Mapping tinnitus

ABSTRACT

In this article, I offer a critical reflection on the production of “tinnitus maps” as part of the Arts and Humanities Research Council project, Tinnitus, Auditory Knowledge and the Arts. Influenced by both methods and critiques of sound mapping, tinnitus maps mark an attempt to creatively document the relationship between aurality, context and place. Tinnitus maps depart from sound mapping’s focus on the aural specificity of “proper noun” places, instead depicting tinnitus as a mode of aurality. This article situates these maps in relation to the practices and discourses of acoustic ecology: a field that has been associated with and been influential for various methods of sound mapping. I posit that tinnitus maps serve to amplify the exclusions created by acoustic ecology’s aesthetic moralism and investment in normate aurality, while also offering novel insights into tinnitus’ spatial and relational constitution.

KEYWORDS:

• Tinnitus
• aurality
• sound mapping
• acoustic ecology
• audism
• aesthetic moralism

In 2005, Soundscape: The Journal of Acoustic Ecology published a special issue on hearing loss. Focusing primarily on noise-induced hearing impairments and their mitigation through hearing protection and hearing aids, the introductory Editorial explains the significance of these issues for acoustic ecology as follows:

Acoustic ecology addresses interactions with our acoustic environment and how we can experience it, affect and sculpt it, preserve and enjoy it, and most of all deepen our knowledge of it. In large part our personal experience and enjoyment of sound is only possible if we have healthy natural hearing. Those with hearing losses can still perceive vibratory energy, but the sense is different, most would agree diminished, from the joys we derive with normal healthy ears, and the mere act of hearing becomes effortful and deliberate. (Berger 2005, 1)

According to the articles published in the special issue, “hearing is one of our most important senses” (Berger 2005, 10): it provides “a fundamental connection between an individual, the natural world and society” (Meinke 2005, 18). Hearing loss, meanwhile, “can disrupt the ability to listen within a soundscape” (Arehart 2005, 11).

Such framings of hearing and its impairment are exemplary of the audist tendencies of acoustic ecology: a field of inquiry concerned with the relationship between sound, environment, technology, and society. As an aesthetic, pedagogic and ecological project, acoustic ecology has had a significant influence on various disciplines and sonic arts practices. Concepts and methods associated with acoustic ecology have been widely adopted, informing scholarly research, urban planning, community engagement initiatives, curatorial approaches, and creative practice.¹ However, acoustic ecology as both framework and method is grounded in – and serves to reproduce – what I refer to herein as normate aurality. Originating in the work of Rosemary Garland Thomson, the normate refers to an ideal yet rarely acknowledged subject position that is “unmarked” by disability, as well as race and gender; and which underpins bourgeois, Eurocentric, and liberal democratic notions of personhood (Thomson 2017). It is in relation to the normate that disability becomes perceptible and functions as such – educational spaces, workplaces, the media, and medical institutions are organized around the normate. However, the normate is also an auditory formation. It is the unacknowledged perceptual norm against which tinnitus, alongside other hearing variations and impairments, are judged as deviation.²

Acoustic ecology’s investment in normate aurality results in the idealization of otologically normal hearing and the devaluation and omission of aural experiences shaped by impairment. As Berger’s description above suggests, those whose hearing is impaired – including those who listen with, through and alongside tinnitus – are thought to be unable to harness the full affective and epistemic benefits of attending to the auditory environment. Rather, hearing impairment and deafness appear as exemplars of noise’s harm, illustrating the need for protection, conservation, and restriction. R. Murray Schafer’s influential text Soundscape: The Tuning of the World and Our Sonic Environment begins with a threat of “universal deafness”, presented as the “ultimate consequence” of noise pollution (Schafer 1993, 3); while Barry Truax’s Acoustic Communication presents hearing loss as an outcome of noise exposure and antithetical to listening as “a set of sophisticated skills which appear to be deteriorating within the technologized urban environment” (Truax 2001, 13). Consequently, acoustic ecology’s normate aurality is imbricated with what I have diagnosed elsewhere as a proscriptive and paternalistic “aesthetic moralism” (Thompson 2017), whereby noise is constituted by affective, ecological and social negativity; and silence (or quietude) is valorized and associated with balance, harmony, clarity and order.

The conservatism of acoustic ecology and its gendered, racial and colonial politics have been critiqued from a range of perspectives (Goh 2017; Kelman 2010; Robinson 2020). However, there is also a growing body of projects that have engaged concepts, approaches and methods associated with acoustic ecology while also seeking to redress its exclusions, omissions, and limitations. Responding to these revaluations of acoustic ecology, I offer a critical reflection on the production of “tinnitus maps” as part of the Arts and Humanities Research project, Tinnitus, Auditory Knowledge and the Arts. Influenced by both methods and critiques of sound mapping, tinnitus maps mark an attempt to creatively document the relationships between aurality, context and place. With reference to the maps that were created and the discussions this activity prompted amongst participants, I posit that these maps serve to amplify the exclusions created by acoustic ecology’s aesthetic moralism and investment in normate aurality, while also offering insight into tinnitus’ spatial and relational constitution. Indeed, despite acoustic ecology’s valorization of “healthy, natural hearing”, to use Berger’s phrasing, I argue that the field’s interest in the relationship between aurality and acoustic environments may help provide an alternative perspective on tinnitus.

Sound maps, acoustic ecology and normate aurality

In its current usage, the term “sound map” refers to a body of artistic projects that seek to gather, organize and archive auditory materials relating to a particular site. Often emphasizing user interactivity, sound maps are, according to Gascia Ouzounian, a “relatively recent invention”, emerging “at the intersection of soundscape studies, acoustic ecology and sonic art practices in the late 1990s” (Ouzounian 2014, 165). Where some sound maps are designed for a gallery space, others primarily exist upon a digital platform. The “sound” of sound maps tend to consist of curated or crowdsourced field recordings, with audio files being attached to the geographic co-ordinates they document. However, while the sound map may have been crystallized and refined as a method since the late 1990s, it can be situated within a longer and broader genealogy of cartographic strategies involving sound and listening.

