How Do Musicians Deal With Tinnitus?

Ben Thompson, AuD.

Just the other day, I was looking at my YouTube comments and I saw a comment from a man named Jack. Jack said, “I’m a musician, I’ve been dealing with tinnitus for a number of years, and I have a message to share.” Today, we are here with Jack Rubinacci, who is a musician, and wants to share some important information about tinnitus. Jack, tell us your journey. What’s been going on for you with music, noise and tinnitus?

Jack Rubinacci

Well, thanks for having me on your show. You do a great job with your YouTube channel. I’ve been a musician my entire life. Started out in bands as a teenager, usual stuff, became serious about it in my early twenties, was in lots of bands, lots of loud noise, guitars, drums, all the time. Worked very hard with the band that was in called Honeyman. We were sort of the band of the moment in my hometown in Birmingham, in England. And developed tinnitus at 27. It wasn’t too bad then, sort of a slight noise. And that’s when I made my first mistake. I didn’t do anything about it.

My tinnitus became sort of much worse when I was 36. I was just doing loads of gigs, recorded two albums and just gigging all the time, no ear plugs, which sounds crazy when I think about it now. And when I turned 40, my tinnitus became what I would say chronic. At the time then, there was nobody really talking about it amongst the musicians at least. I could find a couple of articles from DJs, because there’s quite a bad problem amongst DJs, ’cause they have music straight into their headphones. And reached out to a couple of guys. They didn’t really want to talk about it, apart from this one DJ who sent me a message, he was touring the world, sent me a message saying, “If you want to call me, call me.” I never bothered him, because he was literally touring the world, but it gave me hope and it made me recalibrate the way I feel about my tinnitus and that made it more manageable. And even though I have what I would say is chronic tinnitus, I’ve sort of developed my own tools and techniques to sort of deal with it. And I want to share that message specifically amongst people that are new to tinnitus, like you do yourself, because you know that’s the worst. 

I think there’s three phrases we can get into that, but I think sharing the message amongst people that are new to it. And also, amongst musicians, there are a lot of musicians that reach out to me, because of my books and because of my YouTube videos and they say, “It’s a scary thing, being a musician with tinnitus,” ’cause it’s sort of contradictory, you know what I mean? So that’s sort of in a nutshell, my journey so far.

Ben Thompson, AuD.

Thank you, and we’re excited to get into the books, the message behind the books, your own personal experience as a musician. Before we do that, have you studied or learned about other famous musicians and their tinnitus or tinnitus their ringing in the ears? If we go online, there seems to be reports of very famous musicians and lead singers of bands, lead guitar players of bands who have reported tinnitus. Have you looked into that much or spoken to them?

Jack Rubinacci

That’s the first step that most musicians do? The first thing you do is you look who else has got it. How do they manage it? And even though those musicians are sort of labeled with having tinnitus, they don’t really go into too much detail on how they deal with it. But yes, that’s pretty much the first thing that I would imagine that any musician watching this now with tinnitus, it’s probably the first thing they’ve done. It was certainly one of the first steps I’ve done and I’ve gone back to it, because one of the things that I think is very important where the journey with tinnitus is to, and we’ll get into this in more detail, but to have positive messages coming into your brain. And one of the beneficial things of looking at other musicians that do it and manage to do it, is that it’s giving reaffirming, positive, reaffirming message to your brain, that you can do it too. And that’s sort of what I’m about.

Ben Thompson, AuD.

With the brain’s natural filter mechanism, this limbic system, I equate it to a smoke detector in the kitchen. And if the smoke detector detects a threat, whatever message it is calibrated for, then it will have a loud auditory response. So if there’s smoke in the kitchen, then the smoke detector will have a loud response. Now, what is the signal that’s triggering the limbic system to make the tinnitus so loud? If we can understand that brain science, it can help us manage it. Positive messaging is influencing the subconscious, emotional processing. So practically, that makes sense. And of course, we would want positive messaging no matter what we’re doing. Scientifically, it also has merit based on our understanding of the brain. What have you learned? What are the positive messages you want to share with other musicians, whether they’re one year in or one month in to louder tinnitus?

