Music therapy in cases of tinnitus, hyperacusis and phonophobia


The TIM approach uses the auditory (hearing) system, which is itself closely connected to the centre of emotions, and is hence preferred for addressing hearing difficulties caused by tinnitus, hyperacusis (hearing pain threshold rapidly reached) or phonophobia (some sounds are unbearable).


Tinnitus Centered Music therapy (Tinnitus Integrierte Musiktherapie TIM, according to Dr Annette Cramer, Germany)


Through specific exercises, the same mechanisms of the auditory (hearing) system, which produce tinnitus, can be used to defuse it and relegate it to the background.


Since stress has a huge influence on auditory perception, part of the treatment will also consist of overall awareness connected with auditory impairment and the stress level experienced.

Tinnitus Centered Music Therapy (TIM) is built on several modules:


  • Data on tinnitus or hyperacusis and general advice about listening in daily life;
  • Learning music-therapeutic deep relaxation with listening to music chosen specifically for the individual. This form of relaxation is very different to listening to pleasant music lying on a comfortable sofa;
  • Retraining of the auditory (hearing) system through auditory training, exercises to do at home, 20 to 25 minutes per day with ranges of sounds and specific music;
  • Reshaping of the individual's life in relation to stress management;
  • Possible therapeutic follow-up according to the personal problem(s).


Indications:

  • Acute tinnitus 
  • Chronic tinnitus
  • Hyperacusis
  • Phonophobia


Tinnitus


Tinnitus is not a disease but a symptom!


The origin of tinnitus can vary: disease, exposure to very loud sounds, major or repeated stress, depression… This is why it is essential to consult an ENT doctor for an accurate diagnosis before starting auditory training.


Tinnitus is often associated with partial hearing loss and can be present even in a person who is very hard of hearing or deaf. An audiogram performed by an ENT doctor or specialist in hearing aids (free of charge most of the time) is important to locate the possible loss.


Tinnitus is not located in the ear (as it exists outside of any external noise) but in the auditory centre of the brain, which is directly connected to the reticular formation (brain structure at the interface between the autonomous, motor and sensory systems) and to the limbic system (emotional brain). Through an inadequate feedback loop phenomenon due to stress, tinnitus can be increasingly amplified by the brain, sometimes to the point of becoming unbearable and severely restricting the quality of life of the person suffering from it.


Indeed, the more one concentrates on tinnitus, the more our subjective perception reinforces it, setting in motion a vicious circle. If we are to "not think about it", advice unfortunately given too often, our concentration on it is paradoxically reinforced, since we inevitably check whether it is still there. For example, if someone says to us: "Don't you see before you an elephant in pink pyjamas" … we would inevitably imagine it not to see it is impossible for our brains! Treatment will then also consist of gradually tapping into the tinnitus (instead of rejecting it) through habituation techniques. 


Hyperacusis is often the result of an intense or chronic state of stress, which causes a rise in the hearing pain threshold. Finding oneself in a noisy environment then becomes unbearable (meetings, restaurants, public transport, etc.), and the person suffering from hyperacusis must often abandon situations or drop out of social gatherings.


Treatment of hyperacusis, like that of tinnitus (to which it is often linked), will include learning deep relaxation and retraining of the auditory (hearing) system, with creation of adapted ranges of music. Revisiting situations in the past through music therapy or other adapted techniques may be necessary in order to defuse latent stress.


Phonophobia (certain types of sounds are unbearable to listen to) often stems from intense or chronic stress linked to situations associated with a person's life history.


The treatment of photophobia, as in the case of tinnitus and hyperacusis, will consist first of all of learning deep relaxation and retraining of the auditory (hearing) system. Moreover, revisiting a person's life history will often thwart the stressful situation causing phonophobia. Broadly speaking, music therapy and other techniques adapted to the problems will then be helpful.