Both Tinnitus Retraining Therapy (TRT) and Cognitive Behavioural Therapy (CBT) begin with darkness, but they use it to explain tinnitus distress in very different ways.

In TRT, darkness makes a candle appear brighter, illustrating how reduced background sound increases the perceptual contrast of tinnitus. In CBT, darkness transforms a safe house into a frightening one, showing how uncertainty and interpretation can generate fear.

This article compares these two powerful metaphors and explores how perception and interpretation interact to shape the tinnitus experience, highlighting why both perspectives can contribute to effective tinnitus counselling.

We are pleased to share the full PDF of this article with permission from the American Academy of Audiology.