If you've ever been told that tinnitus, hyperacusis, or misophonia are conditions you simply have to manage and live with, this episode is going to offer you a different perspective. Host Daniel Lyman sits down with Dr. Marcia Dewey, an audiologist who founded the Tinnitus and Hyperacusis Program at Froedtert and the Medical College of Wisconsin and has spent years integrating neuroplasticity-based approaches into her work. Together they break down what these three conditions actually are, how fear and attention amplify symptoms, where structural issues end and neuroplastic processes begin, and how tools like somatic tracking, imaginal exposure, and safety learning can help people change their relationship with sound and, in many cases, dramatically reduce their symptoms.
For most people who experience tinnitus, hyperacusis, or misophonia, the message from the medical system has been some version of the same thing: there is no cure, learn to cope, this is just your life now.
Dr. Marcia Dewey has spent her career pushing back on that narrative, and in this episode she sits down with host Daniel Lyman to talk about why.
Dr. Dewey is an audiologist who founded the Tinnitus and Hyperacusis Program at Froedtert and the Medical College of Wisconsin. After discovering neuroplasticity-based approaches through the Curable app, she began integrating PRT principles into her work with clients experiencing sound-related symptoms, and what she's seen since has changed the way she practices.
What Daniel and Dr. Dewey cover:
What tinnitus, hyperacusis, and misophonia actually are. Tinnitus is any sound you hear from inside your body, not just ringing. Hyperacusis is sensitivity to sounds based on loudness. Misophonia is an intense, often visceral reaction to specific sounds, usually made by other people. Three distinct experiences, but with more in common than most people realize.
Why tinnitus is a symptom, not a disease. Just like pain, tinnitus is a signal, not a diagnosis. And just like pain, what you believe that signal means has an enormous effect on how your nervous system responds to it.
How fear and attention keep symptoms alive. Eighty percent of people who experience tinnitus are not bothered by it. The difference between that group and the group that suffers is not the sound itself. It is the relationship with the sound, and that relationship can change.
Somatic tracking for sound sensitivity. Dr. Dewey uses somatic tracking, which she calls sensation observation, with clients on their very first visit. She also uses imaginal exposure for hyperacusis, having clients imagine triggering sound environments and track what they notice in their bodies, before ever approaching the real thing.
The misophonia piece. Often dismissed as hopeless or untreatable with exposure, Dr. Dewey makes the case that the same neuroplastic tools apply, just applied carefully and starting from the mildest end of the trigger ladder.
Hope as a clinical intervention. One of the most moving moments in this episode is a story about an early tinnitus client who cried for twenty minutes when Daniel told him recovery was possible. He hadn't felt hope in six years. Shortly after, his tinnitus was mostly gone.
If you or someone you love has been told to just live with ringing, sensitivity, or sound reactions, this conversation is worth your time.
Resources mentioned in this episode:
[00:00:00]
Daniel: Welcome back to the Pain Reprocessing Therapy Podcast. I'm your host, Daniel Lyman. I'm a psychotherapist, executive director of the Mind Body Therapy Center, and a certified pain reprocessing therapy practitioner. Each episode of this podcast, we explore the science and practice of recovery from chronic pain and other neuroplastic symptoms through conversations with clinicians, researchers, and people who've experienced recovery themselves.
Today, we're diving into a topic that I get asked about all the time, tinnitus, hyperacusis, and misophonia, and honestly, I've had personal experiences with all of these. If you've ever experienced ringing in your ears, sensitivity to sound, or intense reactions to certain noises, you've probably been told some version of, "You'll just have to learn to live with it."
For many people, these symptoms can become frightening, overwhelming, and incredibly disruptive to daily life My guest [00:01:00] today is Dr. Marsha Dewey, an audiologist who specializes in tinnitus and sound sensitivity. She founded the Tinnitus and Hyperacusis Program at Froedtert and the Medical College of Wisconsin, and over the past several years has begun integrating neuroplasticity-based approaches, including PRT, into her work.
In this conversation, we explore what tinnitus, hyperacusis, and misophonia actually are, how fear and attention can amplify these symptoms, where structural issues end and neuroplastic processes begin, and how concepts like somatic tracking, exposure, and safety learning can help people change their relationship with these experiences a- and in many cases dramatically reduce them.
Whether you personally struggle with tinnitus, know someone who does, or are simply interested in how PRT principles apply beyond chronic pain, I think you're going to get a lot out of this conversation. Here's my interview with Dr. Marsha Dewey.
First of all, thank you so much for being on the, on the podcast.
I really appreciate you being
here.
Marsha: Of course. Thank you. [00:02:00]
Daniel: And let's start, um, let's start off with just defining some of the symptoms that you, or the diagnoses that you work with. Yes. You mentioned tinnitus right away, so let's start there if that's okay with you.
Marsha: Yeah. So tinnitus is one of the more common ones.
About 60 million Americans, um, experience tinnitus on a regular basis, and I like to use a very basic definition, and that is that you hear sounds inside of you, and it's not coming from the outside, but you hear sounds inside of you. Most commonly, we hear it referred to as ringing in the ears- Right ... but it can be any sound, and that's important to differentiate because sometimes people don't quite know if they have tinnitus because they're hearing different sounds, but it can be hissing, roaring, h- humming- Mm
buzzing. It can even be they can hear songs, music. It can sound like people talking. Um, it can be clicking sounds, whooshing sounds. So any sound that's inside of you is tinnitus.
Daniel: And that's, uh, it's not uncommon to hear those other kinds of sounds. It's not just ringing in the ears.
Marsha: Correct. Yep, yep. Yeah. It can be all those sounds, and they all fall under the umbrella of tinnitus.
Daniel: Great. Mm-hmm. Let me [00:03:00] just address this right away. Sometimes people also say tinnitus. Um, I, I know I'm sure you're exhausted by talking about that, but let me just address it. Yeah. Uh, is, is tinnitus wrong? Is tinnitus right?
Marsha: They are both technically correct. I say tinnitus, and one of the reasons is that itis means inflammation of.
Inflammation. Totally. And there isn't an inflammation of a tin. I won't correct people if they say it the other way. They're both correct, technically.
Daniel: There's not tin in our ears that is inflamed. Right, there's
Marsha: no tin. Exactly.
Daniel: When I'm working with a patient, I like to switch back and forth just to keep them confused.
You know- Yes. One second I'll say tinnitus, the next I say tinnitus. Just to keep ... No, I'm joking.
Marsha: Yeah.
Daniel: Okay, great. So we've got a definition for that. We understand what tinnitus is. What are some of the other diagnoses that you work with as an audiologist? Yeah.
Marsha: Yeah, so about 40% of people with tinnitus will also experience a specific type of sound sensitivity called hyperacusis.