Jack Rubinacci

I think there’s three phases to tinnitus. There’s the initial shock when you get it, then you sort of deal with it, you get on with it. You sort of, you look around, you research, you go to the forums, but you probably get to habituation without even realizing what habituation is. Phase 2 is the worst, in my opinion. It’s where you have had habituation, but something has happened, something has happened to trigger it, and all of a sudden it’s got worse. It’s like falling without a parachute. It’s absolutely the worst place with tinnitus. And that’s where the work that you do and everything that I’ve said about tinnitus in the past, which is not as much as you, but it’s sort of where I hope that people pick up on your message and anything that I might say, because stage 2 is the worst, because you think you could deal with it, but all of a sudden it’s got worse. Stage 3 is where I feel that I am. And that is that I’ve been so many times up and down with tinnitus, I’ve had it really bad. I’ve had the habituation, I’ve lost habituation. I’ve just these past few weeks, I’ve been through a terrible spike, but because I have these tools in place, I’m able to deal with it. And some of the tools that I’m talking about are first and foremost, changing the way you feel about it. If you have a small stone in your shoe, when you notice it, it’s going to become a problem. If you can’t take that stone out immediately, but you just sort of flick it out the way you can carry on and you don’t notice it as much. It’s very much about what you’re noticing. And I’m so much going through this right now, because I’ve just been through a really bad spike, but really bad. Probably the worst I’ve been through. And the way to do it is well, I think the way to do it is change the way you feel about it. If you think, “Oh my God, this is really bad. This is really bad,” your brain is reaffirming what you’re thinking and what you’re feeling and it’s going to become worse. If you can get to a point which is where stage 3 is where I feel I am, you say, “Well, yeah, it’s there. I’ve been here before, it’s going to be okay, just by saying to yourself, “It’s going to to be okay,” already takes 50% off your shoulders. You say “I’ve been here before I can relax into this. I know that within a few weeks, it’s going to get better, within a few months, it’s going to get even better. It’s not going to go away, but I’m going to change the way I feel about it.” That to me it’s the first foundation of getting over tinnitus. And it’s the first tool in my book, because I feel that if you get to that point, you’re already 50% there. 

Other things that I would say without going specifically into musicians, but as a whole, people with tinnitus, if you can change the things around the tinnitus, we can’t change the central thing, which is tinnitus. It’s there and we can’t change that right now. What we can change is things around it. So what does that mean? It means, okay, changing the way I feel about it. Already, I feel better, because I know it’s there, but I’m not going to go against it, I’m going to work with it. We’re just going to let it go. Second thing would be exercise. Can I do exercise that sort of makes me feel better? Endorphins into the brain, I’m feeling better. Third thing would be food. I’ve changed some of the food that I eat, breakfast in particular, because it makes me feel stronger. If I can find ways to sort of centralize my core and feel stronger about life in general, I can deal with this thing, because what happens is the bigger these things become, my focus on food, my focus on energy, my focus on reducing stress, which is a huge thing, man, reducing stress is massive. I know it’s not very easy, but it’s fundamental. And I think that if we see ourselves as people with tinnitus, because a lot of the time people that approached me to say, “I’m a musician,” or whatever, “I’ve got this thing.” And I say, if you address yourself as someone with tinnitus, you are identifying yourself as someone with tinnitus, I therefore need to change things around my tinnitus. 

Do you understand why I think identifying yourself as someone with tinnitus is really important, because you say, I have tinnitus, I therefore need to change these things around. So exercise, stress, because reducing stress is not easy. But if you say, “Hey, hold on a minute, I’m a person with tinnitus. I’ve got to find ways of reducing stress.” If there are people in my life that are toxic, can I reduce that engagement that I have to have with these people so that my stress levels are lower? Can I find ways to reduce my stress? All these things, sometimes when you talk about these things to people with tinnitus, they say, “But that’s not what I’m thinking. I just want to get rid of tinnitus.” My message is, if you can change these things around tinnitus, your diet, exercise, reduce stress find distractions, massive, massive thing. I was on holiday in Greece about three or four years ago and it took me two or three days to remember that I have tinnitus and I had pretty bad tinnitus. And that was a big turning point for me, because I was like, “Hold on a minute. I haven’t thought about my tinnitus for two, three days.” Distractions, find things you love and do more of them, because the more you do, the more you enjoy yourself, the more you are forgetting this ridiculous noise in our brain. I really feel that these things, changing things around tinnitus, they don’t get rid of tinnitus, but they strengthen the core and help us not just overcoming tinnitus, but help us reduce the tinnitus by strengthening our core. And I think also help us become healthier people as a whole.

Ben Thompson, AuD.

