I know that there are supposedly 4 stages in the habituation process
What I don't understand is that some people partially habituate or fully habituate and then the Mighty T introduces another horrid noise ,the person gets clobbered and the original habituation process goes back to stage 1 again.
Some folk have had T for 30 years but still find it troublesome so I unsure what happened in these cases .Did they repeatedly habituate but then frequently because of set backs get demoted to stage 1 in each case because of additional noises manifesting themselves?
Can I am assume then that habituation is not as simple as it initially stated in the fact that it is transient and not permanent
Like Covid which you can catch multiple times ,you can get clobbered multiple times with tinnitus and have to habituate multiple times as well ?
Written by
DR650SE
To view profiles and participate in discussions please or .
EXACTLY !!!! You’ve hit the nail right on the head. . I do like your humour , because humour is exactly what helps this dreaded T . Thank you for your post .
Habituation to tinnitus is a gradual process that occurs over a long period of time. To guide your progress, psychologist Richard Hallam describes four stages of habituation. Hallam’s stages provide an overview of the process as it unfolds over months and years. The stages help you what to expect and provide a yardstick to gauge your progress.
Stage One
Persistent awareness of tinnitus except during sleep and masking by louder sounds.
Frequent worrying and depressing thoughts about tinnitus.
Concentration on mental tasks difficult to sustain for more than a few minutes.
Absorbing activities provide only slight distraction.
Insomnia (if present) is severe. Cumulative sleep loss in some cases necessitates medication.
Stage Two
Intermittent awareness developing—especially during absorbing activities. There are moments when you are aware that you have not been aware of tinnitus.
Improvement in concentration reflected in increasing engagement in usual activities
Beginnings of emotional acceptance; the implications of the noises no longer seems catastrophic.
Gradual return to normal sleep pattern (if disturbed).
Stage Three
Awareness mainly limited to periods of fatigue, stress or quiet.
Noises intrude mainly when listening and mental concentration are important (at social gatherings, the theater, lectures, etc.)
Noises are annoying rather than emotionally distressing
Stage Four
Attention rarely given to the noises. Attention limited to periods when they are louder than normal or you are reminded of them.
Noises do not intrude into normal activities.
Emotional acceptance is achieved—the noises are neither pleasant nor unpleasant.
BUT if anyone told you this was a smooth process with no ups and downs they were kidding you!
Hello HRI understand the article but it does talk about multiple habituations that a person may experience each time the nature of the tinnitus changes in terms of volume or noise characteristics
I think the process Stage 1-4 process in isolation is simplistic as it does not tell the full story
It’s just an article,Try the book by Julian Cowan Hill “Tinnitus, from tyrant to friend”. I don’t agree with absolutely everything he says especially about how T might start, but there’s a lot of stuff about habituation there.
Hi , I have read the book by Joey and found it interesting just like many other books on the subject . I have just completed a 12 week course of CBT and it all helps in my experience
Hello. The phrase “Tinnitus Rules”. always comes to my mind. Just when I get a fairly good day and think maybe this is it and I’m learning to live with it it will come back with a vengeance. It has changed my personality and I know at times I am not a very nice person to live with since this has taken over my life. Outwardly, apart from getting older I don’t suppose I look much different to people. My husband at 80 has perfect hearing, always has and I think he finds it difficult to comprehend. We really all do need a glimmer of hope that there is some help on the horizon. Hope everyone has a pleasant day xx
Hi DR650SE All very good questions. I read somewhere that 98% of people habituate. I often wonder what happens to the 2% Why don't they habituate? I was habituated to mild / moderate T for some years but in July 2020 I went back to stage one when my T got louder. Will I get back to stage 4? I don't know . After 21 months I'm not distressed but still aware of it. I've concluded it's a mystery 🙂
I agree Peter . In his book Living with T & H David Baguley says that not everyone 's recovery is complete . I guess he means not everyone fully habituates.
I would say that I had had a reasonable level of habituation for 3 years and then 2 years ago tinnitus changed to become more intense and erratic and I haven’t been able to rehabituate since then. I find it exhausting and debilitating and my life has definitely changed since having it. It is a disability as it prevents me from having much of a life including being able to work like I used to. I find it hard to believe that 98% of people habituate.
I am sorry to hear about your current situationit is pretty tough on some of us and unless you have experienced the problem first hand people won't understand
Hello and all I can say is my T is, incredibly loud, by any measure the audiologist can offer me as a scale. Maybe because mine was caused by a virus that clearly did some physical damage somewhere.Since it started around 2015, I’ve not managed to habituate and I only wish I could. It’s not for the want to try either with pretty much you name it.
I am also unsure what people mean when they say they can do this because I would really like to. I’ve been told in the past by CBT sessions that I’m holding myself back but don’t see it. Maybe the CBT, which unearthed some other not so nice things from my childhood I’d ‘forgotten’ about didn’t really help me to habituate.
Sorry this does not help but after what feels like many lifetimes suffering from this, honestly I’d love to habituate myself.
