Coping Strategies for Individuals with Tinnitus: Acceptance Versus Suppression

Tinnitus is a condition in which people are highly distracted by sounds that most people do not hear. People with tinnitus often hear ringing or buzzing even though there is nothing external causing the sound. This can result in distraction and emotional reactivity. When this occurs, cognitive resources may become depleted. Strategies for managing tinnitus include suppression, acceptance, and avoidance, among others. But how do these unique methods affect cognitive performance?

Hugo Hesser of the Department of Behavioral Sciences and Learning at the Swedish Institute for Disability Research at Linkoping University in Sweden wanted to find out. In a recent study, Hesser enlisted 199 participants with normal hearing and had them complete a mentally challenging task while they were exposed to an annoying sound. They were instructed to either suppress the sound, or do nothing. Next, the participants underwent an attention control task or a mindfulness condition, after which they had to complete math problems while the sound persisted.

Hesser evaluated how well suppression worked in the first task, and how well mindfulness helped cognitive performance in the second task. He found that the participants who were instructed to suppress the sound performed far worse than those who did not suppress the sound. Further, the mindfulness condition reversed this effect.

Hesser believes that cognitive resources used to suppress a sound may actually cause the sound to become more prominent. In other words, when someone focuses intensely on avoiding something, they get more of it. In this case, as participants worked hard to ignore and suppress the sound, they were more distracted by it. After they underwent the mindfulness condition, however, they were able to accept the sound and perform the work at levels equal to participants who were never asked to suppress the sound.

Therefore, mindfulness did not appear to improve cognitive ability above and beyond other measures, but was successful at reversing the negative effects caused by suppression. Hesser said, “This finding is highly consistent with theories that posit that mindfulness and related processes such acceptance may undermine ineffective control strategies.” As such, further research should explore ways in which mindfulness may help with other maladaptive coping mechanisms common among various types of psychological illnesses.

Hesser, H., Molander, P., Jungermann, M., Andersson, G. (2013). Costs of Suppressing Emotional Sound and Countereffects of a Mindfulness Induction: An Experimental Analog of Tinnitus Impact. PLoS ONE 8(5): e64540. doi:10.1371/journal.pone.0064540

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  • eric

    May 24th, 2013 at 11:50 PM

    suppression can make things doubly hard.Ive experienced that with heart ache and have no doubts about it.acceepting the fact that you are in pain and seeing how you can overcome it is a far better approach.not just for tinnitus but for everything.try it and you will know.

  • Catherine Boyer, MA, LCSW

    May 25th, 2013 at 3:54 AM

    I’m a neurofeedback trainer as well as a psychotherapist. I haven’t trained any clients with tinnitus but my own tinnutus no longer troubles me. It’s not that it’s gone, it’s that through neurofeedback my brain has learned to not pay attention to it. I only notice it when the subject comes up, like now. :)

  • Sela

    May 25th, 2013 at 4:39 AM

    I guess this is another one of those things that if you try to supress or ignore, for many it just becomes even more annoying.

    I don’t know how long it would take even the strongest person to reach the point where they can accept over suppress but I guess the training would be worth a try, especially if this is something that there is no cure in sight for.

  • Jennifer

    May 26th, 2013 at 12:20 AM

    I don’t know but acceptance sounds a bit too pessimistic too..What good does it do to accept you have a problem and live with it if you do not go beyond to actually help yourself?suppression can be bad no doubt but acceptance may bring in a feeling of being sorry for yourself which is equally bad..A fresh perspective full of hope and expectation is what could help!

  • leighton

    May 26th, 2013 at 5:28 AM

    So this is something that is wrong with the inner ear? No surgery that can help?

  • townshend

    May 27th, 2013 at 7:10 AM

    This is about so much more than mind over matter. You try to block this out and inevitably you will still hear the ringing. But come to accept it and live with it in that way and there may be a way for you to manage it and control it without allowing it to have so much control over your life. I think that this is a pretty good coping strategy for anything like this in your life that just keeps buzzing around you and you just can’t seem to get rid of.

  • JT

    May 27th, 2013 at 2:25 PM

    what we perceive is what often happens..not that we can control everything but certain things we can..and feeling the effects of something unfavorable is just one of those much any negativity affects us depends upon how much we let allow it to.this seems like one of those things.

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