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How does Cognitive Behavioural Therapy help Tinnitus?

Is Cognitive Behavioral therapy effective in reducing the intrusiveness of Tinnitus, or does it simply make those with Tinnitus feel better about having it despite the intrusiveness?

A question from my Quora postbag. Thank you to Neil Rosenthal.

The two things are interlinked. If you feel better about it, it’s less intrusive.

Hearing is psychoacoustic, so the more you tune into a sound, the more prominent it gets, almost regardless of how loud it is. Try it and see, tune into a sound in your environment and notice how it “comes forward” for you. A ticking clock could drive you mad if you paid attention to it, but during the day it’s easy not to.

You have to concentrate to listen to a friend who is talking about something you’re not interested in, otherwise the words wash over you.

Psychoacoustic hearing means we filter out a lot of what’s out there to hear. We assign meaning and importance on the fly, choosing what to pay attention to. Those things become prominent.

When you care very little about tinnitus, and don’t give it any importance, you stop hearing it ~80% of the time (rough guess/my opinion). It pops up only in the presence of your triggers, then fades back once they go.

CBT helps those who have fallen into the trap of assigning undue importance to their tinnitus. Helps them realise it’s small beans in the context of the world at large. And yes, it reduces its intrusiveness, both quickly but also over time. Especially over time.

I realise the words I have chosen are provocative to some. “It’s not small beans to ME!”. It’s deliberate, because until people realise that their tinnitus is no worse or better than say, mine, they won’t understand how it works.

To anyone lucky enough to be offered CBT, grab it with both hands and engage in it fully. You don’t have to believe in it to start with, you just need to open up to what’s being said.

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