Unexplainable – "The Sound Barrier #2: The Noise That Isn't There"

Podcast: Unexplainable (Vox)
Episode Date: November 5, 2025
Host: Noam Hassenfeld
Guests/Contributors: Kelly (tinnitus patient), Dr. Stéphane Maison (Mass Eye and Ear), Dr. Susan Shore (University of Michigan), Dr. Dan Polley (Mass Eye and Ear)

Episode Overview

This episode explores the baffling phenomenon of tinnitus—the experience of hearing sound that isn't actually present in the environment. Through the story of Kelly, a severe tinnitus sufferer, and conversations with leading researchers, the show investigates why millions hear persistent ringing, buzzing, or other noises with no external source. The episode delves into what we currently know (and don't know) about tinnitus, how the brain creates these phantom sounds, why standard hearing tests often miss the problem, what possible treatments are on the horizon, and what it means to live with such an unexplained condition.

Key Discussion Points & Insights

1. Kelly’s Experience and the Lived Reality of Tinnitus

• [01:23–04:07] Kelly describes first hearing strange noises in her ear that no one else can hear—a persistent, intense ringing on one side, then both.
  • "It's like you're just trapped in a room with a crying kid. You can't stop crying... There's no way to escape it." —Kelly [03:19]
  • Tinnitus negatively affected her work life, friendships, and sleep. She felt isolated.
• [04:07–04:43] Kelly reached out to Unexplainable after hearing a related episode, wanting answers about this mysterious condition.

2. What is Tinnitus?

• [05:50–06:17] Host consults Dr. Stéphane Maison, director of the Mass Eye and Ear tinnitus clinic, who clarifies pronunciation (both "tinnitus" and "tinn-EYE-tus" are common).
• [06:22–07:14] Dr. Maison discusses his own experience:
  • "I've had tinnitus for the past, like, 12 years... I can tell you that I abused my ears." —Dr. Maison [07:02]
• [07:26–08:22] Exposure to loud sounds can induce brief tinnitus; chronic tinnitus is when it persists.
• [08:22–08:52] Analogy: Tinnitus is like phantom limb pain—the brain compensates for lost input by creating a sensation where nothing exists.

3. Hidden Hearing Loss – The Invisible Cause

• [09:31–11:01] Standard hearing tests often miss the true root cause:
  • Tests focus on the ability to detect quiet sounds; loud-sound nerve fibers are not evaluated.
  • "The gold standard of hearing evaluation... is completely insensitive to the loss of those fibers." —Dr. Maison [10:43]
• [11:17–12:01] Damage to loud fibers (hidden hearing loss) goes undetected but causes real-world struggles—especially in noisy environments.
  • "Most people... feel like they don't have any issues in a quiet environment. But as soon as they go to a bar or restaurant, they start to struggle." —Dr. Maison [12:01]

4. Peering into the Brain’s Role

• [13:06–14:28] Dr. Maison uses electrode tests to differentiate nerve and brain responses to sound:
  • Tinnitus patients show less auditory nerve firing but exaggerated brainstem responses.
  • "Tinnitus is not a sound in your ears. Tinnitus is generated at the central nervous system." —Dr. Maison [14:19]
• Not everyone with hearing loss gets tinnitus; the reason why remains a mystery.

5. Searching for Solutions

a) Sound Masking

• [19:12–20:41] Kelly tried YouTube "maskers" (white/pink/brown noise) and custom sound mixes to help sleep.
  • Maskers provide some relief but are "just a band-aid."
  • "It's just a band-aid. I don't think it's very useful." —Dr. Maison [20:41]
• Overuse can remind patients of their condition, making things worse.
  • "We're talking about this right now, so I can hear it much louder thanks to you." —Dr. Maison [21:07]

b) Regenerating Nerve Fibers

• [21:16–22:25] Experimental approaches, like using neurotrophins to regrow auditory nerve fibers in mice, offer hope.
  • "What if you could bring back those fibers? ... Perhaps you could reduce that hyperexcitability in the brain." —Dr. Maison [21:53]
• Human trials might be attempted; regulatory approval pending.