So hyperacusis is a- Essentially sensitivity to sounds by loudness. So- Mm-hmm ... so we get to a certain loudness [00:04:00] level, sounds that for someone without hyperacusis wouldn't be uncomfortable, it wouldn't sound loud, or it might sound slightly loud, but it's tolerable. For someone with hyperacusis, that might, on the milder end, it might be uncomfortable and- Mm-hmm
slightly loud and uncomfortable, or it can even cause pain, and it could be quite severe where even softer sounds are unbearable for them. So that's hyperacusis. Um- Okay ... and then we also see another type of sound sensitivity that's classified as misophonia. Now misophonia- Mm-hmm ... is sound sensitivity to specific sounds.
It's not about volume. So it tends to be sounds that we make in our mouth, in our nose, in our throat. So throat clearing, lip smacking, um, sniffing, and e- eating sounds, chewing. And it can be repetitive sounds, like someone tapping a pen or typing on a keyboard, those types of sounds. So it, they can be very soft, but- Mm-hmm
they can induce a very strong, very quick reaction where a person would go to, it would feel disgusting to them, or even [00:05:00] rage. So, and very quickly. So those are the two types of sound sensitivities that we work with. So those are the three big ones that we work with
Daniel: Tinnitus, hyperacusis, and misophonia
Marsha: Mm-hmm.
Daniel: Yeah, misophonia I can relate to personally in my growing up, my m- the way my mother would clear her throat- Mm-hmm ... used to bother me.
Marsha: Mm-hmm. Yeah.
Daniel: She would clear her throat in this very e- elongated way, and I remember having a strong emotional reaction to it.
Marsha: And th- do you have- Yeah ... to do it like that?
Daniel: Exactly. Like... Right. Exactly. That's exactly-
Marsha: I think
Daniel: this happens a lot between spouses as
Marsha: well. Well, and it's, it, it tends to be a family member that you're bothered by. Yeah. So it's like you may be okay with a stranger or a friend, but w- um, and so with growing up in your household, it may be a parent or a sibling.
Um, and it can, as you get older, it can attach to a, a, a spouse, but it, that's very common reaction to have, yeah.
Daniel: Yeah.
Marsha: Yeah.
Daniel: So of, of these three diagnoses, if you don't mind me asking, have you ever had any personal experience with these three?
Marsha: Oh, good question. So actually I ha- I do experience tinnitus, and I think- Okay
most humans [00:06:00] do. Uh, I actually-
Daniel: I do too,
Marsha: yeah. So I think it's complete- it's a completely normal sensation to have. Yeah. Most of us tune it out. Our brains, y- the, the hearing part of our brain is always on. Oh. So there's always neurology going, even when we're sitting in, quote, silence. Mm-hmm. Um, and most of the time we encode that as silence.
But if for some reason we pa- take more notice of that, like if we have hearing loss or we're sitting in a quiet room- Mm-hmm ... we'll start to n- uh, our brain will start to filter that particular neurology as sound. So it's- Yeah ... very normal. And occasionally get m- you know, various auditory blips where you might hear a high tone for a few seconds, then it goes away.
So all of that would be tinnitus- Totally ... as well. Um, so yeah, I experience that. I'm, I live in a human body, so I do experience tinnitus. But, and not, not most of the time. And when I do, it's, it's very fleeting, it's very soft. Mm-hmm. Sometimes it'll peak up for whatever reason, um, and I'll notice it a little bit, but then it goes back down and goes away, so.
And that's- Great ... that's really the goal we want for, for the people to, who we work with too, is that most of the time it just fades away for them, [00:07:00] so.
Daniel: Yeah, absolutely. Mo- the goal for so many of these, uh, you know, neuroplastic symptoms is not complete eradication of them, because we're in a human body- Mm-hmm
which means we experience these things.
Marsha: Exactly.
Daniel: So, so a quick question about tenni- tinnitus. If I'm leaving a concert, and let's say my ears are ringing for the next few hours because it's been really loud at the concert, do you classify that as tinnitus? Or what do you think of it?
Marsha: That absolutely is tinnitus.
So a lot of times, uh, here's the sort of, I think, misunderstanding of tinnitus, is we often think it's a disease. And so what we know- Right ... is tinnitus itself is not a disease. It's a symptom.
Daniel: Right.
Marsha: Um, kind of like pain, right? Pain in itself- Yeah ... isn't a diagnosis. Totally. Um, and so s- it's a, it's a symptom of something.
And so just like with pain, we want to explore is it a symptom of structural damage? Or is it coming on for other reasons, not due to structural damage? Now, a lot of the tinnitus we see is actually due to structural damage. That is a perfect example. If we go to a loud concert, any sound that is over 85 decibels can damage the inner hair cells [00:08:00] in our inner ear.
Um, they, they're just not made to, to endure sounds that are above 85 decibels. So there can be some temporary damage, and so the symptom that our brain would turn on to warn us of that damage would be tinnitus. Right. You can also get it with other structural things like ear infections, um, different diseases of the ears.
So it's not uncommon. But then also, tinnitus can start, as I mentioned, just with, with n- with b- more benign conditions like gradual hearing loss. So, so because we have hearing loss and things outside of us aren't as loud, the things inside of us become L- more noticeable. And so we might start- For sure ... to notice that neurology which gets encoded as tinnitus.
So in all of those instances, tinnitus is safe to experience, and that's hard to understand because we're associating with structural damage, but the tinnitus itself is just a warning signal. Right. And many people, actually 80% of people who experience tinnitus, aren't bothered by it. And people who are bothered by tinnitus, it's really hard to hear and understand.
And especially when we're talking about pain, most people w- well, don't, you know, 80% of people- Sure ... experience pain [00:09:00] don't
aren't okay with it, but m- a lot- Right ... of people with tinnitus are okay with it. And if you aren't given a message like, "Oh, gosh, we can't get rid of this. This is a no cure," those kinds of nocebo, you know, messages- Uh-huh ... can heighten it, as we know what's the fuel to fear. Of course. Just like with pain. So if you're told, you know, "This is a minor thing, it can get better," and you just kind of ignore it, it fades away.
You don't pay attention too much. You might notice it here and there and, and, and so it can be benign like that. But it's always- Right ... safe to experience even though people might not like it or they might be extremely distressed by it. The presence- Right ... of a sound inside of your body isn't causing physical harm or damage to your body.
Right. That's what I mean by it's safe to experience.
Daniel: Similar to pain, like you said. Yes. Mm-hmm. Pain is not always a signal that something is inherently wrong in our body and we need to freak out.
Marsha: Thanks. Yeah.
Daniel: So, so if I walk out of that concert and my ears are ringing, um... A quick story. A friend of mine, I was once leaving a concert with a friend and they were like, "Oh, I love when this happen.
It feels like the music is still in my ears," which really changed it [00:10:00] for me- Yeah ... because I know a lot of people are, are distressed by that sound. Yeah. But if I walk out of that concert and I'm hearing that, what you're saying is like, okay, my ears might be having some temporary damage- Mm ... from how loud that is, but it's not something that I need to panic about.