Though by no means exclusively associated with the field, acoustic ecology has had a significant influence on the establishment and development of sound mapping practices. In the early 1970s, the World Soundscape Project, a group of researchers and composers led by R. Murray Schafer at Simon Fraser University, produced a range of maps as part of their Music of the Environment series. Different types of map were produced as part of the group’s 1975 comparative study of the auditory character of five European villages (Schafer et al., 1977b). In the Swedish village of Skruv, for example, the research team visually documented tones produced by electric devices. Schafer describes the process as follows:

Electrical equipment will often produce resonant harmonics and in a quiet city at night a whole series of steady pitches may be heard from street lighting, signs or generators. When we were studying the soundscape of the Swedish village of Skruv in 1975, we encountered a large number of these and plotted their profiles and pitches on a map. We were surprised to find that together they produced a G-sharp major triad, which the F-sharp whistles of passing trains turned into a dominant seventh chord. As we moved about the streets on quiet evenings, the town played melodies. (Schafer 1993, 99)

The Skruv map consists of a sketch map showing different streets and buildings, with various sites labeled (e.g. “glassworks”, “metalworks”, “stream”). A musical stave is used to depict the tones that can be heard within a circled area. Other maps produced during the World Soundscape Project’s study of European villages include a map of prominent sounds heard around 11 am on 6^th March 1975 from a hillside near the village of Bissingen, Germany; an Isobel map constructed from ambient sound levels in Cembra, Italy; and a diagram marking the directionality of incoming sounds from a golf course near the Scottish village of Dollar (Schafer et al., 1977b). Though informed by the World Soundscape Project’s acoustic and aesthetic priorities, including a preference for quiet, natural and historic sounds, and a devaluation of industrial and transportation noise, these maps illustrate a range of methods and approaches to documenting sound for the purposes of both conducting research and communicating research findings to others.

In addition to producing various maps of sound that “represent the acoustic properties of places through their graphic design” (Thulin, 2016), members of the World Soundscape Project created maps for soundwalks, and maps in response to listening walks. The distinction between these two practices is made by Schafer in The Soundscape: he describes a listening walk “as simply a walk with a concentration on listening,” while a soundwalk is “an exploration of the soundscape of a given area using a score as a guide. The score consists of a map, drawing the listener’s attention to unusual sounds and ambiences to be heard along the way” (Schafer 1993, 213). The latter approach is illustrated in the World Soundscape Project’s publication European Sound Diary (1977a), which includes instructions for a soundwalk in Stockholm’s Old Town. The group were interested in the area as traffic was prohibited from all but the perimeter streets. They composed the map with a group of music students, each of whom was tasked with finding an original sound for inclusion in a guide for future visitors. The soundwalk consists of twenty-five sounds plotted on a map of the old town.

Although intended to direct or depict aural experience, the maps produced by the World Soundscape Project tend to assume a separation of listener and sound environment. The maps are constructed through an “outside-in” perspective where the soundscape is observed as “raw sonic material” (Eppley 2021), and presented as an external and objective attribute of the environment as opposed to a selective aesthetic abstraction produced in accordance with the values, ideological investments, knowledge, and sensory abilities of a socially-situated listener.³ Schafer does warn that “bad habits” may be implicit in any diagrammatic presentation of a soundscape, concluding that “no silent projection of a soundscape can ever be adequate. The first rule must always be: if you can’t hear it, be suspicious” (Schafer 1993, 132). Despite the centrality of listening to their project, the World Soundscape Project downplay the significance of the “aural observer” in constituting the soundscape as well as its cartographic depiction. Yet the sound map is as much a projection of listening as it is sound.

The work of the World Soundscape Project has remained influential for sound researchers and practitioners. However, there has been a growing body of projects that adopt soundscape as a concept and sound mapping as a method, while also moving beyond some of the aesthetic and ideological investments of Schaferian acoustic ecology. Some projects have aimed to depart from the perceived pessimism of acoustic ecology, its aesthetic moralism and concomitant focus on noise abatement. The Montréal Sound Map, for example, a web-based sound map hosting user-submitted recordings describes itself as encouraging attentive and focused listening, while also promoting a “more optimistic” approach to acoustic ecology (https://www.montrealsoundmap.com/); while Peter Cusack’s Favourite Sounds project uses sound mapping to draw attention to the sounds that are enjoyed by different listeners. The Favourite Sounds website hosts a series of crowdsourced digital sound maps of different cities, including London Hull, Prague, Bejing and Berlin. Stemming from “a long running favorite sound project that, from 1998, has aimed to discover, and celebrate, what people value about the soundscapes of the cities, towns and neighborhoods where they live and work” (https://www.crisap.org/research/projects/favourite-sounds/) the Favourite Sounds maps exemplify a variety of auditory preferences that depart significantly from the World Soundscape Project’s prioritization of quietude and natural sounds.⁴ The Favourite Sounds map of Hull, for example, includes a recording of the sound of traffic inside the metal of Drypool bridge. Other submissions mention the sound of traffic at a distance: participant comments about the sounds of traffic include “it reminds me of London” and “It’s soothing and combines the natural and the unnatural” (Favouritesounds.org). The Favourite Sounds maps therefore address the relationship between sound, listener, and environment while remaining open to the diversity of and commonalities between the sounds enjoyed by participants in different locations.

