Although the three interventions discussed (CBT, Mindfulness, ACT) represent the main ones on which research into tinnitus has been conducted, they by no means exhaust psychotherapy’s role in working with the condition. Indeed, just as taking an active role in one’s physical health is an essential part of tinnitus care, so is taking an active role in one’s mental health. Admittedly and for much of its history, psychotherapy has devoted most of its energy to treating mental illness rather than to creating mental health. Thankfully, this orientation is beginning to change, due in large part to the field known as Positive Psychology. Positive Psychology is specifically concerned with the development of interventions that can be demonstrated through research to increase our mental health and overall well-being. One well-known strategy involves gratitude. In a study by Robert Emmons and Michael McCullough, three groups were given writing assignments. One group wrote about things they were grateful for that had occurred during the week. A second group wrote about daily irritations or things that had displeased them, and the third wrote about events that had affected them (with no emphasis on them being positive or negative). After 10 weeks, those who wrote about gratitude were more optimistic and felt better about their lives. In addition, this group exercised more and had fewer visits to the physicians than those who focused on sources of aggravation (10).
Another positive psychology intervention is called “Taking in the Good,” a version of which can be ascribed to Rick Hansen. Hansen notes that evolution required we be on the lookout for things that could harm us more than for things that could benefit us, since could always find another patch of berries to quench our hunger, but one run in with a tiger and that was it for our evolutionary line. As a result, we developed a “negativity bias” to be on the lookout for bad. Hansen compares it to having Velcro for bad experiences but Teflon for good experiences. Hansen provides the following exercise as a way to combat this negativity bias
1. Let positive facts become positive experiences. (Let yourself feel good if you get
something done, if someone is nice to you, or if you notice a good quality in yourself.)
2. Savor the positive experience for 10-20-30 seconds. Try to let it fill your body, and be
as intense as possible.
3. Intend and sense that the positive experience is soaking into you, like water into a
sponge, becoming a part of you.
Doing this on a regular basis will actually begin to rewire the brain to focus on positive experiences. These are just two of the countless examples of strategies that we know can increase our mental well-being. While these characteristics are obviously worth developing for their own sake, there is some evidence of their relevance to tinnitus management. One study found that individual differences in tinnitus coping ability were related to dispositional personality characteristics such as optimism (11). In short, Positive Psychology exercises should be part of your mental health regimen
Resources
There are a lot of books out there of varying quality on this topic. Martin Seligman’s Authentic Happiness is probably the best single volume introduction to the system. There is an online class taught by Yale Professor Laurie Santos that is grounded in the principles of positive psychology and has been taken by more than 4 million people. Called “The Science of Well-Being,” the course is available for free on the website www.coursera.org You might also want to check out her podcast, The Happiness Lab. Last, I would definitely include the podcast Science of Well-Being along with the related website Greater Good (https://greatergood.berkeley.edu/). Each episode, the podcast introduces an evidence-based intervention proven to increase well-being and provides information for you to try it yourself.