Tinnitus is commonly known as ringing in the ears; its sounds originate in the head. It may be perceived as ringing, crickets, roaring, hissing, bells, whistles, or a pulse, or as any combination of sounds. The sounds may be heard in one ear or both and can be constant or intermittent. Many musicians suffer from tinnitus and its affects can be debilitating. The good news is that the right therapy alleviates tinnitus.
In the ’90s, neurophysiologist Dr. Pawel J. Jastreboff developed a neurophysiological model of tinnitus, and based on it, a clinical approach from which he created a totally new treatment that results in significant improvement for more than 80% of patients. This method, Tinnitus Retraining Therapy (TRT), uses a combination of low-level broadband noise and counseling to achieve the habituation of tinnitus—that is the patient is no longer aware of their tinnitus, except when they focus their attention on it. This makes the condition no longer bothersome. Making Music spoke to audiologist Carol Bass, M.S., a certified tinnitus retraining therapist who runs a private practice, All Ears Hearing Center, Tinnitus and Hyperacusis Center in Ithaca, New York.
Peace is Possible
TRT is a way to retrain the brain to not perceive the tinnitus. Success is achieved when you do not hear the tinnitus at all, or it’s 0% bothersome, which usually happens around the same time.
The most important thing is the counseling. It is imperative to demystify tinnitus. During the first session we talk for approximately an hour about the tinnitus and do a thorough case history to demystify it—so that the brain is free to let go of it. We do that because the survival mechanism, the limbic system, is involved and it’s holding onto the tinnitus. The limbic system is a part of the brain that’s been there since the caveman days for your survival. And if there’s a negative emotion elicited with the tinnitus, the brain, because of this feeling of survival, will hold onto it indefinitely.
There is. Hearing loss could presumably trigger tinnitus, but it doesn’t have to be sustained. And the reason that we know that is because patients can have perfect hearing all across the spectrum and still have tinnitus. Noise exposure is the most common trigger for tinnitus, but medication, aging, change of hearing, like sudden hearing loss, can also trigger it.
We have an 83% success rate. The protocol is about two years, but most of our patients are done in six months. Eighteen percent are done in one or two sessions. I use a 0-10 scale of bothersome, and I see mostly eights, nines, and tens. I find that those are my easiest patients. They are motivated to let it go, rather than if you’re a two and you don’t really care and you’re going on with your life. The ones who say, “I would prefer not hearing it, but I don’t really care,” are the hardest patients.
People are studying all kinds of things like gingko and selenium, but the thing is, if the misconception persists, the tinnitus will just stay. The counseling is so important to get rid of what you think the tinnitus is and how you’re holding onto it. Then the survival mechanism can let go and the tinnitus will, from what we know, recede into the background, where you don’t perceive it anymore. It’s not that it disappears—it’s just that you don’t perceive it anymore. Everybody has tinnitus, because we can all hear.
Both are acceptable, but I don’t like to say “tin-night’-us” because it sounds like a dreaded disease and it’s not. If someone hears over and over that there’s no hope and nothing can be done about it, they get really scared, which reinforces the tinnitus. That will help keep the tinnitus going more than anything. The main thing is to have hope. That’s why our slogan is “peace is possible.” Just giving the patient hope is half the battle.
For more info on TRT visit Carol Bass at www.allears.com.
Other Resources
Hearing Education and Awareness for Rockers—A nonprofit hearing information source for musicians and music lovers. (www.hearnet.com)
American Academy of Audiology—“Tinnitus Retraining Therapy: Update 2008,” an interview with Pawel Jastreboff, PhD, ScD. (www.audiology.org/news/interviews/Pages/20081201a.aspx)
American Tinnitus Association—A nonprofit organization working to improve the resources, information, and assistance available to sufferers of tinnitus. (www.ata.org)
Musicians Hearing Services—This UK-based business specializes in the specific needs of musicians and entertainment industry, and advises on appropriate custom-made hearing conservation solutions. (www.musicianshearingservices.co.uk)
Hearing Review—Drawing on the content and resources of the two leading hearing industry magazines, The Hearing Review and Hearing Review Products, it is a one-stop website hearing industry website. (www.hearingreview.com)
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