Cognitive reframing techniques for tinnitus sufferers

When you live with bothersome tinnitus, the sound never stops, and many sufferers find themselves in a downward spiral of negative thoughts and catastrophic thinking.

It’s easy to see why – the sudden onset of a loud sound that no one else can hear can be terrifying. When it doesn’t go away, most people just want to be able to ignore the sound. They try to push it away and focus on something else, but quickly find that it’s very difficult or even impossible to do.

But there are specific reasons why tinnitus sufferers experience so many negative thoughts. And there are many techniques and strategies you can learn to cope with this challenge more effectively.

In my eight years of working with patients as a tinnitus coach, I have found little else that works as well as cognitive reframing in helping people to deal with negative thoughts.

Cognitive reframing techniques allow you to quickly shift from a mindset of fear, frustration, or hopelessness to one of acceptance, resilience, and empowerment, and can have an immediate and beneficial impact on your quality of life.

First, why negative thinking is so common

When it comes to tinnitus, the problem runs much deeper than simply hearing an unwanted sound, especially in cases where there is no treatable underlying cause.

The sound itself is ultimately harmless. The real problem is the overwhelming emotional and psychological distress patients experience in response to the sound.

In any single moment, the suffering may be very intense, but you also have to contend with the fear of more suffering to come, and the thoughts of how this suffering could shape your future. There is also a clear memory of the peace you lost, and the fear that you may never find it again.

In addition to these psychological challenges, there are also a number of cognitive biases that tinnitus sufferers experience that make negative thoughts much more likely and make it very difficult to think about tinnitus clearly.

For example, most tinnitus patients experience a cognitive bias called negative memory bias.

This essentially means that you are only thinking about your tinnitus when it has your attention and is actively bothering you.

When you are distracted even for a moment, you aren’t thinking about your tinnitus at all, and so you won’t really remember these moments most of the time. This predisposes us to think negatively about tinnitus because we are only ever thinking about it when it’s causing suffering.

We evolved to focus on negative stimuli far more intensely than positive stimuli as a way to protect ourselves from danger. For better or worse, we evolved to survive, not to be happy, and when you are more aware of everything going wrong (negative stimuli), you are more likely to survive.

All of these factors end up fueling the vicious cycle of negative thinking that many tinnitus sufferers endure. And the negative thoughts in turn, only intensify the emotional and psychological distress.

Cognitive reframing - turning the tide against negative thoughts

Cognitive reframing, which is rooted in Cognitive Behavioral Therapy (CBT), offers tinnitus sufferers a direct way to reclaim control over their thoughts and emotions.

By identifying, challenging, and reframing negative thought patterns about tinnitus, patients can begin to improve their emotional responses and behaviors, and directly improve their quality of life.

Cognitive reframing techniques can be quite powerful when fully adopted and should be a part of every tinnitus sufferer’s toolkit. Here are a few of my favorite cognitive reframing techniques you can try today:

1. Observing positive change by noticing negative thoughts

When you notice your tinnitus and are experiencing negative thoughts, it can often feel like you haven’t stopped hearing your tinnitus and have been suffering and thinking negative thoughts all day long without a break.

But that is never actually the case. Tinnitus sufferers get distracted from their tinnitus constantly throughout the day.

We hear it and it bothers us, and then we get distracted for some period of time (however brief), over and over again, all day long. And because we mostly only remember the times when it was bothering us, it feels like it never stopped, when we reflect back with hindsight.

But every time you notice your tinnitus and start thinking negative thoughts, a change in attention has occurred. You went from thinking about something else to thinking about tinnitus, and that implies that for some period of time, you weren’t thinking negative thoughts like this, or feeling this way.

Ask yourself, “How long has it been since I last was thinking thoughts like this and feeling this way?” And then answer that question as precisely as you can.

Maybe it’s only been a few minutes. Maybe it’s been a few hours or a few days. However long it’s been, it gives you the chance to notice something positive, something you would not have noticed otherwise. And that kind of perspective change can really help you better cope in the middle of a difficult moment.

2. Moment-centric coping

When you are living with bothersome tinnitus, it’s really easy to become overwhelmed by difficult moments and negative thoughts.

One really helpful cognitive reframing technique involves shifting your focus to the present moment.

When we are experiencing negative thoughts about tinnitus, we are rarely truly present in the current moment. Instead, we’re lost in the past, thinking about how much better things were before tinnitus started. Or we get lost in the future, thinking catastrophic thoughts about how difficult life may be moving forward, if things get worse, or even if things just don’t get better.

In these moments, where negative thoughts are beginning to overwhelm you, the very best thing you can do is to shorten the coping time frame and focus on winning the moment in front of you.

If your tinnitus is not actually that bothersome today, or not bothersome right now in this moment, seize the moment, and do something fun, enjoyable, or productive. Don’t worry about what it will be like later, just enjoy this moment right now.

Conversely, if the tinnitus is actively causing you emotional and psychological distress, and you are lost in the negative thoughts, ask yourself, “What is the most effective thing I can do to feel better right now? What coping tool, or relaxation technique, or distraction can I use immediately to reduce my discomfort in this moment?”

Don’t worry about whether your tinnitus will affect your sleep later, or how difficult it will be to focus during your meeting tomorrow if it doesn’t calm back down. Just choose the best tool or strategy to help you feel better right now.

3. Adopting a creative gratitude practice

When you’re stuck in the vicious cycle of negative thinking about tinnitus, the emotional and psychological impacts can start to affect every aspect of your quality of life. It can start to feel as though the tinnitus has become a part of everything going wrong in your life, and patients often end up feeling depressed and anxious more and more of the time.

Gratitude exercises are a powerful way to fight back against these negative thoughts and emotions. In my opinion, the very best way to practice gratitude is to adopt a creative gratitude practice.

All you have to do is sit down once per day and write a list of 10 new things you are grateful for in your life, without repeating anything you have written on a previous day.

When you have to come up with 10 new things every day, it forces you to find the good in everything that is going wrong. And it doesn’t have to be tinnitus focused.

An example of this might be, “I’m grateful I got stuck in traffic because I got to listen to another chapter of my audiobook that I have been struggling to find time to listen to.”

This practice will not only help you to have more positivity throughout your days with tinnitus, but it will also train you to view your life through a much more positive lens.

Final thoughts

If you suffer from tinnitus, no matter how bad things may seem right now, I want you to understand one thing: there is hope. Your fears, and the negative thoughts you think during your most challenging moments do not have to become your reality.

I have personally used these cognitive reframing techniques and strategies for many years to great benefit. I hope you give some of these techniques a try!

More from Glenn:

• Facing the fear of hearing loss due to Meniere’s disease
• Brainwave entrainment for tinnitus
• Tinnitus coping strategies for rumination