Tinnitus Retraining Therapy, Part 2


By Robert Mario

There is no cure for tinnitus, but for many sufferers there is a treatment approach.

The work of Dr. Jastreboff, of Emory University, has lead to the conclusion that by retraining the brain to habituate, or ignore certain noises, patients could eventually be free from the annoying symptoms.

The method of treatment based on these principles is known as Tinnitus Retraining Therapy (TRT). 

TRT is based on a new clinical approach for the treatment of tinnitus that results in significant improvement for more than 80 percent of the patients treated.

TRT uses a combination of sound therapy and directive counseling to assist in overcoming the bothersome effects of tinnitus, thus making the patient no longer aware of their affliction, unless they focus attention on it. Even then tinnitus is no longer annoying.

Hyperacusis is a decreased tolerance to sound and can be a serious and frustrating problem. TRT can also be used in the treatment of Hyperacusis to totally or partially restore normal levels of sound sensitivity. The goal of TRT is to retrain the patient’s brain to treat tinnitus and hyperacusis the way they treat the sound of a refrigerator in their kitchen — a sound that they normally are not aware of but when they do hear it, it is not bothersome.

TRT helps people recover from tinnitus by using the very basic theory of brain plasticity. The human brain is capable of increasing or decreasing the attention paid to external and internal stimulation. This increase or decrease happens on a subconscious level in the brain, in a physical location of the central nervous system that also handles essential body functions such as heart rate, sleep cycles, emotional feelings of well being or distress, hormone productions, and other unconscious regulatory functions.

When a symptom like ear noise happens, such as tinnitus, this subconscious brain response can be called into action. If the person feels alarm or concern related to tinnitus, areas of the brain, including the limbic system and the autonomous nervous system, can start a sequence of events that evolve into a serious problem. Negative emotions and conscious reactions can become firmly attached to benign symptoms, like tinnitus.

TRT should always consist of two components: counseling and sound therapy, usually with the use of sound generators. Because of the complexities involved, it is extremely important that specialists who are appropriately trained conduct the course of treatment.

Patients who have been thoroughly tested and diagnosed will begin therapy with a counseling session in which the diagnosis and treatment progression is explained. The patient learns to understand the mechanisms of hearing and basis of the brain function.

Once the patients understand why tinnitus is creating problems they are instructed to follow a specific regimen of sound therapy. Significant improvement occurs typically after three months, with further improvement noted in six months to a year.

Dr. Robert Mario, PhD, BC-HIS, is the director of Mario Hearing and Tinnitus Clinics, with locations in West Roxbury, Cambridge, Mansfield and Melrose. He can be reached at 781-979-0800 or visit their website, www.mariohearingclinics.com. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com