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David Ho

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 #1 
Hi Dr. Nagler,

People who have habituated often say they can't hear (or rather, are unaware) of their Tinnitus unless actively looking for it (including yourself I believe).
From all the descriptions of habituation this is the concept that I find most difficult to grasp. How can you actually not hear a loud sound? Maybe for mild cases, but for severe intrusive T? Sounds preposterous...
My T started almost 3 months ago. I wouldn't call it catastrophic but it's loud/piercing enough to hear it over everything (except shower). Sure I don't have the initial panic/suicidal thoughts I had in the beginning but it's still a real pain relentless 24/7 and a torture without masking. There may be times when having fun with friends or REALLY engaged with an activity that I forget about it for minutes. But NEVER hearing it? Even if I force myself to think about other things it's still there all the time...
I can imagine with time you might reach a point where you are 80%-90% NOT BOTHERED by it but to actually not hear it?
My point is that it takes a huge distraction (whatever form it may take) to make me forget about the T. I can understand that if I get home and the kitchen is on fire I might not think about it but for the bigger part of every day there simply aren't any distractions with a threshold high enough to make me forget about it.
For example I love playing with my kids and it's a really absorbing activity. Does it make me forget about the T? absolutely not.
You yourself have said that you are largely unaware of your T except maybe 10% of the time I believe.
Could you expand on this concept?

Thank you and kind regards

David

Dr. Nagler

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 #2 
David posted [in part]:

People who have habituated often say they can't hear (or rather, are unaware) of their Tinnitus unless actively looking for it (including yourself I believe).

.............

Yes, that's pretty-much where I am. My tinnitus is incredibly loud. It sounds like a cross between a screaming teakettle and a roaring jet turbine. I used to be aware of my tinnitus 99% of the time. I could hear it 100% of the time while purposely seeking it, and I was consciously aware of it 99% of the time that I wasn't purposely seeking it. I mean, if I stubbed my toe on the corner of the dresser, for that split second I wouldn't be aware of it - because I would be in agony - but other than that, yes, I was constantly aware of it. Fast forward twenty-plus years. My tinnitus is still a cross between a screaming teakettle and a roaring jet turbine, and I can still hear it any time I purposely seek it. But other than that, I am consciously aware of its perhaps 5-10% of the time. Moreover, when I am consciously aware of it - while it can distract me, it never causes me distress. In summary, my tinnitus has not changed a bit; what has changed ... is me! Another way of looking at it would be to say that what has changed is the way I react to my tinnitus. And the less you react to your tinnitus, the less you become aware of it ... unless you check.

................

From all the descriptions of habituation this is the concept that I find most difficult to grasp. How can you actually not hear a loud sound? Maybe for mild cases, but for severe intrusive T?

.................

Well much of TRT counseling is devoted to thoroughly demystifying the very phenomenon you describe, but people who live in houses with grandfather clocks or cuckoo clocks will know exactly what I'm talking about. Both of those timepieces make an absolute racket every hour, and visitors to homes that have them wonder how anybody can possibly live there. But the folks who live there are hardly ever aware of the racket they make on an hourly basis. Now I realize that your tinnitus is an internal sound while the clocks represent an external sound, but in the final analysis a sound is a sound; the principle is the same. The only difference is that with tinnitus the process can be more daunting.

...............

Sounds preposterous...

................

That's exactly what I myself thought back in 1994 when these concepts were first explained to me!

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I can imagine with time you might reach a point where you are 80%-90% NOT BOTHERED by it but to actually not hear it?

..............

Go back to the clock example!

.................

My point is that it takes a huge distraction (whatever form it may take) to make me forget about the T.

..................


Habituation has nothing to do with distraction. And it has nothing to do with coping either. It has to do with not reacting! Right now you are likely sitting in a chair. You aren't coping with it. You simply don't react to it. And if you didn't react to your tinnitus, then no matter how loud it might be, you would largely be unaware of it ... unless you checked.


...............

You yourself have said that you are largely unaware of your T except maybe 10% of the time I believe.
Could you expand on this concept?

............

I just now gave it my best shot! :-)

...............

Thank you.

.............

You are most welcome.

Dr. Stephen Nagler

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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