Marsha: Correct. Yeah. And, and we've all done that, even audiologists who are very diligent- Of course ... about, you know, protecting our ears. Sometimes I get in the car the day after I've been driving and I, "Oh, that was pretty loud," or- Yeah. I, my son and my husband and I just went and saw The Black Keys here in Milwaukee- Oh, fun
a couple months ago. Yeah, it was really fun. And at one point, you know, of course I have a sound level meter app on my phone 'cause I'm an audiologist. Of course. I'm measuring it and it tops- Of course ... out at 102 DB and I'm sending it to all my audiology peeps, "Look how loud this concert is." And we're all wearing earplugs, but then at one point, you know, they play, like, Gold on the Ceiling, right?
And so- Mm-hmm ... I look over and my son is taking out his earplugs, and I actually took a picture of him and I show my patients. I was like, "This is my precious boy and I am okay with him- Right ... in 102 DB without earplugs," because Gold on the Ceiling, of course, right? It's a great song. So- Yeah ... [00:11:00] we are resilient.
We can endure- Right ... some things. Just like you can cut your hand, it's gonna heal. We're- Right ... typically resilient. People can have hearing loss over time of noise exposure, but it's usually over long periods of time or a very, very loud sound at once. So- And I don't recommend going to a concert without earplugs.
I made him put his earplugs back in after the song. Yeah. I wouldn't want him to be there for two hours. And again, we know, like, Pete Townsend and Led Zeppelin, they're very hearing impaired because back in the '60s they weren't wearing- Right. Of course ... hearing pr- hearing protection, and they, they do have quite significant hearing loss.
So you do wanna be careful. But we get very overcautious. And especially when we look at hyperacusis, people are experiencing sounds as if they are very loud. They're experiencing sounds as if they are 100, 120, 130 decibels. Their brain is creating the sensation of pain and loudness even though it's well into a safe range of 85 decibels.
So for hyperacusis, the hill I'm gonna die on is telling people, "You are not damaging your ears if it's under 85." [00:12:00] Now, I'm not saying you're gonna go to a concert or you're gonna go to loud sounds, but it is safe. You are not damaging your ears. And what people think is, "There must be something different about my ears, and I'm damaging myself."
Right. And that's not the case. Yeah.
Daniel: It, it happens so often in the general pain world. People think that- Yeah ... there's something very different because they're experiencing the sensation- Oh, yeah ... differently. Right. But that doesn't inherently mean that their body is different.
Marsha: Damaged. Right. Yes. Exactly.
Exactly. And that's hard to understand. Yeah. I mean, we're all humans. Mm-hmm. We live in human bodies. I, I, I have those thoughts at times too. Um- Of course ... but- Of course ... you know, getting that reassurance from a professional who knows- You know, that difference of when you're damaging, when you're not, and when it's safe and when it's not.
And then doing things like graded exposure and, and stuff.
Daniel: Yeah Have you ever experienced any hyperacusis yourself? I'm so curious.
Marsha: Not usually, but every now and then I've had little twinges. So I actually, one of the things that we see a lot is people can experience, like, a sudden drop in their hearing, and we want- Mm-hmm
that's a real structural, real- Yeah ... structural damage, and we want them to come in right [00:13:00] away because we can get them treatment to more likely to get that back. And I've experienced that a couple times just myself. Right. And of course, because I, I have access to equipment, I can test it right away, and mine- Of course
usually comes back in a day or so, so I don't even- Totally ... need to do the treatment. But, um, which is steroids, by the way, 'cause people are w- wondering. Yep. Yeah. Um, but yeah, I've noticed a little, uh, you know, r- raspiness to sounds. They sound a little reverberant. They echo a little bit. So those are other neuroplastic symptoms that we can see.
Sometimes they're due to structural, but in those cases, you know, oftentimes our brain is creating these weird sensations- Mm-hmm ... to give us a signal. And so people, as I mentioned, with hyperacusis, they can experience pain. And people can experience pain in their ears, not hyperacusis, just they're, they're having earaches and pain, and there's no structural damage.
And they can have- Yeah ... a fullness in the ear or flutter in the ear or things like this, and we can test the ear ridiculously easily, and we can tell whether or not there's anything blocking in the ear canal or, uh, something behind the eardrum. We can do tests to see that. And oftentimes these things come back [00:14:00] normal, and then what'll happen- Right
is they're told things like, "You have Eustachian tube dysfunction," which- Mm ... probably not the case. Right. So- Right ... so yeah, so I have experienced it as well. It's, it's a normal phenomena that can happen. Um, and like you said, very fleeting. It's when it sticks around for longer periods, then we're kind of going into the, the classification of you might have hyperacusis.
Daniel: Right. And that's also when it can start to become more upsetting to people, of course- Mm-hmm ... when it sticks around. Yeah. And that's when we kind of have to learn to break that cycle of-
Marsha: Yeah ...
Daniel: not getting so upset by it, not getting so- Yeah ... afraid of it, which is very common in all PRT kind of stuff.
Marsha: Right.
Mm-hmm. Yeah.
Daniel: Okay, so we've got these diagnoses. We have these three diagnoses that you work with pretty commonly. That's great that we got the f- the foundation here of the work that you do. You came across PRT through the Curable app, which is great. How did that change the way you think about this, if at all?
Or how did that change the way you practice as well?
Marsha: Yeah, that's a good question. So the kind of gold standard in the audiology tinnitus treatment management world is something called tinnitus retraining therapy. [00:15:00] It was developed by Pawel Jastreboff in, like, the late '80s and into the '90s. And, you know, I've been trained in that area.
Mm-hmm. And other modalities, they, they all kind of, they all share a common theme, which is sound therapy. Mm-hmm. And we call it sound therapy 'cause it sounds really fancy, but it just means that we- ... use sounds to distract you.
Daniel: Yep.
Marsha: Um, sounds very, very fancy, but, um, it's, but it's actually, you know, when we talk about TRT, it's the avoidance end, right?
Got it. Yeah. So an avoidance is, what does avoidance involve? Don't do the thing that brings your symptom on. Do something that makes your symptom where you don't notice it. You distract from it. So if we play sounds when we have tinnitus, then we don't hear it as much. Totally. It's not as loud. We don't perceive it as much.
So the whole idea with TRT, like, the first rule is don't be in silence, right? Avoid silence. So that's kind of the cornerstone of where I've always worked with tinnitus. Uh-huh. And we know that works. We know that's helpful. And for some people, that's all they need, right? Right. They just need a break. They need to have some space between them and their tinnitus, and putting some sounds on.
Got it. And getting some education and [00:16:00] saying, "This thing isn't gonna harm you, and we've tested your ears," and all that. Yeah. They can start to emerge. We give them relaxation tools and things. So that's something I've, I, I, m- we talk about the limbic system, the autonomic nervous system. So that's brain processes- Right
body processes. So that was- Love that ... the platform that I've been- Holistically, yes. Yes. So I've been using that platform since, you know, since I started in tinnitus in 2008. So it wasn't a big leap. But what the difference- Yeah ... is, especially when you look at specifically TRT, is what's the other arm of that exposure?
