How Does Tinnitus Meditation Work?

Tinnitus meditation works by changing neural networks in your brain that are responsible for making the tinnitus loud and annoying. With tinnitus meditation, you use your mind to heal your brain.

In this review, I’ll cover the following topics concerning mindfulness meditation for tinnitus relief:

• What makes tinnitus loud?
• What is mindfulness based cognitive therapy?
• What is present moment awareness?
• What are some meditation exercises for tinnitus?
• Does meditation for tinnitus work?

What makes tinnitus loud?

The tinnitus ringing sound start with hearing loss, but tinnitus loudness does not come from hearing loss or the various causes of tinnitus. Rather, various different brain regions are responsible for bothersome tinnitus, independent of your hearing system. In fact, studies suggest that the nerve signaling coming from your ears is the same on a good day as it is a bad day.

People experiencing tinnitus have activation of multiple brain centers that share network connections. These are the main parts of the brain involved with tinnitus:

Brain Region	Description
Auditory Cortex	Responsible for processing sound signals received from the ears.
Limbic System	Involved in processing emotions, memory, and the perception of threat or danger associated with tinnitus.
Brainstem	Involved in the transmission of auditory signals and modulation of sound perception.
Thalamus	Acts as a relay station for sensory information, including auditory signals, and plays a role in attention and awareness.
Prefrontal Cortex	Responsible for executive functions such as decision-making, attention, and self-awareness, which may influence a person’s perception of tinnitus severity.

Out of all of these, the only one we can directly control is the prefrontal cortex. What this allows for is the ability of the mind to heal the brain. This is the goal of meditation for tinnitus.

What is the role of the prefrontal cortex in tinnitus?

The prefrontal cortex (PFC) is key in regulating tinnitus severity. When you learn how to harness it, the same brain area can provide tinnitus relief. Here is where the PFC becomes important in treating tinnitus:

PFC Function	Relationship to Tinnitus
Attentional control	The PFC plays a role in directing attention away from tinnitus sounds, reducing their perceived loudness by shifting focus to other stimuli or tasks.
Emotional regulation	By modulating emotional responses to tinnitus, the PFC can attenuate the subjective perception of loudness associated with distressing emotions such as anxiety or frustration. Reducing anxiety and stress helps control the atypical migraine process that makes tinnitus loud.
Cognitive strategies	The PFC enables individuals to employ cognitive strategies such as mindfulness or cognitive behavioral techniques to cope with tinnitus, which may lead to a reduction in perceived loudness.
Habituation	Through repeated exposure and habituation, the PFC facilitates the brain’s ability to adapt to tinnitus sounds, resulting in decreased attention and reduced perceived loudness over time.
Neural plasticity	The PFC is involved in facilitating neural plasticity, allowing for the reorganization of neural circuits involved in tinnitus perception, which may ultimately lead to a decrease in perceived loudness.

Many tinnitus management strategies focus only on the ears, but the key to lasting tinnitus relief is to get the nervous system to rewire so that the tinnitus is not amplified. Without rewiring the brain, you cannot get long-lasting tinnitus relief. As you’ll see below, tinnitus meditation techniques can help do this as part of a comprehensive tinnitus treatment program.

How is chronic tinnitus like chronic pain?

Tinnitus and chronic pain share significant similarities. Both conditions involve subjective experiences without external stimuli and can greatly impact an individual’s quality of life. Both conditions can have a major psychological impact, leading to depression and even suicidal thoughts. And both conditions involve the same brain centers.

The prefrontal cortex is the center for pain processing. It’s where pain transitions from acute to chronic pain. It’s also where we can get pain relief from the placebo effect. So, it can work to amplify chronic pain, but it can also provide pain relief.

Cognitive behavioral therapy (CBT) for tinnitus evolved from its applications in patients suffering from chronic pain. Given the similarities between tinnitus severity and chronic pain, researchers began to see how mindfulness meditation for tinnitus might help patients suffering from chronic ringing in the ears.