Absolutely, you’re bringing up great points. Myself coming from the scientific lens where I’m thinking is, okay you’re working on some frameworks of cognitive behavioral framework, right? The cognitive behavioral techniques or framework. So cognition is the mind. What kind of messaging am I letting come into my mind? How am I responding to the thinking, the automatic thoughts, some of which may be negative? How can I replace those with more truthful, scientific, realistic thinking? And then, the behavioral part of this is what kind of behaviors am I doing? Am I reinforcing that tinnitus is negative, bad, this dark cloud? Or am I changing? Am I modifying? Bringing in the holistic perspective is a great way to accelerate those behavior changes for tinnitus. One thing I say to a lot of my telehealth patients is that the way to treat this condition is through managing it. Through managing it, it becomes treated, right? There is no cure, but there is treatment option. So the way to get to that point is by doing everything, you’re doing, the psychological, the sound therapy, the holistic want to bring us back. What was your timeline when it became louder? Was it sudden, or was it gradual with the loud noise exposure?

Jack Rubinacci

It varied. So between 36 and 39, it was lots of gigs. So I was noticing it more and more. I’d come home from shows and my head would sort of hum. And it would be hot. And I could realize that I could notice that my tinnitus was getting worse. But then, on 17th of November, 2016, I was editing a video that had a particular noise in it and went out to do a show at the end of the day. And that’s the next day was, the next three weeks were terrible, because it was a huge spike, I had some shows to do at the time as well. So I’ve found that my spikes have occurred after an incident. And the interesting thing is that I’m not quite sure whether it was all because of the sound or whether it was a combination of the sound and the reaction mentally to the sound. That’s why I really feel, and I know that you say a lot of this in your videos that the state of mind is so important with us. So it’s actually, so interesting to see how much state of mind changes the level of or the burden of my tinnitus reduces. So this is why it’s so fundamental I think, to try and find ways to adjust your state of mind. So yeah, so several spikes happened after sound.

Ben Thompson, AuD.

Yeah, I had another patient who was a touring musician for years and has chronic tinnitus relatively managed and we met, and one of the points of confusion for them was, “Because I have tinnitus and it’s chronic, does that mean I’m not supposed to play music anymore?” And after our conversation, I determined, “Hey, you’re medically cleared to rock. Just make sure you’re using the right kind of earplugs.” The cells, the stereocilia that inner-hair cells, the outer-hair cells of the cochlea, the hearing organ, that is the biological marker of hearing loss, noise-induced hearing loss, right? Having tinnitus does not mean those cells are at any higher risk of damage. So this is a big point that musicians especially need to be reminded of is that having tinnitus is neurological. Damage to the hearing organ that is biological or physiological. So tinnitus can change up and down, spikes, get better, resolved, habituated, come back a little bit and that’s related, but independent to the cells of the cochlea. How do you use earplugs? And do you still play shows?

Jack Rubinacci

Just to reply to that point, one of the questions that I get asked a lot, I get a lot of musicians approach me. And one of the questions they say is, “Do you have hearing loss?” And I find myself repeating this answer over and over again. I say, “No, I hear like a dog.” So, I actually don’t have hearing loss. And a lot of other musicians are in the same position. They don’t, they have tinnitus, but they don’t have hearing loss. So it’s an interesting point. And another way of dealing with state of mind is the way I feel about it is that as long as I can hear, I can work, because if you can’t hear that changes the dynamic, but I can hear so I can work. And the idea that I can work makes me feel happier. And the size of tinnitus, all these things reduce the size of tinnitus, so that it’s smaller. So yes, that’s a very interesting point.

Ben Thompson, AuD.

I want to add something to that is that from studying with the founder of TRT, Pawel Jastreboff, one important point of those trainings of those mentor programs was that even if the hearing is in the normal range on a typical audiogram test, 250 to 8,000 Hertz, if we’re testing the outer-hair cell function of the cochlea with a test called the OAE test, otoacoustic emission, it’s a specific test on how those cells are operating. And for majority of people with tinnitus, vast majority, the test shows that those cells are not in the normal range, they’re slightly abnormal. And definitely as a musician, we can expect if there’s been 5, 10, 20 years of loud music, something’s got to give, so those cells are sensitive and you’re not hearing how you used to 20 years ago. So I think this can also be a point that’s confusing is doctors tell me my hearing’s normal, but I still have tinnitus, this is not normal. While going deeper and more fine-grained and audiology clinics can do this test, we can see, oh, okay, if we’re going deeper into the physiological marker of this, it’s not what it used to be. Now that’s not to say this makes everything better, but it is one small piece of the puzzle, because tinnitus can be somewhat of a mystery, right? It’s confusing, doctors tell you there’s not many options you’re going online trying to figure it out. So anytime that we can take away that mystery or that confusion has that positive benefit too.

