Tinnitus Retraining

Tinnitus is a common phenomenon that is described as a ringing, chirping, or buzzing sound that persists in one or both ears despite no external source of the sound. Although it affects about 17% of the general population and about 33% of the elderly, only 20% of all the people who experience tinnitus are bothered by it. Those who are bothered by the noise can find it extremely distressing and often debilitating. The 80% of those who are not bothered by the condition, treat tinnitus like any other sound to which they easily habituate. The important aspect is that there is no difference in the loudness, pitch, or other sound characteristics of tinnitus between those who experience tinnitus and those who suffer because of it. This observation is one of the findings responsible for the development of a new model of tinnitus, and based on the model, Tinnitus Retraining Therapy.

We offer a multidisciplinary team approach to the treatment of tinnitus. Our team is comprised of a physician, an audiologist, and a psychologist. Together we evaluate the problem and develop a treatment plan to meet the individual needs of the client. This would include such interventions as:

  • Sound generating devices to help partially mask the tinnitus
  • Counseling to facilitate habituation to the sound
  • Biofeedback to decrease distress and facilitate habituation

The goal of our treatment is to eliminate the distress of tinnitus to the point where the sound is not relevant and therefore not noticed.

Frequently Asked Questions

How do you treat tinnitus?

Our primary treatment is called Tinnitus Retraining Therapy, as developed by Pavel Jasterbof. It involves an extensive initial evaluation, several counseling sessions, the use of external sound, and the use of ear level sound generators in some cases. It does not involve surgery or drugs.

What does retraining therapy mean?

We try to retrain the subconscious parts of the brain to ignore the sound of your tinnitus and to achieve the stage in which you are not aware of and / or annoyed by your tinnitus.

What kind of audiological tests are performed? Will it hurt my ears? What if I don't have tinnitus when I am tested?

The tests include an extensive comprehensive audiogram and several specific tests which will allow us to evaluate the degree of tinnitus and/or hyperacusis if present. The tests begin with low levels of sound and gradually get louder, but, none of the tests will be painful. If your tinnitus is not present on the day of the testing, it will NOT influence the possibility of success with the treatment.

I recently had audiological tests done. Do they have to be repeated?

We prefer to have the tests performed by our audiologist, but you may elect to use your own. If you use your own audiologist we may request that additional tests be performed so that we can adequately diagnosis your condition and generate an appropriate treatment plan.

Is the counseling a form of psychotherapy or biofeedback?

It is neither. The initial counseling will provide you with information about the causes and factors involved in your tinnitus, explain to you how the retraining therapy works, and teach you how to control your tinnitus. The counseling session is a fundamental part of the treatment process. In addition to counseling, we may later include Cognitive Behavioral Therapy and biofeedback to help reduce the distress associated with tinnitus.

What is Cognitive Behavioral Therapy?

The emotions we experience are directly related to what we think is happening to us, not what is actually happening. Often the distress or emotion we experience with tinnitus is related to what we think tinnitus is doing to us or will do to us. Often these beliefs about tinnitus may be inaccurate or distorted. Cognitive Behavioral Therapy reduces distress associated with tinnitus by changing distorted beliefs that you may have associated with your condition.

What is biofeedback?

The goal of our treatment is to reduce the distress associated with tinnitus. This requires you to learn to lessen the emotional response that occurs with tinnitus. One way of lessening the distress is to learn to relax. When we are stressed or anxious our bodies tense. Biofeedback measures through sensors the muscular tension and other physiological symptoms of stress, and then provides auditory or visual feedback to the patient. With guided practice patients learn to relax with the assistance of the feedback. As the patient learns to relax distress from tinnitus is reduced.

What is the role of external sound?

External sound from recommended table top sound machines is used at a low level in order to bring the changes in your subconscious hearing system, and not to cover (mask) your tinnitus. It reduces the contrast between your tinnitus and complete silence, and slightly distracts you from the sound of vour tinnitus.

What are the devices and what do they look like?

