My tinnitus story – Clyde Witchard, HushTinnitus founder
On Wednesday April 11th 2012, at 2.30pm, I did the most stupid thing I’ve ever done. I gave myself tinnitus, in a careless accident. Here’s my tinnitus story: how I gave myself tinnitus, how it devastated me in the early days, what I learnt about it, and where I am with it now.
April 11th 2012 was an unseasonably warm and sunny day here in South West England. It was as though a little bit of summer had come early. I was excited, because I’d just finished putting a new sound system in my car. I work in audio and acoustics research and development. The system was my own design, with some new “world first” technical features. I was feeling pleased about it. It was designed to deliver very high quality audio, rather than out-and-out power. But it could still pack a punch in the power department, as I was to find to my cost.
I gathered together a collection of my favorite music to try out on the new system, and set off for a drive. I set the volume to a medium kind of level, to start with. Not too loud. My first impressions were positive. The sound was clear and detailed. The stereo seemed to have a particularly deep “3D” kind of feel. Not bad for my first prototype of this system, I thought.
“I woke up suddenly. “Daaaaaaaaaaaaaaaaa...” There was a really high-pitched tone in the middle of my head. I realized that this was pay-back for my listening excesses the day before.”
Then I started thinking about the deeper sounds in the mix – the bass. Now, this was an area that wasn’t finished yet. I thought, well the bass is passable, but it could be better. It could go deeper. I turned the volume up a bit, and had a think. I started imagining all the different technical changes I could make to improve it.
I decided I needed to listen to some different music – some tracks that really pushed the bass hard. So I turned the volume up, and put on another track. I was deep in concentration, lost in my technical thoughts and plans. Then I put on another track, and the volume went up again. And another. And another. Each time I bumped up the volume a little bit more.
My drive lasted about 45 minutes. By the end, it must have been very loud. But I’d been edging up the volume gradually, so I’d got used to it. I switched the sound system off and got out of the car. “Hmm. I overdid the volume levels there,” I thought. But there wasn’t anything noticeably different about my hearing – yet.
At 5.30am the next morning I woke up suddenly. “Daaaaaaaaaaaaaaaaa...” There was a really high-pitched tone in the middle of my head. It was quite loud too. Tinnitus. I realized that this was pay-back for my listening excesses the day before. I’d had temporary tinnitus a couple of times before, lasting at most a day. So I reckoned this would be the same, and I just had to wait it out. The tinnitus stayed constantly with me throughout the day.
“I was getting more and more unhappy about my tinnitus. I couldn’t work, because I couldn’t concentrate. I wasn’t sleeping properly either.”
The next morning the tinnitus was still there – but it was notably louder now. I didn’t really get much work done that day. The tinnitus was consuming my attention, and preventing me from concentrating properly on my work.
Over the next week the tinnitus got louder and louder each day. And I was getting more and more unhappy about it. I couldn’t work, because I couldn’t concentrate. I wasn’t sleeping properly either. Also, I’d been reading about tinnitus on the internet, and I knew that it might be permanent. I went to see the doctor. He told me that it would probably get better soon. I wasn’t convinced.
One week after it started, I was giving our children their bath. My tinnitus was very loud. I wasn’t coping well. My wife Lizzie was just outside the bathroom. I came out of the bathroom, and said quietly to her, “I can’t cope with this.” Quietly, I burst into tears. I said I needed to talk, but I didn’t want the kids to see me like this. I went into our bedroom, and Lizzie put the children to bed. Then we talked. I broke down. I told Lizzie that this sound was tearing right through me. It was right at the very center of my consciousness, right at the center of me, every second of the day and night. It was like a form of torture: a piercing unremitting sound, cutting into every thought, pushing its way to the forefront of my awareness – constantly. I couldn’t work. My work needed concentration, pulling together quite complex thoughts – and I just couldn’t do it, not with this sound in my head. (Before the tinnitus had started, I was the sort of person who needed total silence in order to work.)
