What is Tinnitus Retraining Therapy?

Tinnitus is widespread in the U.S. with an estimated 50 million sufferers above age 50. Tinnitus causes those who have it to hear constant sounds “in their heads” that people surrounding them cannot hear – buzzing or roaring sounds, high-pitched whistling or ringing, or rapid clicking. Many people “learn to cope with” their tinnitus, considering it as a nuisance rather than a disorder. But for other people, this constant ringing in the ears produces auxiliary symptoms of stress and distress, fatigue, sleep disorders, depression, and anxiety.

Although there are technological treatments for tinnitus, such as hearing aids that mask and suppress the buzzing or ringing sounds, there is also a form of counseling known as Tinnitus Retraining Therapy. The concept behind TRT is to retrain the brain to reduce sensitivity to the tinnitus noises. The idea is to lower the perceptions of the sounds and reduce negative reactions to the sounds.

Created by Austrian neuroscientist Pawel Jastreboff in the 1980s, Tinnitus Retraining Therapy is a radically different approach to tinnitus treatment. It challenges the assumption among most audiologists that tinnitus is the result of physical ear damage which cannot be reversed. Jastreboff has proposed an alternate model for tinnitus based on his background in behavioral neuroscience. Firmly believing that the condition could be fixed, he focused his efforts on developing behavior modification techniques.

At the core of Tinnitus Retraining Therapy is the proposition that tinnitus is not a disease in and of itself. Instead, Jastreboff believes that tinnitus is a manifestation of hyperacusis which is defined as an over-sensitivity to certain frequency ranges of sounds. A person with severe hyperacusis has difficulty tolerating everyday sounds. In his theory, it is not the buzzing sounds themselves that are a problem, and the distress they cause some people is due to an over reaction to the sounds. Only people who have been trained in how to administer the TRT training can lead the counseling sessions, which use precise and individually-tuned techniques of training and sound therapy to teach people to eliminate their over reactions to the sounds they don’t want to hear, and instead focus on sounds they do want to hear.

Counselors trained in TRT have had remarkable successes helping patient eliminate their negative reactions to the sounds they hear, thereby relieving distress.

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