by Julian Cowan Hill MA UKCP RCST
When you work with hundreds of people with tinnitus, certain patterns become clear. The core issue seems to be learning how to let go at a deep level and, once a person becomes able to do this, symptoms get better. In this article I want to show that if you receive the right kind of support, then the process of letting go takes place all by itself. I have had a lot of experience easing people with tinnitus out of a locked up state, and have witnessed great improvement, not only with the noises in their head but in their ability to be comfortable, positive, relaxed and healthy.
A person with tinnitus typically holds tension at the base of the head and along the length of the spine. Often the body feels like it is standing to attention or bracing itself. One man lay on the couch and claimed he was relaxed, and yet his head wasn’t even touching the pillow! He wasn’t aware of this and, when I told him, he needed to put his hand behind his head to check what I said was true. I have met literally hundreds of people with tinnitus who have not much body awareness because they are too locked up and numb to be able to feel what is going on inside.
If tinnitus could talk, as a symptom, it would cry out, “Listen to your body and learn to let go.”
Tinnitus people live in their heads spending most of their time living in hectic thought processes, planning, analysing, worrying, imagining, sorting out problems. There is always something to be achieved and there is rarely a prolonged period of just being happy with the way things are. Give a person with tinnitus a day off, and they will fill it with frantic activity, rather than sitting somewhere quietly and noticing the surroundings, without a care in the world.
It is always very revealing talking to people with tinnitus about how they relax. They might say they enjoy gardening for example. But when you look into it, rather than being aware of the positions of the body, what they can smell, or how the plants looks, that is simply being aware of the present moment, it seems that they spend most of their time in their thoughts, only vaguely in touch with their body and sometimes miles away from what they are doing. People with tinnitus on a walk, for example, will be much less aware of the simple sensation of their feet on the ground than what is going on in their head.
As a craniosacral therapist you can literally feel how people hold themselves and how open or closed their system is. When treating tinnitus I often find a moment when intense energy at the base of the head releases and suddenly the spine relaxes and people reconnect with the body. When they get up at the end of the session they are much more aware of how their body feels inside and they feel really connected to the ground. When this happens their head feels lighter, calmer and clearer.
If tinnitus could talk, as a symptom, it would cry out, “Listen to your body and learn to let go.” Although this condition actually forces you to listen to your body, most run away and hide in frantic activity, desperately trying to divert their focus away from themselves and their inner world. Sometimes tinnitus makes people run away from themselves even more. They cannot accept the way they are inside. The only place for them to go is into their thoughts and activities.
People with tinnitus have a deep need to be heard and understood
In my experience it only becomes possible for the central nervous system to let go and switch off when genuine support is offered. When this sense of support is felt through direct contact and the nervous system experiences a calm, clear and manageable contact, this brings in a very real possibility of transformation.
We can only let go when we feel safe, and someone is there to hold us. As a practitioner you become very used to meeting people who are carrying too much and do not let themselves be supported. Consequently they spend most of their life in a permanent state of overwhelm.
When this support strengthens into a help network, reaching out over several weeks or months at a time, it can have a profound effect on a person’s sense of well being, and what they are able to manage. It can provide the platform for them to let go much more deeply than they are used to, on a mental, an emotional and a physical level.
CST also brings sensitivity and energetic awareness into contact with your body. This gradually helps you develop your own awareness of how you really are inside at a deep level. In my mind it is one of the best therapies for bringing the nervous system back into a state of manageable calm. This is a very real, palpable experience that you gradually develop over the course of a few months and years, depending on how far people want to go.
People with tinnitus have a deep need to be heard and understood. Because I had tinnitus myself for 16 years, of which four years was so severe I couldn’t hear the phone ring, I am in the fortunate position of being able to understand what people are going through. People find great solace in knowing that I have healed my own tinnitus and this gives them not only a positive sense of hope but also motivation and inspiration to start looking after themselves appropriately.
In a society where people are often told devastating news that there is nothing they can do about their tinnitus and need to learn to live with it, I find providing hope, guidance and a means of being able to let go has proved to be a powerful antidote to this negative “spell”. When a person is in need of support and feels they are losing control, it has very serious consequences when a practitioner they go to for help leaves them feeling hopeless and with no way out. This shows very little understanding of this condition and how to meet people’s needs appropriately.
In circles where there is a lot of awareness and experience with the relationship between practitioner and client, it becomes clear that practitioners need to care about their clients and be open to be affected by their suffering. Deep down we all know that if the person we go to for help doesn’t really care, there is only a limited amount of value in what they are offering and their ability to resolve deeply-held issues.
It is commonly accepted that tinnitus appears when someone’s nervous system becomes stuck between “fight or flight” mode (sympathetic hyper arousal) and the freezing response (parasympathetic overwhelm).
When we move into a state of red-alert the way we hear radically changes. Normally we happily monitor background noises just below the level of consciousness and can focus sharply on important information when needed, e.g. hear one person’s voice in a noisy pub. In red-alert mode, which includes most people with tinnitus, you listen out for any sign of danger most of the time and as a result you notice background noise.
