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 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. This can prove to be much more problematic than the ringing of tinnitus itself.
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.