7 Pro Tips of Tinnitus Retraining Therapy (TRT)

[Music] hey everyone it's ben thompson here founder of puretinnitis.com i wanted to make this specific video to help you understand tin industry training therapy better i recently completed a five-day online course for ten industry retraining therapy including tinnitus treatment hyperacusis treatment and misophonia treatment and i studied with dr powell jastrobov a handful of years ago i would only have dreamed about being able to work directly with the founder of tin industry training therapy and when i saw the opportunity to study with dr jastreboff not only the neuroscientist and creator of trt powell jastroboff but also his wife margaret jasterboff they're both phd researchers in our field they've contributed an immense amount to help understand how we can improve tinnitus and when i had the opportunity to work with them i knew i had to say yes this video is to explain seven pro tips that i learned from the tinnitus retraining therapy course that i wanted to share with you to make these next few weeks or months living with tinnitus easier even if i can help you a little bit a baby step of improvement that'll be worth my time making this video so let's start with number seven number seven is that dr powell jastrobov's main advice the overall umbrella of how tinnitus retraining therapy works to help someone with tinnitus focuses on teaching counseling and constant sound therapy the teaching aspect involves a proper understanding of the relationship between the ear the cochlea the hearing organ the auditory nerve the subconscious auditory processing of the brain and how that system can create bothersome tinnitus it is not only an auditory phenomenon tinnitus is impacted by other areas that are not directly on the auditory pathway that's key to understand and to get into the specifics and connect the dots about how it relates to your history oftentimes is enough to make a big difference in the tinnitus treatment the tinnitus habituation process how we actually get better and reduce the perception of the ringing sound counseling is that ongoing process between you an individual a patient trying to overcome loud bothersome tinnitus that's affecting your concentration at work or trying to fall asleep at night or affecting overall your anxiety and stress levels counseling means the ongoing relationship between myself an audiologist trained in trt and you who are trying to figure out how to live with this condition every hour of every day and trying to go to sleep in the night that's an ongoing relationship and six months is typically a good time frame to use the protocols in place get the progress where we want it to be keep the momentum going and that six months period of working with therapists trained in trt is usually enough to make sure the counseling is ongoing and it has a compounding effect over time when i mention the sound therapy part of this tip tip number seven this is an important basic recommendation for any tinnitus patient who's going through the first stages of tinnitus avoid silence create a sound rich environment use sound therapy constantly during all waking hours of the day if possible usually a high quality speaker playing different kinds of steady state sounds whether that be white noise brown noise crickets anything similar to those kinds of sounds having that in a quiet space that would typically create loud obtrusive tinnitus that is your friend using sound as a therapy is your friend helping at night when you're trying to fall asleep or if you wake up in the middle of the night or you wake up in the mornings you don't want that situation to be quiet either sound can be a therapy for you in those situations as well using constant sound therapy for a period of 9 to 18 months is typically recommended in a treatment protocol for tinnitus for hyperacusis it is possible to treat the sound sensitivity aspect within a matter of months for tinnitus it takes longer it can take a matter of months or it can extend up to about a year it's individualized based on your history and how long you've had tinnitus what are the causes your stress anxiety levels etc the next pro tip pro tip number six is that tinnitus is not in your mind tinnitus itself is not a psychological condition or a psychiatric disorder you do not have a diagnosable psychiatric disorder for having loud tinnitus there's nothing wrong with you for having loud tinnitus it does not mean you're crazy because your tinnitus is loud and it's sustained loud over a period of months or even years there's nothing wrong with the psychological parts of your brain what's important to realize here is that tinnitus is affected by the psychological centers of the brain the emotional networks of the brain that control and regulate emotions fear the fight or flight response safety and anxiety and stress those psychological aspects can make tinnitus worse and often those centers of the brain can lead to a sustained activation of tinnitus in your brain but there's nothing psychologically wrong with you necessarily there's no psychiatric diagnosable disorder because you have chronic bothersome tinnitus and this can help calm some of the catastrophic thinking that can sometimes come when you feel like the sound in your head is stuck in your head there must be something wrong with your brain not so there's not so much wrong with your brain as much as your brain over time needs to be recalibrated and calmed down calming and easing the sustained activation of the limbic system the emotional center of the brain and the central nervous system of the physical body now pro tip number five and let me tell you that this one was hard for me to believe when someone told me but when i looked at the research i couldn't argue with the scientific data that showed that tinnitus distress tinnitus bother does not correlate at a population level with tinnitus loudness so what this means is that if you have a loud tinnitus it does not mean