Tinnitus Retraining Therapy (TRT) – A Primer

Tinnitus is sadly a prevalent problem, affecting approximately 50 million Americans over 50. Tinnitus sufferers hear constant sounds in their heads that others can’t hear such as clicking, buzzing, humming, ringing or whistling. Tinnitus is often referred to by its slang name – ringing-in-the-ears. For many tinnitus sufferers, this persistent barrage of noise is more of a nuisance than an illness, but for many people it’s a cause of severe distress, leading to symptoms such as anxiety, fatigue, depression, and sleep disorders.

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.

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. 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.

According to Jastreboff’s model, tinnitus is not a disease or condition in itself, but a function of hyperacusis – the ability of some people to become aware of normal sounds generated by the auditory system that most people filter out or are unaware of. 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. 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.