Thanks for this message I do think CBT can help - possibly - but maybe not so much if stressed. As others have said the flight or fight seems turned permanently on for me. Since T I constantly feel like I’m running at 100mph away from something. The every night ‘trapped’ nightmares seem to be a gift that doesn’t want to stop giving 😬I try and fail every day to reduce stress but it seems impossible. I think I’ll burn out or have to start some medication. I resist this as I was brought up with the ‘be stronger’ approach 🤦♂️
I’m coming to the fast conclusion that what my very first audiologist told me is the absolute truth of the matter which is,
“Graham your T will stop when you do”
Which is kind of funny/sad/unhelpful/obvious you name it!
So yes I think CBT is very good and helpful it’s just dying my helping my T this ‘horrible’ childhood thing came out that clearly I’d forgotten/pushed to one side and that scuppered my sessions. Some say better out than in but I’m not so sure. The NHS sesssions were too short to deal with T and ‘that’ so I flumped out of the other side wondering why!
Hi DR650SE, After 2 years of Tinnitus I think I have reached stage 3 of Habituation, I can still here it but it no longer get`s me depressed or annoyed and hopefully I can soon reach stage 4. 6 months ago there was no way that I thought I would ever be able to live a normal life with Tinnitus. Good luck to everyone with Tinnitus it is possible to Habituate.
8 years in and I am thoroughly fed up of "hearing" about habituation - never been able to and I would love to meet up, face-to-face, with someone who has because every time I am at ENT I've never met uno!
He was an American professor who did simple scientific experiments on childrens TV For example putting a lighted candle inside a bottle and placing a boiled egg on the spout
As the oxygen was depleted, the vacuum created sucked the boiled egg inside the bottle
I know that this is definitely relevant to T so I had to mention it LOL
I am nearly a year in and my T has got worse. It started off as a hissing noise that I could tolerate. Now I have a high pitched tone on top of the hissing. I do feel like habituation is very much a long way off for me, but I do live in hope. I need that bit of hope to keep me going.
Well Molko, I don't know if this is the 'hope' that you are seeking, but since I have been back to the forum you have certainly given me me hope with your chirpy, enthusiasm and confidence.... In fact I think that you are the outright star of this show!.... Not seen all your posts but the latest is a little bit despondent but I am very sure that you will pick up again soon.... Come on, chest out, chin up!!!
I developed T last August.It definitely is a lot louder now .The only variables that could contribute to this are either riding a motorbike ( I take every precaution to prevent further hearing loss) or mirtazapine .
I started the medication in January to help me sleep but am weaning myself off it as 5% every fortnight. 7.5mg to 5.25mg at present
In terms of habituation ,although there is an absolute din that I have to put up with ,it isnt distressing to the extent that it used to
Just quickly read a few of your posts: my word you do seem to be going through the mire; "Insanely loud" you say, well I can certainly say that I am with you on this. And I have experience of T in the early stages when it was nothing more than a low level buzzing - Why does it get louder, more bothersome and intrusive? And life-altering... I don't know.... After 8 years of this rubbish I really don't have any clue what is going on in my head.... Best of luck with the weaning on medication ✌️
I have had constant T for over a year now, you can read my story on here. Initially I thought the t was going to drive me mad and the underlying fear and anger I felt was off the charts. I was taking over the counter sleeping tablets every night, sleeping with an earbud in with white noise, during the day lots of walking and listening to audio books, music, anything to mask the noise. Then one morning about 8 weeks ago I was laid in bed and just said to myself ENOUGH, and here's what I focused on. I can breathe, I can walk, I can see, I can hear, I can feel. Yes I have T and its loud, and I may always have it, but no matter how loud it gets, it can never take away my joy of hugging my children and grandkids, and the many other things that I do, to the point that now I don't really hear it at all during the day, unless it spikes, then lots of deep breathing and back to the audio books, and I would say stage 2 of the habituation process.
I know I have made it sound a bit easy and corny and it's not, but for me I always acknowledge that the t is there, but I suppose I have stopped giving it the control it once had. My t is screaming whilst writing this, but in a minute I will be focusing on meeting my friend for lunch, and the t will fade until tonight, and I'm OK with that. Do miss the sound of silence though. Apologies if this has been of no use to you.
Thank you so much for sharing your experience .It really gives me encouragement .It sounds like you have naturally acquired the skills that Joey Remenyi is teaching people through her Seek Balance website and her book Rock Solid
I guess the T was screaming because you were replying to me and bringing it back into your consciousness.
I have on the odd occasion subconsciously had the T settle on its own accord for a wee while .I need to be able to develop the skill of giving it the flick when it annoys me .
Perhaps I need to better focus on non T things when troubled .
By the way ,i hope that you had a lovely lunch Catlioness and again thanks for the purrfect inspurrational story to get me motivated
Oh your welcome. I was a bit worried that my reply might have sounded a bit crass and to simplistic and I know nothing about T is. I think it really dawned on me that my t may never go away, and therefore I had to find a way to live with it. I now just carry on with life as I normally did before the t came along, and that has mostly worked for me x
Thanks for replying With joey Remenyi's Rock Solid work ,she claims that T can go away and not bother you as through neuroplasticity you can make different neuron connections in the brain
It is an E course
There is looks of really good feedback as this is cutting edge
Might be worth you at least getting her book RockSolid Sept 21 publication
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.