Is your brain lying to you?

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0:57When you put imagination to work at Canva.com. If you don't know what tinnitus is, it's like that ringing you hear in your ears after getting out of a loud concert, but it's all the time. The den of the tinnitus just constantly coming. It's like man's search for meaning, basically, but in your brain.

1:17Jonquilyn Hill:Okay, before we jump in, I need you to do me a favor. How do you pronounce this word? Aha, yeah, okay. So there are two ways to pronounce it. Most people say tinnitus, but all the researchers I spoke to say tinnitus. This is my colleague, Noam Hassenfeld. He hosts Unexplainable, a show all about exploring scientific mysteries. When I reported this episode, I said tinnitus. That's the one I chose. Okay, well, normally I'm a tinnitus girl, but when in Rome... Which one do you want to do? We can go whatever way you want. It's your show. Tinnitus is a persistent ringing in the ears, and it can range from mild to straight-up debilitating.

2:06Jonquilyn Hill:That was the case for a listener named Kelly. It's like the high-pitched ringing you usually hear in your ear every now and then, but it's, like, more intense, and it's just there the whole time. She wrote into Unexplainable, hoping to understand what exactly was going on with her hearing. She said that she got tinnitus something like four years ago when she was about 25. I noticed around just New Year's time, I just remember there was something on the bright side of my ear going on. And it was going like...

2:41And I thought it was just the pipes. I kept asking my fiancé if he's been hearing something going on in the walls next to me. He wasn't hearing anything. So that didn't make sense to her. She went to her family. They were kind of like, don't worry about it. But then she started hearing a pitch in her other ear. And this one was just kind of like that straight high pitch, just like.

3:06And so she's hearing both of these things in each ear and it's just kind of driving her crazy. I mean, it's like you're just trapped in a room with a crying kid. You can't stop crying or anything. You don't know how to just make it stop. She said it got worse in louder environments, so she had to leave her job. She stopped seeing her friends. She had trouble sleeping. I've grown so distant from my friends because with the lack of sleep, you're just not in any other mood for anybody. and you can't show up like you used to for any of the things that you've done.

3:46Jonquilyn Hill:I've experienced ringing in my ears before, you know, after a concert or, you know, a night out, but it went away after a little while. That's a version of tinnitus too, right? Yeah, yeah. I spoke to this scientist, Stéphane Maison, at Mass Eye and Ear Hospital in Boston. He's the director of the tinnitus clinic there. And he told me that, yeah, if you go to a concert and, you know, you listen to loud music and then you leave the concert and it gets really quiet and you just hear that ringing. As they leave the concert, the hearing is not quite the same. You feel that your hearing is a little bit muffled.

4:22You can even experience that ringing in your ears. That is a form of tinnitus. That's temporary tinnitus. And it usually goes away.

4:34Jonquilyn Hill:But Kelly's tinnitus wasn't going away. This is Explain It To Me From Vox. I'm John Gwlinhill. More than 100 million people around the world suffer from this severe form of the condition. And when Noam and his team set out to understand why, he learned all sorts of things. Not just how we hear, but how our brain shapes the way we perceive everything around us. So Kelly went to the doctor to try to figure out what was going on, but left her appointments feeling even more confused. When she went to get her hearing checked, her audiologist told her her hearing was fine. Like she fully passed this hearing test and that made her feel so crazy, right?

5:16She had this thing that was forcing her to pull away from everything in her life and the doctor saying, your hearing is fine.

5:24Jonquilyn Hill:That is so weird. Why would a hearing test not pick up on this if it's so persistent? Yeah. So this is what I found so fascinating about this recent research that's been going on. This is research that Stefan was doing at Mass Eye and Ear in Boston. It's something called hidden hearing loss. Basically, in your ear, there's fibers that respond to soft sounds and there's fibers that respond to loud sounds. So that means there's fibers that respond to whispers or kind of the ASMR stuff. And then there's fibers that really get activated if you're crossing the street or you're an airplane or a vacuum cleaner or something.

6:06And on a hearing test, what they do is they put you in this, you know, soundproof room. The audiologist sits next to you, says, raise your hand whenever you can hear a beep. and the beep gets softer and softer and softer until you can't hear the beep. And what they're doing is just testing the soft fibers. They're just testing if you can hear the quietest possible noise. And if you can hear the quietest possible noise, they say, hey, your hearing's fine. But that doesn't test damage that can happen to the loud fibers. And you can see what happens to people who have damage to loud fibers if you're in a restaurant and notice that you can't understand the person across from you.

