Tinnitus Retraining Therapy

[Dr. Nagler]

So, I slowly ignore the T more and more although it is there would this mean I am habituating spontaneously?

No. Habituation has nothing to do with ignoring your tinnitus. If you can ignore your tinnitus, there would be no reason to habituate it.

Dr. Stephen Nagler

 

[direct]

TRT (tinnitus retraining therapy)
http://www.worksafebc.com/health_care_providers/Assets/PDF/tinnitus_retraining_therapy.pdf

 

[jeannie]

the audiologist who sold me my hearing aides for 6500 told me the hopes is it completely goess away, that was almost 2 years ago. they prey on us struggling because they know we are very vulnerable

 

[Henrym]

Hello I live in Orange County california. Just wondering if anyone knows the best pace to get TRT close to where I live.

Thank you so much. This started 3 weeks ago and it's been tough but I am hanging in one day at a time.

 

[Rube]

Hello I live in Orange County california. Just wondering if anyone knows the best pace to get TRT close to where I live.

Thank you so much. This started 3 weeks ago and it's been tough but I am hanging in one day at a time.

Hi Henry, give a shout out to @Dr. Nagler Over at the doctors corner maybe he can recommend someone near you.

 

[Cor]

@Dr. Nagler would you say that reading Pawel J. Jastreboff's book yourself would help? I live in a country without easily available TRT professionals (The Netherlands). I have done some CBT sessions, but not specific to tinnitus.

 

[RCP1]

@Dr. Nagler

Dr Nagler. Very quick note to express thanks for the recommendation to Jacqui Sheldrake. I have been to see her twice and am engaged in treatment.
At this point I am very happy with the service I have received.

Many thanks again.

R

 

[Dr. Nagler]

Dr Nagler. Very quick note to express thanks for the recommendation to Jacqui Sheldrake. I have been to see her twice and am engaged in treatment.
At this point I am very happy with the service I have received.

Glad to help. And I am very glad to see that you are in good hands. There's a whole lot of bad TRT out there.

stephen nagler

 

[RCP1]

@Dr. Nagler. Very good hands. As you said yourself I wish everyone had the opportunity to give this a real go.
I will be in touch in a few months to give further info on progress.

R

 

[KingRoanoke]

I believe that meditation and relaxation exercises are beneficial for people, but if your distress is caused by painful tinnitus, it seems that these exercises actually create more distress. TRT says that your pain and discomfort from tinnitus is due to your automatic reaction. Conscious efforts to make yourself react less don't work, according to TRT. I fully agree. TRT says that your best bet is to set yourself up to facilitate tinnitus - they do this with sound therapy to make tinnitus less harsh and counseling to reassure you that you can find relief even with tinnitus.



Fine.


But my experience of hearing my tinnitus and having pain and discomfort are always mutual. I do not have an experience where I hear my T in a quiet room and am not feeling some varied degree of pain. Yet the common knowledge that is dispensed, even by ENTs, but also by CBT books that try to facilitate habituation is to do exercises to relax or to meditate. This is horrible advice. Meditation is completely inaccessible to the sufferer of severe tinnitus. Relaxation exercises similarly end in frustration.


According to TRT, this is not my fault, as I cannot control this autonomic reaction. I have never experienced tinnitus in a quiet room without varying degrees of pain. All meditation and relaxation exercises have brought me is a depressing realization that I can't relax simply by sitting idly and that this condition prevents me from meditating, and a sense of guilt and frustration for feeling like I am doing both wrong.

TRT specifically says that sound therapy facilitates habituation by making tinnitus less harsh and this disrupts the limbic system's bad reaction in the feedback loop by being less reinforcing. So try to meditate and relax with noise generators, right? Still doesn't work for me. The relief brought on by noise generators, like the shower, is the result of me having moments where I lose the signal in the white noise. I am able to hear my T through the highest setting of the noise generators. It's a passive process - I am not doing anything to facilitate these periods of relief. They can be random. Meditating, relaxation exercises, and the like are an active process that shines a light on my T, even with the white noise blaring.


Beyond this, I reject the idea that there is a way to set yourself up to facilitate tinnitus.

There is no amount of CBT that will coax me into believing that I'm okay with pain. Pain is not okay and it always feels bad. I'm not okay with pain. And tinnitus gives me harsh pain. There is no amount of meditation or relaxation that will make me feel less pain. I can hear my tinnitus through anything. If the noise generators give me relief, it's only because I can't hear my tinnitus as well or I have moments where I lose it within the noise-generator signal. That's it. There is no exercise, no mantra, no affirmation, no meditation, that will make this a more bearable condition.


