How To Stop Ring In The Ears
Exercise 2: Internal versus External Sensations
Make yourself comfortable and close your eyes. Spend a few moments focusing on your breathing – just breathe gently in and out, in and out, in and out. Now practice switching your attention. Learn to control it and direct it, just like a searchlight. You can control the focus of your awareness and attention – divert it and focus on one thing, then shift it to another. Ask yourself the question: Where is my attention now? Is it focused on internal sensations inside your body, or on external sensations arising from inside the room, or perhaps on sensations outside the room?
Now, focus your attention on physical sensations. Be aware of the air temperature on your skin. Is it warm or cool? Notice the sensations on your arms and hands. Now try to become aware of other sensations, movements, or sounds within your body. Also notice that whatever thoughts or images come into your mind, these interfere with your awareness and attention.
Now, refocus your attention. Focus on the sounds and sensations within the room. What can you hear? What noises are there in the room? Mentally identify the noises. Now refocus by switching your attention to the sounds and sensations outside of this room – maybe in the hallway, or the next room, or outside in the open. What can you hear outside? Do you notice voices, laughter, birds chirping, the wind, traffic, machinery, footsteps, aircraft? Try to identify any outside noises.
Now refocus your attention. Concentrate on the sensations in your feet. Next, focus just on your toes. Picture each one. And now, focus your attention back onto your breathing. Breathe gently in and out, in and out. Spend a few quiet moments focusing on your breathing and allow all the muscles in your body to relax. After a few moments, slowly open your eyes.
Did you notice the ways you can shift the focus of your attention-from internal physical sensations, to your immediate external environment, and to the further external environment?
You have control of the focus of your attention. With regular practice you can increase your skill in attention control and learn to be confident about your ability to deliberately refocus your attention from one thing to another. Now practice exercise 3, in which tinnitus will be directly addressed.
Exercise 3: Physical versus Sound Sensations
Make yourself comfortable and close your eyes. Once again, begin by focusing your attention on your breathing, gently in and out, in and out.
Now focus your awareness on the noises in your head – tune into the noises. What can you hear? Spend a few moments listening to the noises. Now refocus your attention to your hands. Slowly identify each of your fingers. Now redirect your attention. Shift it further down your body, focusing on your feet. Be aware of your right foot and your left foot, then slowly become aware of each toe.
Next, redirect your attention and focus on your breathing, in and out. Notice the point where your breathing changes from in to out, to in to out. Spend a few moments becoming aware of your breathing.
Now, what external sounds can you hear? Spend a few moments becoming aware of any external sounds and try to identify the source of those sounds. Focus back onto the noises in your head, paying attention to the various noises. Now quickly redirect your attention. Focus on external noises in the room and outside. What can you hear? Spend a few moments trying to identify any external sounds. Next, focus again on physical sensations – notice the air temperature, the sensations on the skin of your hands, the palms of your hands.
Now allow yourself to spend a minute shifting your attention from internal to external sensations; deliberately refocus your attention. Notice that you can only focus on one thing at a time.
Practice moving deliberately back and forth between the noises in your head, physical sensations, and external sensations. After about five minutes, focus your attention back to your breathing. Spend a few quiet moments focusing on your breathing and at the same time allowing all your muscles to relax. After a few moments, slowly open your eyes.
There are three important points to keep in mind when practicing attention control exercises:
- The focus of your attention is, to a large extent, under voluntary control (provided that you are aware of the current focus).
- You can learn to control the focus of your attention under various conditions.
- By exerting control over your attention, tinnitus-related distress will be reduced at certain times.
Daily practice is essential to develop your skill in attention control. I recommend that you practice the exercises for 10 to 20 minutes each day.
Of course, we recognize that for many people, tinnitus appears to have some edge over other stimuli in its ability to command attention. Numerous individuals report that when their tinnitus is particularly troublesome, they find it difficult to attend to anything else. This is another similarity that tinnitus shares with chronic pain. Many of the techniques we described have been adapted from similar approaches that have been found to be highly effective in managing pain. Like pain, tinnitus may represent a challenge to overcome, but we suggest that it is well worth attempting to see just how much control can be achieved.
It might be useful to ask yourself whether you have noticed that, when your attention has been focused on something else, the tinnitus is sometimes less noticeable. Most people can think of examples of this phenomenon. Some examples might include working on your computer, repairing your car, playing golf, watching a favorite television program, sailing, watching football, listening to a friend tell you some gossip, and so on. From our clinical experience with people who have tinnitus, these methods can prove to be as effective as when they are applied to chronic pain patients.
Finally, we would like to emphasize that the idea is not so much to stop thinking about, or focusing on, the tinnitus. Rather, the aim of attention control is for you to learn to develop the skill of being able to direct attention both to and from the tinnitus. This point is very important, as the main goal is to build up the attention control skill per se, and for you to develop your confidence in being able to control the focus of your attention.
With regular practice you can learn to redirect your attention from one source of stimuli to another. This point is crucial, since it is difficult, if not impossible, to stop paying attention to unpleasant sensations (e.g., tinnitus or pain) unless one refocuses his or her attention on to other more pleasant or even neutral things. In the next post we will describe some other attentional control methods that involve the use of mental imagery. Before that, you can check out How To Stop Ring In The Ears for more details.
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