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Tinnitus retraining therapy

Once the tinnitus loses its sinister meaning, however loud it has been, or however unpleasant it may seem, it does begin to diminish, and in many cases, may not be heard forever. In some cases, firmly held beliefs are hard to alter, particularly where there is a conviction that tinnitus is only related to ear damage which cannot be fixed. Retraining the subconscious auditory system to accept tinnitus as something that occurs naturally, does not spell a lifetime of torture and despair, and is not a threat or a warning signal, can take months and occasionally even years. Ideally, retraining should be guided by professionals with experience in this field. However, many people can be helped by understanding the Jastreboff model and applying the principles of retraining as described here. For people who also have co-existing or pre-existing anxiety or depression, it can take longer to change their feelings about their tinnitus.

How retraining works

Tinnitus Retraining Therapy is not simply an abstract learning exercise. In the subconscious part of the brain concerned with hearing, beyond the inner ear, but before the conscious perception of sound takes place, subconscious filters, or networks of nerve cells are programmed to pick up signals on a ‘need to hear’ basis. Think again of the way we invariably detect the sound of our own name, or a distant car horn, or a new baby stirring in sleep, whereas we may be unaware of the sound of rain pounding on the roof or surf beating on a seashore. Retraining therapy involves reprogramming or resetting these networks which are selectively picking up ‘music of the brain’ in the auditory system.

Tinnitus retraining first involves learning about what is causing the tinnitus. Result of this and other therapy including sound therapy, the strength of the reaction against tinnitus gradually reduces. This reaction controls the setting of subconscious filters which are constantly looking for threats. With strong reactions, the filters are constantly monitoring tinnitus, but without a reaction, habituation occurs, as it does to every meaningless sound that is constantly present. Firstly, the disappearance of the reaction means that sufferers no longer feel bad, or distracted, and normal life activities can be resumed – sleep, recreation, and work, as before. Secondly, as the auditory filters are no longer monitoring the tinnitus it is heard less often and less loud. As a result, it can finally become a friend instead of an enemy. Think, now, how much of this treatment depends on being able to believe that tinnitus results from normal compensatory changes in the hearing mechanism, rather than irreversible ear damage. While it is important to have a proper examination by an ear specialist, those professionals who themselves believe that tinnitus is an ‘ear’ phenomenon cannot help your tinnitus. Fortunately, few specialists have already an understanding based on the Jastreboff neurophysiological model ...*

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