The Tinnitus Communication Guide helps you communicate effectively and empathetically with your patients.
The way you talk about tinnitus can have a powerful impact on your patients and how they feel about their future. It is important to communicate in a comforting way that encourages your patients and instills a sense of hope.
Not everyone with tinnitus struggles with managing it or seeks professional help, but when they do, it is important to allow them to discuss their feelings and to let them tell their story.
Start with open-ended questions
Open-ended questions provoke thoughtful responses as opposed to yes or no answers. They allow you to create room for your patient to share their thoughts and feelings about how tinnitus affects their life. This can help them work through difficult emotions and feel less alone. Their answers will ultimately save you time by allowing you to deliver care focused specifically on their individual needs.
Here are some questions you can start with:
“Can you tell me about your tinnitus?”
“Do you have any concerns about it?”
“Are you doing anything differently now because of your tinnitus?”
“How do you feel about it?”
“Is it affecting other people in your life?”
Asking open-ended questions also helps your patient articulate their thoughts and questions about tinnitus. You can then address any misconceptions they may have.
Common questions about tinnitus
Question: Will tinnitus damage my hearing and make me go deaf?
Answer: If you have hearing loss, you are more likely to experience tinnitus, but tinnitus itself cannot damage your hearing. Tinnitus is often the result of hearing loss, especially in the high pitches.
Question: Is tinnitus a sign of something serious that the doctors have missed?
Answer (If a full medical/audiological work-up has been done): Specialists have checked your hearing and are confident that your tinnitus is not a sign of anything serious. Tinnitus is very common, affecting around 10% of the population, and if your audiological check-up is normal, then this means your tinnitus is not a sign of something serious.
Question: Can tinnitus drive me mad?
Answer: Tinnitus can be distressing, particularly when it first starts. It is also worsened by stress. Although this can be difficult to cope with, patients can learn how to manage their tinnitus and live well with it.
Express empathy
It is essential that you give your patient space to express their emotions and to demonstrate that you understand their feelings. You can show empathy with comments that assure the patient that you are actively listening such as:
That sounds very difficult for you.
Tell me more about how that makes you feel.
I understand that you want your tinnitus to go away – I would like that too.
Explain the difference between presence and intrusiveness
The Tinnitus Forecast graph can help you explain the difference between how present (loud) the sound of tinnitus is and how intrusive (distressing) it is.
The Tinnitus Forecast builds on prior work with patients of Dr. Laurence McKenna and Dr. David Scott at the Royal National Throat, Nose and Ear Hospital, London. It is part of the Tinnitus Communication Guide.
Show the graph to your patient. Use it to explain that although the tinnitus may always be present, the level of distress it causes them and how intrusive it is will likely decrease significantly over time. This is called habituation.
It is very important for your patients to understand this key point. Many patients have been told that their tinnitus will never go away. This does not mean that the patient will have to struggle with it forever. The goal of this conversation is to give your patient a sense of hope and reduce their fear that they will always feel the same level of distress.
By showing the difference between how present tinnitus is and how intrusive it is, clinicians can foster hope in their patients and help them think about their tinnitus in more constructive ways. Sharing this information with patients early in their treatment can have a huge impact on how they cope with tinnitus in the long term.
You can also demonstrate that the sound level may vary over time; sometimes it will be a little louder, sometimes a little quieter, but in general, it will persist. Sometimes your patient will not notice their tinnitus (indicated by the dotted line). You can encourage them to focus on what they were doing at those times, for example if they were working, listening to music, or exercising.
To check that your patient understands the difference between the presence and intrusiveness of tinnitus, ask them to show you where they are on the graph. Explain that the forecast is based on the experiences of many people with tinnitus. Neither you nor the patient can foresee exactly what they will experience in the long run. It is unlikely that their tinnitus will go away, but it is probable that it will become less distressing.
Give advice for next steps
Once patients understand that the way they feel about their tinnitus can improve, they often ask what they can do to feel better. You could suggest managing stress and taking care of themselves. Patients can also find help on relevant websites like the Tinnitus First Aid Kit. Other strategies include:
Wearing hearing aids
Using masking devices such as sound generators or smartphone apps
Participating in group sessions to share their experiences with people facing similar challenges
Meeting with mental health professionals who can help them with relaxation techniques
There are many options and it is important that you help each patient find what works best in their individual case.
