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Tinnitus aurium is the conscious perception of an acoustic sensation in the absence of a corresponding external stimulus. Besides other psychological factors, psychodynamic factors play an important role in the disease. This study evaluated patients with tinnitus who attended the tinnitus outpatient clinic at the ENT Department of LMU Munich. In addition to a physical examination, in a psychodynamic interview the trigger situations, parents’ parenting style, relation to hearing personality, and individual conflict dynamics associated with the onset and course of tinnitus were examined. We included 99 patients diagnosed with tinnitus. Besides organ-related triggers, we identified conflict-laden stresses as trigger situations. 53% of the patients described themselves as sensitive to noise before the start of the tinnitus. Compared with the general population, patients with tinnitus showed less overt aggressiveness (P < .001) and more social orientation (P < .001) and state and trait anxiety (P < .001). Inhibition of aggression was a major psychodynamic factor in the development of tinnitus. A conflict of autonomy was found in the majority of cases. The results underline the importance of psychodynamic factors in tinnitus. We were able to put the individual psychological factors into a meaningful overall context.