![Page 1: Hearing and Balance Centre: 2011 Hearing Awareness Week - Managing Tinnitus & Hyperacusis Effectively- Maria Harasymczuk](https://reader035.vdocuments.site/reader035/viewer/2022062319/554ec782b4c905064d8b4c7b/html5/thumbnails/1.jpg)
MANAGING TINNITUS& HYPERACUSIS
EFFECTIVELYMaria Harasymczuk
Psychologist
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WHAT IS TINNITUS ?
• Physical condition
• Experienced as noises or ringing in the ears &/or head when there is no such external noise.
• Symptom of a faulty hearing system, not a disease.
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WHAT IS HYPERACUSIS ?
• Physical condition.
• Experienced as a reduced tolerance & increased sensitivity to everyday sounds in the environment.
• Person experiences physical discomfort &/ or pain in their ears when exposed to sound (quiet, medium or loud in volume).
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PRESENTATION
• Tinnitus & Hyperacusis
• Tinnitus
• Hyperacusis
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Types of Therapy
1/ Tinnitus Retraining Therapy (TRT)
2/ Cognitive Behavioural Therapy (CBT)
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Tinnitus Retraining TherapyTRT
• Developed by Dr Pawel Jastreboff
• Provides a model - explains how tinnitus & hyperacusis is processed by the brain
• AIM for Tinnitus: Habituation
• AIM for Hyperacusis: desensitize auditory pathways
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TRT for Tinnitus
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Tinnitus like a lion
Negative emotional association
Brain monitor threat - like a radar.
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TRT for Tinnitus
Directive Counselling
Auditory Therapy
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Directive Counselling
Reverse negative counselling / information about tinnitus.
Encourage acceptance of the tinnitus through neutral association.
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See one of our Audiologists !
• Have a
hearing test
• Important -
provides information
for auditory therapy
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AUDITORY THERAPY• Appropriate use of sound in environment.
• HEARING LOSS - Hearing aids +
sound machine / iPod, etc.
• NORMAL HEARING – WNG’s &/or
Sound Machine or iPod, etc.
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IMPORTANT RULEof
Auditory Therapy
AVOID SILENCE
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ANOTHER IMPORTANT RULE of
Auditory Therapy
DO NOT
MASK
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CONSTANT NEUTRAL
SOUND BELOW TINNITUS
KEY to Auditory Therapy
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Directive
Counselling
Auditory
Therapy
Acceptance of tinnitus.
Decreased tinnitus severity & awareness
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TRT for Hyperacusis
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Phonophobia
• Fear of noise
• Person avoids
noise exposure:
Physically avoid situation
Wears ear protection
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TRT for Hyperacusis
• Directive Counselling
• Auditory Therapy
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Directive Counselling
• Reversal of negative counselling about Hyperacusis.
• Addresses persons concerns.
• Encourages a neutral association to sounds that cause discomfort.
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Overuse INCREASES
of Ear = Sensitivity
Protection to Noise
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Auditory Therapy
• Appropriate use of sound in environment.
• Aim: Desensitise auditory pathways.
• Constant Neutral sound at comfortable level.
• Gradual exposure to sounds.
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Cognitive Behavioural Therapy
A Event/Situation
B Thought / Beliefs
C Feelings/Behaviours
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Negative Vs Constructive
Increase in Tinnitus Increase in Tinnitus
“My tinnitus is so loud. I can’t cope with this.
What if it gets louder. It is destroying my life. I am going to go mad. I can’t
go out tonight.”
“My tinnitus is loud at this time. I have coped
before. I am going to do my relaxation, as I know
this helps lower my tinnitus. I have had episodes of loud tinnitus & it has got better. I will go out tonight as I feel better
when I go out”.
Extremely AnxiousDepressed
Don’t go out
CalmAccepting
Go Out
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Negative Vs ConstructiveAt Shopping Centre
Grocery Shopping
“This noise is so loud. I can’t do this. It is going
to damage my ears and make things worse.
I have to get out of here”.
“It appears to be loud, but I know it is not going to damage my ears. Other
people are here & they are not bothered by the noise.
The more I expose myself to this noise the less sensitive my hearing will be. I have
achieved this with other noises . I will finish my
shopping and then go home”.
Extremely AnxiousPuts in ear plugs
Abandons shopping trolley & Leaves supermarket.
Little bit stressed.Do Shopping
Go Home
At Shopping Centre
Grocery Shopping
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Cognitive Behavioural Therapy
• Identify thinking style & beliefs about tinnitus & hyperacusis & their effect on feelings & behaviours
• Strategies to challenge negative thoughts & convert them to constructive thoughts
• Management of tinnitus & encourage acceptance of tinnitus
• Management of hyperacusis & encourage neutral association to sounds.
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Helpful Points
• DON’T FOCUS ON TRIGGER OF TINNITUS OR HYPERACUSIS
• Feelings of Guilt, Anger, etc.
• Enhances Negative Emotional Association.
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Live in the Present
PAST FUTUREGuilt WorryAnger
Reduce Anxiety &/or Depression
PRESENT
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Lifestyle Changes
• Balanced Diet
• Regular Exercise
• Good night sleep
• Reduce stress
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Interventions
• Hearing devices (hearing aids, sound machine, etc)
• Tinnitus Retraining Therapy
• Cognitive Behavioural Therapy
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YOU CAN DO SOMETHING ABOUT TINNITUS & HYPERACUSIS!!!!
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Thank
You
for
listening !!!!