Over the past few days, I have received an unusual number of questions about a new tinnitus app that made the news: the Freequency app. In the same RTL Nieuws article, my colleague, psychologist and scientist Rilana Cima was mentioned, leading some to believe that the app was developed in collaboration with Adelante. This is not the case.
These reactions once again highlight the significant influence media coverage has on the expectations of people with tinnitus complaints. The numerous calls and emails I received - full of questions and concerns stemming from misunderstandings - prompted me to write this blog.
More than a birdcage: The complexity of tinnitus treatment
Tinnitus is not something you can resolve ‘playfully,’ and certainly not with a single tool. The message that sometimes filters through the media - that an app or a single technique is the solution - does not only oversimplify the complexity of tinnitus but also disregards the scientific foundation of effective treatments. Tinnitus is more than just the sound in your head. It affects how we live, our mental load, and the balance we must find between the many roles we play.
Hearing is so much more than just the ears.
People who visit a tinnitus consultation often struggle not only with the sound itself but, more importantly, with its impact on their daily functioning. Fear, stress, and loss of control play a major role. Scientific literature supports this broader view of tinnitus. Neurological research shows that tinnitus does not originate solely in the ear but is a complex interaction between auditory and non-auditory brain regions (De Ridder et al., 2011). Cognitive behavioral therapy (CBT) remains the only scientifically proven effective treatment for tinnitus (Cima et al., 2012; 2019). This therapy does not aim to eliminate the sound but rather to change how people cope with it.
When a new method or technology is promoted as the solution, it can create unrealistic expectations. People may become disappointed and think, “Yet another thing that doesn’t work,” discouraging them from seeking truly effective treatments. Additionally, the essence of tinnitus treatment—the process of learning to cope with the sound, habituation, and its impact on life—may be overshadowed, increasing the risk that the truly important factors are overlooked.
This does not mean that technological developments have no value. There are certainly apps that can offer support, for example, by providing relaxation techniques or education. The Freequency app, for instance, could potentially assist in the easier application of exposure techniques. However, it is a tool, not a treatment in itself. Proper research must first establish whether there is a real effect. Prematurely claiming that something works can also have negative consequences for a company—consider the hype around the Power Balance wristband in the 1990s.
Tinnitus requires an integrated approach, incorporating acceptance, cognitive behavioral therapy, and personalized guidance. ACT (Acceptance and Commitment Therapy) is, for example, a valuable addition to traditional CBT (Hesser et al., 2015). Not to remove tinnitus, but to give it a different place in life.
At Adelante, we work daily with people struggling with tinnitus. We see how important it is to consider the full picture: not just the sound, but also the person behind it, their life, and the way tinnitus fits into it. This requires nuance and time.
Tinnitus is not a puzzle piece that can be placed perfectly with a single app. It is a dynamic process that requires insight, guidance, and sometimes a shift in perspective.
References
Cima, R. F. F., Andersson, G., Schmidt, C. J., & Henry, J. A. (2019). Cognitive-behavioral treatments for tinnitus: a review of the literature. Journal of the American Academy of Audiology, 30(6), 498-507.
Cima, R. F. F., Maes, I. H., Joore, M. A., Scheyen, D. J., El Refaie, A., Baguley, D. M., & Vlaeyen, J. W. S. (2012). Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. The Lancet, 379(9830), 1951-1959.
De Ridder, D., Vanneste, S., Langguth, B., Llinás, R., & Vanneste, S. (2011). Thalamocortical dysrhythmia: a theoretical update in tinnitus. Frontiers in Neurology, 2, 1-9.
Hesser, H., Weise, C., Westin, V. Z., & Andersson, G. (2015). A systematic review and meta-analysis of randomized controlled trials of cognitive–behavioral therapy for tinnitus distress. Clinical Psychology Review, 40, 116-127.
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