May 24th, 2012
06:31 PM ET
Imagine the incessant, grating sound of buzzing in your ears - or constant beeping, whistling, dripping, or clicking. Imagine the chatter of crickets or birds resonating in your head all day long.
Then realize that there are no actual birds or crickets. No dripping faucet. No clicking or whistling happening in the vicinity.
That is a small glimpse of life with tinnitus: The perception of sound, that doesn't exist, manufactured by the brain.
"I hear tree frogs and crickets and bugs, and really loud noise on top of that," said Ginny Morrell, 60, who has suffered with tinnitus for two years. "It started one day and never went away. It never wavers, 24 hours a day."
"It's not going to kill me, it's not cancer," said Morrell. "But it might drive me crazy."
But according to a new study, the most effective treatment for Morrell's tinnitus may involve just the opposite of what she's currently doing: Rather than ignoring the sound, focus on it.
"In the study we thought, what if we try to intervene in this avoidance behavior and we expose patients to their tinnitus sounds," said Rilana Cima, the study's lead author and a clinical psychologist at Adelante Centre of Expertise in Rehabilitation and Audiology in the Netherlands. "If you expose people to something they're afraid of, they actually habituate to this stimulation."
Cima compares the approach, which has its roots in cognitive behavioral therapy, to helping people with a spider phobia to slowly stem that fear. Intermittent exposure to a spider - or in the case of tinnitus, that annoying buzzing - may temper the fear associated with it.
The study, conducted in the Netherlands, involved 492 patients. Half received an audiological work-up and no other structured treatment, while the other half received integrated care, including tinnitus-focused cognitive behavioral therapy.
The therapy included having patients perform mundane, everyday tasks, while being exposed to whatever sound is associated with their tinnitus.
"People usually avoid their own sound," said Cima. "So they practice paying attention to their sound and what reactions they're having because of that sound."
Among the group who got the therapy, about 70% reported improvements in their quality of life or decreased tinnitus a year after beginning treatment.
Importantly, for a malady that has its roots in the brain, many patients also reported improvements in tinnitus-related fear and anxiety.
"The sound didn't disappear but fear reactions did," said Cima.
What makes tinnitus so difficult to treat is that it is virtually impossible to pinpoint the origin of the sound (there is no established neural origin for the condition) and each sufferer's experience is unique. That makes it difficult to craft a treatment that works for everyone.
The study, published today in the Lancet, is one of the first rigorous trials suggesting relief for the approximately 50 million tinnitus sufferers in the U.S., according to the American Tinnitus Association.
Richard Salvi, a tinnitus expert with the Center for Hearing & Deafness at the University of Buffalo, said the study is important and should be encouraging for people like Morrell. But, he adds, most tinnitus sufferers are looking for a cure.
"Many tinnitus patients expect immediate and complete cessation of their tinnitus," said Salvi in an email to CNN. "None of the current treatments meet these patient expectations. Consequently, much more work needs to be done."
Morrell is heartened that a treatment may be out there but, from where she sits in small-town Brockton, Massachusetts, it seems elusive. She says few physicians in her area understand her condition, let alone how to treat it using cognitive behavioral therapy.
"I had one doctor say to me I should take Klonopin (an anti-seizure/anti-anxiety medication) for my tinnitus," said Morrell. "He said to take one the first day, two the second, and to keep stepping it up to 12 a day if I needed to. Can you believe that?"
What nags Morrell almost as much as her condition, is the fear associated with it - that it will get worse.
Mostly, she wants something simple that she used to take for granted: "My issue with it is not hearing silence," she said. "I will never hear silence again."
What Morrell craves is a reset button that will make the noise disappear.
Curing tinnitus may never be that simple.
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