Norena Arnaud J
Laboratoire de Neurosciences Sensorielles et Cognitives, CNRS, Aix-Marseille University, 13003 Marseille, France.
Brain Sci. 2023 Jul 27;13(8):1129. doi: 10.3390/brainsci13081129.
Tinnitus is an auditory sensation without external acoustic stimulation or significance, which may be lived as an unpleasant experience and impact the subject's quality of life. Tinnitus loudness, which is generally low, bears no relation to distress. Factors other than psychoacoustic (such as psychological factors) are therefore implicated in the way tinnitus is experienced. The aim of this article is to attempt to understand how tinnitus can, like chronic pain, generate a 'crisis' in the process of existence, which may go as far as the collapse of the subject. The main idea put forward in the present article is that tinnitus may be compared to the phenomenon of pain from the point of view of the way it is experienced. Although the analogy between tinnitus and pain has often been made in the literature, it has been limited to a parallel concerning putative physiopathological mechanisms and has never really been explored in depth from the phenomenological point of view. Tinnitus is comparable to pain inasmuch as it is felt, not perceived: it springs up (without intention or exploration), abolishes the distance between the subject and the sensation (there is only a subject and no object), and has nothing to say about the world. Like pain, tinnitus is formless and abnormal and can alter the normal order of the world with maximum intensity. Finally, tinnitus and pain enclose the subject within the limits of the body, which then becomes in excess. Tinnitus may be a source of suffering, which affects not only the body but a person's very existence and, in particular, its deployment in time. Plans are thus abolished, so time is no longer 'secreted', it is enclosed in an eternal present. If the crisis triggered by tinnitus is not resolved, the subject may buckle and collapse (depression) when their resources for resisting are depleted. The path may be long and winding from the moment when tinnitus emerges to when it assaults existence and its eventual integration into a new existential norm where tinnitus is no longer a source of disturbance.
耳鸣是一种在没有外部声音刺激或实际意义的情况下产生的听觉感受，可能会被视为一种不愉快的体验，并影响患者的生活质量。耳鸣的响度通常较低，与痛苦程度并无关联。因此，除了心理声学因素（如心理因素）之外，其他因素也会影响人们对耳鸣的感受。本文旨在探讨耳鸣如何像慢性疼痛一样，在生存过程中引发一场“危机”，甚至可能导致患者精神崩溃。本文提出的主要观点是，从体验方式的角度来看，耳鸣现象可以与疼痛现象相类比。虽然耳鸣与疼痛之间的类比在文献中经常出现，但往往局限于假定的生理病理机制方面的比较，从未真正从现象学角度进行深入探讨。耳鸣与疼痛类似，因为它是被感觉到的，而非被感知到的：它突然出现（没有意图或探索行为），消除了主体与感觉之间的距离（只有主体，没有客体），与外界无关。与疼痛一样，耳鸣是无形且异常的，能够以最大强度改变世界的正常秩序。最后，耳鸣和疼痛将主体限制在身体的范围内，使其不堪重负。耳鸣可能是痛苦的根源，不仅影响身体，还会影响一个人的生存，尤其是其在时间中的展开。因此，计划被打乱，时间不再“流逝”，而是被困在永恒的当下。如果由耳鸣引发的危机得不到解决，当患者的抵抗资源耗尽时，可能会精神崩溃（陷入抑郁）。从耳鸣出现到它冲击生存并最终融入一种新的生存常态（耳鸣不再是干扰源），这一过程可能漫长而曲折。
