The logic behind behavioural therapy is that “severe” tinnitus is determined
by its emotional impact rather than its auditory qualities. (Research
indicates that tinnitus loudness/pitch has little correlation with
patient-reported distress.) What genuinely burdens the illness are the
unpleasant psychological and cognitive responses patients have to tinnitus.
In other words, the patient’s emotional response is critical in determining
whether tinnitus is seen as troublesome or innocuous, emotionally
disturbing, or unimportant. The purpose of behavioural therapy is to assist
patients in controlling their behavioural responses to tinnitus, thereby
reducing the condition’s perceived impact.
Patients who place a high attention on their tinnitus and lack emotional
coping mechanisms are often more unhappy, upset, and view their disease to
be more handicapping. Behavioural therapies teach patients how to decrease
their internal focus on tinnitus, improve their coping, and develop
alternative thinking and behaviour patterns that divert their attention away
from their tinnitus. The therapy’s overall goal is to boost pleasurable
activity, teach relaxation techniques, and develop cognitive abilities to
substitute negative (or unhelpful) thinking.
Cognitive Behavioural Therapy (CBT): Is a form of talk therapy
CBT uses cognitive restructuring and relaxation to help patients
change their
tinnitus perceptions and reactions. Patients typically keep a
journal and do
“homework” in an attempt to strengthen their coping abilities.
Weekly
sessions for two to six months are common. While CBT cannot
eliminate the
sound entirely, it can considerably reduce its annoyance and improve
overall
quality of life.
Here is a webinar by Dr. Bruce Hubbard, Director of the Cognitive Health
Group on CBT and how it can help those with tinnitus.
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness-based therapy focuses on acute and nonjudgmental awareness of
one’s bodily, sensory, emotional, and cognitive processes. Rather than
trying to ignore tinnitus, MBSR teaches patients to accept, embrace, and
control it. So, sufferers can better manage their condition. It can also
address negative feelings of anger and apathy that so often accompany
tinnitus.
Acceptance and Commitment Therapy (ACT)
ACT highlights the importance of reducing tinnitus avoidance through
mindfulness-based practices. Patients learn to fully experience their ideas,
perceptions, and emotions without judgement. Patients can gain greater
control over their reactions if they are able to fully embrace their
negative thoughts and sensations.
Tinnitus Treatment Activities (TAT)
A subtype of CBT that focuses exclusively on tinnitus management. TAT is an
incremental learning strategy to investigate tinnitus’s four major impact
areas: thoughts and emotions, hearing and communication, sleep, and
concentration. Additionally, the method frequently incorporates a low-level
of additional sound treatment for masking purposes.
Tinnitus Retraining Therapy (TRT): Therapy for tinnitus re-education
This method assumes that tinnitus is caused by abnormal neural activity. The
objective is to train the auditory system to become accustomed to the
tinnitus signals, making them less obvious or annoying. Individual
counselling and sound therapy are key components of TRT. Patients with
tinnitus are also exposed to constant low-level broadband sound to help them
become accustomed to the sound.