As with many sound mapping projects, the majority of sounds included in the Favourite Sounds maps are from outdoor or public spaces. In her influential critique of online sound mapping methods, Jaqueline Waldock notes that

the public realm outside of the home is given significance in a way that domestic sounds are not. Within the short history of soundmaps, there has developed a cycle of otherness that obtains its clarity in the absence of the domestic (Waldock 2011).

This omission seemingly correlates with the ways that gender shapes participation in sound mapping practices, insofar as the majority of editors and contributors to the online sound maps analyzed by Waldock are men. A similar omission can also be traced in the World Soundscape Project’s work, which predominantly focuses on outdoor environments. By contrast, Waldock’s own project, which used soundscape composition and recording as part of a community engagement project involving residents from Liverpool’s Welsh Streets, captured sounds often not included in sound maps. This includes the noises of neighbors through walls or a recording of friends cooking, talking and eating together (Waldock 2011). While the person behind the recording device tends to be absent and inaudible in online sound maps, some of Waldock’s participants make themselves heard and known in their recordings. This distinction potentially reflects differences in audience. Many online sound maps and their associated recordings are intended to engage a general public. The anonymous, de-personalized character of many recordings featured in online sound maps, mirrors the sound map's “public” status: general accessibility is seemingly associated with anonymity. Conversely, the more intimate, domestic sound recordings of Waldock’s Welsh Streets project stem from a sustained interaction between researcher and a specific community group. As a result, Waldock’s project raises important questions about how who is listening – in the case of the Welsh street project this includes women living in an economically deprived area with limited access to recording and internet technologies – informs the construction and documentation of the soundscape.

Favourite Sounds and Waldock’s Welsh Street project illustrate the omissions generated by an aesthetic moralism that posits noise as inherently unwanted and call into question the assumed objectivity of the soundscape, highlighting instead the role of the socially-situated listener in constituting and evaluating significant sounds in the auditory environment (Thompson, 2017). Yet they leave unquestioned the normate aurality that accompanies acoustic ecology and its methods. This normate aurality is traceable in the assumption that the listener can engage with sound recordings as a documentation or depiction of the sound-place relation; or that particular auditory attributes marked on a map can be heard by all.

Other projects have centered the experiences of “auraldiverse” communities in using acoustic ecology’s methods and terminology.⁵ While they have rarely offered explicit critique of the field, their approach and findings make apparent the problems in assuming a general, socially unmarked listener who engages with the soundscape. Asa Skagerstrand et al. have explored the sounds perceived as annoying by hearing aid users in their daily soundscapes. The study maintains acoustic ecology’s focus on the negative effects of noise. However, in the study, unwanted noise is constituted by the particular experiences of hearing aid users, rather than an aesthetic moralism. Indeed, the sound most frequently described as annoying amongst participants was verbal sounds made by people, followed by the sounds of television and radio (Skagerstrand et al. 2014). The health geographer Sarah L. Bell has explored the complex social and emotional interactions between everyday soundscapes and people with Ménière’s disease. As Bell notes, the soundworlds of the hearing impaired are rarely quiet: for those with Ménière’s, the fluctuating sensations of hearing loss, hyperacusis and tinnitus means that corporeal sounds can become “so dominant as to move to the foreground of the soundscape, acting as a sound signal. In so doing, they mask and prevent the processing of many external sounds (e.g. soundmarks and keynote sounds), forcing affected individuals to connect with and attune to previously unremarkable aspects of their everyday soundscapes in ways that can be both emotionally and socially challenging” (Bell 2017, 834). As this description suggests, the assumed separations between externality and internality, sound environment and listener are called into question when the experiences of those with Ménière’s, hyperacusis, and tinnitus are considered.

Mapping tinnitus

These previous critical reconfigurations of acoustic ecology’s tools have helped inform the design and delivery of Tinnitus and the Arts digital workshops. Taking place in February and June 2021, these workshops were part of a larger Arts and Humanities Research Council project, Tinnitus, Auditory Knowledge and the Arts, interrogating how the arts can contribute to understandings of tinnitus and the diverse ways it affects listeners. While in clinical settings, tinnitus is often diagnosed in relation to the quality of the auditory perception (e.g. frequency, pattern) and the extent it impacts upon an individual’s life, the project’s workshops aimed to explore how art methods might enable participants to creatively express their experiences of tinnitus, highlighting tinnitus’ subjective, contextual and spatial qualities. For two pilot workshops, held in February 2021, participants were sourced from the British Tinnitus Association’s consultancy group, and for the five workshops held in June 2021, a call for UK-based participants with tinnitus was circulated via the British Tinnitus Association, the Open University, Oxford Brookes University, and the project’s social media channels.

All prospective participants were asked to complete a preliminary survey that included questions from the Tinnitus Functional Index: a questionnaire often used in clinical settings that aims to assess the severity of tinnitus and identify tinnitus-related problems (Meikle et al. 2012). Due to the workshops being run online, the project team were unable to provide the support necessary for facilitating the participation of those for whom tinnitus has a severe, negative impact on their wellbeing. Consequently, prospective participants with an Index score below 50 were invited to participate, while prospective participants with a score of 50 or above were discounted. A total of 37 people took part in the workshops, including the pilot. While just under half (17/37) of participants responded as having tinnitus only, more than half reported other auditory conditions, including d/Deafness, hearing loss, hyperacusis and Ménière’s disease.

The workshops were intended to be held in-person, however due to the COVID-19 pandemic, were redesigned so that participants could engage remotely. As a result, the digital workshops consisted of two stages. Participants were sent instructions for six workshop activities, including illustrative examples for each activity. They were asked to complete a minimum of two, sharing the outcome with the project team. Participants were then invited to a small (4–6 participant) group conversation, held on Zoom, where different responses to each of the activities were shared and collectively discussed. The group conversations also offered an opportunity for participants to share their own experiences of undertaking the activities. Given that the activities and discussions could lead to participants focusing on their own tinnitus, a series of measures were put in place to help reduce the potentially negative effects of participating in the workshops. This included signposting avenues of support available via the British Tinnitus Association, advising participants to take regular breaks when completing the activities, and having a member of the research team available for pastoral support during the workshop discussions.

