T is a physical ailment, period. I don't understand why everybody is trying to sell us psychology.
I would agree that tinnitus is a physical ailment.
The reason why psychology is 'sold' is because it can bring significant relief. For example, I have gone from scouting out trees in my local neighborhood with branches that were conveniently placed for me to hang myself from them, to being occasionally annoyed and distracted by the condition. I can now go for several hours, sometimes most of the day, without even hearing my tinnitus. Of course, it is entirely possible that my tinnitus isn't all that loud. But then, it sounds bloody loud and piercing to me most of the time, including right now.
The problem is that TRT is expensive, and it is not always easy to find someone who knows what they are doing.
But there are cheaper options.
One of them would be to acquire
Jane Henry and Peter Wilson's book Tinnitus: A Self-Management Guide for the Ringing in your Ears (about $70 on Amazon right now) and to work one's way through all the exercises in it that are practical and designed to promote habituation. I'd recommend doing them systematically twice.
Unfortunately, that approach didn't work for me. The profoundly aversive emotions that tinnitus provokes prevented this cerebral technique - based on CBT - from having any impact. For me, thoughts are ephemeral, however realistic or unrealistic they might be, whereas destructive emotions are like tidal waves that can overwhelm a person and sweep them away.
So why mention this book at all? Because I know that it has helped so many others who would swear by it. My experience with CBT was far less typical.
CBT is also known to be clinically efficacious, with tangible before/after changes in the brain being detected on scans of people before and after they were treated for a spider phobia.
And if CBT doesn't work for you, there's MBCT or Mindfulness Based Cognitive Therapy. John Kabat-Zinn's
Full Catastrophe Living is available for $0.01 on Amazon.com (plus postage) right now. Although strictly speaking, Kabat-Zinn outlines an 8-week programme of MBSR (Mindfulness Based Stress Reduction) in this publication, it's essentially the same method that is being described. It also goes by other names: vipassana, zazen etc.
Even that stalwart of New Atheism, Sam Harris, has apparently taken up the practice, which is Buddhist in origin. He writes about it in his latest book (
Waking Up), which I haven't read yet. Harris also has tinnitus, so I must get around to it eventually.
After CBT didn't work for me, I acquired
Full Catastrophe Living and failed to complete the 8 week programme twice over.
The third time I reasoned to myself that I had to give this approach a full and fair crack of the whip before I topped myself. And third time around, it seemed to do the trick.
What I think happened is that MBCT shaved the edges off the overwhelming anxiety, stress and suicidal despair that I was experiencing. This, in turn, resulted in me being less tormented by the sound. At the cerebral level, I then began to think about tinnitus the way people are meant to after doing CBT. So maybe MBCT is more holistic or something.
Of course, this post is simply an anecdote. And the plural of 'anecdote' is not 'fact'. Plus, I don't have hyperacusis or ear pain, only bog standard tinnitus. But I would venture one suggestion that might apply more generally: suck it and see.
In other words, by all means maintain a healthily sceptical atttitude to psychological approaches to tinnitus management, but at least give them a try before dismissing them. As you can see, I almost flunked CBT and MBCT. It was only with one last gasp effort that I got a handle on this thing myself. So who knows what might happen in other cases?