TRT Question

[Kimbo Slice]

Hi again Dr. Nagler.

First I want to say thank you very much for everything, and all the help you have given us around here. You make it look easy with all the flaming etc. You are a true gem of a man.

Getting to the point, I had a thought about how TRT works the other night. I learnt that our brains adapt to the sound around us. For instance, an example that was given about habituation and how people who live near train stations or in loud areas is basically through habit and that their brains adapt to that type of sound. This might be a silly question but I'm just wondering if you think it could be possible to treat tinnitus using a soundproof room for lets say 8 hours a day, complete silence. (I know this would be hard and would be like putting ourselves in a mental asylum.) Either why what are your thoughts on this?

Thank you for your time. I really appreciate it.
Regards,
Kim

 

[Dr. Nagler]

Hi Kim -

Thanks for the kind words.

The reason that people who live near train stations adapt to that type of sound is related to the fact that over time their brains come to classify the sound of the trains pulling in and out of the station as neutral. The idea of TRT is to retrain your brain to classify the sound of your tinnitus as neutral. The mechanism for doing so is fairly complicated. What is rather easy to do with trains going by and factory sounds is a lot tougher to do with an internally generated sound from which you cannot escape. But in the end that's what TRT comes down to: Retraining your brain to classify your tinnitus as a neutral stimulus.

With the above in mind, placing yourself in a soundproof room is about the worst thing you can do as a tinnitus sufferer. In a soundproof room your auditory system will strain to do what it is designed to do, which is detect external sounds. And since in a soundproof room there are no external sounds to detect, your auditory system will turn up the gain and unnecessarily magnify your tinnitus in order to detect whatever sounds it can possibly detect.

TRT is, as I said, a complex protocol. But amidst all the complexity, there are four simple "Avoids" ...

Avoid overprotection
Avoid masking
Avoid negative counseling
Avoid silence

That last one speaks to your soundproof room idea.

But I do love the fact that you are giving all this a good bit of thought!

Best regards -

Dr. Stephen Nagler