- Published on 28 January 2016
A.I. The first step was to delve into the world of tinnitus.
P.J.J. I knew nothing about this, other than that my grandmother suffered from it, and that she was always complaining because it was annoying. While I was working on the model to learn more about tinnitus, I read a lot of literature. The information I found was very unclear, but there was a common dogma: tinnitus is located in the ear and the auditory nerve. I thought this literature was completely wrong because to find the cause of tinnitus, you have to look at the brain, and not the ear. I designed a practical implementation of my model, which is now known as TRT. I discussed it with Dr Hazell, an eminent expert in this field who resided in London, and he liked it so much that he started using it the following Monday. The results were so positive that I set up a center in the U.S. to treat tinnitus, and to date I have treated over 2,000 patients with very positive results.
A.I. So it was an instant success
P.J.J. Well, actually, the scientific results of my model only became evident after eight years. I had already been treating patients, but a positron emission tomography (PET) study was published verifying the model. The study demonstrated that the limbic system, i.e., the emotional center of the brain, of people suffering from tinnitus is overactive. This came as a surprise to many, because it proved that tinnitus had nothing to do with the auditory canal, but rather that it involved other parts of the brain. This was obvious to me, but not so much for my colleagues at the time.
A.I. So the mistake resided in where tinnitus was thought to originate?
P.J.J. Before TRT, the only therapy available was maskers, which consisted in using sounds to cover up tinnitus. This is still efficient in approximately 10% of patients. In fact, Dr. Hessel had conducted a study with a group of patients which demonstrated that maskers worked, but that as soon as the therapy concluded, most patients felt worse. There were some 30 patients who had been using the technique for 15 years and had seen no improvement. When Dr. Hessel started using TRT on these patients, they improved considerably in just one year, and complained that he had not used this method before. The answer was simple: TRT did not exist ten years ago.
A.I. How does it work?
P.J.J. We teach it as an intensive, three-day course. It consists of a part which involves offering specific advice, to teach people that tinnitus is not something negative; the other part is sound therapy. In the guidance part, we demystify it by clarifying any doubts patients may have. It is very important to offer examples from daily life, and not to talk in scientific terms. An example which works well is to imagine that there is a two-meter cobra in the room which behaves well, has eaten, and its venom has been removed, which means patients do not need to worry, and can focus on me. When I ask them if they believe they can do it, the answer is “absolutely not”, because when there is something in the room which indicates danger, one cannot help but focus all his or her attention on it. Then I tell them that from the beginning it was only a toy snake, that there was no danger, and that despite that, they experienced negative sensations.