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An Introduction to Tinnitus Retraining Therapy (TRT)

Tinnitus is widespread in the United States with an estimated 50 million sufferers over age 50. Tinnitus sufferers hear constant sounds in their heads that others don’t hear such as buzzing, clicking, ringing, humming or whistling. Tinnitus is commonly referred to by its slang name – ringing-in-the-ears. Sometimes, the tinnitus is a minor nuisance, while in severe cases it is horribly debilitating. Constant tinnitus often leads to other ailments such as anxiety, sleeping disorders, fatigue, and depression.

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. Using a combination of mechanisms, TRT “retrains” tinnitus sufferers and gives them the ability to reduce their perceptions of the noises they hear, so they no longer react to the sounds negatively, and thus eventually cease being bothered by them.

Discovered in the 1980s by neuroscientist Pawel Jastreboff, TRT challenges the assumptions of many audiologists that tinnitus is a physical disorder due to ear damage that cannot be fixed. While damage to the ears – for example, exposure to loud noises for long periods of time – is often a cause of tinnitus, Jastreboff drew upon his training in neuroscience to propose an alternative behavioral neuro-physical model that explained the condition. This allowed him to disregard previous notions that the condition couldn’t be fixed, and focus his attention on developing behavioral modification techniques that could, indeed, fix it.

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. Jastreboff reasons that the true problem for tinnitus sufferers is the over-reaction and hyper-sensitivity to the ringing or buzzing sounds, not the sounds themselves. During TRT counseling sessions – performed only by those who have been trained in the technique – a precise and individual combination of teaching and sound therapy are used to enable tinnitus sufferers to use their own cognitive functions to shut down their over reactions to the disturbing sounds, and focus more on the desirable sounds they want to hear.

Over the years, TRT counselors have had success with helping people to overcome their conditioned negative responses to the sounds they hear, and thus eliminate the distress they feel at hearing them.

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