The failure to relax and find relief is not a matter of me not doing the exercises correctly. The exercises are ineffective for a sufferer with severely intrusive tinnitus. I wish every CBT books, ENT, and website would stop throwing sufferers of severe T aside by telling them to meditate. It is inaccessible for us and cannot affect any change.

Tinnitus.org has a 15 minute exercise where you sit and listen to your tinnitus in the quiet and try to learn to live with it. I have tried this for the past 7 years and it has not worked. I want to throw the server that hosts that awful website out the window. My tinnitus is painful and the frustration of not being able to force myself to get used to it through these stupid exercises is more insult to injury.


Thanks.

 

[NiNyu]

@KingRoanoke I feel you. And I totally agree! What could be more stress-inducing than something screaming in your ear 24/7 without a break and knowing that it will NEVER stop until you DIE? Relaxation is impossible.

You can't treat a severe physical ailment that does NOT give you a break with psychology; and that's what TRT actually does, right? For meditation (psych) and relaxation (body) a clam mind is not only needed but a requirement! But how can you access and maintain a calm mind when T is constantly screaming and causing pain?

Imagine the following,
someone punches you in the face repeatedly. Now that someone tells you, 'Relax. Concentrate your mind on something else, inhale, exhale, habituate.' Obviously, as you can see, being punched in the face is a 'physical thing'. And that is why psychological therapies will NOT work. However, if you had anxiety of being punched in the face by someone you could actually use psychology to solve, mitigate your problem because it is a 'mental thing' and not a 'physical thing'. Unfortunately, T (worst malady on this planet) is a PHYSICAL problem; just like pain it's all in the brain. And I go insane!

 

[Vincent R]

I believe that meditation and relaxation exercises are beneficial for people, but if your distress is caused by painful tinnitus, it seems that these exercises actually create more distress. TRT says that your pain and discomfort from tinnitus is due to your automatic reaction. Conscious efforts to make yourself react less don't work, according to TRT. I fully agree. TRT says that your best bet is to set yourself up to facilitate tinnitus - they do this with sound therapy to make tinnitus less harsh and counseling to reassure you that you can find relief even with tinnitus.



Fine.


But my experience of hearing my tinnitus and having pain and discomfort are always mutual. I do not have an experience where I hear my T in a quiet room and am not feeling some varied degree of pain. Yet the common knowledge that is dispensed, even by ENTs, but also by CBT books that try to facilitate habituation is to do exercises to relax or to meditate. This is horrible advice. Meditation is completely inaccessible to the sufferer of severe tinnitus. Relaxation exercises similarly end in frustration.


According to TRT, this is not my fault, as I cannot control this autonomic reaction. I have never experienced tinnitus in a quiet room without varying degrees of pain. All meditation and relaxation exercises have brought me is a depressing realization that I can't relax simply by sitting idly and that this condition prevents me from meditating, and a sense of guilt and frustration for feeling like I am doing both wrong.

TRT specifically says that sound therapy facilitates habituation by making tinnitus less harsh and this disrupts the limbic system's bad reaction in the feedback loop by being less reinforcing. So try to meditate and relax with noise generators, right? Still doesn't work for me. The relief brought on by noise generators, like the shower, is the result of me having moments where I lose the signal in the white noise. I am able to hear my T through the highest setting of the noise generators. It's a passive process - I am not doing anything to facilitate these periods of relief. They can be random. Meditating, relaxation exercises, and the like are an active process that shines a light on my T, even with the white noise blaring.


Beyond this, I reject the idea that there is a way to set yourself up to facilitate tinnitus.

There is no amount of CBT that will coax me into believing that I'm okay with pain. Pain is not okay and it always feels bad. I'm not okay with pain. And tinnitus gives me harsh pain. There is no amount of meditation or relaxation that will make me feel less pain. I can hear my tinnitus through anything. If the noise generators give me relief, it's only because I can't hear my tinnitus as well or I have moments where I lose it within the noise-generator signal. That's it. There is no exercise, no mantra, no affirmation, no meditation, that will make this a more bearable condition.


The failure to relax and find relief is not a matter of me not doing the exercises correctly. The exercises are ineffective for a sufferer with severely intrusive tinnitus. I wish every CBT books, ENT, and website would stop throwing sufferers of severe T aside by telling them to meditate. It is inaccessible for us and cannot affect any change.

Tinnitus.org has a 15 minute exercise where you sit and listen to your tinnitus in the quiet and try to learn to live with it. I have tried this for the past 7 years and it has not worked. I want to throw the server that hosts that awful website out the window. My tinnitus is painful and the frustration of not being able to force myself to get used to it through these stupid exercises is more insult to injury.


Thanks.

