Cognitive Behavioral Therapy

[Nick47]

I hope one day we get real treatments instead of fake ones like CBT and TRT. We're people who count natural remission as the "treatment " helping. If TRT or CBT helped you, you would have been able to do it just the same without it. Like people saying they couldn't have done this or that without God, they could have. Wild. Give yourself and your body some credit. It wasn't TRT or CBT that did it. It was you.

If you can mind over matter and power through the damage you have by putting more sound in your system, you just aren't that bad, and you are lucky. It's so dangerous to promote TRT as a treatment, and talk therapy/CBT is just that. Positive thinking can't change the level of damage you have. Damage control is better than TRT. Time, quiet, rest, and as much sleep as possible, as well as avoiding medications that can make tinnitus worse, are your safest options.

I get pain, and my tinnitus increases from every sound. Let's put more sound in & just think positively about my body getting more and more damaged! Regular sounds can't hurt me. What a crock.

I agree that TRT is a scam. At first, I thought it was viable. However, I looked deeper at the science and found the following:

1) It's not supported. It has succeeded in 1 trial and failed in most. A quick meta-analysis would show that it's ineffective.

2) I have only seen some anecdotal evidence, which, as you say, without the same person cloning to have a placebo, is meaningless. Habituation and time could have played a role. The people claiming success have no placebo to rule out the above.

3) It's not recommended on the NHS.

So that leaves CBT, which isn't a treatment but is recommended to help with psychological distress and help manage the condition. Would you give CBT a go?

 

[Michael Leigh]

It's not recommended on the NHS.

My NHS hospital practices the full two-year treatment of TRT, along with CBT, mindfulness, and relaxation therapy classes for tinnitus.

Michael

 

[momus]

I agree that positive thinking (or any sort of thinking) cannot change anyone's tinnitus. But there are a lot of things in between experiencing tinnitus and not experiencing tinnitus. For myself, and I assume any human, when we're engaged in something we have our full attention on, we are not focused on the tinnitus.

Trust me, if I am having sex, I am ONLY having sex, and for all intents and purposes, I may not even have tinnitus. Now, someone can determine whether or not that is this type of thinking or that type of thinking. It makes no difference. During that experience, there is no perception of tinnitus at all. Zero. That doesn't mean I no longer have tinnitus, but it does mean that at different points in my life, I am not experiencing it.

That's good enough for me. It means I am not locked into it 24/7, and I certainly don't hear it or experience it when I'm sleeping. So if positive thinking (beats negative thinking, LOL) or what you have helps us to experience tinnitus less, then it's a good thing. I don't know why people are so focused on "curing' tinnitus. As it stands, there is no more chance of that happening than there is of curing a broken leg. If you have a broken leg, you don't go around walking on it; it only aggravates the issue. It's counterproductive.

Similarly, not watching our diet, not being engaged in pleasurable activities, etc., just aggravates tinnitus. We have the power to seek out diversions and escapes, to have a great life despite it, and to not do things that just make it worse. So we're not powerless; we can work with it. We have options. If we choose not to go with options, then that's on us; that's our problem, not the tinnitus's.

 

[AfroSnowman]

As it stands, there is no more chance of that happening than there is of curing a broken leg

I broke my ankle and got a cast on my ankle; after eight weeks, they took the cast off my ankle, and within six months, it was as if my ankle had never been broken at all.

Four or five years ago, I got tinnitus; I've done every treatment imaginable for tinnitus. I am still aware of tinnitus a substantial portion of my day, moments of sex or other intense concentration aside.

There is a cure for a broken bone; there is no cure for tinnitus.

CBT can help. I've done CBT for Tinnitus with Dr. Hubbard. It gives some skills and strategies for dealing with tinnitus and not making things worse. It is particularly well suited for those still in the trauma stage of tinnitus, as it may help you get through it more quickly.

If you are going to habituate, the sooner you can defocus and calm down, the better; CBT will help with that. Of course, I am the lucky person who doesn't get to habituate, but at least I am more at peace with it now.

