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Mindfulness and tinnitus: a path to peace in the present

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Although definitions can be more complex, tinnitus is the perception of sound in the absence of external stimuli. Commonly described as ‘ringing in the ears’ tinnitus can also be heard as roaring, whistling and buzzing noises.

Recently, mindfulness has emerged as a promising approach to managing tinnitus symptoms. Tinnitus distress is strongly linked to clinical depression, anxiety and poor sleep quality. But just what is mindfulness?

Imagine walking through a beautiful forest, following a simple path, without thinking about anything in particular. You come to a fast-flowing stream and the only way across is by using stepping stones. You stop on a large stone in the middle of the river and take in your surroundings. Notice the rushing water, the birds singing, your own breath and faster heart rate. You realise this is difficult, you’re worried about getting wet, but you accept this is how things are. Wishing for things to be different is unhelpful, so you accept the situation you are in. This is mindfulness.

How mindfulness can help ease tinnitus distress

Currently, there is no cure for tinnitus. However, the 2020 NICE guidelines for tinnitus management recommend psychological interventions for tinnitus distress. They also note that mindfulness-based interventions (MBIs) and acceptance and commitment therapy (ACT) are effective in managing tinnitus-related distress.

Hundreds of research articles have been published on the benefits of mindfulness meditation, and it has been proven to be effective in treating tinnitus and depression. Mindfulness is not a quick fix for powerful emotions but, practised over time, it becomes more likely that emotional reactions will not be as strong as before. Low trait mindfulness is known to predict catastrophising and rumination, resulting in ineffective coping strategies (i.e. avoidance) and poor mental health and wellbeing. Developing higher levels of trait mindfulness through practice enhances the ability of individuals to positively appraise and accept their condition.

Key challenges for tinnitus patients

Accessibility of interventions for tinnitus management is also problematic. My own research (in prep) suggests that 46% of patients seeing their GP specifically with regards to tinnitus are referred onwards to audiology, whereas only 8% of such patients are referred to psychological intervention. Additionally, psychological interventions require input from psychologists who may not be available, while many individuals seeking a cure for their tinnitus are reluctant to seek psychological help for what they believe to be a physical condition.

When travel, time restrictions and costs are considered, it is no surprise that individuals are further deterred from seeking psychological support. This makes the online space more attractive, especially when coupled with a desire to remain anonymous.

In our most recent paper, my co-researcher, Chloe Woolmer, trainee clinical psychologist and student on the Doctorate of Clinical Psychology at the University of Leeds, and I took a number of readily available and open-source mindful body scan exercises and hosted them online at Leeds Trinity University as part of an eight-week programme of guided online mediations. 52 participants were sent one exercise per week for eight weeks, and were asked to watch at least one exercise, twice per week. One third of the 52 participants saw clinically meaningful reductions in tinnitus distress at the end of the two-month intervention period, also reporting fewer negative thoughts about their tinnitus, and a greater tendency towards mindful thought – both of which are important for tinnitus habituation.

 As such, in the absence of accessible psychological interventions, a structured programme of online mindfulness resources can be recommended for individuals with tinnitus as an effective and low-cost self-help tool.

Mindfulness is not a substitute for proper psychological support and therapy. Instead, it should be seen as an opportunity to reconnect with life, to understand yourself and to stop worrying about the future. Anxiety is a future-orientated emotion based around fear of what is to come. To spend time in the moment, enjoying it, is hugely beneficial for all of us.

 

A more detailed version of the blog which includes in-depth information about Dr Jackson’s current research and next steps can be found on the ENT & Audiology News website.

Dr James Jackson is Reader in Psychology at Leeds Trinity University.

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