Tinnitus Retraining Therapy
Tinnitus Retraining Therapy (TRT) is a somewhat controversial treatment for the condition that, as yet, still has only limited acceptance from the established medical professional. It was developed by J. Jastreboff in the 1980s while he was at Yale University working on a neurophysiological model for understanding the condition. Ultimately, Jastreboff was to argue that tinnitus is not a disease but a natural phenomenon, this principle now underpins much of the therapy's approach.
TRT claims to work through a system of habituation which aims to reduce the way a patient perceives noise. This is done by helping the patient make a conscious decision to increase his or her levels of sound enrichment. For many tinnitus sufferers this can be a difficult step, as a frequent reaction to the symptoms of the condition is to try and block out as much noise as possible.
TRT therapists claim that by exposing themselves to controlled levels of natural-sounding broadband noise, patients reduce their anxiety about their condition and thereby reduce the acuteness of its symptoms. For the TRT practitioner, silence merely provides a mute background for the patient to develop increased levels of sensitivity in the central auditory system. This phenomenon of hypersensitivity to sound is called hyperacusis and is believed to affect around 50% of all tinnitus sufferers and left unconfronted can lead to worrying levels of social impairment.
Through this long process of broadband noise exposure Jastreboff and his proponents believe that the patient will become habituated until they remove their negative reaction to their symptoms and eventually return to a pre-tinnitus level of hearing comfort. While TRT therapists do not claim to offer a miracle cure for the condition, they do claim an 80% success rate, with Jastreboff himself saying that his treatment is "the best available at the time."
Unfortunately, there are few qualified TRT therapists working in Britain right now, making it difficult for sufferers to gain access to this treatment. However, Jastreboff and his followers advise that some TRT methods can be tried at home. He says that while they are not likely to be as effective as when performed with a qualified therapist, they can still yield some positive results.
The following exercise advice is taken from tinnitus.org and can be carried out unsupervised and at home:
Retraining tactics
1) Examine your reaction to tinnitus or unpleasant external sounds (in hyperacusis) for some (short) periods each day. 10 seconds is long enough
2) Practice relaxation techniques to reduce the body (autonomic activity) part and try to reduce you annoyance / irritation / fear (limbic part) by an "act of diplomacy". Don't worry if you can't reduce these things by much, every little counts, and each time the exercise will be easier.
3) Reduce the impact by sound enrichment or use of instruments
4) Do this for only such time as you experience no unpleasant reaction (may be 10 seconds to start with). Do this perhaps 10 times a day only. The rest of the time you may be reacting, as before, with distress, that's OK in the initial stages.
5) Try and identify your emotional and body reaction to the sound, and reduce this by a small amount each time. This is an aversive conditioned reflex response. It takes a long time to retrain conditioned reflexes (like hand writing, or your golf swing!). Be patient.
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