I described to Lizzie how music now sounded awful. As well as listening to music for pleasure, listening critically to music through audio systems was a part of my job. There was now something very discordant and grating about music. Listening to music – any music – was somehow now “confusing”. If any music was playing, I had to switch it off. It was too unharmonious, and I found it too distressing. (I later found out that the parts of the brain that perceive pitch undergo re-organization in the early stages of tinnitus. Perhaps this was related to my jarring and unpleasant perception of music?)
“I broke down. I told my wife that this sound was tearing right through me. It was right at the very center of my consciousness, right at the center of me, every second of the day and night.”
The next day brought tinnitus that was louder still. My despair deepened. ...But the day after that, for the first time since it started, the level of my tinnitus dropped. I was delighted! The tinnitus was still very much there, but the drop in level was a great relief. I assumed that I was now on the mend, that this was the start of my recovery. But it turned out that it wasn’t to be so simple. Over the following weeks my tinnitus level went up and down with each new day. The changes always happened during my sleep, for some reason. I tried to identify links between things in my life, like food or drink, and my tinnitus level. But I couldn’t find any reliable cause-and-effect relationships. For practical purposes, at least, it was random. Each night, during my sleep, the “tinnitus dice” were thrown.
About two weeks after the tinnitus started I discovered something that helped me hugely: masking. I found that by playing a type of sound called “white noise”, I could block out my tinnitus. Wow. This was a breakthrough for me. I found the white noise preferable to my tinnitus: it was easier to tune out, and it gave me a sense of control over it. I put a repeating white noise track on my MP3 player, and I listened to it all the time. I felt I had my mind back. This was a big step forward for me.
I decided to devote my time to finding out all about tinnitus. I put all my work on hold, and dedicated myself to this mission. What theories did people have about how tinnitus works? What could be done about it? How well did the available treatments work? I quickly found information on Tinnitus Retraining Therapy (TRT). I read that this didn’t get rid of the tinnitus sound, but it did reportedly help people cope better with it. It claimed an 80% success rate in doing this.
The aim of TRT is to achieve a state called habituation. Habituation basically refers to your ability to “tune out” from being aware of your tinnitus, so you are less aware of your tinnitus as you go about your life, and you are less bothered by it. It is thought that the more you can tune your attention away from your tinnitus, and the more you can avoid any negative feelings towards your tinnitus, the better your brain gets at doing this – until (after perhaps many months of sustained practice) it comes naturally, with little effort. This is often described as “being habituated” to tinnitus.
“I realized that my thought habits had to change. Any thoughts of my tinnitus being “terrible” or “devastating” were now to be banned. ...I was on the road to habituation.”
I realized that I had been doing the opposite of what TRT recommends. By allowing myself to focus attention on my tinnitus, and by feeling negative about my tinnitus, according to the theory of TRT I was wiring-up connections between my brain cells (neurons) that made the situation worse. My present thought patterns and thought habits were training my brain to be even better at focusing my awareness on my tinnitus and feeling negative about it – the very things I didn’t want. I read that three quarters of people with tinnitus achieve habituation themselves, without any help. I was determined to at least give this a serious try.
I realized that my thought habits had to change. Any thoughts of my tinnitus being “terrible” or “devastating” were now to be banned. I had to focus my thoughts and my awareness onto other things, away from the tinnitus sound. And if I did think about the tinnitus, I needed to try to think of it as being “just a harmless sound” – nothing negative. Of course, all of these things are much easier to say than to do. Habits can be hard to break. Also, I’d read that this wouldn’t be a quick fix: achieving habituation reportedly takes from months to over a year, depending on the patient.
TRT makes extensive use of masking sounds to achieve habituation. But it is very specific about the volume level that is used. According to TRT theory, you should set the volume so that it only partly hides your tinnitus. The idea is that this provides a partial distraction from the tinnitus sound, helping take awareness away from the tinnitus. However, it leaves enough of the tinnitus sound so that the brain can still learn to habituate to it. So, that’s what I did. I carried on using the white noise track on my MP3 player, set to a volume level where I could still hear a little bit of my tinnitus. Even though a little tinnitus remained, the masking noise did partly hide it, and it was easy for me keep my awareness focused on other things. I was on the road to habituation.
“A few weeks later I discovered something quite astonishing. I found that I could completely switch my tinnitus off for a period of time.”
