Hyperacusis is the perception of certain everyday sounds, such as domestic noise or noise in public places, as too loud or painful in such a way that it causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities. Marta’s main complaint was sensitivity to certain sounds started after a head trauma. Her CT scan was clear, and she has seen ENT and neurologist who diagnosed her with post-concussion syndrome with migraine. ENT could not find any physical damage to her ears and her hearing test came back normal. She was diagnosed with severe loudness and pain hyperacusis with no significant misophonia component. Marta was experiencing a continuous dull pain in both ears which exacerbated significantly when she was exposed to any noise. She was unable to use headsets for telephone calls which was required for her job. Marta had to go on long-term sick leave due to the significant impact of hyperacusis on her ability to work and on her mood. She was even sensitive to her own voice. Hyperacusis made her headaches worse, and both her ears felt blocked or full. When exposed to sounds, her ears vibrated and she felt extreme pain inside and around her ears. Her ears started making crackling noise after hearing sounds triggers such as her own voice, own chewing, cutlery, plates, putting things down on a shelf, wrapper, typing, hair dryer, hand dryer, traffic, and so on. She had to avoid going out in the fear that noises might hurt her ears.
Patricia Pugh, Specialist audiologist, adds:
“At Hashir International Institute, Marta enrolled in an audiologist-delivered cognitive behavioural therapy (CBT) sessions which were performed online using video calls. She also took anti-depressants prescribed by her psychiatrist to help with her mood. The therapy program involved 14 one-to-one sessions. The first 10 sessions were weekly. Then the gap between sessions increased to 2 weeks, 1 month, 3 months, and 6 months. Each session lasted about 45 minutes. Several important components of her treatment comprised: (1) learning theoretical underpinnings of CBT and its relevance to the management of hyperacusis. (2) identifying and modifying some of her sound-related troublesome cognitions and consequential emotions and behaviours. (3) SEL: This is an acronym for a CBT exercise (Stop– Expose–Learn) in which she was encouraged to Stop avoidance behaviours and rituals, Expose herself in a step by step and gradual manner to the trigger sounds, and Learn from it. As Marta was experiencing comorbid psychological and sensory processing problems, additional psychological and OT input was provided throughout the treatment. ”
Marta said:
“I came to see you with pain hyperacusis. You took the time to explain the condition to me and made me see it in a completely different light. You changed my attitude from wanting to hurt those making noises as they were hurting me, to understanding that it really wasn’t their fault. It seems crazy now that I ever hated them for it. Anyway, I pushed myself to face the noise. To go out in public. To remove the ear defenders. I’m so grateful that I did. Within a matter of months, I had it under control and within 8 months I was (almost) cured. I say almost because I still get very mild bouts of it whenever I get a head cold. Thank you for everything. The meetings with you were the best money that I ever spent. Keep up the great work!”
Our Director, Dr Hashir Aazh said:
“There is no quick fix for hyperacusis. However, there are several methods that have been used for hyperacusis management with various degrees of success. Some clinics reported undertaking ear operations to cutting a tendon in the middle ear to reduce noise-induced pain, covering parts of the cochlea from the inside the middle ear to reduce vibrations in the inner ear, and some doctors even claim that cochlear implantation can help hyperacusis. Our institute is collaborating with ongoing research on the topic of management of pain hyperacusis. To date, CBT is the most evidence-based intervention for hyperacusis management. At Hashir International Institute, we offer a premier therapy package for hyperacusis rehabilitation based on CBT. CBT helps to understand and manage the emotional, cognitive, and behavioural processes that are often linked to the experience of hyperacusis. This helps to alleviate anxiety, stress, anger, and depressive symptoms by helping the patient to modify their dysfunctional cognitions, ruminations, and safety-seeking behaviours. This provides an opportunity for the auditory pathway to recalibrate itself and stop over amplification of signals within the neuronal network.”
For further information, please contact:
Hashir International Institute, 167-169 Great Portland Street, 5th Floor, London, W1W 5PF
Hashir International Institute, 54 Quarry Street, Guildford. GU1 3UA
admin@hashirtinnitusclinic.com
About Hashir International:
Hashir International is an independent research institute and treatment centre dedicated to improving the diagnostic process and rehabilitation programs for patients experiencing misophonia, tinnitus and hyperacusis. They offer specialist training courses, ethical review of research proposals, research design, research sponsorship, and supervising MSc and PhD students.
