This factsheet is part of our tinnitus range. It is written for people who have tinnitus, their families, friends and the professionals who work with them.

Tinnitus is a medical term to describe noise(s) that people can hear in one ear, both ears or in the head – such as ringing, buzzing or whistling. The sounds heard can vary from person to person, but the common link is that they do not have an external source.

If you would like this factsheet on audio tape, in Braille or in large print, please contact our Information Line.

Read this factsheet to find out:

At the end of this factsheet, we give you details of organisations you can contact for further information.

Medical disclaimer

The information given in this factsheet is not medical advice and by providing it neither RNID nor our tinnitus and medical advisors undertake any responsibility for your medical care, nor accept you as a patient. Before acting on any of the information contained in this factsheet, or deciding on a course of treatment, you should discuss the matter with your GP (family doctor) or other medical professional who is treating you.

What is counselling?

There are many different definitions of counselling. One of the simplest is that counselling is a working relationship between you and a counsellor that allows you to explore difficulties in your life.

Can counselling help me if I have tinnitus?

Yes. Being able to talk to somebody who will listen and show understanding can be comforting and reassuring. Your counsellor may also help you see how other things in your life can affect your tinnitus.

There are several kinds of counselling available:

All of these can help you if you have tinnitus and want to talk to someone about it.

Private counselling

Private counselling involves talking to a counsellor who either practises independently, or through an agency such as a counselling centre. You will usually have to pay and there is no guarantee that the counsellor has specialist knowledge about tinnitus.

Private counselling may be useful if aspects of your life are making you feel unhappy or anxious, such as bereavement or relationship/work difficulties. Stress can have a negative effect on tinnitus and sometimes talking about difficult situations may indirectly benefit your tinnitus.

The experience and qualifications of counsellors can vary greatly, so make sure your counsellor is recognised by the British Association for Counselling and Psychotherapy (BACP; for contact details). You may be able to see an independent counsellor through the NHS. Some GPs employ counsellors on a sessional basis to work with their patients.

Medical counselling

To talk to someone who has a specialist understanding of tinnitus, you really need medical counselling. Most medical counselling for tinnitus is delivered in specialist tinnitus clinics in hospitals. Your GP may refer you to your local ear, nose and throat (ENT) department initially. If the ENT staff feel it is appropriate, you may then be referred to a tinnitus clinic or specialist.

Successful medical counselling is based on knowing the nature and causes of tinnitus and how to manage it. If you have tinnitus, medical counselling can help in several ways by:

Medical counselling may be given by a variety of professionals, including a hearing therapist or audiologist.

NHS hospital tinnitus clinics may refer a person with tinnitus to a clinical psychologist. Some clinics may already have a clinical psychologist in their team for tinnitus management. Some private healthcare providers also offer medical counselling services.

Medical counselling is also an essential part of tinnitus retraining therapy (TRT), which tries to reduce tinnitus distress.

Lay counselling

Lay counselling may be helpful if you have tinnitus. A lay counsellor is not a qualified counsellor, but may have undergone some counselling training, or have some personal knowledge or experience of tinnitus. They could be a member of a local tinnitus self-help group or work on a helpline. You may be able to work through your feelings about your tinnitus in different ways and receive practical and emotional support face to face or over the telephone. Contact RNID’s Tinnitus Helpline for details about groups in your area (see Where can I get further information?).

What is cognitive behaviour therapy (CBT)?

CBT examines your thought patterns, beliefs and the way you do things, in order to understand why you react in certain ways. Therapy may be provided on a one-to-one basis or in a group session. The professionals most likely to offer and use CBT are clinical psychologists or psychotherapists.

How can CBT help me if I have tinnitus?

What you think about your tinnitus affects how you feel about it. The more attention you pay to your tinnitus, the worse you may feel. CBT can help you in a number of ways:

What happens in a course of CBT?

