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Tinnitus Treatment With CBT

Tinnitus is the perception of noise in the ears and can manifest in a variety of sounds such as buzzing, whirring, roaring, etc. Tinnitus can be acute or chronic and can vary in frequency, severity, and duration. While tinnitus is common (over 5 million Americans experience a level of tinnitus, typically noted as “annoying”), some people experience tinnitus at a debilitating level, which may impair daily functioning, relationships and work activities. These severe cases are often accompanied by an anxiety, depression or other mood difficulties. Tinnitus may make it challenging to concentrate and at times, may interfere with sleep.

Cognitive Behavioral Therapy for tinnitus addresses the cognitive, attentional, and behavioral processes that are typically observed in people with severe tinnitus. People with tinnitus tend to expend a lot of energy and attention scanning for the presence of tinnitus sounds. This attention reinforces the need to “detect and protect” the body from the sounds. Unfortunately, the more one scans and listens for sounds the more sounds one is likely to notice. People with severe tinnitus commonly engage in maladaptive thoughts regarding their experience of tinnitus, which can result in anxiety, depressed mood, insomnia, difficulty concentrating, hopelessness, and helplessness. Additionally, people may withdraw from their usual activities, as they misjudge how negatively the tinnitus will interfere with their enjoyment.

Cognitive Behavioral Therapy (CBT) treatment teaches people to understand how their thoughts, behaviors, and their attention/focus on noise intensifies their experience of tinnitus, anxiety, and depressed mood. CBT teaches people to engage in more adaptive thought processes, to resume engaging in enjoyable activities, and to focus on living their life according to their values (instead of focusing on the perceived limitations imposed by tinnitus). Stress Reduction exercises, Behavioral Activation, and Cognitive (Thought) Restructuring are tools that are typically learned during a course of Cognitive Behavioral Therapy to address the distress experienced by the tinnitus patient. CBT treatment also addresses insomnia related to tinnitus or its associated anxiety or depression.


Misophonia is a condition that involves a negative emotional response to common sounds made by others, such as chewing, slurping, talking, eating, yawning, coughing, or even breathing. Misophonia can sometimes be triggered by visual repetitive cues such as observing someone twirling their hair, fidgeting with their hands, or tapping their fingers against a table. The negative emotional response can be mild, moderate, or severe, and can be experienced as anxiety, panic, a desire to flee, irritability, or even rage. Misophonia usually presents between ages 9-11 years of age and can cause significant impairment, especially in relationships. 
Treatment may include Cognitive Behavioral Therapy to address the emotional distress related to the misophonia.  The person with misophonia will likely learn a combination of essential mood regulation tools and skills, including stress reduction exercises (such as progressive muscle relaxation), coping skills (such as diaphragmatic breathing), and methods to engage in adaptive thinking (such as cognitive restructuring and identifying thought distortions).  Additionally, the person with misophonia may benefit from identifying values that are important to them as they engage in meaningful activities when they encounter misophonia triggers.  
Although misophonia may be a chronic condition, CBT may assist the person with misophonia to better manage their emotional distress and to learn to live their life even with their sound sensitivity.
If you have tinnitus or misophonia it is important that you seek the consultation of an appropriate medical provider (a General Practitioner, an Ear, Nose, and Throat physician, and/or an Audiologist) to assess and address the physical dimension of your disorder. If you decide to seek treatment with us we will work collaboratively with your treating physician.