The devices used in retraining therapy are called "sound generators." Presently, we are recommending two styles. One is a pair of small instruments that are worn behind both ears. They look similar to the behind-the-ear hearing aids and can be worn with glasses. The other style is worn in the ear, but not blocking the ear canal as is the case for many hearing aids. They do not interfere with your work or talking on the telephone. When indicated, we are using hearing aids or combination instruments.

Can I just buy the devices?

The devices are used to help speed up the process of retraining, but will not work alone. The manner in which the devices are used depends on each patient's individual needs. If you just buy and wear the devices you most probably will not achieve improvement, and in some cases you may even hurt yourself. We will teach you how to use them effectively.

Do I need to have the devices?

Not everybody needs the devices. After the medical and audioiogical evaluation, we will give you our recommendations and you can choose your treatment.

I am using hearing aids; how can I use other devices?

Depending on the type of hearing aids, it is possible that we can work with your hearing aids and you will not need any other devices.

I was using maskers without effect. What is the difference between masking and these devices?

Masking is aimed at making tinnitus inaudible. When the device is removed, however, the tinnitus returns. In addition, the level of sound required to mask the tinnitus may be uncomfortable. We use the devices to generate sound, not to cover the sound of tinnitus. The goal of retraining therapy is to retrain the brain so that it eventually does not pick up the tinnitus sound, and in order to do this, the tinnitus sound cannot be covered. Generating sound that mixes with your tinnitus will help you feel more comfortable and remove the emotional response to tinnitus. At this point, tinnitus no longer bothers you, even when it is perceived.

My mother is deaf and she has tinnitus. Can she benefit from Tinnitus Retraining Therapy?

This therapy uses sound as a part of the protocol. So if your mother is completely deaf and does not have a cochlear implant she would not be able to benefit from this therapy. However, the use of electrical stimulation of the ear (through cochlear implant or external stimulation) combined with Tinnitus Retraining Therapy may help. If she can hear sound, even if she cannot recognize speech, we can try to help her.

I am taking some medication. Will I be able to continue?

Our medical evaluation will provide the answer to this question. In general, if you are taking medication for any other reason than tinnitus, you will be able to continue taking the medication.

How long does the treatment take?

The treatment takes twelve to twenty-four months, if you carefully follow the protocol, you should see an improvement within the first few months.

Will I be cured?

You will no longer be bothered or annoyed by your tinnitus. However, if you concentrate and want to hear your tinnitus, you will. This is why we refer to Tinnitus Retraining Therapy as a treatment, and not a cure.

What is the guarantee that I get better?

There is no guarantee, but from our experience over 80% of our patients have reported significant improvement.

How long is the first visit?

If you are utilizing our physician and audiologist, first visit consists of a medical evaluation, an audiological evaluation; and an evaluation/counseling session with the psychologist. Typically this would require at least four hours. We can schedule this in one day, or over several days depending on your time constraints.

How frequently do I need to return for treatment?

There are a minimum of two 50 minute follow-up sessions with the psychologist: Additional sessions may be required depending on the needs of the individual.

Are there any side effects of the treatment?

There are no side effects.

Is this treatment covered by insurance?

Many, but not all, insurance carriers will cover the initial medical evaluation and baseline audiology testing. The Tinnitus specific audiology testing, counseling, and devices are generally not covered by insurance companies. There is a list of all the procedures performed, and their fees, in the Tinnitus packet. Not all procedures will be performed on all patients. Payment for those services performed, but not generally covered by the insurance companies, will be collected on the date the service is provided.

I am interested in TRT, but I am not sure if I am ready for treatment. What should I do?

You may opt to schedule a short consultation with a member of our staff to address your questions and concerns. The consultation lasts approximately 30 minutes, which may be conducted either telephonically or in person. This consult does not include evaluation or treatment, but will clarify any concerns that you may have about TRT or tinnitus.

  • Address
    34 Sycamore Avenue
    Little Silver, NJ
    07739 USA
  • Telephone
    (732) 576-8925
  • Fax
    (732) 576-8814