While I don't agree with the conclusions in this message, I think many observations are spot on. Personally, I don't think a sound is as much of an issue when it comes to meditation and relaxation as pain would be, but it's not that far behind. Chronical pain and severe T have much in common. (I've experienced both.)

A person who is already in a very bad spot is bound to run into walls if any kind of meditation or hypnotic method is applied. If the teachings doesn't adress these inevitable and enormous walls, as well as show how to overcome them, then the teachings are incomplete.

Instead of promises of blessnings, genuine meditation teachings should include a detailed map of Hell, and the roads out of there, assuming there are any.

 

[NiNyu]

genuine meditation teachings should include a detailed map of Hell, and the roads out of there, assuming there are any.

There's only one bumpy road out of T-hell that I know about, and this road's name starts with the letter D and ends with the letter H. Go figure.

 

[RCP1]

@NiNyu

You are truly a gas man or Lady? I don't know which.

I know you are suffering right now - I don't doubt how bad you feel. But you don't have statistics on your side.
Many many people recover from Loud Intrusive Tinnitus and go on to lead completely normal lives.
The numbers and reality of the matter don't support what you are saying.

Yes there are people who will never recover as the T just won't yield and is so intrusive the brain can't deal with the sound - However for every one of these there are loads who do.

You have come on to this board and made comments on nearly every thread regarding the hopelessness of the particular treatment and that it's all snake oil. I agree with a lot of what you have said. However when it comes to recovery in general I don't agree.

It is possible a) For the T signal to weaken over time and become softer and b) For the signal to remain the same but the brain to put it on the backburner as it is no longer interested in it. I'm afraid your scaremongering won't work in this instance. Why you say ?...well fine I'll tell you why. Are you familiar with the mathematical term "Proof by Contradiction"? Well I contradict what you are saying as in my instance the experience of TRT has lowered my perception of T tremendously in a very short period of time.

3 months ago I was lying on my back in bed listening to a really loud T sound - It engulfed me completely - I saw only 1 way out as you have already described. Thanks to a certain Mr Dr. Nagler I made contact with the aforementioned Tinnitus Clinic above (In London) and started treatment. I no longer lie in bed looking at the ceiling - I am back to being a Dad and a husband and getting on with my life. I really enjoy the majority of my day. I am confident of getting completely back to normal. The confidence is half the battle - If you believe recovery is possible and will be attained then it is possible. I am not talking about dealing with High Pitched Screaming T and battling on regardless - I am talking about not noticing it for the majority of the day and carrying on as normal. This is what has happened in my case anyway - And if it can happen for me it can happen for others. Thats a fact.

You are only a few months into your Tinnitus experience - Things may improve if you approach it in a systematic and structured way. To the Individual giving out about the exercise part of the Tinnitus.Org site - you may well be correct that in isolation these exercises don't work - I would accept that as listening to your Tinnitus for 15 mins a day probably will do nothing. What you are doing isn't TRT. What you are doing is taking a bit of advice given to you for free by a caring therapist because it may make you feel better but by no means is guaranteed to work. It is the charitable crumbs off the table of a well respected TRT clinician who has countless proven results.

@NiNyu I am sure you feel great about preverbially p*ssing all over this fantastic facility which is Tinnitus Talk. Everyone knows there is no side effects free narcotic or scientific based solution to Tinnitus so don't feel too great about stating the obvious on every individual thread. Nothing you have said requires any great amount of critical thinking or use of the cerebrum.

However the Potassium based solutions which are on the way may indeed provide relief. Indeed they already have if you look at the Retigabaine thread. So that is hope.

My opinion is this - Tinnitus Talk is full of individuals who have been struck very hard with this condition - The 1% of folk who are deeply distressed. These folk need this Board to get through their day and give themselves a little shot in the arm to continue on. Therefore this Board Implicitly helps sufferers. So as smart as you seem to think you are what you are doing is p*ssing on a tool which actually in itself successfully gives relief to sufferers. Isn't that Ironic.

What I would suggest is that you take a back seat for a while and see how your Tinnitus pans out. You may well be surprised just how well you may be doing in a month or so.... This may not be the end game you think it is.
Continuing what you are doing is undoing the good work of @Markku and his team of administrators who selflessly create this quiet space which is unique in the world of Tinnitus sufferers and which should be shown a lot more respect than has been shown.

Cheers

R

 

[skoupidis]

So, I slowly ignore the T more and more although it is there would this mean I am habituating spontaneously?

No. Habituation has nothing to do with ignoring your tinnitus. If you can ignore your tinnitus, there would be no reason to habituate it.

Dr. Stephen Nagler

Ignoring is not the same as being ok with it or even dealing with it. He suffers by it but continues to live.