Daniel: Right. Exactly.
Marsha: And I call it engagement because especially with hyperacusis, if I were to say, "We're gonna start to do some exposure," that, that feels very nervous. Very- For sure. It scares people. I get that ... I'm gonna expose you to sound. Yeah. Absolutely. So I said we're actually going to start to engage with sounds because we're gonna- Cool
do it in a comfortable way. Yes. And so we actually start, "You're safe. This is, again, it's under eight, 85 decibels. We're gonna begin to engage with that sound." And on the tinnitus end of that, the engagement basically is stop- Is start being in silence. Gradual exposure of- Right ... turning your sounds, [00:17:00] your sound therapy down.
Right. Of being in quieter environments. And I still haven't thought of a better way to say this. I say, you know, "We just are getting to the point where you can just allow your tinnitus to be there. Just allow it to be there." Right. I don't know how else to explain it. And then of course, my absolute favorite, somatic tracking.
Yeah. Best thing ever. Good. Yeah, so we said- I promise she's not paid to
say
Daniel: this
Marsha: Yeah. No, I love it. And I, I kind of re-coined it a little. I say to patients, I would actually say a more accurate term would be symptom observation. Great. Um, or even- Great ... sensation observation. Great. So we're just observing.
Again, it's a mindful practice. You know, it's, we're observing that sensation inside of you. So I think even saying sensation is helpful- Yeah ... because it just neutralizes that, and you're just watching it. '
Daniel: Cause it, it's just a sensation. Yep.
Marsha: It's just a sensation. Yep. And we're watching it, and we're paying attention to it on purpose.
And then they start to realize that they can sit with it. They can watch it without fear. And, um, and it changes, or it stays the same. One or the other, [00:18:00] right? Right. Right. Like, I, I always say, "I can't think of a third option. Let me know if something else weird happens besides staying the same or changing."
Daniel: Or changing. Totally.
Marsha: And we talk about, yeah, if it changes, it could, it could change in pitch. It could change in the quality. It could go on and off. It could become intermittent. It could become steady. It could go up. It could go down in intensity. Yep. So either way, all of it's okay. And if it, if it does change, that's pretty cool, you know?
Yeah. Totally. Because now we know it's neuroplastic because you're not doing anything to your ears. Totally. We're not moving your ears. We're not exposing you to sounds other than my voice, you know? Right. And if it changes. And then I actually use somatic tracking for hyperacusis as well. So I don't actually expose them to the sounds.
Okay. I just have them imagine it. "So let's imagine, what's a sound that really bothers you? Okay, let's think about going to Panera at lunchtime, and all the dishes and," you know. Yep. "And what are you noticing in your body?" "Oh, I'm getting anxious." "Where do you feel that?" "My chest is really tight." Or so we'll just- Track the emotional s- that, that somatic response [00:19:00] that comes up in the body with that anxiety or fear.
And-
Daniel: Yeah, let's break, let's break that down really quickly if you don't mind. Yeah. Mm-hmm. Mm-hmm. Sort of like in Panera, for example, like, you're hearing all those dishes clank together. Yep. It's, uh, they sound like loud clanks. I can, I can hear it in my mind right now. Yeah, yeah. We've all been there. It's, uh, so it's a loud noise, and as each, you know, bowl is hitting a plate and fork is hitting the bowl, our anxiety's increasing because we are sensitive- Uh-huh
to that noise. Yeah. So we're sitting there getting more and more anxious hearing those noises. Oh. That's what you're saying, right?
Marsha: Yeah, yes. So
Daniel: we're imagining that.
Marsha: Yeah, so whoever's listening to this podcast and has hyperacusis is probably- Mm-hmm ... like, "Ooh, I feel it right now." Right? You know?
Daniel: Totally. I'm even kind of feeling it.
I don't have hyperacusis-
Marsha: Yeah ...
Daniel: right
Marsha: now, so. Right. Well, I w- I work in a hospital, and I'll say- Uh-huh ... "Okay, you, have you ever been to our cafeteria here? It's really big." Oh, yeah. And all these. So we'll just, and I'll go, "How are you feeling right now?" And they're like, "Ooh, I don't like it." So-
Daniel: Yep ...
Marsha: you know, I used to say that to them to sort of point out that there's a lot of anxiety going in this reaction, uh, this emotional component.
But now I'm like, "Where are you feeling that in your body?" So- Yeah ... and you know, oftentimes that might be the tightness in the chest or [00:20:00] tightness in my throat or flushing in my face, whatever that. For sure. And that's actually, we're actually tracking the somatic response that goes with the emotion, right?
'Cause all emotions- Of course ... have a felt sense in the body. So in that case, I don't actually expose them. I- Right ... have them do that imagination. Now, there could be a point as they're getting better and they're g- you know, getting more confidence that they may be around a sound, and maybe there's a loud sound.
And they can stop and s- you know, track that response just in the moment. But we start- Yep ... with imagination, and that can be very powerful.
Daniel: Huge. It can be everything. Mm-hmm. Imaginal exposure's massive. So with hyperacusis- Yeah ... what I hear you say is that the exposure or the engagement is to these sounds, whether it could be imaginal at first or, you know, maybe eventually, like, you go into the cafeteria in the hospital- Mm-hmm, mm-hmm
and you hear those noises.
Marsha: Yeah.
Daniel: With tinnitus, some of the exposure or the engagement is with the tinnitus itself, is with the- Just like pain ... just like pain. So it's with- Mm-hmm ... the ringing in our ears, let's say. Mm-hmm, the sensation. And it's learning to be, the sensation in our ears, it's learning to be less sensitive to it, learning to be [00:21:00] more at ease with the presence of it regardless of how- Right
it's showing up.
Marsha: Yep. When I'm meeting with someone, I'm typically, my first appointment's about two hours 'cause that includes the testing. Amazing. And a lot of times, I'd say maybe 75% of the time, they're actually open to doing somatic tracking on that first visit. Amazing. Cool. Um, because they really have the education.
And, and it's like, "Let's just do it. For, do you wanna do it?" And it's like- Yeah ... the last thing we do, two, three minutes, four minutes. And I just guide 'em. And they didn't know. Yeah. Yeah. It's just a couple minutes, and then they're like, "Wow, it, yeah." And if it just hangs out there and doesn't move, I'm like, "So we've looked at it without your amygdala, your fear center, getting involved."
Yeah. "So even though it didn't change, that's okay because you're rewiring those fear pathways that go." Um- Yeah. Absolutely ... and I actually show a picture of the brain with all the different centers that light up with tinnitus. Um, so there's functional MRI research out there about tinnitus and looking at all the brain areas, and obviously they overlap with chronic pain.
Yeah. Um, so we talk about this part here. This is the fear center, the amygdala. If you can sit here with me and know you're safe and just observe it- Then we've, you still lit [00:22:00] up your, some of your tinnitus areas, but not the fear center. Yes. And that's, that's, that's what you're doing. So I say, "We just fixed a little glitch."
