STAGES OF TINNITUS HABITUATION
In his seminal self-help book "Tinnitus: Living with the Ringing in Your Ears", CBT tinnitus researcher Richard Hallam describes four stages of habituation to tinnitus. These stages are not scientifically-derived. They are drawn Dr. Hallam’s decades of experience coaching hundreds of people through tinnitus distress.
- Persistent awareness of noises 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 severe (if present). Cumulative sleep loss in some cases necessitating medication.
- 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 (desensitization); the implications of the noises no longer seem catastrophic.
- Gradual return to normal sleep pattern (if disturbed).
- 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 annoying rather than emotionally distressing
- 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 (desensitization) achieved—the noises are neither pleasant nor unpleasant.