Cognitive behavioral therapy for tinnitus: Application of mindfulness meditation to the management of chronic tinnitus.

Abstract

　　Much of the difficulty associated with chronic tinnitus is due to the inability of the patients to distract the mind away from the tinnitus. If tinnitus causes anxiety, it shall inevitably draw attention. When the stress responses resulting from anxiety become associated with tinnitus through classical conditioning, tinnitus itself would pose a threat. However, diverting attention away from tinnitus would remove the stress responses. The effectiveness of Cognitive Behavioral Therapy (CBT) has been shown for patients with tinnitus. In recent years, mindfulness-based CBT has gained momentum in clinical practice.“Mindfulness” is a state wherein the person pays attention exclusively to events that are taking place “here and now.” Tinnitus patients are instructed to direct their attention to their own natural breathing, and if they are distracted by the tinnitus or other thoughts, to return their attention to the breathing as soon as possible. If done successfully, they will learn to perceive the tinnitus, but without the suffering, and obtain the insight that they can manage tinnitus with attention control. Once it is understood that tinnitus can be managed by the patients themselves in combination with sound therapy, often, no further visits to the clinic are required.