You know? Like, and you'd keep doing it, and you're gonna keep fixing those little glitches until they just become softer and-
Daniel: And, and, and for some people then, what you're saying is over time the tinnitus goes away? Mm-hmm. And it sounds like even if the tinnitus does not go away, they've learned to respond in a healthier, easier way.
Is that what you'd say?
Marsha: Yeah. Exa- And that's the thing that's a little bit different. Like I say, pain and tinnitus are the same. I don't like to come in and be, "It's so different and special," 'cause it's not. But there, the, but I would say one of the differences is that you don't necessarily have to get rid of tinnitus to be successful.
Totally. And like you said, even with pain, we're always gonna experience pain. We're in human bodies. And even those of us, like I tend to have a neuroplastic symptom of back pain, which is funny. I'm under stress right now at work, and it's moved into my left hip. Okay. And it's never been there before. And I was like, "Aren't you just cute and funny over there?"
We can, we can somatic track later. Yeah, yeah. Yeah. Exactly. I was like, well, when I try to smack, it goes away, so. Of course, yeah. [00:23:00] But I just sometimes just let it hang out. It needs to do whatever it ... I know we're stressed, thank you. Exactly. Hang out there in my left hip. Yeah. But yeah, so with tinnitus, though, you know, when I, and I, it, it can be like that where most of the time they don't hear it, but it might flare up when they're stressed.
Yeah. So that's a, hey, this is a great way that your body knows how to talk to you. Like, listen to it. Yes. And this sounds crazy, but- That's how
Daniel: my tinnitus acts, actually. Go ahead.
Marsha: Mm-hmm. Mine sometimes does too a little bit, but really it's, then it's, we can almost be grateful for it. And it sounds crazy.
Mm-hmm. And I used to say that, is that you can get to a point where you can actually be, there's a reason you might be grateful for your tinnitus, 'cause it's giving you a message. Yes. So if it calms down most of the time, it leaves you alone. And when you're not putting up the boundaries, you're not saying no, you're really stressed, you're, you're not being authentic, then it's gonna needle at you and be like, "Hi.
Remember the deal we made?" Yep. And you're gonna go- Yeah ... "Oh, thank you, brain- ... for the reminder. I need to say no to that thing 'cause I'm overwhelmed right now." So if we can look at it that way. And then other people, it can just sort of hang out, and they can still sort of hear it softly, but they don't, they [00:24:00] have a different relationship, as you said.
So if they don't care, which 80% of people start there, right? Yeah, totally. So, yeah. And then there's one other thing that when I did the PRT training, Alan was telling a story about, um, someone he saw who had, I don't know, like back pain. And he said, "Okay, I want you to go home, and you're gonna go outside and do the thing that you fear," say gardening, "and come back next week."
So he came back in a week, and he said, "How was the gardening?" And he said, and the patient or the client says, "Uh, I don't really remember, but I'm, I'm sure I had pain." Yeah. And he said, "Pain is a conscious experience."
Daniel: Yeah.
Marsha: If you are not aware of it, you're not experiencing it. And that- To apply that to tinnitus, it blew my mind because patients, patients will come in and see me and say, "Oh, my tinnitus is always there.
Sometimes I don't notice it, but it's always there." Yeah,
Daniel: exactly. Yeah.
Marsha: And so I used to say, "Oh, yeah, it's probably always there." But now I say, "Okay, here's the thing. If you're not exper- if you don't notice it-
Daniel: Right ...
Marsha: then you're not experiencing it. And if you're not experiencing it, then you're not experiencing it.
It's gone." Right. "It's off."
Daniel: Then [00:25:00] it's not an issue.
Marsha: It's not an issue. Right. And if you go looking for it- Right ... your brain may initiate it, but it probably is off at those times. Totally. Not that you just ignored it. So, and when I say that, that reframe, then, then all of a sudden people come and saying, "I hear it 100% of the time."
Then they're saying, "You know what, when I think about that, I, it's probably only on 50% of the time."
Daniel: Totally. Yes. Yeah.
Marsha: So that awareness component, if you're not aware of it, then it can't be bothering you. You know, I mean-
Daniel: Yeah, where we put our attention, that's where things grow, right? Exactly. That's where things thrive.
Exactly. I love it. And, and think, talking about the gratitude piece, you know, I, I'm grateful for the check engine light in my car-
Marsha: Yes ...
Daniel: because it tells me that something's wrong with the engine. If that didn't go on, the engine might just fall apart, and I know nothing about cars, and I wouldn't be able to drive.
Right. And that's when I think- You're stranded
Marsha: somewhere.
Daniel: Right, yeah, exactly. And that's what these symptoms in our body are. They're the check engine light. They're telling us- Mm-hmm ... like, "Okay, hey, you're stressed. You need to take care of yourself," for sure. I like that. So I appreciate that. Uh, there's also a, um, you know, when, with my own tinnitus, I can think back on a couple times in my life, maybe they were a week or two-week long [00:26:00] periods, I can't really remember, quite honestly, where I thought, "Oh, man, I've got bad tinnitus right now."
Marsha: Something's going on.
Daniel: Yeah, like it is sticking around. It's not going away. And then, you know, day three, day four, I, my attention grows and I'm paying more attention to it. I can't- Mm-hmm ... I can't think about something else.
Marsha: Mm-hmm.
Daniel: And then I never remember when it goes away.
Marsha: Mm-hmm.
Daniel: Because something might, I get distracted, something changes, maybe- Something else takes more, uh, importance
something else. Yeah, or maybe I got, like, an incredible night's sleep and I woke up and just continued my routines and I wasn't, it wasn't really there. Yeah. Um, and I think of that often because tinnitus, because it's not a big trigger for me inherently- Mm-hmm ... I might be part of that 80%, whereas, like, other pain and other stuff has been in the past for me.
Marsha: Mm-hmm.
Daniel: Uh, I think it's been easier for me to not give it all of my attention.
Marsha: Yeah.
Daniel: Um, but it's fascinating that we can just, like so many of these sensations, we can kind of let them be, and if we don't respond- Mm-hmm ... with panic or rumination-
Marsha: Fear. Mm-hmm ...
Daniel: they just-
Marsha: Mm-hmm ...
Daniel: they do kind of just go away-
Marsha: Yeah
over time. [00:27:00] Well, and even people are bothered. It's like that, too. Like, there's a, um, Christy Weipe, I think, did a podcast, I think it's Like Body Like Mind. And- Like Body Like Mind, yep ... the episode, yeah, the episode was Five Things I Wish People in Chronic Pain Knew. Mm-hmm. And one of them is you won't know when you get out of pain.
Daniel: Totally.