In fact your hearing becomes so sensitive that you hear the noises inside as well as outside the body. Nervous impulses along the auditory nerve can sound like a buzz or hiss. Movements inside the head such as changes in pressure can sound like crackles and pops. For some, the sound of the heart beat becomes noticeable and, for many, it can become hard work trying to distinguish what’s important from all the cacophony going on in the background.
Gradually symptoms become harder and harder to notice
The cerebral cortex also becomes highly activated and so the part of the brain that remembers sound, recognises it and can conjure up any imagined sound, becomes over-amped and too switched on. This means that our sound imagination can take over. I can remember, when my tinnitus was bad, listening out for the doorbell and often swearing that I heard it, when in fact it was just my auditory cortex being very active. It was very confusing.
When I take on a client with tinnitus, my aim is to help bring them back into a switched off, not-a-care-in-the-world mode. As they move more and more into that state, people commonly improve in the following ways:
The first sign of relief comes as you stop being bugged by symptoms so much. This often happens fairly quickly, after four to six sessions or so. The tinnitus is there but it is not nearly such a big deal. I find that knowing others have got better really helps at this stage, as well as understanding that tinnitus is just a central nervous system reaction to having too much undigested life experience going on behind the scenes. This helps the whole condition feel less and less threatening.
Then, as you genuinely start learning how to let go, you start paying less attention to it and forget about it. You can spend a few days without bothering to notice how it is. This can be a milestone of progress, as it gives you proof that you are going in the right direction. This in turn can help you let go even more, creating a positive circle of progress. To get to this stage may take anything from a few months to a year or two depending on how much people need to process and release.
Gradually symptoms become harder and harder to notice, and although you can readily find the noise again if you look for it, tinnitus has really started to play a minor role in your awareness.
It is at this stage, that something vital happens. Tinnitus will often come back if there is acute stress, tiredness, anger, illness etc, but you start to learn that how you are has a huge effect on symptoms. As a result you start to take more responsibility for your own health and really start to look after yourself. You notice that your usual habit of getting twitched up about things doesn’t help, and may well take this into therapy.
Tinnitus now has become a “healthometer”, acting as a happy warning system telling you to calm down, get help or have a few early nights, knowing that if you have a bad week it will soon balance itself out again. You also start to become much more self-sufficient in your own management and are motivated to look after yourself, knowing what you need and have ready access to that help.
Eventually, as the nervous system strengthens more and more, it takes more and more resistance, stress, illness, trauma etc to bring the symptoms back. For example, just a couple of years ago, I found coffee and wine made my tinnitus come back, but these days I can get away with coffee and wine every day (not something I encourage!) and still be free of it.
I believe that CST is particularly good for tinnitus as it works very specifically on the parts of the central nervous system that switches off the stress response. It helps people come out of the freezing response, pass through fight or flight, back towards the ideal and calm state of homeostasis. It is important to note that some people may never have experienced this ideal state of calm and well being and it can come as a real surprise and new experience, as it was for me!
I have tried to capture some of the main qualities of these states in the chart below:
|FREEZING RESPONSE||Very accelerated and anxious||So tense it is numb; you feel out of it, body feels empty, cold hands and feet||Fearful, hunted, fretting about most things||Disconnected, floaty, tight core, icy cold||Irritated by most sound, which can be painful, sound can be a cacophony|
|FIGHT OR FLIGHT||Agitated and busy, switched on all the time||Tense and achy, sensitive, uncomfortable, hot body with cold hands and feet||Over-reactive, flighty, irritable running on a short fuse||Buzzy, electric, swirling||Aware of all sounds around, can't tune out of certain noises|
|HOMEOSTASIS||Calm and clear||Relaxed, easy to feel, and expanded||Positive feeling, no worries, life is manageable and easy||Smooth, expanded, warm, clear, flowing, grounded||Unaware of background sound unless focusing on it, can pick out certain sounds in focus|
The longer you stay in homeostasis the harder it is for tinnitus to carry on.
Sometimes people move from one state to another in just a couple of treatments, but usually their life pattern is so strong that they soon move back into a similar situation, albeit with some improvement. This is why I insist on seeing people for a minimum of six sessions.
More significant and long-lasting changes happen gradually over an extended period of time. This long-term approach takes root much more deeply and feels so manageable and right that people very often don’t notice how much they have improved until you ask them about their symptoms. I often have to refer back to my notes to remember what they came with at the beginning of the process.
Most people work well with a treatment once a week or every two weeks. I would say that over 90% of those I treat at least six times notice that they are not bugged by their tinnitus as much and feel more comfortable with it.
As people slow down, let go of their baggage and relax, they usually make big changes to their lifestyle. People naturally find themselves working less, spending more time looking after themselves, eating better, taking more exercise, sleeping more and, most significantly, being able to stop and watch the world go by without filling their free time with frantic activity.
At the beginning of the process I usually teach people relaxation techniques and provide plenty of counselling regarding specific issues of life with tinnitus. I help people develop a better relationship with their own symptoms and eventually to treat it as a positive health indicator.
Sometimes it is clear that people need more support above and beyond what I can offer. I often suggest they have psychotherapy to help deal with core issues in their lives and will refer them to other practitioners if I feel that is more appropriate for their specific issues.
