Audiology Associates of Westchester - White Plains, NY

A tablet computer with the words tinnitus on the screen.

Tinnitus can be maddening for a any number of reasons. The first thing that comes to mind is it’s entirely subjective. Because of this, you can’t simply go up and show anyone what the ringing sounds like, how loud it the ringing may be at any given time, or how bothersome the condition can be for you.

Second, there isn’t yet an objective way to measure tinnitus. What this means is you can’t, for example, walk to the doctor’s office, have some blood drawn, and go on to get diagnosed with tinnitus.

Third, and most frustrating, we still don’t understand exactly how tinnitus works. Our understanding of the causes and treatment options remain less than perfect, and the medical field is still trying to completely understand this condition.

This can all be discouraging, of course, but those affected should not feel hopeless. Despite the many possible reasons frustration, many patients go on to display significant improvements in their symptoms with the right treatment plan prescribed.

Throughout this article, we’ll be going in-depth with one promising treatment option in particular, known as Tinnitus Retraining Therapy (TRT). This has proven to be a very effective and reliable treatment option for tinnitus, but to understand how it works, we 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.

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

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

First, the 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.

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.

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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