Tinnitus Retraining Therapy Is Ineffective, Latest Study Finds

One possible reason why TRT may have been thought of as having been" ineffective" is that although the TRT protocol follows a strict ruleset, it also takes into account that no two people will respond in an identical manner to the treatment, let alone their perception of tinnitus. People have different personalities, different lifestyles, different responses to tinnitus, and indeed the tinnitus sound is as unique as the individual experiencing it.

There are so many variables involved with tinnitus that it would be pretty difficult, if not impossible to develop a standardized double blind placebo experiment protocol, the same criteria could equally apply to CBT, both approaches can only be tentatively valuated scientifically, indeed TRT and CBT have many features in common with each other in the way that they work. They do not cure the problem they are addressing, their purpose in both cases is to change how the patient perceives the bothersome problem.

This is also called re-framing (something that will be familiar to anyone who has looked at Neuro Linguistic Programming, which is also a behavioural modification therapy of sorts).

 

The audiologist at the medical college of Wisconsin told me not to use formal sound therapy and just instead gave me a free plan to use (sounds on apps for a few hours a day for a couple month). She also told me that in time the noise will just be something I'd get used to and learn to ignore most of the time. That is what happened. I am not sure it's different with those with hearing loss (I have normal hearing).

 

You know damn well your tinnitus was caused by hearing damage.

Google hidden hearing loss, thank me later.

 

In some regards I think your Audiologist gave you good advice, having looked through the TRT book critically, it does look more and more like an overpriced, very long, sales pitch (or am I just being too cynical?). if you pay shed loads of money, and are repeatedly fed material to support a given idea until you believe it at a subconscious level, then in that respect it "works" to a degree.

Having read around the subject it does appear there is a significant drop rate for TRT, in the end analysis though, if it works for some people and does no additional harm, then I'm OK with that, it does have a lot of correlations with CBT (as I mentioned in a post or so back).

Personally I think it is only viable in fairly severe cases of tinnitus or hyperacusis, and if you can afford the fees AND have the degree of perseverance to follow through with the full protocol.

 

I wonder if Jastreboff wants to be laid to rest with his first edition original copy of the Jastreboff model across his chest...?

I can see the headline already - BREAKING NEWS!!! JASTREBOFF DEAD

 

I am currently undergoing TRT. My practitioner / clinician whatever you prefer to use is the best in the field, world renowned. I’ve been using TRT for approx 6 months. I have proper setting, etc. Again my practitioner is the best. Trust me when I say it. The generators are torturous. The broadband noise is hideous. Listening to pink noise for 8 hours a day is maddening. The sounds you hear after wearing them all day are indescribable. There’s a heightened level of anxiety with taking them off knowing you will have to listen to high pitch whistles and static mixed with your ring all night. Counseling from the best was no more than a 1 hour session thumbing through diagrams of the brain. You say well did they not mention CBT, nope. I was told they would blend in. It never happened. After that you are on your own. I have no hearing loss. My hearing may be too good. I have hyperacusis and tinnitus. I can see why JAMA published an article that stated in part that white noise can negatively affect the brain. I am seriously considering to discontinue using them. Of course I could stop and my practitioner would never know because they never check on you. God Bless. Peace.

 

Wow.

How long does it take you to make a decision in the drive-thru?

After 6 months of torture and you have no results, and there is no practitioner better, what are you waiting for?

 

Wow. Just. Wow.

 

In all fairness I must provide an update. I have not worn generators for 14 days. In that time, my tinnitus is significantly lower and on some nights not detectable. Now, is it because of wearing generators for 6 months or is it the brain habituating on its own. Tough call. One thing that has not gotten better is the echo I hear when I talk particularly in the evening. But to be fair the tinnitus is not noticeable.

 

Jazzer, your story really pulled on my heart. I live for music of all genres. My wife and I lives centered around listening to good music. Now, like you I have cried on her shoulder because those days seem so unattainable. It hurts to the core. I also cannot play my Taylor acoustic guitar anymore. I am sorry for your struggle and I pray one day soon we can continue to enjoy the sound of music in the arms of our wives.

On another note, my ring is noticeable after stopping TRT. Wasted several grand to end up right where I started. Compliments of Jastreboff.

 

My dear friend Christopher,
thank you so much for replying to me with such beautiful understanding, and comforting words.
I picture you both holding on to each other with love and empathy - and tears.
Was there ever such a vile and hateful predicament?
I don’t believe so.
Keep in touch if you feel it’s relevant.

My deep love to you both,
Thinking of you right now,

Dave xx
Jazzer

 

My Audiologist never mentioned Tinnitus Retraining Therapy for me. It looks like a pseudo-science anyway. First off, what is being 'retrained', the tinnitus? Tinnitus can be trained and then trained again, like refried beans are fried and refried? I am confused. Is this like Lenire?

 

TRT resembles a mental traineeship where the patient learns to respond differently to tinnitus: not with fear, but with "disinterest" of sorts in the end. It has nothing to do with Lenire.

The core principles of TRT can be helpful to some, but practice shows that they don't apply to everyone.

