A tablet computer with the words tinnitus on the screen.

Tinnitus can be frustrating for a number of reasons. First, it’s entirely subjective, so you can’t show anyone what the ringing sounds like, how loud it is, or how bothersome it is.

Second, there’s no objective way to measure tinnitus, so you can’t, for example, go into the doctor’s office, get some blood drawn, and get diagnosed.

And third, we still don’t understand exactly how tinnitus works, so our understanding of the causes and treatment options remain less than perfect.

This is all frustrating, of course, but not hopeless. In fact, despite the frustrations, many people do show significant improvements in their symptoms with the right treatment plan.

In this article, we’ll be discussing one treatment option in particular, known as Tinnitus Retraining Therapy (TRT), that has proven to be particularly effective. To understand how it works, you first have to understand the two parts of tinnitus.

The Two Parts of Tinnitus  

Tinnitus is the perception of sound when no external sound source is present. We can break tinnitus down into two parts:

  1. The actual sound – usually perceived as a ringing sound, but can also be perceived as a buzzing, hissing, whistling, swooshing, or clicking sound.
  2. The emotional reaction – the perception of the loudness and character of the sound and its disruption to everyday life.

The effective treatment of tinnitus therefore requires addressing both parts, which is the underlying rationale of Tinnitus Retraining Therapy.

Sound Therapy

Sound therapy is the use of external sound to “mask” the internal sound of tinnitus. By doing so, this can help to lessen the tinnitus symptoms across a number of levels.

First, the newly introduced external noise can either somewhat or completely cover up the sounds that tinnitus produces. By doing so, diverts the patient’s attention away from the tinnitus while the external sound is being played. This provides an immediate sense of relief and can help the patient quickly and reliably.

Second, sound therapy can eventually work to result in what is now labeled as “habituation.” Habituation occurs when the brain is slowly trained over a period of time to recategorize the underlying sounds of tinnitus as an unimportant noise that should be ignored by the body. All things considered, habitation is the hopeful end goal of any tinnitus treatment plan.

Lastly, the use of specialized sound minimizes hyperactivity in the brain which is believed to be an underlying cause of tinnitus. This is called “neuromodulation.”

It can then be decided that sound therapy has both short-term and long-term benefits. Sound therapy can work across multiple levels to help lessen the intensity of tinnitus symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.


While it is accurate that any noise can in theory provide a masking effect, specialized medical-grade devices deliver customized sounds or music programmed to match the characteristics of the patient’s tinnitus. Your individual hearing care professional can help you select the right device and sound.

Cognitive Behavioral Therapy

In tandem to sound therapy, TRT also makes use of behavioral therapies that can help to address the second, emotional part of tinnitus. In many ways, this is the most important component to the treatment options, as tinnitus can trigger strong emotional reactions like anxiety, depression, and anger. Over time, these symptoms can become almost too much to handle for those affected.

Research in this area has led to some surprising conclusions. For example, studies have found no correlation between the loudness/pitch of tinnitus and patient-reported distress. Whether or not tinnitus is viewed as no-big-deal, slightly bothersome, or devastating is largely dependent on the cognitive/behavioral response of the patient.

Behavioral therapy can be delivered one-on-one or in groups, from a clinic or over the phone or internet from the patient’s home. Therapy includes education, identifying tinnitus triggers, instituting healthy lifestyle choices to mitigate symptoms, and mindfulness-based stress reduction.

Take Action and Silence Your Tinnitus

Tinnitus Retraining Therapy is effective because it leads to habituation on both fronts, both in terms of the actual sound and in terms of the emotional and behavioral responses.

While there is no known cure for tinnitus, you can mitigate the symptoms with the right plan and some perseverance. As your tinnitus is masked and the brain is trained to ignore it, you’ll be able to better cope with the sounds and improve your quality of life.