Tinnitus: Redefining the Condition

Medical practitioners often refer to tinnitus as "perceived" sound that has no external source. This definition of tinnitus causes the condition to be taken less seriously than it should be. Why? Because some people wrongly equate the word "perceived" with the word "imaginary."

People who don't have tinnitus have a hard time understanding the difference. This mindset leads to all kinds of problems and misconceptions by the people who know the tinnitus sufferer (including the treatment professionals). The mindset creates a gap.

Here is a classic case of the gap in action:
Tinnitus treatment professional: "Just ignore your tinnitus."
Tinnitus patient: "I can't. It has become too loud. It is affecting my work, my relationships, and my sleep."
Tinnitus treatment professional: "It is all in your head. Trust me. Just ignore it and it will go away."
Tinnitus patient: "You don't understand. It is just too loud to ignore any longer. Help me."
Tinnitus treatment professional: "Listen, it is a perceived sound. I've treated patients just like you and they just ignore the internal sound and it goes away."

Some people, who do not have tinnitus, can't seem to understand why a tinnitus sufferer cannot just distract his or her brain away from the perceived sound and be healed. In milder tinnitus, it is possible to distract the brain. In some severe chronic cases it may not be. Every tinnitus sufferer is unique. For example, maskers do not work for everyone. Sometimes a person's tinnitus sound is louder than the masker. In fact, the internal sound may be louder than workplace regulations would even allow. It can be downright maddening.

So, how should we redefine tinnitus? Well, let's take a look at how the brain and the central nervous system work together to communicate. Let's imagine that you go in for acupuncture and a needle is pushed into the bottom of your foot, right in the middle of the arch. Your foot's pain transmitter cells would send a signal to the brain, where pain is produced, and you would experience foot pain.

Imagine that a brain surgeon blocks the area in the brain that is responsible for that particular part of your foot and you experience no pain. Or imagine that you are in the brain surgeons office and he or she stimulates that area of the brain so that you feel pain as though a needle is entering your arch, yet there is no needle. Either way, the pain would be identical. One has an external source and the other does not. In the later situation, the needle is perceived but not the pain. Pain is pain. Sound is sound.

The sound that the brain produces to indicate cell damage in the auditory system is identical to sound from an annoying external noise producing object. There is no difference. Therefore, the word "perceived" should be dropped from the definition. It should be assumed that all pain and sound is "perceived" in the brain, whether the source is external or internal, which makes the need for the word "perceived" irrelevant in the definition of tinnitus.

Tinnitus should therefore be redefined as a sound that is generated by the brain to indicate auditory system cell damage. 

Why is this important? Because, the quicker medical practitioners get past the "perceived" notion that the internal sound is somehow different than an externally noise generated sound, the quicker we will gain traction for research and ultimately a cure. As long as people believe that chronic severe tinnitus is imaginary or somehow easily treated or curable (which it is not) then there is less of a drive for a cure. Those with severe chronic tinnitus want a cure. For now, we have to learn to manage it.

Let's try the treatment scenario under the new mindset:

Tinnitus treatment professional: "You say that you are experiencing tinnitus. Let's figure out what type of tinnitus that you have and work on some ways to manage your tinnitus. We have to prevent it from getting worse. We may have to experiment with diet, exercise, and medications to minimize it. It may take awhile to figure out the right combination necessary to minimize your specific tinnitus. Each person's tinnitus is unique. If your tinnitus is chronic and severe, there is no cure yet. But, researchers are working on a cure."

Tinnitus patient: "I understand. I'm willing to try anything at this point, the tinnitus is affecting my work, my relationships, and my sleep."

Tinnitus treatment professional: "I understand. The sound that you hear is your brain telling you that there is something wrong with your auditory system. It is very similar to pain. We have to figure out what is wrong first. Let's run some tests."

Tinnitus patient: "Thank you."

Tinnitus treatment professional: "You are welcome."