The autonomic response is a main driver of tinnitus distress, therefore this has to be addressed. How it is addressed is entirely dependant upon each individual person because each of us 'operates' at our own level at any given time.
It is this area of Tinnitus Management in particular where the knowledge and skill of clinicians varies enormously.
Most audiologists should be able to help with the first aspect of Tinnitus Management (concerning the mechanism of tinnitus) and the third aspect of managing an aidable hearing loss through the use of hearing aid amplification as sound therapy. Some audiologists may also be able to help people to improve basic autonomic responses through teaching relaxation training.
Through understanding the physiology and neurobiology of the Autonomic Nervous System, and learning how to bring about balance within this complex nervous system, significant physiological changes take place to reduce levels of "arousal" that heighten tinnitus loudness and distress