c) Retraining the Brain – Touch and Sound Therapy

• [22:25–24:46] Dr. Susan Shore's research leverages the connection between hearing and touch:
  • Electric stimulation plus carefully matched sound delivered to patients reduced tinnitus severity in trials.
    • "We found that we got a clinically significant, significant decrease in people's tinnitus." —Dr. Shore [24:16]
  • Results (over four and six weeks) suggest potential for long-term improvement, but more research and FDA approval are needed.

d) Mindfulness and Therapy

• [26:02–27:35] Dr. Dan Polley explains that severe tinnitus involves the whole brain, not just perception:
  • "Their tinnitus has expanded, and it's incorporated other brain networks... It hasn't changed the ability of my executive control to concentrate or... to find all sounds horribly aversive and make me depressed." —Dr. Polley [26:23]
• Mindfulness/Cognitive Behavioral Therapy can help severe sufferers "retrain" the brain to manage the disorder, reducing impact even if the sound doesn't disappear.

6. Underfunded and Understudied

• [28:10–28:35] Dr. Polley laments the lack of research funding and collaboration despite tinnitus’ prevalence.
  • "It's bizarre, right, that for a problem this prevalent that there is so little federal funding for tinnitus and such a small community of researchers working on it." —Dr. Polley [28:10]

7. Living with Tinnitus and Seeking Community

• [29:10–30:46] Dr. Polley suggests agency and community support are vital for sufferers.
  • "If they can find agency... and acquire some tools to cope... Sometimes by seeking community... it can help them realize that they aren't so isolated and alone." —Dr. Polley [29:10]
• Kelly shares incremental improvements in her quality of life by being more open and gradually weaning off her maskers to reconnect with the outside world.
  • "I'm actually just spending days in my apartment... and just trying to take in all the sounds." —Kelly [31:35]
• Positive note: experiencing fireworks again, reacclimating to the world’s sounds.
  • "It's really weird to know the world again." —Kelly [32:13]

Notable Quotes & Memorable Moments

• "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." —Kelly [03:19]
• "I've seen some patients who are borderline suicidal. So I was interested in being able to provide some beginning of an answer... That's why we opened the tinnitus clinic." —Dr. Maison [06:26]
• "Tinnitus is not a sound in your ears. Tinnitus is generated at the central nervous system." —Dr. Maison [14:19]
• "If you could bring back that signal to the central nervous system... perhaps you could reduce that hyperexcitability in the brain." —Dr. Maison [21:53]
• "People with really severe tinnitus have, like, a whole brain problem." —Dr. Polley [26:23]
• "If you can take the 1 in 10 who’s severely debilitated... and turn them into, like, the other nine, I'd still take that as something useful." —Dr. Polley [27:35]
• "It's bizarre, right, that for a problem this prevalent... there is so little federal funding for tinnitus." —Dr. Polley [28:10]
• "I'm actually just spending days in my apartment... trying to take in all the sounds." —Kelly [31:35]
• "It's really weird to... know the world again." —Kelly [32:13]

Important Timestamps

• [01:23–04:07] Kelly’s onset of tinnitus and impact on daily life
• [06:22–07:14] Dr. Maison’s personal story with tinnitus
• [09:31–11:01] Explanation of hidden hearing loss and why tests can be misleading
• [13:06–14:28] Evidence that tinnitus originates in the brain
• [19:12–20:41] Kelly’s experience with sound maskers and their limitations
• [21:16–22:25] Cutting-edge research on regenerating auditory nerve fibers
• [22:25–24:46] Sound and touch therapy for retraining the brain
• [26:02–27:35] "Whole brain" nature of severe tinnitus
• [29:10–30:46] Advice on agency, community, and therapy
• [31:35–32:13] Kelly’s progress in re-engaging with everyday sounds

Conclusion & Resources

The episode ends with Kelly reflecting on her ongoing adaptation and a message of hope regarding slowly gaining control and openness about her condition. Listeners are directed to the American Tinnitus Association (ata.org) for support.

Tone & Style:
Warm, empathetic, conversational; blends personal anecdote, clear science explanation, and gentle humor.

Useful for:
Anyone curious about tinnitus, those suffering from it, and people interested in the mysterious ways our brains shape our perception of reality—even when reality seems not to be there at all.