Tinnitus can be frustrating for a number of reasons. First, it’s entirely subjective, so you can’t show anyone what the ringing sounds like, how loud it is, or how bothersome it is.
Second, there’s no objective way to measure tinnitus, so you can’t, for example, go into the doctor’s office, get some blood drawn, and get diagnosed.
And third, we still don’t understand exactly how tinnitus works, so our understanding of the causes and treatment options remain less than perfect.
This is all frustrating, of course, but not hopeless. In fact, despite the frustrations, many people do show significant improvements in their symptoms with the right treatment plan.
In this article, we’ll be discussing one treatment option in particular, known as Tinnitus Retraining Therapy (TRT), that has proven to be particularly effective. To understand how it works, you first have to understand the two parts of tinnitus.
The Two Parts of Tinnitus
Tinnitus is the perception of sound when no external sound source is present. We can break tinnitus down into two parts:
- The actual sound – usually perceived as a ringing sound, but can also be perceived as a buzzing, hissing, whistling, swooshing, or clicking sound.
- The emotional reaction – the perception of the loudness and character of the sound and its disruption to everyday life.
The effective treatment of tinnitus therefore requires addressing both parts, which is the underlying rationale of Tinnitus Retraining Therapy.
Tinnitus Retraining Therapy
Let’s break TRT down into two parts, the first part addressing the actual sound tinnitus produces and the other part dealing with the emotional and behavioral repercussions.
Sound therapy makes use of an external sound to “cover” the ongoing, underlying internal sounds of tinnitus. This can help to mitigate the condition of tinnitus in a variety of ways.
First and foremost, the newly introduced external sounds can either partially or completely cover up the sounds that tinnitus produces. By doing so, it sound therapy can divert the patient’s attention away from the tinnitus while the sound is being played. This can provide an almost instantaneous sense of immediate relief for those affected with tinnitus.
Second, sound therapy can result in what is called “habituation.” Habituation is achieved when the brain slowly trained over a period of time to categorize the underlying sounds of tinnitus as a background noise that should be ignored. Essentially, habituation is the desired end goal of any tinnitus treatment option.
Third, the use of specialized sound minimizes the hyperactivity in the brain thought to be the underlying mechanism of tinnitus. This is called “neuromodulation.”
It can then be decided that sound therapy has both short-term and long-term benefits for potential patients, and can help to work across multiple levels in order to lessen the severity of your tinnitus symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.
While it is true that any noise can in theory provide a desired masking effect, specialized medical-grade devices can help to deliver customized sounds programmed to match the unique characteristics of the individual patient’s tinnitus condition. Your hearing care professional can help you select the right device and sound.
Cognitive Behavioral Therapy
In addition to sound therapy, TRT also employs behavioral therapies that address the second, emotional component of tinnitus. In ways, this is the more critical component, as tinnitus can trigger strong emotional reactions like anxiety, depression, and anger.
Research in this area has led to some surprising conclusions. For example, studies have found no correlation between the loudness/pitch of tinnitus and patient-reported distress. Whether or not tinnitus is viewed as no-big-deal, slightly bothersome, or devastating is largely dependent on the cognitive/behavioral response of the patient.
Behavioral therapy can be delivered one-on-one or in groups, from a clinic or over the phone or internet from the patient’s home. Therapy includes education, identifying tinnitus triggers, instituting healthy lifestyle choices to mitigate symptoms, and mindfulness-based stress reduction.
Take Action and Silence Your Tinnitus
Tinnitus Retraining Therapy is effective because it leads to habituation on both fronts, both in terms of the actual sound and in terms of the emotional and behavioral responses.
While there is no known cure for tinnitus, you can mitigate the symptoms with the right plan and some perseverance. As your tinnitus is masked and the brain is trained to ignore it, you’ll be able to better cope with the sounds and improve your quality of life.