Tinnitus/Hyperacusis Desensitisation Therapy (TDT)

Discussion in 'Treatments' started by ifilip, Sep 29, 2017.

    1. ifilip

      ifilip Member

      Tinnitus Since:
      10/2016
      Cause of Tinnitus:
      Loud sound
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    2. Pleasure_Paulie

      Pleasure_Paulie Member

      Location:
      Australia
      Tinnitus Since:
      06/2016
      Cause of Tinnitus:
      Noise or maybe... unicorns!
      It looks to be exactly the same as TRT. I would check the TRT thread for advice and guidance there. There is a lot of clinical evidence to support TRT and other sound therapies.
       
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    3. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Location:
      Brighton, UK
      Tinnitus Since:
      April /1996
      This treatment comes in packages and it is similar to TRT in the sense that one wears white noise generators that provide the desensitisation of the auditory system. I advise you to be careful. Unless you have regular counselling with this treatment you may not get satisfactory results wearing white noise generators alone. Please read my post below and click on the links.

      Michael

      Someone recently asked me: What happens in TRT sessions?

      I feel this question deserves an appropriate answer but I’m unable to do that in a few sentences so please bear with me. Whenever I mention TRT and the benefits that a person with tinnitus is likely to get from it, someone says to me: The treatment cost a lot of money and many can't afford it. One person even had the effrontery to ask me not to mention TRT in any of my posts because of its cost. Then I was asked if I’m an audiologist trying to promote my TRT business through tinnitus talk. For the record, I am not an audiologist nor do I work in the medical field.

      It is unfortunate that many things in this world are only obtainable if a person is able to pay for them and this is especially sad when it includes healthcare. I was fortunate to have TRT treatment twice and live in the UK where we do not pay for our healthcare at the point of delivery. However, TRT is not available at many UK hospitals - although there are usually alternative treatments and devices such as hearing aids and white noise generators that are given free that help tinnitus patients.

      I believe the reason TRT is not more readily available here is due to its cost and the duration of the treatment. Therefore, if people in the UK want to try TRT and it's unavailable at a hospital where they live and they are unable to travel the distance to a hospital were it is available; their other option is a private tinnitus clinic which again cost a lot of money and will be comparable to other countries across the world.

      If a person is referred to a hearing therapist for TRT (tinnitus retraining therapy) and they also have hyperaucusis (sensitivity to sound) that often accompanies exposure to loud noise, it will also be treated. TRT or tinnitus retraining therapy is exactly what it implies. It is a retraining of the mind or the way a person thinks about their tinnitus and the impact that it has on their life. In my opinion, ninety percent of how a person is able to cope and overcome tinnitus is in the mind and this is why tinnitus counseling is so important when the condition is severe.

      A person’s emotions can be seriously affected and their ability to carry out everyday tasks. Things such as going to work, relaxing or to go for a leisurely walk can become very difficult. It can put immense pressure on a person’s relationship with their partner and friends because one feels no one understands what they are going through. Through regular counselling sessions with a Hearing Therapist trained in TRT, the patient learns not to look at their tinnitus as non-life threatening nor to be constantly afraid of it and to be monitoring every little change in its perception.

      The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified. Therefore, it must be stressed and understood, this treatment takes time and is something that cannot be rushed.

      The second part of the treatment requires the patient to wear two white noise generators for up to ten hours a day. They are first put on in the morning and the white noise set to just below the tinnitus, and then left alone. It can be tempting to turn up the volume when out on the street as traffic noise can make it difficult to hear them. Please don’t do this. Constantly adjusting the wngs volume will delay the habituation process. Over time the brain habituates to the white noise generators and pushes the tinnitus further into the background where it becomes less noticeable. This cannot be successfully achieved if the wngs is repeatedly adjusted throughout the day.

      While the auditory system is being treated with white noise it is gradually being desensitised and treating the hyperacusis. White noise generators should not be used when going to sleep at night. When retiring one should use a sound machine by the bedside and the volume adjusted to a level just below the tinnitus. The sound machine should be set to play throughout the night until morning and this provides the brain and auditory system with sound enrichment.

      To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

      There are a few misconceptions about TRT and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

      https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

      https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
       
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    4. Markku
      Inspired

      Markku Founder Staff Podcast Patron Benefactor Hall of Fame Advocate

      Tinnitus Since:
      04/2010
      Cause of Tinnitus:
      Syringing
      A few experiences here (source thread):
       
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    5. Geoff alston
      Torturous

      Geoff alston Member Benefactor

      Location:
      Ireland
      Tinnitus Since:
      02/2017
      Cause of Tinnitus:
      Chronic stress
      I recently attended the London Tinnitus Clinic and have been recommended TDT, tinnitus desensitisation treatment.
      This involves wearing hearing aid like devices with noise like my T for a number of hours a day, gradually increasing useage.

      At night I am to use my phone via bluetooth for sound enrichment all night.

      I developed my T from Lyme disease but it was at a low level. My chronic T is caused by emotional breakdowns, one in particular set it off to this chronic level. I have chronic T for 6 months now.

      I was told there is no counselling at the tinnitus clinic, so where to go other than the surrey hospital in Guilford, where I found counselling via scype or in person.

