Tinnitus is frustrating for a multitude of reasons. On one hand, it’s entirely subjective, so you can’t show anyone exactly how the ringing sounds like, how loud the ringing is, or how bothersome the ringing can be to you at any particular moment in time.
Another bothersome aspect to tinnitus; there’s no objective way to measure it. You can’t, for example, go into the doctor’s office, get some blood drawn, and get diagnosed with tinnitus. Unfortunately it isn’t that simple.
Lastly, we still don’t have a complete medical understanding of how tinnitus works, so our collective grasp of the causes and treatment options remain less than perfect.
This can all be frustrating, of course, but we are not without hope. In fact, despite the many frustrations and possible roadblocks along the way, many people do show significant improvements in their symptoms with the right tinnitus treatment plan.
Throughout this article, we’ll be discussing one treatment option in particular, known as Tinnitus Retraining Therapy (TRT), which has proven to be particularly effective at treating those who have to deal with the condition on a day in, day out basis. To understand how TRT works, you first have to understand the two parts of the tinnitus condition.
The Two Parts to Tinnitus
Tinnitus is defined as the perception of sound when no actual external sound source is present. Let’s break tinnitus down into two parts below:
- The actual sound of tinnitus – This is normally perceived as a ringing sound, but can also be perceived as a buzzing, hissing, whistling, “swooshing”, or even a clicking sound.
- The emotional reaction – This is characterized as the perception of the loudness and character of the sound, and its disruption to your everyday life. This is the much more subjective side to tinnitus, as it can vary from person to person.
Therefore, to effectively treat the condition, it requires addressing both parts. This line of thinking is the underlying rationale of Tinnitus Retraining Therapy (TRT).
Tinnitus Retraining Therapy (TRT)
We are going to continue breaking TRT down into two parts; the first part addressing the actual sound and sensations that tinnitus produces, and the other part dealing with the emotional and behavioral repercussions, as we listed above.
Sound Therapy
Sound therapy is the use of external sound to “mask” the internal sound of tinnitus. This helps to subdue tinnitus in a wide variety of ways and can be quickly effective.
First, the added external sound can partially or completely cover the tinnitus sounds, and can also divert the patient’s attention while the sound is being played. This can provide immediate relief to the patient, and can mask the various symptoms of tinnitus. While not addressing the root causes of tinnitus directly, this is a proven method that has shown it can quickly alleviate the symptoms of tinnitus in patients.
Secondly, sound therapy can result in what is called “habituation,” where the brain is trained over time to slowly recategorize the true tinnitus condition as an insignificant sound that should be ignored.
Thirdly, the use of specialized sound minimizes the constant hyperactivity in the brain thought to be one of the underlying causes of tinnitus. This is called “neuromodulation.”
Taking all of this into account, sound therapy treatment has both short-term and long-term benefits, and can work in many different ways to mitigate the severity of symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.
While in theory any sound can provide a masking effect, specialized medical-grade devices help to deliver customized sounds programmed to match the characteristics of the patient’s tinnitus on an individualized basis. This results in a unique, customized treatment. Your hearing care professional can help you select the right device and sound to suit your specific needs.
Cognitive Behavioral Therapy
In addition to sound therapy, TRT also employs behavioral therapies that address the second, emotional component of tinnitus. In some 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” by those affected, slightly bothersome, or devastating, it is largely dependent on the cognitive/behavioral response of the individual patient.
That’s good news because it means that you can learn various techniques to reduce the anxiety caused by tinnitus (which itself can make the tinnitus worse). And that’s 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. 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 by getting past this condition.