 

[RunningMan]

Trust me, if I am having sex, I am ONLY having sex, and for all intents and purposes, I may not even have tinnitus. Now, someone can determine whether or not that is this type of thinking or that type of thinking. It makes no difference. During that experience, there is no perception of tinnitus at all. Zero. That doesn't mean I no longer have tinnitus, but it does mean that at different points in my life, I am not experiencing it.

That's good enough for me. It means I am not locked into it 24/7, and I certainly don't hear it or experience it when I'm sleeping. So if positive thinking (beats negative thinking, LOL) or what you have helps us to experience tinnitus less, then it's a good thing. I don't know why people are so focused on "curing' tinnitus.

Distractions don't work for me. I can get involved in a movie or be around a group of people that distracts me from my tinnitus for a while, but I still feel high anxiety. My subconscious still picks up on it, even if I'm directing my focus elsewhere, and there's that automatic response from the sympathetic nervous system engaging the flight or fight response. There's still that layer of brain fog caused by tinnitus, even when I'm focusing on something else. If only it were that easy, I would have figured it out a long time ago. Although, years ago, when I had mild tinnitus, it was much easier. Having severe tinnitus is a whole different matter.

I apparently still hear it when I'm sleeping because I keep waking up after not sleeping for over two years. If not a cure, we at least need an effective treatment that significantly lowers tinnitus. Benzos help temporarily, at least, but that's not a good path to take.

 

[Nick47]

when I had mild tinnitus, it was much easier. Having severe tinnitus is a whole different matter.

Me too! This idea of volume doesn't matter is not my experience at all.

 

[ZFire]

I prefer Acceptance over CBT. I found it to be way more beneficial personally. I mean, I'm still not thrilled with my tinnitus at all and it can still very much bother me, but acceptance has helped me manage it better throughout the day.

We still need proper treatments though. 100%

Me too! This idea of volume doesn't matter is not my experience at all.

Volume definitely matters. This is why I hope we can measure it objectively one day to assess perceived loudness instead of depending on subjective reports. Through objective methods, we can show people how loud tinnitus can get.

It would be the best way to demonstrate the changing nature of this condition.

 

[Benjaminbb]

Distractions don't work for me. I can get involved in a movie or be around a group of people that distracts me from my tinnitus for a while, but I still feel high anxiety. My subconscious still picks up on it, even if I'm directing my focus elsewhere, and there's that automatic response from the sympathetic nervous system engaging the flight or fight response. There's still that layer of brain fog caused by tinnitus, even when I'm focusing on something else. If only it were that easy, I would have figured it out a long time ago. Although, years ago, when I had mild tinnitus, it was much easier. Having severe tinnitus is a whole different matter.

I apparently still hear it when I'm sleeping because I keep waking up after not sleeping for over two years. If not a cure, we at least need an effective treatment that significantly lowers tinnitus. Benzos help temporarily, at least, but that's not a good path to take.

Was there a cause for your increase in 2022? Or was it spontaneous? How would you rate it before and after?

 

[RunningMan]

Was there a cause for your increase in 2022? Or was it spontaneous? How would you rate it before and after?

I think it was the noise trauma from a loud, continuous chirping sound that started between a Bluetooth transmitter and Bluetooth earbuds (or headphones) that continued for a few minutes while I was using a treadmill. I would probably rate my old tinnitus a 3 or 4, and I rate it a 7 to 9 these days since it's variable. But those ratings don't mean much since everyone has their own idea of how to rate their tinnitus, and tinnitus has no limit. So, I usually just say it's severe tinnitus.

 

[Furetto]

Hello,

I am considering CBT counseling and have an in-person appointment today. However, I'm wondering if it's worth it compared to an online course. What are the community's recommendations for the best online CBT courses?

Thanks!

 

[AfroSnowman]

Bruce Hubbard does a very well developed online CBT for Tinnitus course.

