Our practice runs a Tinnitus Clinic specializing in minimizing ringing sounds in the ear(s).
Lynette traveled overseas to attend a world-class Cognitive Behaviour Therapy (CBT) course for tinnitus and hyperacusis at the University of London in the UK.
Only a handful of practices in South Africa can provide you with this specialized treatment.
What is tinnitus?
Tinnitus is the perception of sound in the absence of an external sound source, its name stemming from the Latin word “tinnire”, which means “ringing like a bell”.
People typically describe their tinnitus as buzzing noise, high-pitched noise, hissing noise, whistle, waterfall noise, ringing, white noise, wind noise, bubbles, clicks, or beeps.
It can be perceived on one or both sides of the head, it can be of short duration, or be persistent and it can be a continuous sound or a pulsating sound following the rhythm of your heartbeat.
It is important to keep in mind that tinnitus is a symptom, not a disease.
Causes of Tinnitus
Tinnitus can be caused by the following:
- exposure to loud noise
- a side effect of medication
- ear or head injuries
- diseases of the ear
- ear infections
- emotional stress
Why doesn’t the tinnitus sound go away?
“For individuals with long-term tinnitus, one or more of the causes above have, at some point, led to an auditory malfunction. The brain’s attempt to compensate for this malfunction is the start of a vicious cycle.
The auditory cortex is the part of the brain that is responsible for hearing. Every stimulus perceived by the ear is transmitted to and processed by the auditory cortex. Nerve cells in a specific area of the auditory cortex are ‘tuned’ to a certain frequency, similar to the arrangement of keys on a piano.
No matter what triggers may be responsible for the tinnitus – noise, medication, stress – they all lead to an interruption of the signal transmission from the ear to the auditory cortex. This means that some of your nerve cells no longer receive any signals. To stay with the piano image: some of the piano’s keys no longer work and cannot be struck by the pianist.
However, these nerve cells do not react to the lack of stimulus by simply remaining ‘silent’. Instead the nerve cells begin to ‘chatter’ spontaneously and become synchronously attuned to one another.
Once they have become hyperactive and synchronous in this way, the nerve cells simulate a tone that the brain ‘hears’ – the tinnitus tone. Coming back to the piano; the broken keys have created their own permanent tone even without the keys being struck by the pianist.
Over time, this pattern strengthens and the tinnitus becomes permanently anchored – the brain has learnt a phantom sound.”
Not all people with tinnitus will have hearing loss. To that end, they may require counseling and certain strategies to cope with tinnitus. Or perhaps they just need a better understanding of their tinnitus and how it affects others as well as themselves.
What is the treatment?
Cognitive Behavior Therapy
Audiologist-delivered CBT is focused on managing tinnitus/hyperacusis/misophonia-related distress.
Cognitive behavioral therapy (CBT) is a psychological intervention that aims to alleviate anxiety by helping the patient to modify their unhelpful, erroneous cognitions and safety-seeking behaviours (Beck 1976; Clark et al. 1999).
Hyperacusis is intolerance to certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities.
Intolerance to certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds and tapping noises is also known as misophonia or annoyance hyperacusis.
People often benefit from various forms of therapy that help them learn alternative ways of cognitively reacting to tinnitus. This makes it possible for the perception of tinnitus to fade away to the background instead of being in the centre of the attention.
For many people the initial assessment with 1-3 follow-up therapy sessions may be enough to help them overcome the problems caused by their tinnitus, hyperacusis or misophonia. For people experiencing severe symptoms, treatment may take between 6 to 12 sessions. Our approach is a very flexible and dynamic way of reducing tinnitus/hyperacusis/misophonia distress.
The aim of the therapy is to learn alternative ways of cognitively reacting to tinnitus and certain sounds (in the case of hyperacusis and misophonia) which will modify the emotional disturbance caused by them.
Following therapy, you are likely to:
- Gain more confidence and become less troubled by your tinnitus, hyperacusis or misophonia.
- Feel more supported.
- Have a clearer knowledge of tinnitus, hyperacusis or misophonia and why you have developed it.
- Think about your tinnitus less often.
- Be able to hear and communicate better in everyday life.
- Cope better in environments that you previously struggled with due to certain noises.
- Understand when and how to protect your ears.
- Be more empowered and able to cope by yourself.