essence of managing tinnitus it to learn not to fight it, but to enjoy life around it. Making this cognitive shift to true acceptance can free you up more than you might imagine. By applying these strategies, getting appropriate treatment for tinnitus and becoming an expert at identifying your tinnitus free moments, tinnitus can be relegated to just one of life’s myriad, minor problems.

Silence and Suffering
If you suffer from tinnitus it can feel like you never have any respite from this irritating constant sound, and this can be very distressing.  This hidden chronic condition leaves many suffering in silence – literally!   The quieter the ambient background, the more your mind will notice the tinnitus. 

Many tinnitus sufferers talk of their grief about never being able to enjoy the peacefulness of silence again. And this is certainly a loss. However, an interesting point to consider is that “silence” in nature is a sign that a predator is approaching and thus, in reality, a more relaxing and soothing sound environment would have the sounds of nature like chirping birds and crickets. Enriching background surroundings with sounds of nature can provide the tinnitus sufferer with some relief as it distracts and may even mask the tinnitus.

Enrich your sound environment
With tinnitus, it is worth experimenting with a range of sounds such as relaxing music or recordings of sounds from nature like moving water, birds and insects, wind or white noise. You can find more information about tinnitus and some free sound recordings to install on your computer and play in the background on this excellent website (click on "about tinnitus" and then on drop down menu, click on "sound enrichment" and scroll down to their free download called Aire Freshener). Alternatively you will find some Apps with sounds to mask tinnitus that you can always have with you on your phone. As tinnitus often makes sleeping difficult, it may help you to sleep by having these soothing sounds playing in the background.

We notice the negative
One of the reasons that tinnitus is so hard to ignore is that our brains are wired to make us pay much more attention to negative stimuli than positive stimuli. Paying attention to negative stimuli and noticing threats has survival value. Thus, we are automatically more aware of the negative, and tend to easily over look the positive.

Tinnitus Free Moments
To counteract this, we need to actively work at paying attention and recalling positive experiences and times we seem to be free of the tinnitus.  So become more mindful and appreciative of the “tinnitus free moments.” These times occur when ambient sound masks the tinnitus. This will vary for different people, but examples of such moments may include:

•  Having a shower
•  Being outdoors with nature
•  Anything that gives you wind in your ears e.g. riding a bicycle, boat or convertible car
•  Listening to a fountain or other water features
•  Being in a noisy restaurant or nite club
•  Listening to a live band
• Swimming
• Walking along the beach

Make your list
Experiment with situations like these to see if they work for you. Be on the lookout for other tinnitus free moments that you may discover. Start to make your own personal list of these times and learn to savour these moments. Keep this list handy so when your mind tells you things like “I can’t stand this... I am never free of this” you have the evidence to challenge these unhelpful negative thoughts that are compounding your distress. You will also be more aware that there are times you can count on for some respite from the tinnitus.