The first workshop exercise – “tinnitus map” – invited participants to develop a personal, visual and textual depiction of the relationship between experiences of tinnitus and place. Where sound maps tend to be grounded in a specific environment, such as a city, the tinnitus maps instead center the listener and their tinnitus, using this to connect and differentiate multiple auditory sites. The project team provided a series of instructions to be used as a guide: participants were asked to identify 3–5 different places where their tinnitus was more or less noticeable, loud or quiet; mark these on a page using a words, photographs, or drawings; and create a key that illustrated how tinnitus was experienced in these different places. The project team suggested that participants may wish to include a depiction of what the different identified places sounded like. Three illustrative “tinnitus maps”, which were by the research team and took different approaches to the task were shared with participants alongside the instructions (see Figure 1). However, participants were also told that they should not feel limited by the illustrative examples and were welcome to approach the activity in any way they saw fit. A total of 32 out of 37 of the participants completed the activity, producing a series of hand-drawn and computer-generated maps using a variety of representational strategies.

Figure 1. Three illustrative examples of tinnitus maps, produced by the research team (Marie Thompson and Patrick Farmer).

Figure 1. (Continued).

As noted earlier, sound mapping often concerns proper noun places, seeking to capture the auditory distinctiveness of cities, regions, and iconic locations. Furthermore, as Waldock (2011) has noted, they have often prioritized public, outdoor settings. By contrast, the tinnitus maps produced in the workshops foreground generalized yet intimate, domestic, and everyday settings, such as living rooms, supermarkets, workplaces and modes of transport. The map pictured in Figure 2, for example, depicts how tinnitus varies across different spaces in a home near Heathrow airport and a house in the country. Using orange and red circles, the map suggests that when airplanes are landing at Heathrow airport, the participant’s tinnitus is less noticeable. The relative absence of airplane noise during the COVID-19 pandemic means that their tinnitus is more noticeable in the kitchen, the lounge and the bedroom. The diagram of the house in the country shows tinnitus as noticeable in the kitchen and the lounge: below the image the map maker has written “this place is so quiet I can here [sic.] my tinnitus a lot”. The focus on the domestic amongst the tinnitus maps is partly reflective of the timing of the workshops: the tinnitus maps were created while pandemic-induced restrictions continued to limit participants’ shared, social lives. Furthermore, two of the three illustrative examples provided to participants were maps involving domestic settings (see Figure 1). The focus on different places in the home may therefore reflect the influence of these examples. However, in drawing attention to such sites, the participants’ responses also illustrate the pervasiveness of tinnitus within the everyday. Mapping tinnitus, and its relationship with place, thus directs attention to environments that are often left outside the frame.

Figure 2. A map of home, near Heathrow and of a house in the country.

During the workshops, some participants remarked that it made more sense to reflect on their tinnitus in relation to what they do as opposed to where they are, while many of the maps submitted made reference to different activities in addition to, or instead of, specific locations. The perceived limits of an approach that only focused on different environments was articulated by some participants during the discussions of the tinnitus maps. For example, during a pilot session, a participant highlighted that many other elements contributed to their experience of tinnitus:

Participant 1: I use headphones to listen to the television […] they work very well, it’s really quite useful, except of course there’s so much background noise and background clatter and everything now that you can’t hear what people are saying anyway. But I find actually, after watching television for a couple of hours, if I take my headphones off my tinnitus is much worse, so I think it does cause a change in … something you’re doing or something you’re listening to, might cause a change in your tinnitus. On the other hand, I wear two hearing aids and they’re very good ones and I have actually found that if I’m wearing my hearing aids, my tinnitus does get quieter. (Pilot 1)

The notion of place as a static or a-temporal site has been readily critiqued by scholars who have sought instead to highlight the temporal transience of environments (Lynch 2009; Massey 2012). Nonetheless, participants felt the focus on place or environment usually implied by mapping did not sufficiently capture tinnitus’ relationship with activity, nor its unusual temporalities – for example, where previous listening activities can aggravate tinnitus at a later point in time. As a result, many participants elected to include details about activities and time of day in their maps. This tendency is reflected in Figure 3. Titled “Tinnitus map – places + activities”, the map consists of a series of annotated drawings. A color key is used to depicted situations in which tinnitus is “very loud” (“sitting or lying in bed – daytime and night time”), “present” (“doing yoga in the living room”) and “not noticeable” (“being with friends”, “cycling anywhere”).

Figure 3. Tinnitus map with places and activities.

Some participants also made apparent the significance of mood, emotion, and bodily state for their experience of tinnitus. The submitted map shown in Figure 4, for example, depicts various elements that may contribute to different experiences of tinnitus, combining references to particular places (e.g. food shop, garden), specific sound sources (cutlery drawer, plates), social situations (work, with friends), activities (exercise), and physical and emotional states (hungover, stress). Others chose to express their varying experiences of tinnitus in relation to a daily cycle or routine, highlighting the temporal rhythms of tinnitus in relation to different sites. In the case of Figure 5, for example, produced during the pilot workshops, the map maker’s tinnitus is placed within their daily routine during the COVID-19 pandemic. Titled “The tinnitus lockdown cycle,” the map contains different locations within the home. The map suggests that the living room in the evening is where the listener experiences their tinnitus as particularly “bad,” while tinnitus is shown as absent in relation to “bath” and “bed.”

Figure 4. A tinnitus map combining places, sound sources and emotional states.

Figure 5. Tinnitus map with daily routine during the COVID-19 pandemic.

