Roaring In Ear
Shulman speculates that there may be a lesion in the brain of individuals with central tinnitus (tinnitus that emanates from brain and not necessarily the ear). My personal experience with such tinnitus, and that of my clients, leads me to believe that if there is such a lesion, the effects of the lesion can be regularly bypassed and do not demand hearing tinnitus all of the time.
Shalman also has discovered in over 90 percent of all individuals he has examined using advanced SPECT imaging of the brain, side to side perfusion asymmetries involving the medial temporal lobe system (MTLS); frontal, temporal, and parietal areas of the brain.
Neuroscientists believe that the MTLS, which includes the amygdala, hippocampus, and other portions of the brain, is the location where memory and stress meet. The MTLS, which is part of the limbic lobe, encircles the upper brain stem.
Returning to Le Doux's research for a moment, we can consider the fact that Le Doux has identified a neuroanatomical subcortical processing circuit (i.e., thalmo-amygdala), in which the emotional significance of an auditory stimulus can be learned, stored in memory, and be expressed in body physiology by the autonomic nervous system. Shulman has hypothesized that sensory systems and emotions are linked by memory.
For the lay reader, the key to understanding tinnitus is realizing that you are hearing an ever-present memory. This "memory" is similar, if not identical, to a Pavlovian conditioned response that loops endlessly:
Hear Tinnitus -> Feel Depressed -> Hear Tinnitus -> Feel Depressed and on and on.
Another loop that may have been conditioned is
Hear Tinnitus -> Feel Anxious -> Hear Tinnitus -> Feel Anxious.
Eventually there is a question of "Which came first: the chicken or the egg?" The link between emotion and tinnitus is so powerful and so bonded in the brain that the loop is tight and spins endlessly. Shulman calls this kind of feedback loop, "masking," not to be confused with the therapy for tinnitus called tinnitus masking. Shulman considers tinnitus to be "an auditory error, i.e., a defect in the ability of the masking neurons to function normally."
Dr. Shulman publishes updates on tinnitus research twice annually in his publication, The International Tinnitus Journal. The ITJ is the best publication in the world for keeping current on scientific tinnitus research.
A key objective of this blog is to help you, the reader, replicate the experience of millions of people who experience tinnitus but do not suffer from it. Those people who hear tinnitus but do not suffer have had no internal emotional (amygdala) negative evaluations of the sound(s) itself. This is one goal I would like you to consider setting for yourself.
People who find tinnitus to be irrelevant rarely notice the noise, since it is not picked up as important by the subcortical (emotional) brain.
In my experience with hundreds of clients, these feedback loops can be unhooked, or at least loosened, in most cases. As you can imagine, the process will take time, and the path will be fraught with difficulties that test your will and determination. You will learn a few self-help techniques later in this blog, but you will eventually contact a skilled therapist and a medical doctor to assist you with proper medications to nurture the process.
For many people, the sound of tinnitus is not generated, at least initially, in the brain, but in the inner ear. For these people the mechanism of generation is often the emissions of damaged hair cells in the cochlea. These sounds are interminably being generated through the auditory nerve into the brainstem for the same looping that was discussed previously. In these cases, we must also work on volume reduction in the inner ear. In addition, even if we unhook the stimulus tinnitus from the negative emotional responses, we realize that they can easily pair up again at a later date. Another very big challenge is about to be faced head on.
Here's the good news. These cases are happening much less often in clients than I once believed. I wouldn't call them rare, but I will say that I rarely see this.
Tinnitus and Your Inner Ear
In this section, we will not discuss in great detail types of tinnitus that are related to typical otological events and disorders (ear problems). Here we want to consider what is normally missed with standard audiological instruments. A competent Ear, Nose, and Throat doctor (ENT) will detect and treat any presenting ear problems for you. This portion, for the most part, will show you what the ENT's Instruments do not pick up. Then, if initial treatment fails, you can share this information with your ENT, otologist or other medical professional.
Tinnitus can be considered an auditory perception, for our discussion later. Once a "physical" cause for the tinnitus has been eliminated, it is useful to view tinnitus in this fashion. We can then treat the noise as an auditory perception. It is neither good nor bad. It simply is something that is perceived. If you are fortunate enough to have tinnitus that is phantom auditory perception, you have several options for treatment. To learn more, you have to check out Roaring In Ear.