Marsha: And yeah. Yes. And people are like, "Oh, I'll know. It's so bad. It's all the time." Totally. Same with tinnitus. And, and it's funny, 'cause- Yeah ... even before I found Curable and neuroplastic tools, I would say to the patients I work with, you know, years ago, I would say, "You know, there's gonna be a day where you're gonna wake up, and you're gonna be going about your business, and you're gonna get your coffee, and you're gonna head to work.
And all of a sudden it's gonna be like 10:30 in the morning or 11:00, and you're gonna think, 'Where'd my tinnitus go?' And as soon as you think that, you're gonna go looking for it, and you'll find it." Yeah. "And you'll realize, I just went four hours without tin- hearing my tinnitus." Yeah, exactly. So again, like this- Exactly
it's so bad, I will notice. I, I would totally notice if it was gone. But once you start letting go of it and engaging in life again, it [00:28:00] just kind of fades. And- Right ... like, it was really interesting that she said that about pain, 'cause it was like, well, that's how I talk about tinnitus. It- Yeah ... is the same way.
Daniel: Same,
Marsha: same.
Daniel: Same. Yeah. Same, same. I love that. Yeah, exactly. So for, uh, and, and what a wonderful moment when we can recognize that we haven't been, uh, been dealing with tinnitus. Yeah. But for those people that are listening to this episode right now and are dealing with it-
Marsha: Mm-hmm ...
Daniel: what would you recommend they do?
Marsha: So, so f-- I would recommend reading the book, The Way Out.
Daniel: Okay, good. Yep.
Marsha: Check. Yep. Um, and, and, uh, and oftentimes, you know, because tinnitus isn't really listed a lot, like, sometimes there'll be- Yes ... a list of things, but it's not like, "This is how you do it with tinnitus." It's not the primary one. So I often say-- Exactly.
So I often say, "When you're reading this book, every time he says the word pain, put in the word tinnitus." And I think it's on, like, page 10, he lists, like, his 22 symptoms. Mm-hmm. One is tinnitus, and one is vertigo, which is- Right ... can often-- can be an ear issue, or it's associated with ear issues, vertigo, and- Yep
chronic, chronic dizziness. Um- Yep ... which my colleague, Dr. Yonit Arthur, The [00:29:00] Steady Coach, so find her online and on YouTube- Yep ... to find out more about that. She's
Daniel: got great content.
Marsha: Yep. Um, yeah. Like, I don't even need to go there. She's got it all. Go there. Mm-hmm. Um, and by the way, she also has a free tinnitus course on her, uh, website.
That's right, she does. Yeah. So thesteadycoach.com, and it's under resources, and it's called Tinnitus, and it's free, and it's very comprehensive. It's, it's amazing. It's all about that. So that's something they can do. But reading The Way Out is great because it really does-- I start with PRT. That's what I start with.
Mm-hmm. And, um, so that framework of, again, and even if you can't find someone with neuroplastic symptoms, if you find someone who is somewhat good at tinnitus, they are going to be talking about that avoidance. They are gonna be talking about the sound therapy. So you can do that part of it. Yep. And then, you know, I have a YouTube page.
I only have a couple videos, but it's Dr. Marsha Dewey, all one word, and I have some somatic tracking for tinnitus and, and I have some things like that, so you can kind of play with that end of it a little, read the book. And s- and, and start to move from the avoidance to the engagement. So I say that's our goal, is to move away [00:30:00] from that avoidance, distraction end, and start to approach the engagement and exposure.
Yep. So this education is huge, just like with Dr. Sarno's work. Absolutely. People read the book and gotten better. Really? Same with tinnitus. Some people come in, and I just go, "You're okay. You're safe." They think they have a tumor. "You don't have a tumor." Right. Um, "You don't have Meniere's disease," you know, all these things, or even if you do.
I have a colleague, one of my colleague's office right next to mine, she just came in my office. She's like, "Okay, this is my patient with Meniere's." They don't have tinnitus anymore. It's gone. It turned off. They don't hear it anymore. Amazing. So even when there's structural damage-
Daniel: Yep ...
Marsha: again, it, it flu- if, if your tinnitus is fluctuating, that's neuroplastic because- Yeah
ear symptoms just don't fluctuate. They don't usually fluctuate even over months- Mm-hmm ... but certainly not days or within the day. Right. So if your tinnitus is louder at night and quieter in the morning or vice versa, that's neuroplastic. So- That makes perfect sense ... yeah. So, so just collecting the evidence as much as you can.
Mm-hmm. There's a really great book called Tinnitus: From Tyrant [00:31:00] to Friend, so again, to that friend. Okay. Um, by Julian Cowan, C-O-W-A-N, Hill, Cowan Hill, and he's in the UK It's not really in the ATMS neuroplastic realm, but it really is a good book for tinnitus specifically. So read The Way Out- Great ... read Julian's book, and I think you'll be able to piece that together- Great
um, to really get that confidence of, like, do these tools apply to tinnitus, and do they apply to me and my tinnitus, right? Great. And so that would be a great place to start, and then Yunit's course. And just really accepting the diagnosis, believe that you can get better. You know, don't believe the regular hype, 'cause if you go to a typical audiologist or ENT, ear, nose, and throat physician, they're often gonna say things like, "There's no cure.
We can't help you." Right, "You're gonna be
Daniel: stuck with this forever." Yep.
Marsha: Yeah, yeah. And how many other diagnoses are also fall in this realm- That's crazy ... that's like that? Fibromyalgia, you know. Yeah, totally. Totally. We're told about pain, all the things. Yeah. So it's the same. Yeah. And it can turn down, where it's so [00:32:00] soft you don't notice it, and it can turn off.
I have, I have someone who came back for a follow-up, and I was, "Let's practice some somatic tracking," and he went looking for it, and we, we could not find it. He was, "I can't find it"- ... even when he's looking for it. So that does happen. Yeah. That can happen. Now, again, as we know, that don't go into your practice with trying to turn it down, 'cause that's not gonna work.
Exactly. Oh, totally. You have to be okay with it being there. It's that weird catch-22. Uh-huh. It's like as soon as I don't care if it's there, that's when it goes away. But all those tools- It's like trying hard to fall asleep. Yep, yep. Right. Yes. Exactly. Yes. I was like, you know, we don't fall to sleep. We go into sleep.
You know, it's a
Daniel: process. Exactly. Right, yeah. You can't
Marsha: force it. Yes. Yeah. It is a passive process by definition, right? Yeah.
Daniel: So let's, let's talk about, you know, we've talked a, a- about tinnitus and, and hyperacusis, but let's talk about misophonia and how you would treat that. 'Cause that's a- Yeah ... that feels a little more complicated to me.
Marsha: It, it, it always felt extremely complicated to me, and only just recently I'm like, "I think I'm getting it now." Great. Because the reaction is- Share what's up to- Yes ... or share us your
Daniel: secrets.