 

I hated the TRT which I started following with lots of hope in 2002. I remember it was two doctors out of John Hopkins that moved on to Emory. As I remember one of the two had a picture of himself next to a big boat. At that time I was prescribed valuium/diazepam for my tinnitus when it got real bad. I emailed one of the two docs and was told something like, "Oh no, don't use that, you won't adjust." So I stopped using it. After several months I was a "nut case" and felt like a piece of luggage. So am I happy to hear the TRT is baloney (my interpretation)? Yeah. Hate to say it, and I'm sorry to offend anybody. But, boy, my intro to the whole thing was not good.

 

My tinnitus and hyperacusis are caused by a sound generator (PA). Whenever they present me a device to habituate or to 'cure' my tinnitus or hyperacusis, I refuse.

 

When one sees what is required to research central auditory system plasticity... well, it's easy to see what a joke TRT is:

Post-doctorate position for studying central auditory system plasticity after hearing loss

We are looking for a candidate with experience in:

• central electrophysiology with arrays of micro-electrodes
• and/or strong background in neurophysiology and audition
• and/or strong background in signal processing, information theory and computational neuroscience
• excellent programming skills in Matlab and/or Python are also highly desirable

https://academicpositions.es/ad/aix...y-system-plasticity-after-hearing-loss/121326

I just got a book on neurophysiology (Neurophysiology, a conceptual approach, by Carpenter and Reddi) and don't really understand the formulas... seems very complicated.

 

6 year long tinnitus study shows Jastreboffian TRT ties with normal sound generators

Lots of people here (including myself) like ad hominening TRT, because it's shilled by audiologists everywhere. However, it's always good to have an intellectual backbone behind the memes and trash talking. Especially if we want Academia to know we are fed up with poorly researched TRT being shoved down our throats. Here is a scientific study that shows TRT; which features Jastreboffian educational counseling, the special ear pieces etc... vs generic white noise generators. Despite the white noise machines not featuring the same educational protocol and magic ear pieces, (relatable to Mormon underwear) they tied.

The study isn't directly saying TRT is worthless for tinnitus. It's saying generic sound therapy is significantly less expensive and ties with TRT. A big thanks goes out to Bryan Pollard's HyperacusisResearch.org for listing the results of the study below:

• Effect of Tinnitus Retraining Therapy vs Standard of Care on Tinnitus-Related Quality of Life
• Effect of Tinnitus Retraining Therapy vs Standard of Care on Tinnitus-Related Quality of Life: A Randomized Clinical Trial
• Hyperacusis: A focus area for University of Iowa Conference

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In the study, three groups competed. (TRT vs. Generic Sound Therapy vs. Standard Control "aka nothing"):



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Around half of the subjects reported reduction in tinnitus distress, not subjective experience, via that tinnitus question form. Which they refer to as TQ (tinnitus questionnaire):



From the study:

All three groups improved significantly and were statistically matched in results. After starting tinnitus questionnaire scores around 55, each group improved as follows: Standard of Care: -16.5, Partial TRT: -19.0, TRT: -18.2. Most all of the improvement occurred in the first 3 months for all groups, with a leveling off in the last 12 months.

It looks to me like SOC had a barely significant lag behind the others, but over all they all tied as effective.



Combine this with what the BTA is saying:

https://www.tinnitus.org.uk/tinnitus-and-trt



I think it's safe to scientifically say; despite being shilled by academic drones for the past 25 years, TRT really doesn't have much scientific evidence.

 

I like shellfish allergy retraining therapy. No EpiPens, just have to eat and believe.

 

It's like if insulin didn't exist and diabetics just had to do CBT.

 

It is quite possible TRT may or may not help people. There must be several thousands of people that have done or are doing TRT right now and I am sure anyone suffering with tinnitus knows about this forum or have visited it.

Why is it the same handful of people are the only ones that keep arguing back and forth?

The sample size of the posters here who fight over TRT is about as bad as the sample size of subjects in these studies.

Look, if it helps some people that is all that matters. This severity of this affliction is so variable from person to person I really doubt anyone has a straightforward answer on the effectiveness of any therapy.

I think people who are hateful toward TRT and those that promise it is the answer should all STFU and quit attacking or discouraging others one way or another.

All that matters is that one day we get better, how we get there is a journey that will differ vastly from person to person.

 

I would argue against TRT, but I don't argue with people on the internet because most of the time they're not open to having their opinion changed and they're not likely to change their mind because of a stranger on a forum.

I'll admit, sometimes I know for sure I'm not going to change my opinion, so I don't engage into the argument in the first place. So maybe that's another reason why it's a small sample size of people debating TRT.

 

Did you have a bad experience with TRT?

 

I mean, the hate is mostly based off the fact that there are plenty of studies concluding that TRT is clinically ineffective and that improvements can be explained by natural fading/nerve healing. There is also a ton of shady internal politics of organizations like the ATA only funding research that focuses on CBT and TRT, so people are understandably angry that it's halting progress for a cure.

Yeah there's no reason to be a dick, but most of the comments I've seen have been pretty level-headed. It's always the TRT supporters that never provide research to back up their stance/rely on their own personal experience or anecdotes, or dismiss the idea of research altogether (Michael Leigh).

 

As long as TRT does no harm and you have the money to spend, what the heck!

 

If true, then what type of therapy should one seek? We have few options.

 

None. The current therapy options are no better than natural habituation.

 

The expectation is not to seek any therapy whatsoever? What about therapy to address anxiety caused by tinnitus?