6:48It might be loud, it might be in a bar or something. But if you're in a quiet room, you'll have no problem hearing the conversation. What's happening there is you have damage in your louder fibers, and that damage is not going to show up on a hearing test. But that damage could lead to tinnitus. That's the type of hidden hearing loss that could end up leading to tinnitus. So the gold standard of hearing evaluation around the world to this day is completely insensitive to the loss of those fibers.

7:18Jonquilyn Hill:Well, I will say I've been blaming the restaurant situation on the fact that why is there a DJ in here? It's so loud. Well, it's just too loud, right? I mean, come on. Like, we don't need a scientist to tell us they need to turn the music down at a restaurant.

7:35Jonquilyn Hill:Okay, so hidden hearing loss may factor into tinnitus. But whether the ringing in your ears is persistent or temporary, Noam says that buzzing sound is actually your brain trying to tell you something. One of the researchers I talked to, Dan Polly, who's also at Mass Eye in Ear, he said it's basically like a climate control system in your brain. You program it to maintain an ambient temperature of whatever, 70 degrees. And then the temperature goes down, you know, 68, whatever. The heat's going to kick on. And like hot air will come out of your vents and bring the ambient temperature back to the set point and then the heating shuts off.

8:12Now, what happens in your brain is your brain is kind of doing a similar thing for sound. But when some of the nerve fibers are damaged, you're getting less input than the brain would expect. And so it's kind of like turning on the heat, so to speak. But it can't get the sound that it needs. So it kind of creates its own sound to fill in that gap. Oh. These neurons sensitize themselves. They're like, oh, I need to make my activity level go back to where it's supposed to be. I'm going to swap out different parts and make myself more sensitive to excitatory inputs. So now you start to perceive a sound that is not there.

8:53The process doesn't work as it's supposed to. Like the heating system turns on, but it doesn't turn off. Stefan told me it's almost like a form of phantom limb syndrome, where, you know, you might have had your leg amputated. The leg is gone, but you start to feel pain where it's missing. Now your brain is no longer getting the nerve input from your leg or your foot, but it is kind of like creating the sensation it expects to feel. Your brain is artificially increasing the perception. So in the case of touch, if I touch my finger like this, you're going to feel my finger. If I increase the perception, that's going to turn into pain.

9:36And in a lot of ways, that's often what's happening with tinnitus.

9:39Jonquilyn Hill:Why would our brains do that to us? This is what I find so fascinating because it just seems like it's this curse, right? Why would our brain do something so torturous to us? Why would it make up a sound that would keep us up at night? But it turns out, I found out in reporting this series, that this is actually kind of the tip of the iceberg of the way our brain hears the world. And it's kind of the dark side of a superpower that allows us to even hear the world to begin with.

10:20Jonquilyn Hill:So our brain has a superpower. How do we use it for good? That's up next.

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13:18Jonquilyn Hill:We're back. It's Explain It To Me. I'm JQ and we're talking to Unexplainable's Noam Hassenfeld about tinnitus. And it turns out that annoying ringing in your ears, it's just one example of the way your brain does its job. By the way, you're going to want to put on headphones for this next part. All right. So tinnitus is your brain constructing a sound when it's not getting the input it expects. It's your brain editing the world you hear. And the thing is, what sounds in tinnitus like it might be a problem, it's actually a necessary way that our brain works in order to let us hear anything at all.

14:01So imagine a waveform, right? If you just look at a waveform, it's just going to be a blob of sound, but it's got maybe a word in there. It's got a car honk. It's got a bird song. The world is just a big blob of sound and somehow our brain can pick out bird song, word, car honk. And it's because our brain can edit this waveform blob of sound. And you can actually hear your brain doing this editing in real time.

14:33Jonquilyn Hill:Oh, I would love to hear my brain do something. So I talked to Diana Deutsch, who's this psychology professor at UC San Diego. And she likes to study all these weird ways our brain edits the world. These weird kind of audio glitches. she loves to research audio illusions. Oh, yeah. Like, do you hear someone saying Laurel or do you hear them saying Yanny? Laurel. Laurel. Yes, exactly. Oh, okay. It's exactly Laurel Yanny. One of these illusions I love is called the octave illusion. I wonder if I can play it for you. Tell me what you hear. Okay. I hear one note in my left ear and one note in my right ear and they are going back and forth, kind of ping-ponging.

15:21Low on one side, high on the other, right?