Marsha: So, um, so and my, my [00:33:00] colleague, her name is Dr. Annie Smith, and she, uh, works at the hospital with me, and she, she sees a lot more of this than I
It used to be I was the only one who did it and then she came aboard, and now she's kind of taking it on. And, and she has a YouTube page too that she's starting, and it's Dr. Annie Smith. Uh-huh. N-A-N-N-I-E. Um, and, um, so here's the thing about misophonia. Again, the narrative around that is doom and gloom. You- Yeah
and, and probably if somebody stumbles across that from that narrative, I'm gonna get the pitchforks of like, "Don't tell people. Don't promise them. Blah," you know?
Daniel: Yep.
Marsha: But it, it feels different because the reaction is so quick. Yeah. And there's, uh, so much narrative in that camp of you do not do exposure therapy.
Absolutely not. Don't do it. If anybody tells you that, run from the hills. They're horrible. Turn them into the board or something. I mean, it's just very, very, very anti- Okay ... exposure. Interesting. Now, people don't, under cert- normal exposure therapy, they don't get better. But is can [00:34:00] there. Now, it doesn't always mean it's always has to be, just like we don't always have to do somatic tracking, right?
Mm-hmm. It, they don't always have to do exposure, but some element of that, again, imagining it. Because their reaction- Yeah ... is so quick and so fast and so visceral that they can't see that it's zero to 60. Yep. But there is zero to 10. There is zero to 20. There is zero to 30, and that is, like, pick your lowest trigger- Yeah
that only mildly bothers you and imagine a stranger doing it. And it's like, "Oh, that doesn't even bother me." Okay, there you go. Great. Perfect. And just moving up- Good place to start ... so, yes. Yep. So that, on her site she has some stuff. On my or her YouTube, on my YouTube I have my somatic tracking is for sound sensitivity, and it works for both hyperacusis and misophonia.
Great. So I, I think that that narrative is harmful because people just don't have hope. Absolutely. Um, just like we know with other symptoms and, or diagnoses. And so I do think that some of these tools work. And th- for that there's a really great book called Demystifying Misophonia [00:35:00] by- Mm-hmm Uh, she's changed her last name.
Barrick, B-A-R-R-I-C-K, I think. Great. But it's Demystifying Misophonia. It's a fantastic book. If you know about neuroplastic symptoms, again, she's not in this realm of neuroplastic symptoms, but if you read it, you're gonna see all the stuff. It's the same
Daniel: stuff.
Marsha: Great. It's gonna be like, "Oh, yeah, this makes sense."
Awesome. And she has all kinds of tools, and she talks about coping, right? She has a whole chapter on coping, which, again, that would be that distraction or that, you know, avoidance. But then she's like, "How do we start to unpackage that?" And it is a lot of, what are the emotions behind this? What are- Yes
what's going on behind it? When did it develop? What was going on in your life at the time it developed? Just like other symptoms.
Daniel: Sounds, yeah, sounds like- Mm-hmm ... just like the rest of the neuroplastic stuff. Yep.
Marsha: And the other thing that I would add about misophonia, and I have found this almost exclusively, and I don't know that there's a, a study that s- you know, has a, a definitive number, but they usually are what we would call highly sensitive people.
Mm. So I, I usually... You know, there's the work of, uh, uh, Er- Elaine Aron is- Mm-hmm ... so if you look up, like, [00:36:00] highlysensitivepeople.com or something. Yep. It's her website. She has a quiz. And I mean, I'm, almost without exception, every patient that I've seen, and I've worked with misophonia- With misophonia. Mm-hmm
yep, are h- h- identified that way. And so that contributes because it is that I'm a highly sensitive person, and so I just... Uh, the highly sensitive people, what we know is they engage their senses more. They're more sensitive in their senses, but also in reading people's emotions. Mm-hmm. Their mirror neurons are more, um, activated, and so when someone's upset or even just, again, hearing sounds or smelling something, there are canaries in the coal mine.
There's a reason that a certain, I think it's, like, 20% of the population falls in that category. They're the- Yeah ... canaries in the coal mine for the rest of us. So you know, we don't want every to be that sensitive, but if just a couple of 'em are, they'll warn us when something weird is going on- ... and we'll listen to 'em.
Yeah. So they, they, they're very valuable. Mm. But they can get very sensitized to things, and especially- Right ... if other things in their life are going on and people don't recognize that highly sensitive. And so that tends to be sort of the recipe. I [00:37:00] tend to see that happening around pu- uh, puberty, around puberty time.
So I think that hormonal changes along with that. That's kind of- Hmm ... where it's starting. You see
Daniel: misophonia happening more so during puberty?
Marsha: It usually comes on in that preadolescent, adolescent- Interesting ... like, 8, 9, 10. Yeah, it is, and that's pretty- 'Cause I- ... universal ...
Daniel: that's interesting. I mean, I've seen it a lot in my adult patients, but I don't work with a lot of, uh, very-
Marsha: But if you ask 'em when- Yeah,
Daniel: when it
Marsha: started
they'll probably say 10, 12. Interesting. Yeah. Yeah. Yeah.
Daniel: Mm-hmm.
Marsha: Um, yeah, I, I've, I don't think I've ever seen someone that said it started when I was 22. Like-
Daniel: Yeah ...
Marsha: never. You know? Um- Okay.
Daniel: Fascinating. Yeah.
Marsha: Yeah. And so, and again, they're not born with it- Yeah ... it doesn't seem, you know? So, but it, there's something...
So I think there's just some magic potion recipe- ... about highly sensitive. So it is a little bit... You know, it, you always kinda wonder, like, why does someone get tinnitus versus back pain or versus... And there's so many factors- Right ... that we know, but this one tends to be a little more- clear, I don't know, like very common.
And then the- Okay ... personality trait, and again, there is literature on this and I think the literature says 97%, [00:38:00] the personality trait that emerges with, with misophonia is perfectionism.
Daniel: Oh, yeah. For sure. Absolutely. I see that
Marsha: all the time. Which is a common one, but with that- Of course ... particular. So there's just some kind of, and maybe that's to do more with a highly sensitive person or what that is, but that tends to be, again, and there's literature on that.
It's quite high.
Daniel: So as far as I know, the, we haven't, there hasn't been a lot of research in terms of PRT and let's say hyperacusis or even tinnitus. Right. Correct. There's a lot of anecdotal evidence. I've worked with hundreds of people myself- Yep ... with tinnitus especially. You've worked with a lot of people.
There's a lot of us doing this work from this lens. That said, the research is out. Mm-hmm. Um, we, we're still trying to figure that out, you know. The research takes time. We've got research on other, other symptoms, fibro and back pain, all those kinds of things. But we don't have- Yeah ... research specifically on this.
Yeah. That said, which we, you know, we should make happen for sure. But that said- Mm-hmm ... what kind of success are you seeing?
Marsha: So it's, it's just like with other neuroplastic symptoms. It really, to me, I sa- here's what I say. Uh, so we're having a lot of good success, a lot of good [00:39:00] success. Yeah. And I would say, you know, I had success before.