that you're very bothered by tinnitus now if you're watching this video you probably are bothered by tinnitus but it doesn't mean that your tinnitus is so so loud there are many people who have a severe amount of hearing loss and who report loud tinnitus but if you ask them does it affect your sleep concentration or stress they say no i basically tune it out most of the time i barely notice it so that shows it's not loudness of tinnitus that is the only factor at play and this makes you scratch your head a bit because you think well it must be related to loudness it's the ear it's the auditory system dr ben how can you tell me that my loud tinnitus is not guaranteed to have this enhanced sustained reaction between my brain and my body and i'm here to be the middle man between the scientific research the researchers who have studied this at a population level for 30 plus years and you who's looking for the right kind of scientific information that loudness of tinnitus does not correlate with how much it bothers someone so this can be eye opening because we realize it's not only an auditory phenomenon and there's other influences between your brain and your body that we can understand and if we understand the system then we know where the healthy inputs are and we know what part of the system we can positively influence the term neuroplasticity or brain changes it means that you went from point a to point b in your state whether that's your mind your body your nervous system whatever it may be you went from point a to point b so a negative change would be you were healthy point a and then point b things are not healthy not feeling quite right so most people that means everything was fine in my life and then somehow a period of time passed or suddenly and then point b loud obtrusive tinnitus and that creates a cascade of negative effects on your life and quality of life so that's a negative trend now we can take neuroplasticity and flip it into a positive trend as well we're starting at point a now which is at a negative state bothersome tinnitus loud obtrusive negatively affecting you and we're going to enact certain methods certain protocols so over a period of time your brain and body can change and improve itself so that point b the new point b is a healthy calm state where you're not bothered by your tinnitus and you rarely think about it listen to the success stories of tinnitus whether it's here on my channel or other places on the internet or talk to someone in person at a support group and ask them what is it like to be habituated to tinnitus and that may help you get a sense of the right kind of expectations or the goal of how much better we can get your life and doing that i'm hoping that you'll be able to better understand what is the end goal or the end result that we're after in this process how much better can you get and recover with your tinnitus pro tip number four is that tenderness retraining therapy induces habituation that means it's using your brain's natural abilities between your brain and your body to heal itself over time this means that with the right kind of resources direction support education counseling and sound therapy that your brain and body can naturally take care of the problem people get better from tinnitus without a surgery without a pharmaceutical pill to cure the problem and it gets better to the point where they realize hey my life is good now i don't need to try to silence tinnitus because i don't mind if i hear it every now and then that means your brain and your body over time can recalibrate the system and calm down the loudness of tinnitus i have seen it personally and i wanted to make sure i make it clear that it's possible out there i work with some patients who are religious who connect with this on a religious and spiritual level on the sense that their body the body they were born with the spirit they have within them and their body and their brain can naturally get better over time now pro tip number three that i learned with dr powell jasterboff in the tinnitus retraining therapy course is that the loudness of tinnitus on average for a patient it's only five decibels above the threshold of hearing that they have at that pitch some people report tinnitus as being very loud and that makes researchers measure actually how loud is the tinnitus and when we try to measure the loudness of tinnitus we measure what pitch what frequency is your tinnitus and what is the softest sound you can hear at that pitch at that frequency and then we measure the loudness of your tinnitus by matching the loudness at that pitch and that creates this differential and that's considered the sensation level of tinnitus now for most people that sensation level is on average around five decibels and that's not loud at all if you play a five decibel difference of sound between one decibel sound level one loudness level and the next you wouldn't think it's too dramatically different and when we get to the very soft levels five decibel sensation level means that you wouldn't need much noise to influence or interact with the tinnitus and this is useful to educate someone that your tinnitus may be perceived as being loud but when we use sound around you when we consistently use sound therapy that sound therapy doesn't need to be so loud that sound therapy will be a background sensation just like your tinnitus that sound therapy will be a background sound and it won't interfere with your speech it won't make it harder to hear people and overall tinnitus does not negatively affect your ability to hear people that's because the sound of the tinnitus is at a very small sensation level that for most people any kind of conversational sound or important sound is going to be much louder than the sensation level of their tinnitus so it might seem very loud and it might be perceived as being very loud but for most people when it's tested in an audiology booth the sound level it's not extremely loud in fact it's