15:23Jonquilyn Hill:Yeah. Okay, I hear the exact same thing. The issue is that there is a low note and a high note on each side. Each ear is getting low, high, low, high, low, high. They're overlaid over each other. You think you're just getting low one ear, high in the other, but you're actually getting two sequences of low, high. And the reason you only hear low in one side and high in the other is that your brain is editing the sequence for you. Because your brain needs to separate sounds to make sense of them, right? It has to separate that blobby waveform to pull out the words of the bird song. And that's what it's doing.

16:02It's pulling out high and low and separating them between your ears.

16:06Jonquilyn Hill:Can I make my brain stop doing that? I really have no idea. I cannot listen to this and hear the tones in both sides. Wow. Like, I just hear low on one side, high on the other side, even though I know that that's not actually what the audio is. But in his reporting, Noam found out that people are trying to train their brains. And they're having some success. I even spoke to this science writer named Mike Corist, who lost his hearing and then got a cochlear implant. And it made everything sound kind of weird and robotic. Like, you ever see that movie Sound of Metal? Yeah, Rezamed. Where the drummer loses hearing, he gets a cochlear implant, and then everything sounds metallic and robotic and glitchy.

16:51Yeah.

16:52Jonquilyn Hill:This is not sound like you remember. And it's the implant in your head that's tricking your brain into thinking you're actually hearing. Amazing movie. But what this guy Mike did is that he practiced and he retrained his brain to listen to music. He really wanted to listen to his favorite piece of music, Bolero. It was kind of my piece of music that I would come to again and again and again to test out new hearing aids. And he practiced listening over and over again. He remembered what it sounded like and he retrained his brain so that it sounded less robotic and metallic. So this was an iterative process that went on and is still going on.

17:34And he told me that he can listen to Bolero again and really enjoy it. He actually retrained his brain. He used this superpower.

17:43Jonquilyn Hill:Okay, so does that mean we can train our brains to stop the ringing in our ears? It is not that simple. Tinnitus usually comes from hearing damage, and it's really difficult to figure out the best way to fix that. There are some people out there thinking about trying to actually fix the damaged fibers, like regrow their connections with a protein called neurotrophin. There's another scientist I talked to who's trying to retrain individual neurons using the sense of touch, which is really cool, like playing a tinnitus sound and then putting an electrode on the spine and kind of trying to activate the individual neurons when that sound is coming in.

18:26Kelly tried something different. She tried to do something called masking, which is listening to kind of white noise or pink noise or brown noise that's sort of at the same frequency as her tinnitus. You know, kind of like sleeping with a fan on to drown out traffic noise or something. And it did help her a bit. But some of the researchers I spoke to don't love that idea because it can make you constantly be thinking about the tinnitus even more. And one of the things that can actually make tinnitus worse is thinking about it. Like when I was speaking to Stefan, he told me he had tinnitus. And he was like, and actually it's way worse than normal right now because we've been talking about it for an hour and it's really annoying.

19:15Jonquilyn Hill:So wait, the way you're supposed to deal with tinnitus is just like not think about it. That feels like when people tell you like, hey, stop being anxious. And it's like, oh, OK, I'll shut that off. I mean, honestly, it really, really does. It's so frustrating. The best way that is available right now for treating tinnitus does seem to be something like mindfulness. I look at the example of Kelly. She said, OK, I was using these maskers before, but I'm trying not to use the maskers anymore. I'm trying to let my brain hear the entire world again. I'm actually just trying to take in all the sounds.

19:54I'll have the windows open because the maintenance guys are working or the gardeners. And I'm even trying to, like, vacuum without any type of, like, hearing protection and just recognizing that sound, too. You know, she told me she went to go see fireworks. And at first, the fireworks were, like, really upsetting and scary. And she kind of got used to it. This is what we used to do. Like, it's literally just, it's really weird to know the world again. And that's not to say it's been easy. That's not to say her tinnitus is gone. but what she's doing now is just trying her best to hear the tinnitus along with everything else.

20:35Jonquilyn Hill:Has this reporting made you think differently about how our brains work? Oh yeah. First of all, it's made me so paranoid about my hearing. Yeah. By the end of these conversations with these scientists, I basically got to the point where I guess I would say that it feels like our brains are just kind of putting on a play for us. Like we're not actually hearing the stuff that's out there. It's like the stuff that's out there is the script. And then our brain is reading the script for us and acting it out. And that's actually what we're observing. Is our world a lie? Like what of anything we hear is real?

21:15It's not a lie. I think our perception does a lot more work than we would think.