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Definitions of tinnitus and related conditions which can be treated by tinnitus retraining therapy (TRT)
tinnitus, sound sensitivity, phonophobia, Jastreboff model, TRT, tinnitus retraining therapy
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 -The Tinnitus and Hyperacusis Centre, London UK –


Jonathan Hazell (retired) , Jacqueline Sheldrake
Nicholas Lee, Larry McKenna


Once you know that the important parts of tinnitus and hyperacusis distress are NOT due to damage that can’t be fixed, then you can figure out treatments that will work. In London at the Tinnitus and Hyperacusis Centre, we started to apply the Jastreboff model as early as 1988, and were the first to use TRT. After 20 years of tinnitus research using every tool know to medicine and surgery, we suddenly got results – that lasted.


Many accounts and treatments of tinnitus are based on outdated ideas. Many of the support groups are simply phobic training camps! Read the articles and references on this site (and Jastreboff’s) and make up your own mind.

Some simplified definitions to help you get started:



not a disease, just the ability to hear sounds generated by the auditory (hearing) system, evidence of compensatory mechanisms that are part of its normal function. The problem is the distress created – not the type of sound.


(body sounds) generated elsewhere e.g. heart sounds, muscle clicks, which become noticeable or instrusive. The problem is the distress created – not the type of sound! See Things that go bump in the night


dislike of environment sound(s). With or without tinnitus! Varies from ‘chalk scratching on blackboard’ to dislike of all sounds around you.


fear of environmental sounds. Fear that they may damage hearing or make other symptoms worse…


over-amplification of environmental sounds in the auditory pathways. Everyday sounds seem too loud, but  other people aren’t complaining!

Jastreboff model

a new scientific analysis of tinnitus and hyperacusis.Since 1990 this thesis has never been seriously challenged, and is being adopted and referenced by increasing numbers of researchers and clinicians. It explains clearly and simply all the above phenomena and their close relationships.

Tinnitus Retraining Therapy (TRT)

treatment based directly on the Jastreboff model. It uses a precise and individual combination of sound therapy and teaching / demystification / learning about tinnitus and  hyperacusis mechanisms, with directions about how to return to normal life without provoking symptoms.  1000+ professionals around the world have attended training courses and many have published identical excellent results to our own (see downloads).

Go to ‘How to use this site’ first


Any advice given by email or website about hearing disorders must be viewed as a general comment. It is not a substitute for proper medical or audiological diagnosis, and no responsibility can be accepted for the outcome of any health problem on which we may have commented in this way