TINNITUS MANAGEMENT
At Golden Ears Audiology Clinic, we provide tinnitus Management which includes:
– Sound Therapy
– Hearing aids
– Tinnitus counselling – CBT/TRT
Did you know?
Your brain is constantly on the alert for potential danger. Any unexpected sensory stimulus such as a movement in your peripheral vision or a sudden noise, can trigger your brain to react against a possible threat.
This reaction is called HYPERVIGILANCE
When the suspected threats turn out to be false alarms, in most cases, the brain quickly learns that the sound is not a threat. It then relaxes hypervigilance and the sensory stimulus (sound) is gradually screened out of awareness through a process called HABITUATION.
Habituation explains why people routinely stop noticing annoying noises (Tinnitus) after prolonged exposure.
When the brain judges tinnitus, as a threat to ones wellbeing, it puts the body on alert.
TINNITUS DISTRESS is your brain sounding the alarm about a perceived possible danger.
Tinnitus Management costs £79 and follow ups at £59
Frequently Asked Questions
Is there a cure for tinnitus?
People want to know if tinnitus be cured. The premise of medical treatment is to medically or surgically resolve any active disease processes. If there is an active disease process that causes the tinnitus and we can eliminate it, then yes, we have cured the tinnitus. There are issues that can be treated medically or surgically that will make it go away.
What is Sound Therapy?
Sound therapy relies on the use of masking sounds to suppress the spontaneous nerve activity underlying tinnitus.
When there is less sound coming into the auditory system, it turns its GAIN up, with the consequence that the spontaneous nerve activity is also amplified, potentially leading to tinnitus.
When sound is provided, e.g. by a hearing aid or a sound generating device, the benefit is that the central gain, which works on both spontaneous and stimulus-driven nerve activity, is turned down and amelioration of the tinnitus may result.
Do hearing aids help with tinnitus?
Amplification provides masking in the frequency range of tinnitus, especially if the hearing aids have a good high frequency response, and in addition it allows brain plasticity to play a role.
What is Audiologist based CBT?
CBT uses a psychological approach that treats tinnitus within a cognitive behavioural model.
It is believed that emotional aspects interfere with the tinnitus habituation process. In this treatment approach, tolerance to tinnitus will be facilitated by reducing levels of autonomic nervous system arousal, changing the emotional meaning of the tinnitus, and reducing other stresses.
What is Tinnitus Retraining Therapy (TRT)
TRT involves the use of directive counselling and sound generators.
TRT proposes that the process of increased auditory gain within the auditory system during periods of restricted sound input, or as a consequence of cochlear damage, may account for the emergence of tinnitus.
The key assumption in TRT is that tinnitus becomes problematic because of the improper activation of the brain’s limbic system, which plays a role in emotion, memory and learning.
Why is tinnitus bothersome for some people and in others it does not affect them?
A person’s emotional response to tinnitus that determines the course of habituation.
An emotional response to tinnitus, that consists of resisting and bracing against tinnitus maintains hypervigilance by reinforcing the brain’s perception that tinnitus is an imminent threat, an “intruder” that must be closely monitored. Rather than learning to ignore tinnitus, the persistently hypervigilant brain is locked into a negative pattern that maintains emotional distress and prevents habituation.
What is habituation?
Short Description
” The handicap associated with Tinnitus can arise from any combination of stress, anxiety, depression, emotional distress, insomnia, difficulties concentrating, or impairments in quality of life or everyday functioning. “
Why does tinnitus become troublesome ?
To understand this, lets first look at how sounds travel from the cochlea to the cortex.
Sounds stimulate the cochlea, travel along the auditory nerve, and then the subcortical areas of the brainstem detect those sounds. The information is passed on to the cortex, where it perceives, evaluates, differentiates, discriminates, and performs associated higher tasks. This is hierarchical processing of sound.
But it does not stop there .
Sounds can trigger emotional associations in the Limbic system
Sounds can trigger emotional associations in the limbic system. We can have both positive and negative reactions to sound, as well as ones that evoke historical memories. We might hear a song and it reminds us of a loved one. Screeching brakes may remind us of a terrible car accident.
Annoyance at a barking dog, is one of the emotional associations we can experience that activates our sympathetic nervous system, and we get physiological responses.
These sounds create feedback loops within our system. When we are annoyed and the sympathetic system is activated, the emotional associations and reactions are stronger. This is what makes us able to detect these sounds in background noise and other contexts. The feedback loop forms a vicious cycle and creates a problem.
Processing of sensory information seems to go wrong
The sensory gating, or the hierarchical processing of sensory information, seems to go awry, and tinnitus is always at the forefront of our
perception. It is the only thing we can hear, so it is the only thing we can think about. We reinforce the sound by listening to it, talking about it,
monitoring it, measuring it, writing about and charting it.
Negative counselling from physicians who say there is nothing that can be done about it or that it might be something like a brain tumor feed back into the problematic aspects of tinnitus and make it more difficult to deal with.
“The Goal of Tinnitus Management is to reduce the perception of and reaction to tinnitus, so that one has control over their life again ”
What is CBT?
CBT stands for Cognitive Behavioural Therapy.
CBT sessions are directed toward learning and applying CBT skills to help detach from tinnitus, and direct attention where you want it. CBT skills provide steps you can take, throughout the day—and night—to take charge of tinnitus.
Sounds can trigger emotional associations in the Limbic system
Our internal thoughts (cognitions) can exert a strong influence over our feelings and actions. Personal judgments, beliefs, and expectations can either nurture healthy emotions and lifestyle, or promote suffering, avoidance, and withdrawal.
Negative thinking reinforces hypervigilance, blocks habituation, and impedes recovery. Common examples are “catastrophizing,” where we jump to the worst case scenario without considering other, more likely outcomes, and “Mental Filter” where we pick out a single negative detail and dwell on it exclusively so that their vision of all reality becomes darkened.
Processing of sensory information seems to go wrong
CBT can help change how an individual thinks and behave in response to tinnitus.
CBT is a set of learned skills, healthy habits and perspectives that work together to change a person’s emotional response to tinnitus.
CBT begins with a careful look at the patient’s thoughts to identify cognitive patterns that fan the flames of tinnitus distress.
The goal is to develop reasonable judgments and expectations about tinnitus, a new perspective that is grounded by facts, to provide reassurance and guidance throughout recovery.
“With practice and patience, CBT can help habituate to tinnitus and quiet the alarm in the brain”
