Tinnitus – Treatment

A typical example of such disease-reinforcing patterns would be the assumption that the tinnitus will get worse as it progresses and could lead to deafness (cognitive). The associated fear of the future (emotional) results on a behavioral level in a constant focus on the tinnitus (“Has it gotten louder since yesterday?”) and in the avoidance of any acoustic exposure (which is counterproductive, as silence usually leads to an increase in tinnitus perception).

The interventions of CBT are aimed at teaching strategies for

• Reduction of the focus of attention on the ringing in the ears,
• Reassessment of tinnitus and its consequences and
• improved coping (for example, confidence in one’s own influence and abandonment of avoidant behavior). We offer tinnitus therapy both in individual settings and as part of group therapy for those affected.

Outpatient therapy for people with chronic tinnitus

• Today, chronic tinnitus is attributed to the so-called bio-psycho-social model. This means that psychological factors are considered to play an important role in the development and/or maintenance of chronic tinnitus. Accordingly, tinnitus psychotherapeutic procedures are used at the USZ as part of diagnostics and therapy.

• Psychotherapy can be helpful in treating the tinnitus as a symptom and its triggers. We have had particularly good experiences with behavioral therapy. In this way, those affected learn to replace negative thought sequences with new, positive ones.

• We offer both individual and group psychotherapy for people with chronic pain. The latter serves on the one hand to provide information about the mechanisms and ways of dealing with chronic pain and on the other hand to facilitate an exchange between those affected.
• We also offer other relaxation methods in the form of progressive muscle relaxation in group therapy according to Jacobson.

Procedure

The initial assessment is carried out by the ORL specialists at the USZ as part of the tinnitus consultation. If indicated, the tinnitus team at the Clinic for Psychosomatics and Consultative Psychiatry will be consulted for further clarification or treatment. There is a regular exchange between the various specialist disciplines to discuss patients.

How you can help yourself with tinnitus

Tinnitus – whether acute or chronic – can be very stressful. In the case of acute tinnitus directly after a bang trauma or extreme stress, you can be reasonably certain that the unwanted sound in your ear will disappear on its own. Take care of your ears for a few days after the event.

Otherwise, there are strategies for both acute and chronic subjective tinnitus that you can use to counteract the noises in your ears and the stress they cause:

• Reduce stress: learn a relaxation technique. In hectic times, it often helps to concentrate on your breathing. When we are tense, we tend to breathe shallowly into our chest. Consciously practise belly breathing and use it when you feel under pressure.
• Avoid silence: Although it is mainly noise that damages your hearing, ear noises become even more prominent in absolute silence. For example, listen to soft music, birdsong, the sound of wind, rippling water or other natural sounds that you find pleasant as you fall asleep.
• Get active: If you withdraw and pay too much attention to the constant sound in your ear, you can exacerbate the symptom. Sports, meetings with friends and other activities divert your attention from the tinnitus to positive experiences.
• Use tinnitus as an early warning system: change your attitude towards tinnitus. See it as a signal from your body that wants to warn you of overload, rather than seeing it as an impairment. Interpret it in a positive way.
• Learn to overhear: To do this, listen to about ten minutes of classical music or a piece of music with several instruments every day. Adjust the volume so that you can just hear the piece. Now concentrate on one instrument and try to follow it by actively listening.