A few weeks later I discovered something quite astonishing. I found that I could completely switch my tinnitus off for a period of time. This happened while I was trying to find the pitch of my tinnitus with some audio software that produces single-frequency “pure tones”. I found that when I tuned the pitch of the pure tone near the pitch of my tinnitus, it masked the tinnitus very effectively, so I couldn’t hear the tinnitus any more. But the thing that really surprised me was that when I switched the pure tone off, my tinnitus remained silent. For the first time since my tinnitus had started, several weeks earlier, I was now experiencing total silence. I was astounded. A minute or two later the tinnitus started to come back, and then it crept gradually back up to its original level. So I tried the experiment again. I played a minute or so of pure tone, then switched it off. The effect happened again: total silence. I called to Lizzie, “I can switch it off – my tinnitus. It’s amazing!” I showed Lizzie what I was doing. Of course she could not hear the silence in my head – but I had to share my excitement!
The next day, the first thing I did was to record some of the pure tones as sound tracks that I could listen to on my MP3 player. I recorded various durations of pure tone, followed by various durations of silence, so I could experiment to find out what worked best. I set the MP3 player to just keep repeating whichever track I played. I found I could keep my tinnitus silenced in this way, and it remained silent for as long as I kept the repeating track playing.
I now felt a much greater sense of control over my tinnitus – more than with white noise masking. Being able to experience silence was hugely satisfying, a really positive experience. I kept the track playing on my portable MP3 player all of that day. I found that by letting my earphones sit quite loosely in my ears I could still hear sound around me. I could move around and enjoy the most normal hearing experience I’d had since the whole ordeal started. I was delighted.
From that point I started trying to find out more about this mysterious but welcome effect. I knew there were a lot of people in the world with chronic tinnitus – as many as one billion, by some estimates. I reckoned that if this effect happened to me, then it would probably happen to at least a proportion of the vast number of people with tinnitus. I’d stumbled across the effect quite easily, so I guessed that medical science must have discovered it already. I guessed right. After a bit of searching, I found that the effect was called residual inhibition, and it had been quite well studied and reported by mainstream tinnitus research. Several studies reported that in fact most people with tinnitus can experience residual inhibition, at least to some degree.
“I now felt a much greater sense of control over my tinnitus – more than with white noise masking. Being able to experience silence was hugely satisfying, a really positive experience. ...After a bit of searching, I found that the effect was called “residual inhibition”.”
I wanted to find out everything I could about residual inhibition. I’m very much a scientist at heart, so for me the process had to start by finding all the relevant research publications to date. The research trail I found led back to 1903, when the effect was first reported; but it was only in 1975 that it was named “residual inhibition”. I found more and more papers that dealt with various aspects of the effect. However, there didn’t seem to be any document that brought together and reviewed all of the main research findings on residual inhibition, comparing the different sources. So I decided to write my own review document, aimed at the general reader, and keeping technical and medical terms to a minimum. If you’re interested, you can read it here.
As I found out more about residual inhibition from the published research, I realized just how varied the effect was from one person to the next. Some people had strong residual inhibition responses, others had little or none at all. A few people even experienced the reverse effect: their tinnitus would get louder for a period of some seconds afterwards (which has been called residual excitation). I realized that my own residual inhibition response was probably quite strong, but less strong than for some.
I became interested in finding the most effective sounds for causing residual inhibition, using research from mainstream independent published papers. There didn’t really seem to be a name for sounds designed specifically for triggering residual inhibition, so I’ve called them quieting sounds or trigger sounds. I wanted to find the most effective quieting sounds for a wide span of different people’s responses.
It was clear from several research sources that the quieting sounds should be custom made for each person, to give the most effective residual inhibition. So I wrote a web-based computer program to produce custom optimized quieting sounds. It was the first version of what is now the HushTinnitus system.
“I became interested in finding the most effective sounds for causing residual inhibition. I was also interested in producing optimized masking sound, for people with little or no residual inhibition response.”
I was also interested in producing optimized masking sound. This can be particularly useful for people with little or no residual inhibition response. From the published research, it was evident that simple white noise is not the most effective type of sound for masking. Similar to quieting sounds, the most effective masking sounds need to be custom made for each person. So I added custom optimized masking sounds to the HushTinnitus system too.
