How The Two Components To Tinnitus Retraining Therapy (TRT) Can Help To Ease Your Tinnitus

A tablet computer with the words tinnitus on the screen.

Tinnitus can be a rather perplexing condition for any number of reasons. First, it’s a very subjective experience. What we mean by that, is you can’t just go and show anyone what the constant ringing of tinnitus sounds like, how loud the ringing may be, or how bothersome the ringing of tinnitus can get over time.

Second, there isn’t any one true, objective way to measure the intensity of tinnitus. Unfortunately you can’t simply walk into your doctor’s office, get some blood drawn, have some tests ran, and get diagnosed.

Lastly, unfortunately we still don’t have an exact understanding of how tinnitus works. As such, our grasp of the causes and treatment options remain less than perfect.

This can all amount to an incredibly frustrating experience, but those affected should not feel hopeless. In fact, despite the many possible reasons for frustration, many of those same people affected go on to report significant improvements in their tinnitus symptoms when paired with 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:

  1. The actual sound – usually perceived as a ringing sound, but can also be perceived as a buzzing, hissing, whistling, swooshing, or clicking sound.
  2. 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.

Sound Therapy

Sound therapy is the use of external sound to “mask” the internal sound of tinnitus. This mitigates tinnitus on a number of levels.

First and foremost, the newly introduced external sound can either somewhat or completely cover up the underlying sounds of tinnitus. By doing so, it can also divert the patient’s attention away from the tinnitus sounds while it is being played. This can provide an immediate sense of relief for the patient.

With time, sound therapy can result in what is called “habituation.” This occurs when the brain is trained over a period of time to re-categorize the sounds of tinnitus as an unimportant noise that should be ignored. The end goal of any tinnitus treatment program should result in habituation.

Third, the use of specialized sound minimizes the hyperactivity in the brain thought to be the underlying mechanism of tinnitus. This is called “neuromodulation.”

Sound therapy therefore has both short-term and long-term benefits, and works on multiple levels to mitigate the severity of symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.

While any sound can theoretically provide the masking effect, specialized medical-grade devices deliver customized sounds or music programmed to match the characteristics of the patient’s tinnitus. 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.  

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