Although there were some (common noun) places that recurred across the submitted maps, they sometimes held opposing connotations for different participants. For example, many of the submitted maps feature “bed.” While some identified this as a place where their tinnitus was particularly loud or noticeable – as shown in Figures 2 and 3 – others suggested that this is where their tinnitus was least audible. In Figure 5, for example, tinnitus is depicted as absent in relation to bed. Though none of these examples provide details as to what “bed” sounds like – for example, whether these participants, like some others with tinnitus, use noise generators to mitigate the quietness of the bedroom – they illustrate how the same, generalized place can have different implications for people with tinnitus. Indeed, some participants noted in the discussion about the activity that they were struck by these differences highlighted by the maps. In the Saturday workshop discussion, for example, participants reflected on how they were engaging with maps made by others. One participant suggested that they felt the mapping exercise had surprised them in showing how people’s experiences with tinnitus differed to their own:

Participant 2: Can I just say that it’s interesting that it showed a real range of different triggers or different situations, and I’m surprised that some people’s experiences are very different to mine so it was really interesting to see, of those situations that made the tinnitus more noticeable or more disruptive.

Facilitator: Great, so you got a sense that what was negative or positive in relation to different people’s tinnitus was quite different to your own experiences?

Likewise, a second participant in the group noted how other people’s experience of tinnitus in relation to different sound environments was the “exact opposite” of their own:

Participant 3: […] like [participant 2] said at the beginning, it is interesting how some of the triggers for other people are the exact opposite for me, such as the one being in a loud environment that agitates the tinnitus, which is the exact opposite for me.

A third participant, however, was keen to note that they had approached the maps aiming to identify commonalities with other people’s experiences of tinnitus:

Participant 4: I saw a lot of my own experience in other people’s maps, and I think that I saw the resonance in other people’s maps, not the dissonance. So, I saw similar experiences to mine and I ignored or I didn’t focus on those things that were different from mine […]

As this discussion suggests, although there are some recurring themes across the different maps (such as “bed”), and although some participants could identify with elements of maps by others, it is difficult to draw generalizations about the relationship between tinnitus and place based on these submissions. Rather, they highlight its variability.

Attempts to map auditory phenomena have recurrently been subject to critique insofar as there is a tension between mapping as a tool predicated on depicting fixed points and the spatial and temporal transience of sound (Anderson 2016; Ceraso 2010). Yet equally, not all sound maps conform to normative, diagrammatic representations of place, as is illustrated by projects such as London Sound Survey. Aiming to describe variations in sounds across London, Milena Droumeva describes the survey as “stretching the limits of ‘mapicity’ through whimsical embedding of logos, legends, photos and other symbols in place of geographical grids” (Droumeva 2017, 346). The participants’ tinnitus maps can similarly be considered to push at the boundaries of “mapicity”: they are by no means straightforward cartographic depictions. Although there are some notable aesthetic recurrences – red and orange for example, are often used to show tinnitus at its loudest or most noticeable, while green and blue are often used to signify quieter times and places – taken together, the tinnitus maps make apparent the diversity of visual communication modes and methods that can be used to depict the relationship between tinnitus and context. Furthermore, although the method was informed by previous practices of sound mapping, the submitted tinnitus maps incorporate limited information about the auditory character of these different locations. Indeed, the apparent absence of information about sounds other than tinnitus – their limited representation in visual and textual form – is striking. Some participants include brief descriptions of sounds: in Figure 4, for example, the identified sound source of “plates” is accompanied by the word “clang”. However, many of the submitted tinnitus map require the reader to infer what these environments sound like based on their own pre-conceptions. In assuming that others already know the auditory character of, for example, the study or the bedroom, the tinnitus maps are reliant on generalizations about sound and the home. These generalizations are potentially problematic: for example, while it is common to associate “bed” with quietude, as noted above, some listeners – both with and without tinnitus – use noise generators to mitigate against absolute silence. The use of common noun places without further description of their sonic attributes risks concealing a spectrum of auditory preferences and practices. Nonetheless, when read collectively, the maps make clear that for people with tinnitus, these generalized auditory environments have various affective associations.

In her article “Sound mapping beyond the grid: alternative cartographies of sound”, Isobel Anderson argues that “if we are to harness sound as a creative and expressive cartography, we must map listening rather than solely fixed sound” (Anderson 2016). Anderson’s compelling suggestion raises the question of what it is that tinnitus maps document: in providing a personal depiction of tinnitus and its variations, do they map sound or listening, both or neither? This apparent ambiguity is partly symptomatic of tinnitus itself. Tinnitus manifests as sound, although one that – with the notable exception of pulsatile tinnitus – is inaudible to others. The “silent” character of the tinnitus maps (inasmuch as they remain textual and visual depictions⁶) coheres with tinnitus’ inaudibility to others: where contemporary sound maps tend to use sound recordings to evidence what a place sounds like, no such evidence can be provided of tinnitus. However, tinnitus shapes and is shaped by acts of listening. As the tinnitus maps illustrate, it can be amplified or masked by listening to other sounds, and it can affect how other sounds are listened to. Indeed, these artifacts can be understood to produce tinnitus as a particular mode of aurality: it is a changeable condition of perception that is impacted by and informs how different places are heard, felt and understood. If sound maps have often been grounded in a normate aurality, which takes otologically normal hearing as a given, then tinnitus maps offer an alternative perspective on the complex, multidirectional relationship between listening subject, sound and place.

