Chronic tinnitus is a common and often highly distressing phenomenon that, in its chronic phase, is primarily maintained by psychological factors. Individuals affected by tinnitus frequently attribute fluctuations in their emotional well-being causally to the tinnitus symptom. However, from a psychotherapeutic perspective, both the perception of symptoms and the resulting emotional distress are shaped by complex, dynamic interactions involving (a) personal life experiences, (b) personality traits, (c) the subjective interpretation of intrapsychic and interpersonal stimuli, (d) emotional states, and (e) coping strategies at both intrapsychic and interpersonal levels. This review begins with a brief introduction and then connects a well-established psychological theory of chronic tinnitus development and maintenance with a broader vulnerability-stress-coping model. Within this framework, we present key research findings from both somatic and psychological perspectives, ultimately offering insights for psychotherapeutic prevention and treatment approaches.