A common condition that is hugely unsupported and misunderstood is Candida or thrush. Frequent courses of antibiotics have meant many people have this chronic condition, which usually leads to tinnitus, a feeling of low energy and a clogged up head and hearing system. I often suggest they see a nutritionist or find out more about this condition for themselves on the Internet or in a bookshop.
Finally a new area I am starting to work with is the ability to work with our imagined sound in our “mind’s ear.” Most people are able to imagine the sound of a waterfall, for example. If you play around with your imagination, you discover that you can increase, change, manipulate and control the sound, so that it can take the focus away from the tinnitus. This is a huge untapped resource in our hearing world. Learning how to increase the imagined sound of something you really love listening to, like the sound of the sea, your mother or wife singing a lullaby, the wind in the trees, your favourite piece of music, is very calming for the nervous system. With practice, I believe it could have the same effect as a sound-masker, with the added bonus of being much easier to use and far more tailor-made. This area of work was inspired by training in Neuro Linguistic Programming.
How to look after yourself to help tinnitus
It is essential to develop body awareness and learn how to relax if you want to help your tinnitus. Go to a yoga, tai chi, or Pilates class on a weekly basis so you will have correct tuition and learn to get out of your head and get in touch with your body. This will prove invaluable in the long-term and will teach you techniques for those bad days when you feel overwhelmed.
Find a body therapist you like and feel comfortable with, and who can drop you into a deep state of calm and relaxation. Visit them once a week until things feel more manageable and then renegotiate how often is appropriate. You will need direct support in learning how to let go. It is much easier with someone else helping you.
If you are suffering from severe tinnitus, find a tinnitus counsellor or someone who has worked through tinnitus themselves and understands what you are going through. Please avoid practitioners or other tinnitus people promoting negative views on tinnitus. It is important to maintain a clear and positive focus with this condition with caring support. STAY AWAY FROM NEGATIVITY ON THE INTERNET.
Avoid too many stimulants like coffee, chocolate, tea & alcohol. These all raise you adrenaline levels and therefore make you more sensitive to tinnitus. Bring about any change very gradually so it is not stressful for your body. Too much salt and sugar can also make tinnitus worse.
Put aside one part of the day which is for you, where you are not to be disturbed. This means switching off the phone and telling others that you are having some down time. Ideally spend time relaxing, noticing how you are feeling, and do something which calms the mind. If this is difficult for you because you are too accelerated, unhappy or agitated, then consider visiting a psychotherapist or counsellor who can help you feel more comfortable with yourself. If you cannot fit this in because of your lifestyle, then seriously consider changing your lifestyle.
Learn specific relaxation techniques for when you have a bad day. When things get bad learn to recognise that you have gone into orbit and take positive action. Contact your therapist and go and get support. Do something calming rather than allow your thoughts to run away with themselves. Practise a body calming technique that you have learnt from your classes.
Take regular low-impact exercise that is calming and puts you in touch with your body, e.g. when you walk, feel yourself walking and notice what is going on around you rather than planning, analysing, and thinking furiously in your head.
If you have had thrush or Candida seek the help of a nutritionist or read about the condition, which can lead to tinnitus. You may need to avoid sugar, yeast, cheese, bread, wine and beer etc to help your system settle and let go of tinnitus. There is plenty of information in bookshops and on the internet. The condition can arise after antibiotics, and you might need to take probiotics to help balance your gut.
Keep your auditory environment comfortable. Sometimes silence can make you more aware of your tinnitus, sometimes it can be relaxing. Learn to choose sounds which are comforting to listen to or have them in the background. They might include your favourite music, or the sound of a river or the sea. Spend time specifically listening to something you love hearing on a regular basis. Listening to the radio is more normal and less “tinnitussy” and will help you take your mind off the ringing.
When you find yourself worrying or feeling negative, take positive action. Do something that focuses you, calms you down, and makes you feel better. Don’t stew in the stressful theatre of your mind.
Start using your tinnitus as a “healthometer”. It will soon tell you if you are doing the right thing because it will calm down. If it has got worse, try and consider what made it worse.
Take a long-term view. Expect things to improve gradually the more you look after yourself, give yourself time out and get support. Your tinnitus will get better the more you feel comfortable in yourself.
Yawning, humming, laughing and sighing are very helpful, especially yawning. This opens up and releases tension in the structures in and around the ears and can release feelings of blockage and discomfort.
Cold showers or baths, or oscillating between warm and cold, can be very helpful for grounding and bringing down the ringing.
Julian has an App called QUIETEN full of useful information, techniques and approaches to help let go of tinnitus: https://www.quietenapp.com
Julian has written three books on tinnitus available on Amazon:
Tinnitus, From Tyrant to Friend: How to Let Go of the Ringing in Your Ears
A self-help book with a clear guide to show how you are getting better
A Positive Tinnitus Story
A brief overview of Julian’s experience as therapist helping tinnitus
The Long Tide to Silence
Julian’s own personal journey from deafening tinnitus to quiet
The opinions expressed in this article are those of the author and do not necessarily reflect the viewpoints of the CSTA.