Hi-fi and lo-fi environments

In highlighting how tinnitus is understood to change across different sites and situations, the tinnitus maps offer an account of tinnitus that extends beyond the interior, private experience of the listener, drawing it into relation with a wider milieu. Some participants felt that they were unable to complete the exercise for this reason, suggesting that their tinnitus was an unchanging presence, irrespective of where they were or what they did. However, for others, the focus on tinnitus’ variation across different places was revealing. This resulted in different emotional responses from participants. In the Monday workshop discussion, for example, a participant reflected on the map they created (see Figure 4) and suggested that identifying places that they did not notice their tinnitus was “comforting”:

Participant 5: Going back to the map task, one thing I found really comforting about it was actually the places that I didn’t notice my tinnitus and, um, tucked away in the corner of my map was food shopping. I dunno, whenever I think about going around, there’s a big Sainsbury’s near where I live and I’ve never ever once noticed my tinnitus in there! <Laughs> And I don’t know why, I’m just quite … you’ve got a nice little task, you can just push around the trolley, I’ve never noticed it. I was just trying to think about that in comparison to other places [… .]

Participant 6: Just pop to the Sainsbury’s every time you’re angry with your tinnitus.

Participant 5: Yeah, literally!

Participant 7: Fantastic. You’ve just given me a fantastic excuse now to go shopping more often!

Participant 5: Sometimes notice it in Aldi, but I dunno what they build in those Sainsbury’s!

Where participant 5 felt their tinnitus map highlighted for them sites that provided relief from tinnitus, participant 6 suggested the map had made them feel “sad.” They note that their map highlights how they are less conscious of their tinnitus in outdoor spaces. However, it also revealed tinnitus to be a “constant” accompaniment to life inside the home:

Participant 6: […] my map was […] a really basic one […] so when I’m out the house or out and about doing things I generally don’t notice it, but when I’m at home it’s like … yeah, if I don’t have things to mask the noise then I notice it all the time. So I have headphones and sound machines in every room and that’s just how it is. And I suppose that this process of thinking about it and looking at the map actually made me a bit sad … well it made me a bit sad in that it’s a constant thing and I don’t think I’d ever thought about it before […]

Participant 7: Do you feel like it’s sad because it’s worse where you should be safe in your home?

Participant 6: It’s sad because it’s a constant thing, that there’s never any silence anywhere.

Participant 6’s reflections on their map draw attention to the complex relationship between tinnitus, affect and quiet places. They understand tinnitus to inhibit the experience of “silence:” in places with little background noise tinnitus becomes more noticeable, impinging on their aural experience. Consequently, they feel it necessary to employ sound producing devices (i.e. headphones and sound machines). These devices allowed the participant to shape their sound environment by ensuring a degree of background noise in quiet spaces and, in so doing, exert some control as to where and when they hear their tinnitus.

While participant 6 felt some degree of noise was necessary for masking their tinnitus, other participants in the group suggested they had a different relationship with quiet spaces insofar as they anticipated their tinnitus becoming more audible:

Participant 5: […] it was really interesting for me as well because thinking about some of them [the maps shared with the group] I noticed that on all of them sleep was mentioned, and on certain maps sleep was noted as maybe more negative or more noticeable, but I find times when I expect to hear my tinnitus, so for example when I’m in bed or when I know it’s an actively quiet environment, it doesn’t tend to bother me as much, ‘cause I think well, you’re more aware of it so you will notice it – which I found quite interesting anyway.

For participant 5, the recurrent theme of “bed” prompted them to recognize that they anticipated and to some degree accepted tinnitus in quiet environments; and this anticipation meant they were less “bothered” by it than they might be otherwise.

The different perspectives offered by participants 5 and 6 on experiences of tinnitus in relation to quietude further highlight the limitations of acoustic ecology’s hierarchical distinction of “hi-fi” and “lo-fi” soundscapes. As noted earlier, Schaferian acoustic ecology’s methods, concepts and practices are informed by an aesthetic moralism, which informs the distinction between good and bad sonic environments. “Good” soundscapes are typically characterized as hi-fi, where discrete sound signals are in balance with one another, where quietude is readily available, and where background and foreground can be easily distinguished from one another. Indeed, Schafer’s discussion of hi-fi soundscapes reveal an aesthetic and ideological investment in clarity, order and harmony. By comparison, “undesirable” soundscapes are characterized as lo-fi: they are characterized by high levels of background noise, an absence of quiet and a lack of clarity. Where hi-fi soundscapes are associated with the rural, the natural and the past, lo-fi soundscapes are associated with the urban, the technological and the present. Even in the seemingly less proscriptive publications of the World Soundscape Project, such as European Sound Diary, a preference for hi-fi environments and devaluation of lo-fi environments is traceable: in the editor’s conclusion, Schafer writes: “As Europe succumbs to the chaos of modern technological noise, it is interesting to note the few opportunities for quiet found by the diarists. Some are searched out as respite from the noise, as when Howard [Broomfield] feels ‘pushed out onto the waterfront’ and across to Skansen to escape the Stockholm traffic” (1977a, 81).

Despite the World Soundscape Project’s interest in the cultural contingency and historical specificity of the soundscape, this rigid distinction between hi-fi and lo-fi soundscapes underlines a grand historical narrative, in which Western society has gone from quiet to noise, and from balance to the “overpopulation” [sic.] of the soundscape. As Ari Y. Kelman notes, this rigid distinction leaves “very little room for agency for those people who populate the ‘lo-fi soundscape’” (Kelman 2010, 217). Furthermore, acoustic ecology’s narrative in which the Western world is overtaken by a lo-fi acoustic environment is accompanied by the degeneration of hearing. Where in the quiet ambience of the hi-fi soundscape of the past, the human ear “operated with seismographic delicacy” (Schafer 1993, 44), the technological, “inhuman” noise of the lo-fi soundscape has resulted in widespread hearing loss and impairment. For Schafer, the increasing damage to both the soundscape and hearing is counteracted by encouraging a return to discerning listening: “the very emergence of noise pollution as a topic of public concern testifies to the fact that modern man is at last becoming concerned to clean the sludge out of hears ears and regain the talent for clairaudience – clean hearing” (Schafer 1993, 11). As this description suggests, Schafer’s distinction of hi-fi and lo-fi soundscapes is underpinned by his investment in normate aurality, whereby the “natural” capacity of the ear is threatened by the “unnatural” lo-fi acoustic environment. Those who experience hearing impairment, hearing loss or d/Deafness are simply victims of – rather than listeners to - the soundscape.