But making sounds that are simply effective at suppressing tinnitus, while important, was not my only concern. I was equally as concerned about making the sound as unobtrusive as possible. In the first weeks of my own tinnitus journey, when I was at the early stages of habituation, I was playing my sound tracks all day. Although the very first quieting sounds I made were effective, they were quite obtrusive. Even though I preferred the sounds to my tinnitus, now the tinnitus was silent I really wanted to make the quieting sounds as unobtrusive as I possibly could. So I made this a high priority for my work. Fortunately, I had some previous experience in some relevant research areas. As the work progressed, I was surprised by how much could be done, in a number of areas, to reduce the obtrusiveness. I was able to test my sounds not only on myself, but more importantly (from a scientific point of view) I used some independent research, based on tests on groups of people, to provide argument that I was indeed reducing the obtrusiveness for people in general.
In the end I’ve given the HushTinnitus system three types of “sound structure”. These are designed to cater for a wide range of people – from people with a strong residual inhibition response, through to people with less response, all the way through to custom masking sounds for people with no residual inhibition response at all. I’ve developed the system a lot since the simple pure tones I started with (although pure tones are still one of the four basic sound types in the system). If you’re interested, I wrote up the HushTinnitus system in much more detail in my Residual Inhibition document (please see page 20). This contains references to all the independent research on which the work was based.
As I’m writing this now, it’s just over a year since I had my careless accident and gave myself tinnitus. In terms of my work life, developing the HushTinnitus system has been my full-time job for the past year. Finding the research papers, reading them, collecting and comparing the findings, writing it all up, designing a system based on the findings, writing programs to create the sounds, and putting this website together. It turned out that all that took me a year. (And working on the project, and supporting users, is still my full-time job.)
“Where I really see the benefit of the HushTinnitus system is in short-term relief, and also in its use as an aid to help people on the road to long-term habituation, as part of an approach like TRT. Also, for people who do not achieve habituation, it seems to me that masking or residual inhibition can play an important palliative role.”
But what about my tinnitus? In short, very positive things have happened. Firstly, I now only get tinnitus about every one day in four. On the days I do get it, it’s at a much lower level than in the early days. Secondly, when I do have my tinnitus, I’m now much better habituated to it. I’m not distressed about it. I’ve got my life back. And I’m really happy about that.
So what part did my sound tracks play in my very fortunate long-term tinnitus reduction? Well, first please let me share briefly with you a little bit about my point of view as a scientist. Frankly, I hate claims like, “I cured myself so I can cure you.” Firstly, assuming the person making the claim actually did get better (from whatever it was), how do they know that they cured themselves? What about natural recovery rates? What about the placebo effect? Secondly, even if their treatment did help them, what proportion of other people will it help? Some medical conditions (like tinnitus) are known to be highly variable from person to person, sometimes in terms of both symptoms and underlying causes. Just because one person was helped, this doesn’t really give us any information about how many other people could be helped by that treatment.
In the absence of convincing evidence and argument to answer a question, I believe that all good scientists have a standard answer: “I don’t know”. So, as for the question at the start of the last paragraph, my answer (trying to be as good a scientist as I can) has to be the same: I don’t know if my sound tracks helped with my tinnitus reduction. I don’t think anyone really can know for sure what did or didn’t influence my individual case.
Looking instead at published research, there are a number of reports of people who have experienced long-term increases in the duration of their residual inhibition. (This was after sustained or repeated listening to various masking/quieting sounds.) A number of these reports are from well-known tinnitus researchers. There are even a few cases reported of tinnitus going into complete remission. (For more details, please see page 9 of my document.) However, the proportion of people experiencing longer-term improvement is not clear in most of these publications – it may have been just a small proportion of the participants. Given the state of this research, I don’t primarily see the HushTinnitus system as being a therapy for bringing long-term reduction in tinnitus level. If any HushTinnitus users do experience any long-term improvement that they think is due to the system, then in line with the prior published research, I think it should be viewed as a “lucky bonus”.
“But what about my tinnitus? In short, very positive things have happened. I’ve got my life back. And I’m really happy about that.”