relatively quiet but if there's no other sounds around you then the tinnitus can be perceived as quite loud you guys still with me thank you again for being here and watching this video as well as being here in this community we have two more pro tips left pro tip number two is that sound therapy may actually be better when it is simple has few adjustments and it can become a background sound not something that changes not ocean waves going not all kind of not these crazy dramatic changing sounds that bring your attention to the sound but sound therapy may be best when it's a consistent neutral background sound that does not have many adjustments for you to tinker with throughout your day and is probably best when that is coming through devices that are sitting on your ears those are called ear level sound generators or combination instruments for tinnitus i learned that in the course and i believe it's true we don't want to be spending too much time focusing on changing the sound adjusting the sound around us making sure there's sound therapy everywhere we go it might be best to just have simple steady state sound therapy played through our ears that we don't have to tinker with or adjust too much now this is more of my opinion that this is better because it has not necessarily been studied so extensively about what is the best proven sound therapy type most of the protocols use a steady state white noise or something similar and that's what i recommend when i'm working with patients in telehealth for a tin industry training therapy protocol however if this is true that a simple sound therapy is best for most people then this would mean something like the widex zen therapy which has ding ding ding ding ding ding ding it's more variable with different kinds of tones those zen tones and a lot of the neural modulation audio sounds that are on youtube which aren't medically or scientifically validated but they do have different kinds of beeps and boobs and apps like t minus for example that would mean that those types of sound therapy aren't simple because those kinds of sound therapy do have variability to them and that might be right for you i'm not here to say that's wrong for every person but overall at a population level i believe that steady state sound therapy is the fundamental here those other kinds of sound therapies that have different qualities to the sound that can be considered as well now last but not least pro tip number one from my tinnitus retraining therapy course with dr jastroboff is drum roll please that almost 100 of tinnitus patients who get a pure tone audiogram hearing test within the normal range almost 100 of those patients have some degree of cochlear damage or dysfunction in the outer hair cells part of the cochlea the hearing organ has little cells which have what's called stereocilia and those little cells are called the outer hair cells i mentioned this on some of my other videos i won't go into the depth of the details but most people who have tinnitus that get a hearing test and the hearing test shows your hearing is in the normal range a vast majority nearly a hundred percent of those cases when we perform a more specific objective test we can point to part of the anatomy and explain your hearing is overall fine you're hearing well but part of your cochlea part of your hearing organ has a dysfunction and this may have happened from some loud noise exposure it doesn't take much to create this dysfunction it may have happened from the natural aging process those are the two most common situations or potentially some form of infection or virus that sounds very simple but imagine you're told that from your doctor and how you would understand better how the system works and what part of your ear your brain your body is malfunctioning now it's a quite different experience for most people who go to their audiologist to their doctor and they say well the hearing test showed your hearing is fine so the tinnitus is not an ear thing that creates a lot of confusion and it can potentially lead to a long path of getting highly specific medical tests related to things that are completely irrelevant and essentially bringing you down the wrong path of misinformation or trying to solve tinnitus without focusing on the fundamentals of the tinnitus retraining therapy which are proper education about the ears and normal hearing and the outer hair cells of the cochlea how that system all relates to itself in your history ongoing counseling and then consistent use of sound therapy for tinnitus and or hyperacusis i found a research paper that i wanted to include just to validate this point scientifically and is talking about the test called oae autoacoustic emissions or dp distortion product autoacoustic emissions and the article is titled evaluation of cochlear function in patients with normal hearing and tinnitus it was a study that looked at the oae objective test of patients who have normal hearings and tinnitus and i'm reading here these findings show that tinnitus in normal hearing patients is often associated with varying degrees of cochlear dysfunction all right that was a long video but those are the seven pro tips that i learned from personally studying with dr powell jasterboff and his wife dr margaret jastroboff they're both neuroscientists phd researchers very well known in the audiology field and those are the pro tips that i'm sharing to help you wherever you are at with your experience with your journey with thinniness the very beginning in the middle or you've had it for many years these seven pro tips can still be applied thank you for watching if you want to work with me or find out more about pure tinnitus head over to puretinnitis.com leave a comment on this video or you can directly email my team at contact puretinnitis.com thank you again make sure to subscribe to this channel and i will see you on another video may you be well thank you

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