Tinnitus
Tinnitus is the perception of sound in the absence of an external sound source, its name stemming from the Latin word “tinnire”, which means “ringing like a bell”. It is generally described in common English as “a ringing in the ears”. It can be perceived on one or both sides of the head, it can be of short duration, or be persistent, and it can be a continuous sound, or a pulsating sound following the rhythm of your heartbeat.
Tinnitus is a widespread phenomenon and experienced by 10-15% of the population. It is not an illness per se, but rather a symptom of something else in the body being affected. Tinnitus is sometimes linked to serious medical conditions such as tumours, vascular problems, Meniére’s Disease or superior semicircular canal dehiscence, but most of the time it is connected to hearing loss, ear conditions or stress. The audiologist and ENT conduct evaluations to find out where the tinnitus is coming from.
Tinnitus becomes a relevant problem when it is negatively perceived by and causes distress to the person experiencing it. Some people may not attach any significance to it, while others may perceive it as annoying, debilitating and threatening. This “bothersome tinnitus” may lead to rippling effects affecting basic daily tasks, such as sleep disturbances, poor concentration, difficulties in performing tasks and a variety of negative emotional reactions. Tinnitus and stress often form a vicious circle where stress makes the tinnitus worse, with the tinnitus in turn causing even more stress.
There is currently no magic pill that can cure tinnitus. Where physical conditions are present, treating that condition often helps to relieve the tinnitus. But tinnitus is a very complex phenomenon involving also the emotional system in your brain, therefore treatment cannot be complete without specialised counselling.
Hannelie Kroon has been studying tinnitus management since 2013. She runs a multidisciplinary tinnitus team to offer patients various services as each individual case dictates. She has spent numerous hours in consultation with the audiologists, ENT specialists, psychiatrists and psychologists in her team to ensure that each member knows their role in the team. The team therefore combines their knowledge about the ear, brain, tinnitus, the limbic (emotional) system and psychology to offer an expert team approach in the management of tinnitus. The audiologist starts the patient’s journey off with thorough audiological testing and (where necessary) liaison with an ENT specialist to exclude medical conditions. She provides a combination of amplification and sound therapy (where indicated) and in-depth, intensive Tinnitus Retraining Therapy (TRT) counselling, educating the patient on the mechanisms of tinnitus and how the brain responds to it. She is internationally trained to screen for emotional factors that may influence the patient’s tinnitus, and to provide Cognitive Behavioural Therapy (CBT) to assist the patient in changing his/her thought patterns about tinnitus. Studies show that patients can find significant relief from their tinnitus through this process. When she finds that the patient experiences a deeper level of emotional involvement in the tinnitus, she includes the psychologist in the therapy, who is trained and specialises in dealing with a patient’s emotions and thought patterns more profoundly. Together they draw up an individualised plan for each patient and provide CBT, counselling and support to achieve the patient’s goals. All psychological sessions remain confidential. They also offer off-site support in between and after sessions to keep track of their patients’ progress and experiences.
This evidenced-based team approach has helped countless people to take back their lives where it was once thought that they will be stuck with the tinnitus forever. Tinnitus can be successfully relieved, lessened and managed with the correct support. As Hannelie’s Masters Degree research showed, the combination of TRT and CBT really works – it resulted in incredible improvements in the patient’s tinnitus related distress. The improvements also remained steady over the long term, showing that the approach is rock-solid.
There is no reason to have to “live with tinnitus” – contact us for world class support.
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Frequently asked Questions
How many sessions will I need?
This will depend on your test results and your needs. All new tinnitus patients start off with an extended first session where tinnitus scores are taken, a hearing test conducted and a TRT session is done to explain the mechanisms of tinnitus. Patients with mild tinnitus may just need one more session, whereas patients with moderate, severe or catastrophic tinnitus will be asked to attend more sessions in order to do thorough tinnitus counselling and CBT. Ideally, CBT is done in 6 sessions.
Do the medical aids cover the tinnitus treatment?
The tinnitus sessions are billed either as audiological or psychological services rendered, which are approved by the Health Professional Counsel of SA and therefore covered by medical aids provided that your funds are not depleted. Medical aids have various funding options for hearing aids depending on your plan type, and should you be a candidate for hearing aids, we will communicate with the medical aid on your behalf and explain their funding thoroughly to you.
Could someone have caused my tinnitus?
More often than not, the answer here is no. Patients are sometimes worried that an operation, loud sound or pill has caused their tinnitus and they can spend a lot of energy blaming someone or circumstances for it. This only makes the tinnitus worse as the brain connects a flood of emotions with the tinnitus. The fact is that something (like a loud noise) can be a trigger for the tinnitus to start, but the reason why the tinnitus persists is because of the way your brain processed and reacted to the tinnitus sound, and it learns this behaviour so that it becomes a habit. That is why tinnitus often persists long after the trigger has gone. Understanding the TRT model will help you to deal with this concept, and our therapy is aimed at teaching the brain to ignore the tinnitus.
My loved ones don’t understand what I’m going through, how can I make them understand?
Feeling like others don’t understand your tinnitus adds to the isolation you might feel. You are most welcome to bring your significant other(s) along to some of the therapy sessions. Especially by seeing your test results and having the mechanisms of tinnitus explained to them, they should have a far greater understanding of your situation when they are included in the session. We can guide them on how to support you best. We encourage patients to bring others along to the support group nights as well, where they can relate to other people supporting loved ones with tinnitus. Having sturdy support should speed up your progress, so bring them along.
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