Folks with tinnitus often complain that those who do not have the condition cannot possibly understand what they are going through. To a degree this is true of any medical condition, from diabetes or drug addiction, from heart attacks to herpes. However, there is one condition experienced by many of those without tinnitus that has some significant parallels to tinnitus.
I am referring to the “inner critic.” This is the critical voice inside many people’s head that judges and demeans a person and often produces feelings of shame, deficiency, low self-esteem, and depression. Like tinnitus, the inner critic is beyond the individua’s control, coming into the person’s awareness contrary to their wishes; like the sound of tinnitus, the voice of one’s inner critic is invariably a cause of great distress; finally, the source of this critical voice is as much a mystery as the cause of tinnitus.
I bring up these parallels not to inspire a camaraderie with a larger population and engender decreased isolation (though that’s not a bad idea). Rather, as a therapist I find one strategy used to deal with the inner critic to be potentially valuable in working with tinnitus.
The strategy comes from an intervention known as Internal Family Systems (IFS). Invented by Richard Schwartz, the therapy in fact has nothing to do with families; rather, it involves viewing the individual as one views a family—as a single unit consisting of a number of parts. Without going into the details, one of the goals of IFS is to create a harmony among the parts of the self so that the greater good of the whole can be achieved. A guiding principle in IFS is that there are no bad parts. All parts, even seemingly self-destructive parts, are in fact trying to help out the individual, although sometimes they are misguided and misinformed. By figuring out how a disruptive part is attempting to benefit us rather than rejecting it or trying to eradicate it, we can actually undercut its harmful impact and generate well-being. In the case of the inner critic, we often find that it actually believes that by being extremely harsh it is helping us to achieve higher ideals. Now, this is admittedly a really messed up strategy for self-improvement. But the inner critic doesn’t know any better, since its reasonings are often connected to childhood experiences, for example, this may be how we were treated by a parent or other authority figure.
Although the natural reaction is to be upset when it shows up and want desperately to be rid of it, this is precisely the wrong strategy. First, the inner critic is not going anywhere. For better or worse, it is a part of you that you are going to have to deal with it. To want it to be gone or to be other than it is (kinder, gentler) is to wish the impossible. Second, entering into a hostile relationship with the inner critic is counterproductive. When we become antagonistic towards a person or situation and view it as a threat, the body goes into what is known as fight or flight, activating our ancient defense mechanisms. Although this heightened physiological state of arousal does have some benefit in energizing the body at specific times, to enter into it on a regular basis—as we do when we get upset every time the inner critic shows up—is inherently destructive to the body (and no bargain for the mind either).
If instead of reacting negatively and pushing it away we understand that this immature part of the self is trying to help us out in the best way it knows how, we can stop being upset by its presence and begin to feel compassion, recognizing it as misguided but well-intentioned. When we do this, we can stop taking its dictates seriously, for it is like a 5-year-old expressing its irrational concerns about the nature of adult life. Instead of getting angry, we can use our more mature resources to calm it down, assuring it that all is well, which in turn helps calm us down, creating a better outcome all around.
In the same way we initially view the inner critic as a threat and want it to be gone, those of us with tinnitus view the sound of the tinnitus as a threat and want nothing more than to be rid it. And just as with the inner critic, this desire backfires, since the tinnitus is not going anywhere. As a result, our wish for the impossible is destined to be a source of misery. Even more importantly, reacting hostilely towards the tinnitus merely increases the tension in our bodies as well our vigilance with respect to the tinnitus. This is the worst possible outcome. First, the nervous system of those with tinnitus is already overactivated. Viewing tinnitus as a threat only exacerbates this condition when what we need the body to do is to calm down. Second, just as the presence of a sworn enemy would keep you ever vigilant, so when you make tinnitus your enemy, you guarantee that your brain will constantly be focused on the tinnitus. This is in direct contradiction to what we want our brain to be doing, which is to focus on something besides the tinnitus.
As in the case of the inner critic, the solution is peaceful cohabitation. We turn towards the irritant and attempt to understand why it is behaving the way it is. In fact, just as with the inner critic, tinnitus consists of nothing more than a part of you trying to help out. That is, on one of the more plausible ways of understanding what is happening with tinnitus, the brain is trying to fill in for missing frequencies, and winds up instead creating the noise we are all so familiar with. Understanding this, that this sound is the result of our brain trying desperately to come to our rescue, we can perhaps change our attitude towards it, treating it the way we might treat someone dear to us who was trying their best to help us out but failing miserably in the process. This allows the body to calm down and the mind to focus on something besides the sound, since we now no longer see the sound as a threat.
Interestingly, Jon Kabat-Zinn recommends the same strategy in working with chronic pain. While the natural strategy is to resist the pain and wish it to be gone, Kabat-Zinn points out that in the case of chronic pain this is unwise for two reasons. First, it is impossible, and so results in the suffering that naturally arises from wanting the impossible. In addition, the antagonism towards the pain increases the tension and stress in the body, adding to the unpleasantness of physical pain and making it that much more difficult to achieve the relaxation that might bring relief. Instead, he recommends “putting out the welcome mat” for the pain—not because we want to be masochists but because in so doing we ease a suffering mind and bring relief to a stressed body.
Now we don’t have to go that far with tinnitus (although I would argue it might not hurt to try). But we could at least declare a truce, and in that interim when hostilities cease, see if we can instill two emotions: Gratitude and compassion. We bring gratitude to our body for all it has done for us over the span of our life and compassion for it for failing in this task despite a noble effort. If we could reside in gratitude and compassion instead of hostility and resentment, this would be a game changer. Take a minute to sit with these two competing sentiments. What does the former feel like? The latter? My guess is gratitude and compassion bring about relaxation and the body and calm in the mind, while hostility and resentment result in physical and mental agitation.
So which would you rather experience?
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