Norman--

For a good introduction to TRT, go to any of the following three Web sites:

http://www.salon.com/health/feature/1999/05/06/tinnitus/print.html
http://www.tinnitus-pjj.com/
http://www.tinnitus-hyperacusis.com/

TRT is a process using hypnotic style suggestions and other techniques to
convince yourself your tinnitus noises do not exist. Many feel it can have
detrimental side effects, such as sociopathic behavioural problems,
psychotic episodes and possibly multiple personality disorder.

As an new and experimental therapy is may be best to stay well away from
until the techniques are better understood. Many call themselves
"therapists" with none to a couple  days of trainin from other
experimenters.

Another useful article that covers TRT, among other issues concerning
tinnitus and its treatment:

The New York Times
October 29, 2002, Tuesday
HEALTH & FITNESS

PERSONAL HEALTH; New Hopes for Quieting the Roaring in the Ear

By JANE E. BRODY (NYT)

External sounds that disrupt your concentration and your sleep are bad
enough. But in most cases they are either short-lived or there is some way
to escape them or shut them out. But when the noise is inside your head and
continuous or nearly so, it could literally drive you crazy.
Such is the case with a disorder called tinnitus (tin-EYE-tus and TIN-uh-tus
are correct), a hissing, roaring or ringing of varying volume in one or both
ears or in the head that may be steady or intermittent but persistent.

About 17 percent of the general population and as many as a third of the
elderly experience it. For some 10 million Americans, the problem is
distressing enough to prompt them to seek medical help, and for at least two
million, it is so debilitating that they no longer have any meaningful
quality of life.

Tinnitus remains a rather mysterious disorder and can present a challenge
even to hearing specialists. But far too many people who complain about
tinnitus to their physicians are told, inappropriately, ''Just go home and
learn to live with it.''

A number of possible causes have been discerned, many of them correctable,
and treatments have been devised that can minimize or even eliminate the
disturbance tinnitus causes.

Even if you have been told that nothing can be done for your tinnitus, it is
time to try again. New treatments are continually being developed.

Tinnitus is frequently associated with hearing loss, and treatment with a
hearing aid often relieves the problem. But the presence of tinnitus does
not necessarily lead to a hearing loss, according to the American Academy of
Audiology. Hearing aids can also help those with tinnitus who are
excessively sensitive to sounds, with a disorder called hyperacusis; even
moderate everyday sounds make them want to cover their ears.

What Causes Tinnitus?

Exactly how tinnitus arises is not yet known and, experts believe, given the
variety of possible causes, a number of different mechanisms are probably
involved. Tinnitus can result from problems in the outer ear, like excessive
ear wax; in the middle ear, like an infection or otosclerosis; or the inner
ear, like noise damage or age-related hearing loss.

Getting an accurate diagnosis is a critical first step, and this may require
referral to an ear, nose and throat physician who specializes in problems of
the ears.

Several causes are reversible, including a buildup of ear wax or a hair or
foreign object touching the eardrum. Infections can be treated and even
otosclerosis can be corrected surgically.

Also, high doses of certain medications -- including anti-inflammatory drugs
like aspirin and ibuprofen, quinine and certain sedatives and
antidepressants -- can cause tinnitus that goes away when the medication is
discontinued or the dose is lowered. But tinnitus caused by anticancer drugs
and certain antibiotics may not disappear when the medication is stopped.

Also potentially reversible is tinnitus caused by treatable disorders like
high or low blood pressure, anemia, diabetes and other disorders of glucose
metabolism, thyroid disease, acoustic tumors, head or neck aneurysms and
hormonal irregularities.

Other possible causes may present more of a challenge, including trauma to
the head or neck, misalignment of the jaw, blood vessel disorders and
permanent hearing loss caused by noise exposure or aging. But even if the
cause cannot be discerned or removed, treatment to relieve tinnitus is still
possible.

Tinnitus appears to have both a physiological and psychological component.
Different people react differently to the same disorder, and there is often
a relationship between the perception of tinnitus and stress.

Onset of the condition frequently coincides with a disruption -- emotional,
physical or social -- in a person's life.

There are two main categories of tinnitus, subjective and objective, and
each of these may occur either as a pulsating sound synchronized with one's
heartbeat or as a steady buzz or tone similar to the hissing of a radiator
or crickets, explained Dr. Jack J. Wazen, a hearing specialist at
Columbia-Presbyterian Medical Center in New York. Subjective tinnitus, which
is much more common, can be heard only by the person who has it. Objective
tinnitus can be heard by the examiner.

Getting Relief

Treatment starts with a thorough examination by a physician who is a hearing
specialist and correction, if possible, of the underlying cause. But even if
the cause cannot be discerned or corrected, tinnitus can be treated.

Most people with tinnitus can experience considerable relief from one or ano
ther or a combination of available treatments. Whatever the chosen treatment
method, counseling by a hearing professional should be part of it to help
control the stress and distress associated with tinnitus.

A simple, effective therapy is the hearing aid. When external sounds are
more readily discerned, the loudness of inner sounds is likely to be reduced
or even masked. In addition, a hearing aid can make it easier for a person
with tinnitus to communicate.

Maskers are external devices that produce sound either to cover up or to
alter the sounds of tinnitus and provide temporary, partial or complete
relief for some patients. Maskers are worn at ear level like hearing aids or
are combined with hearing aids. Tabletop devices can also be used at bedside
with speakers or headphones.

One of the newest and most comprehensive approaches, tinnitus retraining
therapy, was devised by Dr. Pawel Jastreboff at the University of Maryland
Tinnitus and Hyperacusis Center. It involves retraining, or habituating, the
brain through counseling and sound therapy to remove the fear and distress
associated with tinnitus and to teach the brain to ignore the internal
noise. The technique helps patients learn to control their tinnitus rather
than have it control them.

Dr. Natan Bauman, director of the New England Tinnitus and Hyperacusis
Clinic in New Haven, reports that 80 percent of patients treated with this
technique have experienced significant improvement.

Dr. Bauman, himself a sufferer since an accident caused hearing loss and
tinnitus, invented an in-the-ear device called the tinnitus retraining
instrument to help people adapt to this method.

Many patients are also helped by stress management techniques, including
relaxation therapy and biofeedback, but no evidence shows that approaches
like acupuncture, hypnosis, dietary supplements or chiropractic manipulation
can relieve tinnitus, according to the audiology academy.

But the academy does suggest a number of ways to minimize tinnitus: avoid
loud noises, wear proper ear protection in high-noise areas, control stress,
avoid fatigue, exercise regularly, maintain good nutrition, lower salt
intake and reduce or eliminate consumption of brain-altering substances like
caffeine and alcohol.

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Copyright 2002 The New York Times Company

TRT, or Tinnitus Retraining Therapy, is based on what "some" believe
is a model of tinnitus. There is no proof which is likely why
insurance companies do not cover it unless they are apparently duped
by coding.

The largest proponent of it - one Stephen Nagler MD who has no formal
training as an ENT - hawked it here while trying to sell his services.
He has since closed down his tinnitus clinic under very strange timing
as a complaint was lodged weeks before with the Georgia State Medical
Licensing Board. Having been the Chair of the American Tinnitus
Association, one would think that if anyone could flood people into a
clinic it would be he. I think that in itself should answer any
questions about considering the treatment.

Good luck,
Martin