Understanding Tinnitus and Tinnitus Retraining Therapy (TRT)
A key part of managing tinnitus effectively is changing the way it is perceived. Our goal is to help you move away from viewing tinnitus as a threat, and instead, retrain your brain to categorise it as a neutral, non-disruptive sound. During our sessions, we’ll work together to shift your perspective, answer your questions, address any concerns, and guide you through a personalised treatment plan.
Tinnitus Retraining Therapy (TRT) focuses on reducing the emotional and physical distress caused by tinnitus—not necessarily eliminating the sound itself. While you may still hear it, it will no longer bother you or interfere with your daily life—much like the background hum of a fridge that you eventually stop noticing.
We want to be realistic: TRT is not a promise of silence, but a path to relief. Most patients begin to notice improvements within three months, with continued progress over time. The full course of TRT typically spans 9 to 18 months, with a minimum of nine months to support long-term results and reduce the risk of symptoms returning.
Once treatment is complete, there’s usually no need for ongoing intervention. However, following our recommendations and engaging with the process—including any exercises or strategies we give you—is essential for success.
Why Does Tinnitus Become a Problem?
The brain has strong connections between the auditory system (hearing) and the emotional and stress centers (limbic and autonomic nervous systems). If your brain labels tinnitus as a threat or something unpleasant, it keeps paying attention to it—like an alarm you can’t turn off. This can lead to distress, anxiety, sleep issues, and a lower quality of life.
What to Expect from TRT
Two Core Parts of TRT: Counselling + Sound Therapy
TRT combines two essential components that work together:
1. Counselling
This isn’t just general reassurance — it’s a structured education process covering:
How the auditory system works.
Why tinnitus can trigger strong emotional or stress responses.
How your brain and nervous system contribute to tinnitus distress.
Strategies to reduce negative reactions to tinnitus.
Counselling aims to reclassify your tinnitus as neutral, reducing the stress and anxiety that keep it in the forefront of awareness. This is repeated at follow‑ups to reinforce learning and adjust strategies as needed.
2. Sound Therapy with Sound‑Generating Devices
Sound therapy is an important part of TRT. The goal isn’t to “mask” your tinnitus, but to enrich your sound environment so the contrast between silence and your tinnitus decreases. This makes it easier for your brain to habituate to the tinnitus signal. We do this via:
Wearable sound generators: small ear‑level devices (hearing aids with no microphone on) that emit a low‑level, neutral broadband sound throughout the day, personalised to your tinnitus.
These sound‑generating devices are fitted and adjusted by our audiologist, and you’ll be coached on how to use them most effectively.
The Goal
Reclassification of Tinnitus: Your brain learns to treat tinnitus as neutral—not dangerous, not annoying. This is done through repeated, calm exposure paired with neutral reactions.
Habituation: Your brain starts to stop noticing the sound, then your emotional and physical responses fade.
The goal is not silence but to make tinnitus no longer bothersome.
Most people notice improvements within 3 months, with full therapy lasting 9 to 18 months.
The first step is removing the negative emotional response to tinnitus.
Consistent commitment is important—you’ll need to follow recommendations and complete suggested activities between sessions.
After completing therapy, no ongoing treatment is needed, and relapse is unlikely with proper habituation.
Duration of Treatment
TRT is not a quick fix — it is a longer‑term process that supports gradual change in how your nervous system responds to tinnitus.
Estimated amount of appointments:
Trial Device Fitting
Follow up at:
1-2 weeks
1 month
Then roughly every 3 months (depending on progress)
At these sessions, we check how you’re responding to sound enrichment, review your progress and adjust counselling and sound‑generator settings accordingly.
Most people undertaking TRT will engage with the therapy for 12 to 18 months, with some variation depending on individual response. Initial improvements are often noticed around the 3‑month mark, but significant habituation tends to take a year or more.
Summary
While we cannot eliminate the source of tinnitus, we can change the way the brain processes and responds to it. This is the foundation of Tinnitus Retraining Therapy (TRT).
The brain is adaptable—it constantly reshapes how it processes information. With time and the right strategies, it can be trained to filter out the tinnitus signal, preventing it from activating emotional and stress responses. This all happens at a subconscious level.
The first step in reducing the impact of tinnitus is to remove its negative emotional meaning. This allows the brain to begin treating it as a neutral, non threatening signal.
Sound therapy plays a crucial role. By introducing soft background sound, we reduce the contrast between the tinnitus and silence. This makes it easier for the brain to tune it out.
Over time, the subconscious brain is trained to stop reacting to tinnitus, which reduces the emotional and physical response. This is called habituation of reaction.
As the reaction fades, the perception of tinnitus also decreases, meaning your brain stops bringing it into conscious awareness. This is habituation of perception.
Sound therapy involves gently increasing background sound levels, either through environmental sounds or sound generators. These sounds may or may not be amplified, depending on your needs.
The goal is not to mask the tinnitus completely. If the brain can’t detect the tinnitus, it can’t learn to ignore it. We aim to reduce contrast—not eliminate the sound. Continuous exposure to low-level sound helps to recalibrate the gain (or sensitivity) in the auditory system, which not only eases tinnitus but can also reduce sound sensitivity.
Tinnitus Retraining Therapy is a gradual process, not a quick fix—but it is backed by strong neuroscience and has helped thousands of people regain peace of mind. With your commitment and our support, we’ll work together to retrain your brain and reduce the impact of tinnitus on your life.
Tinnitus Retraining Therapy is a gradual process, not a quick fix—but it is backed by strong neuroscience and has helped thousands of people regain peace of mind.
With your commitment and our support, we’ll work together to retrain your brain and reduce the impact of tinnitus on your life.