How does tinnitus meditation affect the brain?

Research suggests that meditation exercises like mindfulness based-interventions directly affect prefrontal cortex (PFC). Tinnitus meditation can be used, therefore, to improve the functional connections in the PFC that drives and perpetuates tinnitus loudness. This reduces chronic tinnitus symptoms and helps people manage the stress that triggers it.

What is mindfulness-based cognitive therapy?

Mindfulness-Based Cognitive Therapy (MBCT) integrates principles of CBT with mindfulness techniques, emphasizing present-moment awareness and non-judgmental acceptance of thoughts and feelings. MBCT combines cognitive restructuring with mindfulness practices to help individuals develop more adaptive ways of responding to challenging situations and reduce anxiety or depression.

CBT is a psychotherapeutic approach that aims to identify and modify negative thought patterns and behaviors associated with psychological distress. It focuses on changing dysfunctional beliefs and behaviors to alleviate symptoms and improve overall well-being.

What is catastrophization in tinnitus?

Catastrophization refers to the tendency to magnify the negative aspects of a situation and anticipate the worst possible outcomes. In tinnitus, catastrophization significantly contributes to the vicious cycle of tinnitus loudness. It manifests as excessive worry, fear, and anxiety about the tinnitus, leading to increased distress and suffering, which then further increases tinnitus severity.

Mindfulness meditation for tinnitus pairs exceptionally well with CBT exercises that focus on cognitive distortions like catastrophizing. CBT helps us recognize our cognitive distortions and tinnitus meditation helps us correct them.

By learning to observe your fear using mindfulness tools, you can develop a more balanced perspective and reduce the tendency to catastrophize tinnitus symptoms. It can help you cultivate acceptance and resilience in the face of tinnitus, allowing you to live more fully and develop increased tolerance of the ringing sounds.

Does mindfulness help with stress reduction?

Stress can disrupt prefrontal cortex function, impairing cognitive abilities and emotional regulation. Mindfulness practices can rescue the brain from stress-related dysfunction by fostering better stress management and emotional control. Multiple studies show that mindfulness practice is a powerful tool for stress reduction.

Mindfulness techniques can also help stress-related health conditions. For instance, meditation can help lower high blood pressure and can reduce anxiety.

What is present moment awareness?

Present moment awareness is the practice of intentionally focusing one’s attention on the current moment without judgment or attachment to thoughts, emotions, or sensations. It involves being fully immersed in the present experience, rather than dwelling on the past or worrying about the future.

This mindfulness practice encourages people to cultivate a deeper sense of clarity, calmness, and acceptance, allowing them to experience life more fully and respond to stressful situations with more balance.

How can present moment awareness help tinnitus?

Present moment awareness can help people with tinnitus develop a non-reactive and accepting attitude towards their tinnitus. By cultivating present moment awareness, you can learn to observe your tinnitus sensations without getting caught up in negative thoughts or emotions about the ringing.

This can reduce distress and anxiety associated with chronic tinnitus, allowing you to respond to your symptoms with greater calmness and resilience.

What is a meditation anchor?

Breathing mindfully can help develop your present moment awareness skills. Breathing is a “meditation anchor”, a focal point to guide your attention back when your mind wanders, ensuring you remain centered and focused on the present moment.

What are some tinnitus meditation exercises?

So far, the focus has been on mindfulness-based cognitive therapy. But what about mindfulness meditation? Mindfulness meditation practice is less cognitive focussed and more exercise based. The exercises are geared towards cultivating the mindful state, which is peaceful, accepting, and calm.