 

[Furetto]

Bruce Hubbard does a very well developed online CBT for Tinnitus course.

Yes, but it costs a 1000 freaking bucks.

I also found these two:

iCBT for Tinnitus Online

icbt4tinnitus.com

Cost: unknown.

Cognitive Behaviour Therapy for tinnitus

How much of a problem is your tinnitus? Do you experience anxiety and stress with tinnitus? The CBT for Tinnitus E-Programme (CBT4T) content is online and includes clinical support by email and with one to one appointments

www.tinnituseprogram.org

Cost: 295 - 625 pounds (depending on how many personal consultations you want).

I have not found other courses.

Han anyone tried these? Thoughts?

 

[RunningMan]

Bruce Hubbard does a very well developed online CBT for Tinnitus course.

I know @gameover didn't have a good experience with Hubbard:

I'm Travis, My Tinnitus Is 10/10 — Please Send Good Vibes and Advice

@Greg Sacramento

www.tinnitustalk.com

 

[UKBloke]

Han anyone tried these? Thoughts?

My NHS audiology dept. promised me CBT a couple years ago but never got back in touch (even to this day). I dabbled with the idea of paying privately and ended up having an email exchange with Debbie Featherstone, who provides the CBT4T programme you've linked to above.

I was really impressed by how much she appeared to care about my predicament. She also wrote me a very heartfelt, detailed message that set out what one can, and perhaps cannot, expect to gain from this type of therapy.

I was very keen to point out to Debbie that I am a veteran of tinnitus who experienced a significant worsening aggravated by hyperacusis. Reading the client testimonials on her website, I noted that those who'd volunteered the information about duration since tinnitus onset seemed to be in the very early stages and perhaps more treatable.

I don't think it would be proper to publish further details of our email exchange here on the above point; suffice it to say, I was more than satisfied by the end of our conversation that Debbie had encountered many patients like me over her professional career.

For various reasons, I decided not to do the programme for now. I just kind of grit my teeth and bear it. On the more important question of whether or not CBT could "work" for you and me, all I can say is; I like to keep reminding myself that CBT4T is a programme aimed at reducing tinnitus distress and not the tinnitus itself.

 

[Furetto]

My NHS audiology dept. promised me CBT a couple years ago but never got back in touch (even to this day). I dabbled with the idea of paying privately and ended up having an email exchange with Debbie Featherstone, who provides the CBT4T programme you've linked to above.

I was really impressed by how much she appeared to care about my predicament. She also wrote me a very heartfelt, detailed message that set out what one can, and perhaps cannot, expect to gain from this type of therapy.

Thanks very much for the useful feedback. Distress has now become a bigger problem than the tinnitus itself, so I am almost convinced to try CBT.

 

[AfroSnowman]

I know @gameover didn't have a good experience with Hubbard:

I'm Travis, My Tinnitus Is 10/10 — Please Send Good Vibes and Advice

@Greg Sacramento

www.tinnitustalk.com

I did his course, and it is what it is. CBT is a tool set that, at its best, creates a virtuous cycle of a deescalation of reaction that leads to a state of habituation.

I think that this outcome is possible for many people with moderate and lower tinnitus; for those with very severe symptoms, it might be of some limited use but really isn't much of an answer.

He was quite forthright in telling me that with the symptom set that I described and having no underlying anxiety or OCD issues, CBT would likely be of limited use to me.

 

[Cmspgran]

I did two private sessions with Dr. Bruce Hubbard (not cheap) and completed his online course. He's a nice enough guy, but as others have mentioned, CBT didn't feel groundbreaking to me. Essentially, it focused on encouraging you to resume normal activities and being mindful of negative thoughts. Unless I missed something, there didn't seem to be much more to CBT than that. Many of the tips were things anyone who's browsed this forum or done some quick research would have already seen, like sound masking. It does a disservice to severe cases to consider CBT a one-size-fits-all solution.