A preference for “natural” hi-fi soundscapes is traceable amongst the submitted tinnitus maps: gardens, parks and the countryside are often identified as locations where tinnitus is less intrusive. Given the strong cultural association of “nature” with health and wellbeing, it is unsurprising that the tinnitus maps reproduce aspects of Schaferian aesthetic moralism. Yet, at the same time, many map makers also q quiet, hi-fi environments as places in which their tinnitus was at its loudest, or noticeable. As a result, the tinnitus maps offer a more diverse and nuanced assessment of hi-fi soundscapes. In addition to the recurring theme of bed/the bedroom, home studies, offices without background music and walking in quiet outdoor spaces were identified as sites that participants felt their tinnitus to be more present. Some noted the heightened presence of tinnitus in such environments led to a negative association since tinnitus was felt to be bothersome or intrusive in these spaces. Listening with tinnitus thus made quiet, hi-fi soundscapes undesirable. However, this was not the case for all. Echoing the aforementioned discussion from the Monday workshop, a participant in a one to one discussion about their use of color (see Figure 6) notes that they “love absolute quiet mornings”, despite their tinnitus being more audible:

Figure 6. A tinnitus map using color, text and emoticons to communicate the relationship between different sound environments, tinnitus and emotional impact.

Participant 8: So for the light-blue it’s the nicest point of the moment, it’s the most comfortable. Red is the most uncomfortable and then the dark, really dark blue is kind of the neutral every-day, this is what happens. So I tend not to think about tinnitus through the blue points. Light blues I really enjoy, so when I wake up I love absolute quiet mornings, even though that means I can hear that it’s more, it’s there. The quietness brings a calm, and I really enjoy that […]

Facilitator: I noticed that you had super-quiet midnight in red … so I’m assuming this means your tinnitus is bad or more noticeable or aggravated, but then you’ve got a smiley face.

Participant 8: That’s kind of my favorite time of the day and though it’s quiet and though the tinnitus is loud and all that, it’s all in control, so it’s not can uncomfortable feeling, it’s just more of OK, it’s there but everything’s calm and everything’s happy. So yeah.

What might be categorized as lo-fi sound environments were met with similarly divergent responses amongst the participants. Unsurprisingly, many of the maps highlighted that tinnitus was less audible in relation to places and activities accompanied by some degree of background or foreground sound. Some tinnitus maps highlighted that tinnitus was less audible in environments with traffic noise. Figure 2 is a notable example: the map suggests that the sounds associated airplanes landing nearby at Heathrow airport, and which are audible in the house, are associated with the participant’s tinnitus being less noticeable. Furthermore, while acoustic ecology offers a pessimistic assessment of such environments, Figure 5 suggests that for some, there are positive associations with traffic noise: under the heading “out”, “regular traffic noises” are accompanied with a smiley face.⁷ However, as was the case with quiet, “hi-fi” environments, noisy, “lo-fi” environments had varying connotations for participants in terms of their affective and aural experience of tinnitus. The elaborate map pictured in Figure 7, for example, shows a live music concert with a lively crowd in the bottom right corner. While this might be considered in Schafer’s schema a lo-fi environment, with high levels of background noise and loud, amplified sound, their tinnitus is shown as loud – a quaver note appears in a red circle. In Figure 8, meanwhile, the theme of traffic noise returns under the heading “town”. This, alongside “people noise” and “sirens” is associated with tinnitus being “difficult”.

Figure 7. A hand-drawn tinnitus map in a comic style that plays on themes of conventional maps (e.g. through the use of a grid system).

Figure 8. A diagrammatic tinnitus map highlighting the relationship between traffic noise, urban noise and tinnitus.

While noise and quietude are recurring themes of the tinnitus maps and the discussions generated by them, they do not conform to the strict opposition created by Schaferian acoustic ecology. Rather, for listeners with tinnitus, both noisy lo-fi environments and quiet hi-fi environments can be pleasant or bothersome, soothing or aggravating, enabling or distracting, depending on context. In allowing “clear hearing,” hi-fi soundscapes may serve to amplify tinnitus, yet whether this amplification is a source of negative affect is contingent. Conversely, the relative lack of aural clarity in lo-fi soundscapes with background noise can provide relief from tinnitus by masking it, yet in some instances lo-fi soundscapes are perceived to aggravate tinnitus. By foregrounding the listening experiences of those with tinnitus, then, the tinnitus maps offer an alternative perspective on noisy and quiet soundscapes. In so doing, they highlight the limitations of a Schaferian approach grounded in a normate aurality.

Conclusion: what does a tinnitus map do?

Tinnitus maps can be understood to document tinnitus as a mode of aurality. Though informed by methods of sound mapping, tinnitus maps depart from sound mapping’s focus on the aural specificity of proper noun places, which tend to be documented using a combination of diagrammatic representation and sound recordings. Created by and for people with tinnitus during the COVID-19 pandemic, these maps use diverse textual and visual modes of communication to foreground common noun places, naming intimate yet generalized sites such as “bed”. Where sound maps have often involved collating recordings or aural descriptions of a singular place (e.g. a city), tinnitus maps are necessarily plural. Indeed, tinnitus’ variability means that the same common noun place can hold different connotations for different map makers. Furthermore, where sound maps tend to assume a separation between sonic environment and listener, tinnitus maps instead make apparent the imbrication of aurality, context and place. However, in order to more fully capture their experiences of tinnitus, participants felt it necessary to include various types of subjective and contextual information.