You are usually asked to keep a diary of the times that your tinnitus noises are most annoying or distressing, making a note of the nature of the distress and any thoughts that go with it. For example, you might write: “Tonight I feel upset and scared about the cause of my tinnitus noises. I worry about my health”. The therapist will help you look at the reasons behind your strong reactions to your tinnitus.

Your therapist will discuss your thoughts with you and suggest different ways of doing things. Throughout therapy, you are encouraged – and given help – to challenge your ways of thinking. A therapist will not try to force a set of beliefs on you, but will help you find the best way of approaching your tinnitus.

Group sessions

Sometimes, your therapist may suggest you participate in a group session. A group of you meets the therapist for a number of sessions. During these sessions, you are taught how to discover your hidden beliefs and how to challenge negative thoughts. The people in the group will have at least two things in common – they have tinnitus and they are upset by it.

What is tinnitus retraining therapy (TRT)?

TRT is based on the neurophysiological model of tinnitus developed in the late 1980s by Pawel Jastreboff and Jonathan Hazell. The neurophysiological model of tinnitus suggests that it is the limbic system – the subconscious part of the brain responsible for our emotions – that gives importance and meaning to the tinnitus signal.

According to this model, we perceive the tinnitus signal to be a threat or a danger and this provokes an emotional response. Our awareness of tinnitus is heightened and so we perceive it to be louder or more persistent.

TRT is the term given to tinnitus treatment that combines counselling and low-level sound therapy. It does not work directly on your tinnitus, but on your awareness and understanding of it. In time, as your awareness of the sounds is reduced, you will only notice it when you focus on it. This is known as ‘habituation’ and is the ultimate goal of TRT. Results and their time-frame can vary from one person to another.

How does TRT work?

TRT works through a combination of two main elements – counselling and sound therapy.

Counselling

Counselling is a key part of TRT. In-depth explanations of how your hearing works will help you understand why you have tinnitus. Similarly, talking and learning about your hearing system can help you overcome your fears and make your tinnitus seem less threatening. This is all part of the habituation process.

Sound therapy

Your tinnitus may seem louder in quiet environments (for example, at night). Sound therapy works to make tinnitus less noticeable by reducing the contrast between tinnitus sounds and background sounds. It also helps your hearing system become less sensitive to the tinnitus. This can be achieved by wearing ‘white noise’ generators – these produce a soothing shhhh sound – and by using environmental sounds, for example, from CDs, cassettes or table-top sound generators. For more information, see our factsheet Equipment, sound therapy and tinnitus and Where can I buy products that may help?.

If you have hearing loss, having a hearing aid fitted can help. The hearing aid will compensate for your hearing loss and provide sound therapy by making environmental sounds louder – this, in turn, can distract you from your tinnitus.
 

Therapy with a clinical psychologist

If your GP refers you to hospital for tinnitus assessment and treatment, you may be seen by a clinical psychologist. A tinnitus clinic may also refer you to a clinical psychologist if they feel it would be beneficial.

What does a clinical psychologist do?

Clinical psychologists work in healthcare or social care settings, including hospitals and health centres. They work with people with psychological problems such as anxiety or depression. They help people understand the causes and effects of their problems and to reduce their distress.

You may be referred to a clinical psychologist if you are in a lot of distress because of your tinnitus. Psychologists help people with all types of problems and being referred to one does not mean that you are in danger of ‘going mad’!

As well as assessing and giving therapy, clinical psychologists are often involved in research to find out if, and how well, different psychological therapies work. A clinical psychologist’s role is different from that of a psychiatrist who has qualified in medicine and can prescribe drugs.

How can a clinical psychologist help me if I have tinnitus?

The clinical psychologist may offer strategies to help you cope better with the effects of tinnitus. These could include:

Some tinnitus clinics and hospitals use a clinical psychologist as part of a team approach to tinnitus management. The clinical psychologist may visit the tinnitus clinic and see you there, or you may be referred by the hospital to your local health authority’s clinical psychology services. You may see a clinical psychologist on a one-to-one basis, or in group therapy sessions with other tinnitus patients.

