Understand the key stages of sound perception and what goes wrong in tinnitus with this informative handout.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
Sound perception is a complex process that involves converting sound waves into electrical signals that the brain interprets. How We Hear Sounds provides an illustrated overview of this process for mental health professionals who wish to incorporate sound perception psychoeducation into tinnitus treatment.
This handout is designed to enhance both clinician and client understanding of auditory processes by breaking down the components of sound perception.
Suitable for clients distressed by internal body sensations such as ringing in the ears.
Helpful for clients who experience strong emotional reactions to everyday sounds.
Use this resource to inform clients about the basics of how we hear.
Initiate discussions to explore any misconceptions clients may hold about their hearing.
Enhance clinician knowledge on auditory processes, improving therapeutic strategies.
Sound perception is a multi-stage process that begins with the mechanical transmission of sound waves through the outer, middle, and inner ear, and culminates in the brain’s interpretation of those signals. Hair cells in the cochlea convert vibrations into electrical impulses, which are then relayed via the auditory nerve to various processing centres in the brain, including the auditory cortex (Moore, 2012). Importantly, this process is not merely passive; the brain plays an active role in prioritizing and interpreting sensory input through mechanisms like auditory attention and filtering (Winkler & Schröger, 2015). Understanding these steps is essential for clinicians working with individuals who experience distressing auditory phenomena.
In conditions like tinnitus and hyperacusis, this otherwise adaptive system becomes dysregulated. Tinnitus is often associated with peripheral hearing loss, but the distress it causes is believed to be shaped by central mechanisms — particularly how the brain responds to the absence or persistence of auditory input (Eggermont & Roberts, 2004). Hyperacusis, similarly, involves atypical loudness perception and emotional over-responsiveness to everyday sounds, which are believed to be amplified by heightened attention and negative interpretations (Jastreboff & Jastreboff, 2000). Psychoeducation about normal auditory function can help clients contextualize their experiences, reduce fear, and support therapeutic engagement.
Providing a clear, accurate model of how we hear can be a valuable early step in therapy. Clients who understand that their symptoms reflect altered auditory processing—not evidence of damage or disease—may experience less fear and more psychological flexibility. This foundation supports psychological interventions such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), both of which have demonstrated efficacy in reducing tinnitus-related distress (Cima et al., 2012; Hesser et al., 2011). In CBT, psychoeducation facilitates the identification and restructuring of catastrophic beliefs (McKenna et al., 2014), while ACT emphasizes acceptance of internal experiences and commitment to meaningful action despite discomfort (Westin et al., 2011). By normalizing auditory symptoms and contextualizing them within a broader therapeutic model, this resource helps prepare clients for effective engagement with these evidence-based interventions.
