Tinnitus is certainly frustrating for a number of reasons. First, it is entirely subjective, so you can’t truly convey to anyone what the ringing sounds like, how loud it may be, or how bothersome it can get.
Second, there is not yet one true, objective way to measure tinnitus. You can’t, for example, drive to your nearest doctor’s location, get some blood drawn, and get diagnosed with tinnitus.
Third, and perhaps most frustrating, we still don’t understand exactly how tinnitus works. As such, our understanding of the causes and treatment options remain less than perfect.
This is all frustrating, of course, but not those who have the condition should not feel hopeless. In fact, despite the mounting frustrations, many patients show significant improvements in their symptoms with a correctly applied treatment plan.
In this article we’ll be discussing one promising treatment option in particular, known as Tinnitus Retraining Therapy (TRT). This treatment has proven to be particularly effective, but to truly understand how it works, you first have to understand the two parts of tinnitus.
The Two Parts of Tinnitus
Tinnitus is defined as the perception of sound when no external sound source is present. We can break tinnitus down into the following 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 across everyday life.
The effective treatment of tinnitus therefore requires addressing both of the two outlined parts, which represents the underlying rationale of Tinnitus Retraining Therapy.
Tinnitus Retraining Therapy
Following with what we spoke about above, lets break TRT down into two parts; the first part addressing the actual sound tinnitus produces and the other part addressing the emotional and behavioral repercussions.
Sound Therapy
Sound therapy is the use of an external sound to “mask” the internal sound of tinnitus. This mitigates tinnitus on a number of levels and has proven to be an exciting treatment method for tinnitus.
First, the external sound can partially or completely cover the tinnitus sounds, and as such, can divert the patient’s attention while the sound is being played. This can provide a sense of immediate relief for the patient.
Second, sound therapy can result in what is called “habituation,” where the brain is trained over time to reclassify the tinnitus as an unimportant sound that should be ignored. Through habituation, those affected can begin to truly overcome tinnitus.
Third, the use of specialized sound minimizes the hyperactivity in the brain thought to be the underlying mechanism of tinnitus. This is called “neuromodulation.”
One can come to the conclusion that sound therapy has both short-term and long-term benefits, and can work across multiple levels to mitigate the severity of symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.
Cognitive Behavioral Therapy
In addition to sound therapy, TRT makes use of behavioral therapies that address the second, emotional component of tinnitus. In many ways, this is the most critical component. Tinnitus can trigger strong emotional reactions like anxiety, depression, and anger in patients and can have debilitating effects on everyday life.
Research in this area has led to some surprising conclusions. For example, studies have found no link between the loudness/pitch of tinnitus and patient-reported distress. Whether or not tinnitus is viewed as a mild burden, slightly bothersome, or devastating, is largely dependent on the cognitive/behavioral response of each person.
This is good news, because it means that you can learn different techniques to reduce the anxiety caused by tinnitus (which itself can make the tinnitus worse). This is why behavioral therapy has been so effective—in fact, a 2010 meta-analysis of eight research studies showed significant improvement in depression and quality of life for patients that participated in the programs.
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. This type of 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.
