People are often surprised to know that there are many effective ways to treat tinnitus so it is no longer bothersome for them, however there no cure to eliminate tinnitus completely.
There is no one way to deal with tinnitus. Irrespective of the cause, once medical attention has been addressed our aim is to deliver the most appropriate treatment to the individual by designing a Personalised Tinnitus Intervention and Management Plan to suit the individual needs of each of our patients.
The approaches that we use for Tinnitus management are as follows and could be used on their own or combined for better results.
Education: Information on anatomy of the auditory system, hair cell loss, neural networks, autonomic nervous system and the Neurophysiological Model of Tinnitus. The neurophysiological model conceptualizes tinnitus as a neural signal that can have varying effects on the central nervous system.
Hearing Devices: As 80% of tinnitus sufferers have some hearing loss, when the loss is addressed the tinnitus becomes less noticeable.
TRT: Tinnitus-Retraining-Therapy using white noise generators to make the habituation process easier. The goal of TRT is to teach the brain to switch focus from tinnitus neural signal and process it like irrelevant auditory signal i.e to the subconscious. So TRT results in tinnitus signal correctly being identified as an irrelevant stimulus (habituation) and so it does not normally evoke reactions and enter consciousness. TRT involves counselling and sound therapy through the use of a noise generator. Progress is evaluated quantitatively through questionnaires.
CBT: Cognitive Behavioural Therapy identifies and modifies behavioural change and cognitive restructuring to enable the patient to think different about their tinnitus. Negative thinking brings about behavioural changes that reinforce a person’s awareness of the tinnitus. CBT helps to relieve the negative cycle of tinnitus, reduce stress and annoyance caused by tinnitus and can redirect attention from the tinnitus sound. In other words, while the tinnitus may still be heard, attention is rarely given to it and emotional acceptance is achieved. Over a course of consultations CBT will reduce the distress caused by tinnitus however the patient must be committed to attending regular consultations to achieve this.
Tinnitus is often associated with increased bodily tension, not the least because of how one reacts to tinnitus: studies suggesting that muscular tension can be associated with increased loudness of tinnitus. Relaxation can make tinnitus more tolerable.
The most important consideration in counselling is to dispel any fears or anxieties that have become associated with the tinnitus. It gives the understanding that the tinnitus is treatable, much is known about it and there are many avenues that can lead to tinnitus being processed as a benign signal.