Jack Rubinacci

Yeah, getting back to your point with earplugs. I’m very, very proactive with earplugs and I’m very, very sort of proactive with telling other people about earplugs. When I was in bands back in early nineties, when I was really working quite a lot with bands, the knowledge that we have was general, so you got knowledge from the bass player, the sound man, we didn’t have such access to the internet, so we didn’t talk about it, so no one took action, nobody had earplugs. And that was a huge mistake, ’cause we rehearsed in a room the size of a shoe box, and it was very loud, four guys, drums, guitars. And when I think back to my experiences with music and all the gigs I’ve done with no earplugs, it scares me now to see musicians, still, it’s very, very better now. 

A lot of musicians with in-ear monitoring, earplugs, but there are still lots of musicians not wearing earplugs. I don’t bring this up, but I feel emotional about it. I wish that you knew just how important it is to wear earplugs. It doesn’t change the experience of the music, because there’s different schools of thought with musicians, they say, “I need to hear it to feel it.” I don’t have the option anymore, because my tinnitus is so loud. So I’ve trained my brain. Again, it’s about adapting to your new situation. I’ve trained my brain to be able to hear less, because of the earplugs, but to perform more. So the way I deal with earplugs is I have earplugs on all my sort of situations. I have them on my car keys, I have them in my wallet. I have silicon-molded ear plugs in my wallet. They’re the ones that I use the most, minus 30db. I have minus 30db silicon’s on my mixing desk. And then when I do shows, I have a thing that’s called Hunter’s ear earplugs, which are minus 36, minus 37, which is getting towards the maximum you can attenuate, ’cause your cranium attenuates at minus 30, I’m led to believe. And you can only attenuate to a certain point. So minus 36, minus 37 is what I think is the limit. And these are pretty much that. And what they are, is they’re a lump of silicon molded to my ears so that I can sing and I can protect my ears with the absolute maximum. And you just learn to train your brain to not have to hear at loud volumes, but still be able to sing and perform at a high level. It’s not easy, but it’s a bridge that once you cross it sort of keeps me in the game.

Ben Thompson, AuD.

Absolutely, totally necessary. And what did that take a few weeks, a few months? How long did it take to adapt to that?

Jack Rubinacci

Yeah, it took a few, a good few shows. So a few weeks, the first thing you want to do is take them out.

Ben Thompson, AuD.

Our message to musicians, younger musicians, especially even younger festival-goers or concert-goers. That was me, I was there, first few rows dancing, having fun, no earplugs. Probably didn’t do all that much, but cumulatively, it can have a big impact, especially for younger musicians who are playing live. What I wanted to share was that noise exposure has a delayed effect of hearing loss. So to have decades of noise exposure, you’re likely not to experience hearing loss until you’re 40 or 50 years old. What we typically see is that people start to lose their hearing as a society between 60 and 70 years old. About that time for someone who’s had loud noise exposure, whether that’s music, military, hunting, industrial, that hearing loss is likely to show between age 50 and 60. So there’s this delayed effect. And that’s why you can be touring for decades and your hearing test is normal. You’re experiencing some tinnitus and will typically follow that trend over time. So make sure to get your hearing tested. And as you’re doing, as you’re doing Jack, be proactive about it. This has been an excellent conversation and perhaps we will speak again. I really value what you’re bringing here to our community, by volunteering your time. Tell us where people can find your books and any last messages you have for our community.

Jack Rubinacci

Last message is you will be okay with tinnitus. It’s something you can deal with. I think it’s very important to share that message, because I’ve sort of been at all levels with tinnitus at the start. I’ve been very bad with tinnitus and I’m still here. I’m still rocking, I’m still writing, I’m still recording. So that’s sort of the message I’d like to share with everybody. Books, jackrubinacci.com. They’re on Amazon, Kindle and paperback. And I also have a website called helpmytinnitus.com. helpmytinnitus.com, this shares information about me and my journey and the sort of the points that I’ve been talking about today. I want to say thank you for having me on the show. You have a fantastic YouTube channel with a lot of good information, so thank you.

Ben Thompson, AuD.

You’re welcome. Thank you so much, Jack. And for anyone listening, make sure to check out our other podcast episodes. We’ll see you next time, thank you.