Dr Liz Marks is a clinical psychologist and a lecturer in psychology at the University of Bath. She specialises in understanding and treating distressing tinnitus, particularly approaches based on Mindfulness and Cognitive Behavioural Therapy (CBT).

My research into Mindfulness Based Cognitive Therapy for tinnitus (MBCT-t) (in collaboration with University College London Hospitals (UCLH)) proved that this novel treatment, based on mindfulness meditation and CBT is an effective and acceptable treatment for people with chronic tinnitus. The results of the research found that MBCT-t could reduce tinnitus distress in most tinnitus patients, and over half of people reported a clinically meaningful reduction. This is a significant proportion of patients when compared to outcomes found in other types of treatments. With MBCT-t, the tinnitus itself does not disappear, but it does become much less problematic. MBCT-t also leads to reductions in psychological distress, anxiety and depression and improvements in daily functioning.

Interviews with people after completing MBCT-t have found that patients think that mindfulness helps them as they learn to relate to tinnitus in a new way. Specifically, they move away from ‘fighting tinnitus’ to ‘allowing it’ into their awareness. This approach is counter to traditional treatments that tend to suggest that tinnitus should be ‘masked’ or ‘ignored’, but it actually makes sense when one considers the theory. By ‘not fighting but allowing’ tinnitus, people have a chance to habituate to tinnitus, it becomes less threatening and with this it stops being so intrusive and problematic. Alongside this people described many other holistic benefits arising from MBCT-t, including improved well-being and quality of life.

More recently, I have been testing a different type of treatment that is designed to help people who find that their sleep is badly disturbed by tinnitus. Not everyone with tinnitus has problems sleeping, but those who do tend to describe their tinnitus as more severe and troubling. Many people have insomnia, where they have difficulties in falling asleep, staying asleep, or waking up to early, and feeling tired during the day. Currently no specialist treatments exist to help people with tinnitus-related insomnia. To address this problem, I and the psychology team at UCLH have been developing and testing Cognitive Behavioural Therapy for insomnia (CBTi) in tinnitus. A small evaluation of this treatment indicated positive effects, and I've just finished running another clinical trial to test whether such effects are reliable and clinically significant. The results of this trial will be published in the next year.

Plans are to continue to develop research into improving the treatment options that are available for people with tinnitus. This includes finding ways to make our existing psychological treatments more effective and accessible.

Tinnitus is a very real and very challenging physical condition, which can have profound emotional and psychological impacts upon people. A psychological approach aims to reduce these impacts, recognising how difficult it can be to live with a condition like tinnitus.  Psychological treatments are one avenue for future research, which complement the other exciting biomedical research that is also under way at the moment.