For some participants, the tinnitus maps provided a useful means of communicating to others their experiences of tinnitus, as well as an opportunity for self-reflection. However, these maps, as well as the discussions prompted by them, also serve to reveal the omissions and exclusions created by the influential discourses, methods and practices of both sound mapping and acoustic ecology. This includes acoustic ecology’s aesthetic moralism, whereby quiet, “hi-fi” spaces are considered ideal, and noisy, “lo-fi” environments are considered detrimental. This distinction has already been critiqued by both artists and scholars for its conservatism, pessimism, universalism and dismissal of listener’s own experiences of such environments. However, considering the tinnitus maps in relation to acoustic ecology’s framework reveals how its aesthetic moralism is also grounded in a normate aurality. By instead highlighting how experiences of tinnitus produce diverse assessments of both quiet and noisy environments, the tinnitus maps therefore contribute to a growing body of work that make apparent the ways that d/Deafness, disability, impairment and “auraldiversity” challenge and reconfigure of normative understandings of auditory experience.⁸

There are, however, elements of acoustic ecology that can help offer a novel understanding of tinnitus. Although acoustic ecology has little to say about the aural experiences of the many whose hearing abilities differ from the ideal of otological normalcy, beyond presenting them as evidence of the harms of an unnaturally noisy soundscape, its focus on the relationship between listener, sound and environment nonetheless provides a framework through which to develop an alternative account of tinnitus. Tinnitus is often considered and depicted in relation to the sound that is heard, and vis a vis the interiority of the subject. By foregrounding the relationship between tinnitus, sound and place, as well as affective state, activity, mediating technologies and time, the tinnitus maps instead highlight its relational, temporal and spatial constitution, revealing how tinnitus shapes and is shaped by different auditory environments, in coincidence with other factors. Taken collectively, the maps illustrate that experiences of tinnitus varies significantly between individuals but also for individuals, depending on context. In so doing, they provide an alternative perspective on this frequently stereotyped yet diverse auditory experience.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Arts and Humanities Research Council [AH/T001011/2].

Notes on contributors

Marie Thompson

Marie Thompson is a Senior Lecturer in Popular Music at the Open University, UK. She is the author of Beyond Unwanted Sound: Noise, Affect and Aesthetic Moralism (Bloomsbury, 2017) and the Principal Investigator of the Arts and Humanities Research Council project, Tinnitus, Auditory Knowledge and the Arts.

Notes

1. The concept of the soundscape, for example, which pre-dates acoustic ecology but was popularized by Schafer, has gained traction in a range of disciplines and fields. In 2014 the International Organization for Standardization published the first part of a standard on soundscape (ISO 12,913–1.2014), citing R. Murray Schafer (1993) and Barry Truax (2001). However, as Ari Y. Kelman makes clear (Kelman 2010), the soundscape has often come to be a vague and often ill-defined concept. Although Schafer’s work is frequently cited in scholarly and practical engagements that make reference to the soundscape, his specific usage of the term and his accompanying framework tend to be overlooked.

2. Normate aurality is very similar to Renel’s (2019) notion of the auditory normate. Renel also draws upon Thomson’s concept of the normate to articulate how design often assumes an ideal sonic citizen, and therefore serves to exclude d/Deaf and disabled people. My own use of the normate in this context has significant overlaps with and indeed complements Renel’s project. However, although “aurality” and “auditory” tend to be used interchangeably, I use the former here to mark the normate’s specific formation in relation to listening and hearing as its sensory substate. The “auditory” is used by Renel in a broader sense to refer to hearing and communication, which includes the creation of sound in public space.

3. Indeed, this construction of the soundscape runs counter to the World Soundscape Project’s own acknowledgment of the important interplay between affect, signification, sound and context. For example, an entry by Howard Broomfield included in European Sound Diary describes how another member, Jean Reed, responded to a recording of a North American police car siren while staying in Germany. Reed remarks that the siren sounds quite beautiful as it reminds her of home. For Broomfield, this illustrates the interaction of mind and environment, inasmuch as he proposes that if Jean had heard the same siren in Vancouver, she may feel anxious, or experience it as a noisy distraction if she is reading or writing.

4. This is not to deny the coherences between this method of map construction and some of the World Soundscape Project’s own work. In Five European Villages, for example, the team discuss using a “Sound Preference Test” with students to reveal information about attitudes about the local soundscape. Indeed, this openness to different perspectives exists in tension with a more proscriptive approach that is also embedded in the work of the World Soundscape Project: it is one of several apparent contradictions that run throughout their publications.

5. I borrow the term auraldiverse from John Levack Drever (2019). Borrowing from the distinction of neurotypical and neurodiverse, Drever uses this term to refer to the diverse spectrum of human hearing, and is opposed to the auraltypical: that is, those who have “otologically normal” hearing. Auraldiversity, in other words, names a spectrum of aural experience – including tinnitus – that diverge from normate aurality. Aural diversity (in contrast to auraldiversity) has also been used as a framing concept by Drever in collaboration with Andrew Hugill for an AHRC network grant an edited collection of essay. Here, aural diversity is used slightly differently to refer to the plurality of senses of hearing, including machine and animal listening. For more on this see Drever and Hugill 2022.

6. The relative absence of sound may also reflect a limitation imposed by the activity instruction. Due to the remote format of the workshops, and some of the difficulties of playing recorded sound over Zoom to a group with tinnitus, participants were encouraged to use visual and textual methods of communication. Future workshops could potentially explore how sound might be more directly incorporated into tinnitus maps.

7. This is not to deny the real concerns about the environmental impact of traffic congestion. However, there are issues with acoustic ecology’s tendency to conflate air pollution and noise pollution.

8. This work includes Drever (2019), Drever and Hugill (2022) and Renel (2019).