Yeah. Even before I had this, using PR- Yeah ... uh, TRT, tinnitus retraining therapy. Right, tinnitus. Mm-hmm. Lots of patients got better, and some didn't. Um, but I feel like the difference now is that some of those patients before that I maybe couldn't reach, I can reach now.
Daniel: Yeah.
Marsha: And I think that sometimes- So a higher percentage.
Yeah ... yeah, and I think that they're getting better faster too.
Daniel: Yeah. What kind of hope do you offer patients, then? If someone's listening to this and they're like, "I've had tinnitus for 20 years- Mm-hmm ... and I'm listening to this podcast as a last resort, and I think this is nuts." Yeah.
Marsha: Right. Uh Well, and that's, and I do see people who've had it for many, many, many years, right?
Of course. And, um- Yeah ... and so, and actually on our website, it, I have a section called Hope, and I ju- I think hope is so important in this work because- Yes ... um, I was actually just talking with someone about a book they were reading about, oh, you know, don't try to give people false hope. And I was like, hope, how, that, how is hope false, you know?
Yeah. Hope is like a wish for the future. You, you don't know- Yeah ... what's gonna happen. You know, there's like maybe f- false hope or almost I've read something [00:40:00] about pathological hope, right? So that you're- Mm ... you're wishing for something that just isn't possible, right? Right, right. But to say, "Could I be better?"
And, and is, is, if there is people saying they're getting better, and there is people saying it's possible, that hope is, that's the opposite of that nocebo effect, right? Right. Is, you know, is having hope and being open to it. Because what I do say in this realm, no matter what your neuroplastic symptom is, is I believe that anyone with a neuroplastic symptom can recover.
Absolutely. It doesn't mean everyone will, and I think that difference really is your mindset. If you really can accept the diagnosis, as Sarno would say, um, do the work, right? Understand that that's what it is. Yeah. And then you can move past the fear because you know you're safe. But we get stuck, right?
So I can't say- For sure ... everybody can get better. It's-
Daniel: No, of course not. Yeah
Marsha: And I always say, "I'm not a healer. I, I just, I can guide you. I can give you tools. But you, you know, the only person I can heal is myself." Right. And not even always then, right? But- Right. That's- Yeah [00:41:00] So, so that mindset shift is very important.
So as much as you need to read and get education to help yourself accept that- Mm-hmm ... um, and, and then you have to start doing, using some of the tools. You have to start to move towards something that feels uncomfortable. You have to be okay with- Absolutely ... a little discomfort. Yeah. And realize that it is gonna be okay, um, and collect that evidence.
So yeah, so hope is the first step. And sometimes that's huge. I mean, people will come in, and when I say, "You know, you've come to the right place, and you know, we, some people can recover from this," they'll, they'll be in tears. You know, they- Of course ... uh, they'll say, "You've given me hope." Right. Because without hope I read a quote that says- What else do we have?
Yeah. I, uh, a quote that says something like, "Without hope, we can't endure," right? Right. And- Yes. Yeah ... you need to have hope that it, it can get better, and, and hopefully people listening to this will, um, start to have some hope. Yeah.
Daniel: I ha- I had to ... One of my early tinnitus patients, the early patients always stand out.
They stick in my memory- Mm-hmm ... much more so. Mm-hmm. But one, an early tinnitus patient, he came in and [00:42:00] we were talking through it, and he said, "You mean this, it's possible this could go away?" And I said, "Absolutely." Mm-hmm. And I just remember he cried for 20 minutes. Yeah. He's like, "I haven't felt hope like this in," I think it was- Yeah
"six or seven years." He was like, "I've just been-" Right ... "stuck with this for so long." Yeah. It can be, hope can be so transformative. And actually- It is ... quite quickly, that patient, he was feeling-
Marsha: Yeah ...
Daniel: the, the tinnitus was, was mostly gone.
Marsha: Right. Yeah. Yeah. And I just listened to, um, Yonit just did an- Mm-hmm ... uh, Arthur did a interview with Howard Schubiner, and she was saying, you know, in the tinnitus world, what we say is, "You can learn to cope."
And she says, "If all we tell people is all you, the best you can do is cope, then that's the best they're ever gonna do."
Daniel: Yep, exactly.
Marsha: Typically, typically speaking. And then there are some people who go like, "No," you know, there, there's those people out there who go, "No, I'm gonna find a b- way," and they do. Like, and they meditate- Yeah
and they calm themselves. And then they come back. Totally. And then us people, my people, the audiologists- ... and the ENTs write them off. Or they even say- Mm ... "Don't tell people that. You c- that's not true. Don't tell people." Oh, gosh. Oh, wow. And yeah. And so because they don't [00:43:00] know how to do it, right? Right. You know, so if they- Right
don't have the tools, they're afraid to even suggest it. Or, uh, I mean, again, if I, in the tinnitus realm, to say to someone, "You can get rid of your tinnitus," is a big no-no.
Daniel: Right.
Marsha: You know? Of
Daniel: course. Yep.
Marsha: And, uh, but it's like, well, I've got some patients who can tell you otherwise, so you know, it's just- Right
they're collecting the evidence. It's like, yep, nope. Ex-
Daniel: exactly. Yeah. I could think of a roster of people that said had, don't have tinnitus anymore. Yeah.
Marsha: Yeah. I just, again, I, I think ending on hope is the big thing.
Daniel: Yeah.
Marsha: Yeah. Yeah.
Daniel: Absolutely. Ending on hope. Yeah. I love that.
Marsha: Mm-hmm.
Daniel: Great. Well, thank you so much for being on the podcast.
Thanks for sharing your knowledge. Thanks for your enthusiasm. My pleasure. Thanks for being open to thinking about- Yeah ... audiology with a, with a flair of psychology here. As a therapist, I love that. Yeah. I think everyone should be holistically thinking about things. Yes. So thanks
Marsha: again. Yeah. I appreciate the opportunity.
Thank you so much.
Daniel: Of, of course. And lastly, if people wanna get in touch with you, they can find your We- YouTube page. That's the best thing to do.
Marsha: Yes. Yeah. Yep.
Daniel: Great. Dr. Marsha Dewey on YouTube.
Marsha: Yep. All right.
Daniel: Amazing. All right.
Marsha: Thank you. [00:44:00] Thank
Daniel: you so much. Thanks so much for listening to this episode of the Pain Reprocessing Therapy Podcast.
If you enjoyed this episode, I encourage you to check out Dr. Dewey's YouTube channel, as well as the resources we mentioned in the interview, including "The Way Out" by Alan Gordon and Alon Ziv, and the Steady Coach's free tinnitus resources. As always, if you're enjoying the podcast, please consider subscribing, leaving a rating or review, and, and sharing the episode with someone who might benefit from it.
It helps more people discover this work and the possibility of recovery. And if you have suggestions for other topics you'd like covered on the PRT podcast, feel free to reach out to me directly at daniel@mindbodytherapycenter.org. Thanks for listening, and I'll see you next time on the Pain Reprocessing Therapy Podcast.