      In turn I am suffering from depersilisation for the last four months, I am like a zombie. I am planning to go on an anxiety and stress intensive programme for a number of days in a few weeks time.


      Can anyone please tell me their expierence of tdt, trying to make the right decisions, and any advice about the right type of counselling. I'm in Ireland and there arent the resources here. I have to travel to the Uk for everything now. I did this last year for Lyme treatment too to Germany so am used to travelling for help.

      The good thing us i'm very proactive but exausted and trying to improve my mental health is challenging so am taking a Ssri despite some warnings from other peoples expierences. I feel I need to get the old me back, and fear staying like a zombie.

      Thanks
       
      Last edited: Mar 27, 2018
    6. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      This is repacked TRT
      upload_2018-8-5_6-46-23.png
      in the trash it goes, it's not bringing us closer to a cure it's just the same ol same ol status quo
       
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    7. dingaling
      Relaxed

      dingaling Member

      Location:
      London UK
      Tinnitus Since:
      2016
      Cause of Tinnitus:
      unknown, probably loud music
      Just to add to Michael Leigh's post...

      Most, if not all UK hospitals are in the business of generating income (apart from providing free healthcare) and basically, TRT does not make money like Direct Access Audiology or surgery.

      Also, many ENT doctors don't understand/or care about tinnitus and thus don't promote TRT as a treatment
       
    8. Geoff alston
      Torturous

      Geoff alston Member Benefactor

      Location:
      Ireland
      Tinnitus Since:
      02/2017
      Cause of Tinnitus:
      Chronic stress
      I have tinnitus at at 95 % scale on the international tinnitus questionnaire.

      I attended the Tinnitus Clinic in London, and it was decided to try desensitisation using hearing aids which omit a white noise sound and also have slight amplification.

      I wear the hearing aids for 8 hours a day.

      I have hearing loss only slightly at high frequency.

      I'm wondering has anyone else had any success using this treatment method or are currently doing the same as me?
       
    9. Marko Nakovski
      Bored

      Marko Nakovski Member Benefactor

      Location:
      North Macedonia
      Tinnitus Since:
      27.04.2017
      Cause of Tinnitus:
      Loud music
      I wanted to start this therapy too but I changed my mind. I have been told that this therapy is very expensive. How many time are you in this? I read somewhere that this therapy takes at least 3-6 months for improvements but it's worth it in the end. It helps with both hyperacusis and tinnitus I think.
       
    10. Geoff alston
      Torturous

      Geoff alston Member Benefactor

      Location:
      Ireland
      Tinnitus Since:
      02/2017
      Cause of Tinnitus:
      Chronic stress
      I've been doing this for 6 months so far. I've been to the T clinic to recalibrate my hearing aids 3 times since. This could take a year or less, or longer It will give my brain an opportunity to reduce the severity of my T but of course this is not certain it will help.

      The cost is expensive at 4500 pounds.

      I am going to keep. Going with this treatment for as long as I see fit.. hopefully there may be an improvement.
       
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    11. GregCA
      Jaded

      GregCA Member Benefactor Hall of Fame

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      Just a word of caution: there is some recent data showing that feeding the ears with constant noises such as colored noises or maskers can be counter-productive long term. I don't have the link handy, but perhaps @kelpiemsp does.
       
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    12. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      you may have a lot more 'hidden hearing loss"

      speech in background noise, music distortion, muffling that isn't detected by pure tonal audiometry.
      http://hyperacusisfocus.org/innerear/#hiddenloss
       
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    13. kelpiemsp
      Swamped

      kelpiemsp Member Benefactor Hall of Fame Advocate

      Location:
      United States
      Tinnitus Since:
      birth/ recent spike 2/2018
      Cause of Tinnitus:
      Born with ETD, several acoustic traumas, most recently ETD
      https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2697852

      "exposure therapies offer a seductive short-term solution for relief but, in the long term, undermine the functional and structural integrity of the central auditory system and the brain more generally. Sound therapies using unstructured, random (“white”) noise should be avoided as a treatment for tinnitus. Alternative therapeutics that drive positive, adaptive plastic changes are discussed."

      The full text is paywalled.
       
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    14. grate_biff
      Alone

      grate_biff Member Benefactor

      Location:
      Oslo, Norway
      Tinnitus Since:
      09/2014
      Cause of Tinnitus:
      Acoustic trauma, benzo/mirtazapine withdrawal, or combo!
      I developed hyperacusis after using WNGs for 8-12 months.

      Got a love/hate relationship with them:banghead:
       
    15. Allan1967

      Allan1967 Member Benefactor

      Tinnitus Since:
      1997
      Cause of Tinnitus:
      Ear infection
      How is that possible when specialists say don't overprotect your ears and make sure you have sound enrichment and treatment for hyperacusis involves WNGs?
       
    16. GSC
      Wishful

      GSC Member Hall of Fame

      Tinnitus Since:
      02/2019
      Cause of Tinnitus:
      Acoustic trauma.
      Because specialist are generalizing everyone's ears and their ears tolerance.
       
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    17. Lane

      Lane Member

      Tinnitus Since:
      February, 2018
      Cause of Tinnitus:
      Ototoxic Drug
      @GSC -- Wouldn't you think there should be a limit on how much "generalizing" "specialists" can do? :rolleyes: ;)
       
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