Where can I buy products that may help?

RNID Products sells a range of equipment for people with hearing loss and tinnitus. Visit the RNID Shop at www.rnid.org.uk/tinnitusproducts (external link) to buy items of equipment online. Alternatively, you can request a copy of the Solutions catalogue by contacting RNID Products directly or by contacting RNID Tinnitus Helpline.

RNID Products, 1 Haddonbrook Business Centre, Orton Southgate, Peterborough PE2 6YX
Telephone: 01733 361199
Textphone: 01733 238020
Fax: 0870 789 8822
Email: solutions@rnid.org.uk
RNID Shop website (external link, opens new browser window)

Where can I get further information?

British Association for Counselling and Psychotherapy (BACP)

BACP can provide a list of therapists in your area.

British Association for Counselling and Psychotherapy (BACP), BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire LE17 4HB
Telephone: 01455 883300
Textphone: 01455 552078
Fax: 01455 550243
Email: bacp@bacp.co.uk
BACP website (external link, opens new browser window)

British Association of Behavioural and Cognitive Psychotherapies (BABCP)

The BABCP provides information for professionals and the general public. You can search for a private BABCP-accredited therapist on their website.

British Association of Behavioural and Cognitive Psychotherapies (BABCP), Victoria Buildings, 9-13 Silver Street, Bury BL9 0EU
Telephone: 0161 797 4484
Fax: 0161 797 2670
Email: babcp@babcp.com
BABCP website (external link, opens new browser window)

British Tinnitus Association (BTA)

The BTA campaigns for better services for people with tinnitus. It supports a network of local tinnitus groups around the country, has a range of publications and produces a quarterly magazine, Quiet.

British Tinnitus Association (BTA), Ground Floor, Unit 5, Acorn Business Park, Woodseats Close, Sheffield S8 0TB
Telephone: 0800 018 0527
Textphone: 0114 258 5694
Fax: 0114 258 2279
Email: info@tinnitus.org.uk
BTA website (external link, opens new browser window)

Hush

Hush is the name of the Hull tinnitus self-help group. They run a helpline and produce information and tapes for people with tinnitus.

Hush, 109 Southella Way, Kirkella, Hull HU10 7LZ
Telephone: 01482 656033
Email: hush@bbhoward.karoo.co.uk
Hush website (external link, opens new browser window)

UK Council for Psychotherapy (UKCP)

The UKCP provide information for public and professionals. They can help you find a psychotherapist in the UK. You may find their website FAQs helpful.

UK Council for Psychotherapy (UKCP), 2nd Floor, Edward House, 2 Wakley Street, London EC1V 7LT
Telephone: 020 7014 9955
Fax: 020 7014 9977
Email: info@psychotherapy.org.uk
UKCP website (external link, opens new browser window)

Contact a local group

If you feel you need more help with tinnitus directly from other people who also have it, you could contact a local tinnitus support group. They are set up and run by people with the condition or by professionals who work with tinnitus patients. The type of support and help they are able to offer varies between groups. Contact RNID Tinnitus Helpline for details of your nearest group.

Further information from RNID Tinnitus Helpline

RNID Tinnitus Helpline offers information and advice to people with tinnitus, their families and friends, and the professionals who work with them. You can contact us for further copies of this factsheet and the full range of our products for people with tinnitus. We also sell a book, "Understanding tinnitus – managing the noises in your ears or in your head", and a range of relaxation CDs and cassettes.

RNID Tinnitus Helpline

19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 6666
Textphone: 0808 808 0007
Fax: 020 7296 8199
SMS: 0780 0000 360 (supported by Lloyds TSB)
Email: tinnitushelpline@rnid.org.uk  
Tune out tinnitus website (external link, opens new browser window)
Available Monday-Friday, 9am-5pm