There are many free guided meditation videos available on YouTube. They have great videos for experienced meditators as well as for those just starting their meditation journey. Here are some examples of exercises used meditation for tinnitus:

Exercise	Description
Breath Awareness	Breathe naturally while you focus on the sensation of your breath. Note the rise and fall of your abdomen or the sensation of air passing through your nostrils.
Body Scan	In this guided meditation, you bring attention to each part of your body sequentially, noticing any sensations without judgment or reaction.
Mindful Walking	Pay attention to each step as you walk, noticing the sensations in your feet, legs, and body, as well as the sights, sounds, and smells around you.
Sound Meditation	Focus on the sounds around you, both near and far. You can even do a form of tinnitus meditation, where you meditate in silence and explore the tinnitus sound in a non-judgemental way.
Body Movement Meditation	Engage in gentle movement practices such as yoga or Tai Chi, focusing on the sensations and movements of your body as you move mindfully.
Visualization Meditation	This is typically a guided meditation where you imagine yourself in a peaceful and calming place, using all your senses to fully immerse yourself in the experience.
Progressive Muscle Relaxation	Tense and release each muscle group in your body systematically, noticing the difference between tension and relaxation.

The last exercise, progressive muscle relaxation (PMR), is particularly well-suited for use at night as it can help you fall asleep.

What if I hear ringing during tinnitus meditation?

In tinnitus meditation, it’s common for the ringing sound to persist, especially in quiet environments. However, the mindfulness technique known as “detached awareness” can aid in your journey towards managing it. This practice involves observing the presence of the ringing without becoming overly attached or reactive to it, allowing you to cultivate a sense of calm and acceptance amidst the persistent sound.

How long should tinnitus meditation sessions last?

With meditation for tinnitus, the most important thing is to incorporate meditation practice into our daily lives. The length of the meditation session is far less important than practicing meditation daily. Consistent daily effort is needed to reshape the neural networks that drive tinnitus distress.

Another point is that mindfulness sessions don’t need to be formal. One of the goals is to bring mindfulness into your daily life. In this sense, it’s a frame of mind rather than a formal meditation session. This is called “trait mindfulness”, where you can slip into a mindful perspective at any given moment throughout the day.

A simple 5-minute meditation session, if performed daily, may be all you need to get started and see results. The important thing is to practice meditation daily.

Does meditation for tinnitus work?

The medical literature shows strong clinical evidence of the effectiveness of mindfulness meditation for tinnitus [1-2]. In a systematic review of 7 clinical trials that used mindfulness interventions (including 3 randomized controlled trials), six of seven showed a statistically significant reduction in tinnitus distress scores and other tinnitus symptoms [3].

In the only study that showed only marginal improvement, the authors admit that the study design was flawed because given the way it was structured, “progress tended to stagnate in our study” and that “mindfulness-based therapy depends on practice behavior” [4]. This reiterates my point that practicing meditation on a daily basis is the key to reducing tinnitus severity.

Conclusion: Tinnitus Meditation Works!

Mindfulness meditation for chronic tinnitus is a not cure, but it is a powerful natural remedy that is underutilized both by doctors and tinnitus patients. Why? Perhaps because mindfulness is not a quick fix and it takes daily practice, focus, and discipline. 

I hope that this article convinced you of the importance of meditation for tinnitus as part of a balanced rehabilitation program. If you’re experiencing tinnitus distress and you’re willing to commit to a daily meditation practice, you can achieve a significant reduction in your symptoms in a short period of time.

Good luck on your meditation journey!

Meditation for Tinnitus References

[1] Arif M, Sadlier M, Rajenderkumar D, James J, Tahir T. A randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus. J Laryngol Otol. 2017 Jun;131(6):501-507.

[2] McKenna L, Marks EM, Hallsworth CA, Schaette R. Mindfulness-Based Cognitive Therapy as a Treatment for Chronic Tinnitus: A Randomized Controlled Trial. Psychother Psychosom. 2017;86(6):351-361.

[3] Rademaker MM, Stegeman I, Ho-Kang-You KE, Stokroos RJ, Smit AL. The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review. Front Neurol. 2019 Nov 1;10:1135.

[4] Kreuzer PM, Goetz M, Holl M, Schecklmann M, Landgrebe M, Staudinger S, Langguth B. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study. BMC Complement Altern Med. 2012 Nov 28;12:235. doi: 10.1186/1472-6882-12-235.