Where I really see the benefit of the HushTinnitus system is in short-term relief, and also in its use as an aid to help people on the road to long-term habituation, as part of an approach like TRT. This is where I’m certain that the system helped me. There’s an abundance of evidence that most people with tinnitus have masking and residual inhibition responses, giving them a means for immediate short-term relief from tinnitus. The HushTinnitus system brings together custom-optimized forms of masking and quieting sounds, based on the published research. In terms of long-term effects, there’s also a body of evidence supporting habituation approaches like TRT. Conventionally, TRT uses masking sound, but there has been some discussion in the published research of using residual inhibition (in one form or other) in similar habituation approaches.
However, it is a reality that some people do not habituate to their tinnitus. This group even includes some people who have tried professional help (such as TRT) but who still did not achieve habituation. For people in this group, it seems to me that masking or residual inhibition can play an important palliative role. For those who respond, the methods can provide relief that is available by few other means.
But getting back to my own tinnitus story... If you’re interested, here’s a little more detail on my experiences using the sound tracks:
- As I mentioned above, when I first discovered residual inhibition, I spent a whole day listening to my new quieting sound tracks. The next morning, to my pleasant surprise, I awoke to a much lower tinnitus level than I’d awoken to since the accident. I hadn’t had the quieting sound playing while I was asleep, so I wondered, could this be some sort of after-effect that has lasted the eight hours or so of my sleep? Well, that day I again spent the whole day listening to the quieting sound tracks, and the same thing happened the next morning: my waking tinnitus was still at a notably lower level. And so on – actually for weeks.
- In those first weeks, I kept the sound tracks playing during all my waking hours. Because I was wearing my earphones loosely in my ears, and because the tracks were mainly silence, I was able to move around and hear other sounds, and live life, quite normally. (I soon bought myself some open-ear miniature headphones, which were even better.) In those early weeks with the quieting sound, I didn’t really pursue habituation. I was just enjoying the relief, and sense of control over my tinnitus. But then I decided that I needed to work on my habituation, so that I could cope better with my tinnitus when I wasn’t listening to the sound tracks. So I started to spend an hour or two per day with the sound tracks not playing (or with them playing, but at a lower volume level, so my tinnitus partly returned). Sometimes, this was quite a tough change. But, although I was not on a formal TRT program with an audiologist, I was applying some of the key ideas of TRT, and in quite a determined way. My biggest step forward came when, on a one-week family break on the Devon coast, I decided to not listen to the sound tracks during the day. I restricted my listening to just a short session each evening. The change of scene, and a busy schedule of activities with the family, really helped throw my thoughts onto things other than the tinnitus. After the break, I stayed with that pattern of using the sound tracks; and then gradually reduced my daily listening time.
- My tinnitus improved over the months, I’m very pleased to say. This improvement happened in fits and starts. After about six months I started getting occasional days where I had no tinnitus at all. Then these became quite regular, so that every third day was usually a “zero day”, as I call them now. Eleven months after the accident, there was another sudden improvement. The zero days started joining up. Currently, I get an average of about three zero days in a row, then one day with a little tinnitus. Needless to say, I’m very pleased that I’ve had this improvement, and I feel very fortunate that it has happened. There was one small hiccup on the way, though. In month eleven, I had a slight setback with my habituation. I think this may have been because the days I had tinnitus were now less often, and my brain was less accustomed to having to habituate. So I started using my sound tracks more, on the tinnitus days. Since then, I’ve gradually brought my usage back down again, as I’ve improved my habituation. Now, I only use the sound tracks for an hour or two, say once a month – for example, if it’s a tinnitus day, and the tinnitus is a little louder than I am used to.
- As a final comment, I’d like to share that I now carry earplugs everywhere. If I walk past loud road work, or if I’m somewhere with loud music, the earplugs go in – straight away – even if I’m the only one doing it. I’d like to think I’ve learnt my lesson!
Well, thank you for reading my story. I hope it’s given you a bit of background on how I came to develop the HushTinnitus system, my general approach, and how I see the HushTinnitus system fitting in as an option for people with tinnitus. Whatever steps you take with your tinnitus, I wish you positive progress.