Another habituation question

[Freddie]

Hello DR Nagler I have spoken to you a few times before but again I feel I need a little bit of guidance from you please.

I am in the process of doing TRT therapy and my therapist has given me an in canal receiver tuned to the small mid tone hearing loss I have in one ear so theory goes that the ear concentrates more on the extra noise that is coming in there fore should distract the listening brain to the tinnitus, a slow process I know but I am finding it increasingly hard to try and tune out to the T and to get to that land of habituation where the noise can become softer as the perception fades.

Can you help me regarding anything else that I can do to turn my attention away, I think I have my head in a better place from where it used to be so I can accept it more but somehow I can never seem to get to that point where I can totally ignore it a and move on.

Ant extra advice would be greatly appreciated please.

Thank you

 

[Dr. Nagler]

Hi @Freddie -

I have been really struggling with your question. I guess the best thing to do would be to answer it directly, and let the chips fall where they may.

You wrote:

I am in the process of doing TRT therapy

..............

TRT is a very effective way of facilitating habituation to tinnitus. But unfortunately you aren't in the process of doing TRT; you just think you are.

..................

and my therapist has given me an in canal receiver

...................

In TRT you never use a single device; moreover the devices you do use require open molds. In-the-canal devices are generally too occlusive to be used in TRT.

..............

so theory goes that the ear concentrates more on the extra noise that is coming in there fore should distract the listening brain to the tinnitus

.............

That's not the theory of TRT, nor is distraction involved

................

I am finding it increasingly hard to try and tune out to the T

..............

TRT does not involve trying to tune out your tinnitus

....................

and to get to that land of habituation where the noise can become softer as the perception fades.

.................

In the land of habituation the noise does not become softer.

..............

Can you help me regarding anything else that I can do to turn my attention away

...................

TRT does not involve turning your attention away from your tinnitus

.............

I think I have my head in a better place from where it used to be so I can accept it more but somehow I can never seem to get to that point where I can totally ignore it

...............

TRT does not involve ignoring your tinnitus.

................

Ant extra advice would be greatly appreciated please.

................

Well here's the thing, Freddie. I realize that I have told you a lot about what TRT isn't without telling you what TRT is. But that's a whole different story. My advice, since you asked, is to realize that whatever your therapist has been doing, it isn't TRT. And if your therapist is calling it TRT, then he or she is either ignorant or dishonest. So my advice is if you want to do TRT, then fire your therapist and do TRT with somebody who is knowledgeable and experienced in TRT.

Dr. Stephen Nagler
(with apologies for being so blunt)

 

[Freddie]

Hello there DR Nagler I asked you a question last week regarding habituation and you kindly replied last Friday evening ( as below, just the first few lines )

Hi @Freddie -
I have been really struggling with your question. I guess the best thing to do would be to answer it directly, and let the chips fall where they may.

You wrote:
I am in the process of doing TRT therapy ..............

TRT is a very effective way of facilitating habituation to tinnitus. But unfortunately you aren't in the process of doing TRT; you just think you are.


It has left me really in a situation that I am not sure what to do for the best as I thought I was using one of the top people in their field here in Jacqueline Sheldrake, and everything I told you is exactly as it was all explained to me from her.

Where do I go from here as I would like some really good advice and help regarding the best approach for facilitating the TRT process so I can get on that road to habituation, can you give me some help please or piint me in the right direction.

Thank you in anticipation.

 

[Dr. Nagler]

Hi @Freddie -

So now you have given me a piece of information that changes the entire dynamic.

I originally concluded that even though you thought you were doing TRT, you weren't. I based that conclusion on the fact that the type of device you were using (and that you were using only one device) is not what one would ordinarily use for sound therapy in TRT and the fact that the points you raised in your question suggested a lack of understanding of the Neurophysiological Model as well as the overall focus of TRT. So I said if you really wanted to do TRT, you should "fire your therapist and do TRT with somebody who is knowledgeable and experienced in TRT."

Well, it turns out that your current TRT clinician is exactly the person I would have recommended for you!!! Jacqui Sheldrake is extraordinarily knowledgeable and experienced. I know her quite well and have the utmost confidence in her. Indeed, if Jacqui recommended a particular device for you that would not ordinarily be used in TRT, I am sure that she had a very good reason for doing so, and I would defer to her in that matter. Moreover, regarding what appears to me to be your lack of understanding of the Model and the overall focus of TRT, my recommendation would be for you to set up an appointment with Jacqui for follow-up TRT counseling and for clarification of your various issues of concern. You are already in the hands of one of the very best TRT clinicians in the entire world!

Hope this helps.

Dr. Stephen Nagler