Tinnitus Today, Vol. 23, No. 3, 17-18 September 1998
By Dr. Norma Rivera Mraz

The relationship between the healer and the patient has a major impact on the healing. We know this scientifically and intuitively. The human touch, for example, and expressions of understanding and compassion have been shown in numerous studies to be effective tools in the healing process. We need only to think back on our own lives to recall how a soothing word has eased a pain or lessened a fear. It is therefore important that hearing health professionals communicate wisely, compassionately, and accurately with patients from the very first meeting, whether that communication occurs by phone or in person. Because we all form our first impressions in a matter of seconds, we as audiologists must be acutely aware of—and ready to use—our abilities and power to build a healing relationship at the very first meeting.

Many people who experience illness or a disorder like tinnitus automatically feel that no one—especially their healthcare providers who do not have or have never had tinnitus themselves—can comprehend the magnitude of their pain and suffering. If this were the case (which fortunately it is not), many of us in the hearing health community would not be able to cultivate the relationships necessary for positive, effective results with patients.

When a tinnitus patient is on the receiving end of empathy, I often hear them say, "You can feel what I hear!" They are amazed to learn that I do not have tinnitus, and even so, I genuinely understand the abyss they are in and the despair and loneliness they are feeling. When tinnitus patients come to you, know that they will notice your professionalism and the degree to which you care—even through all of their confusion and concerns, even before they begin to tell their stories. They can see it and keenly sense it.

Expressions of empathy can be easily communicated through body language—relaxed posture, uncrossed arms, leaning forward toward the patient, and eye contact, steady and warm—all executed naturally and without mechanical effort. Most health professionals are not prepared to offer this focused attention to their tinnitus patients at every encounter, perhaps because of tight schedules or other factors (like a bad hair day). But it is crucial that we do so each time and every time we come into contact with our tinnitus patients.

Another vital role the audiologist must play is as an "active listener." Active listening is absolutely necessary when working with and counseling tinnitus patients and their families. It is not a matter of parroting what your patients say to you, then nodding your head in response to their comments. It is instead hearing what your patient is saying to you, and taking those statements in compassionately just as you would do for a close friend or family member who is in distress. Active listening is another step in the healing process, and it creates hope for the future.

Tinnitus patients appear to have a heightened sense of awareness of everything about themselves and any change that might occur within their bodies. Every word uttered by their audiologists or their doctors takes on heightened significance as well. For many patients, just being told, "there's nothing we can do for your tinnitus," can greatly distort their sense of reality and, tragically, their peace of mind. Consequently, it is imperative that we choose our words and the overall message we wish to convey with precision. Negative comments, such as "go home and learn to live with it," can sound just as loud and intrusive as any tinnitus signal. And besides, they have already tried to live with their tinnitus and have found unfavorable results, hence their visit to your clinic. Patients often feel like they are failures or weak in character because they can't just "forget it." It is even more problematic when healthcare providers fail to advise patients on how to accomplish this daunting task.

What DO they need to hear from us if we do not have the answer? How about, "There are options available elsewhere that can better address your tinnitus issues. Unfortunately these options are not available at this clinic today." Suggest other clinics, the American Tinnitus Association, the Internet. Tinnitus patients can easily access true (and false) information, especially via the Internet. But even true information can be misinterpreted or misrepresented and can lead individuals with tinnitus down a lonely and dismal road unnecessarily. Inform them that there are viable treatments that work. Be a wealth of good information. It is not the audiologists' and doctors' responsibility for tinnitus patients to get better, but it is the audiologists' and doctors' responsibility to be a source of guidance for these patients.

This paper is based on my professional experiences as an audiologist and the personal value system I bring to each of my patients. I am gratified by the comments from my patients: "You really do understand me and my tinnitus issues." "I thought no one could comprehend what was happening with me, especially if they didn't experience tinnitus themselves." "You speak as if you've lived in my home." "You have described me in great detail." "You are an oasis in the desert."

I have seen tinnitus patients begin to feel reassured, educated, enlightened, and invigorated because of the time and patience I've given them. Personally and professionally, it is one of my greatest achievements.