The right question about habituation and TRT is: Does it make you forget your tinnitus?

 

[marqualler]

I have some thoughts on my experience with looking into Tinnitus Retraining Therapy that I've been thinking about since my initial appointment with a clinic near my home. The below review pertains to my experience with the "Tinnitus and Hyperacusis Evaluation" offered by the clinic linked below.

@Dr. Nagler had recommended that clinic to me on the Doctor's Corners back in November when I was really struggling with coping with T. I went to the website at that time and was not overly impressed--it looked very sales-y and dated but unfortunately I was not getting a ton of help at all from my ENTs and was pretty desperate for someone to talk to who had an idea of what tinnitus was. Finally I made an appointment when in December I was REALLY feeling lousy--I was taking eardrops prescribed from my ENT which seemed to just exacerbate the tinnitus and I was severely depressed about the holiday season with tinnitus, seeing no end in sight. Step one of setting up an appointment with the clinic was to complete this Tinnitus Reaction Questionnaire (TRQ). I ended up scoring 48/104 (in reality, I probably would have scored higher if I was not hedging my responses somewhat.)

I had another ENT appointment on Dec 26 2014 to follow up on the eardrops he had prescribed and he actually removed some debris from my eardrum that initially did not give me a lot of relief but over the next few days, I came to realize that my T was much less "reactive" after that--i.e. noisy restaurants, places, etc., no longer set my T at a volume as high as the volume around me. I'm not sure if that is a coincidence or not but that relief plus the relief that my ENT no longer recommended surgery was very nice. On Jan 1 I went to the Mall of America with my friends & family which was one of the places where two months prior I had had a horrible T experience--and this time it didn't bother me at all. So I was on Cloud 9 from that and just feeling a lot better overall, leading into my Jan 5 2015 appointment.

On Jan 5 2015 I went in, thinking I was going to meet with Paula Schwartz, who Dr. N had recommended, but instead I was meeting with one of her colleagues at the clinic. We started the first 20-30 minutes talking about my tinnitus--I explained that since I had done that TRQ I was feeling better but would like to get more relief--and going through a PowerPoint-style presentation on his computer about "what tinnitus is".

That presentation was based on The Neurophysiological Model of Tinnitus by Pawel Jastroboff (from 1990 which, to me, was a red flag.) He also covered the concept of "habituation" by using the "if you live near a train you will eventually ignore the train sounds" example Dr. N uses.

One main point he talked about here was how TRT "success" is measured--I believe it was a "40% decrease in your TRQ score is considered a success." I completed the TRQ again later in January and was down to about a 10/104, which meant that I had achieved "TRT success" without having started TRT. All in all, in my mind, rating TRT a success based on this score seems like a highly subjective and slippery way of measuring success.

Next, we did an audiogram that included tinnitus loudness and tinnitus pitch matching, and testing up to 16000 hZ. This was I would say the most helpful part--my other audiograms at my ENT were not quite as thorough, and the doctor I worked with is an audiologist so I assume this was his specialty. I'm sure if I had asked my ENT to do a more thorough test or asked for either of those they would have done it as well but regardless, this was at least somewhat informative.

Finally, we walked back to his office and he introduced a whole host of different hearing aids, white noise generators, and desktop white noise generators. He also pushed the Neuromonics device, offering all of them up for trial use in office and perhaps for leaving. Given that I have subsequently learned about Neuromonics' clinical studies being all conducted by the developer of the product itself, I have some misgivings about that particular product being offered. As I had told him at the onset that I wasn't interested in using any of the devices for now and not really all that interested in TRT, he didn't push them too hard on me.

At this stage he also mentioned that he "also has tinnitus" that he got while hunting without ear protection--which, on the face, I don't really have any reason not to believe him, but is not extremely relevant to what I was there for. In retrospect, it seemed an odd thing to inject in light of the context of the evaluation itself.

In a few follow-up emails I have had with him, I have sent him links to things I've seen on TT and he has mostly pointed out what is wrong with them while also pointing out Neuromonics as one of the better devices with good clinical data supporting it. (Another red flag to me)

All in all, I definitely came away with the idea that I had just spent $400 on what amounted to a dated presentation about information I had already known from my time here at Tinnitus Talk, an audiogram, and a sales pitch on hearing devices. Had I known that the Evaluation was spent mostly on education and presentation of hearing aid and masking devices, I would have spent that money elsewhere on products that have given me a more measurable source of relief, like mindfulness or CBT training.

 

[Dr. Nagler]

@marqualler, I am so very sorry to read that you had the experience you describe. As you write above, "On Jan 5 2015 I went in, thinking I was going to meet with Paula Schwartz, who Dr. N had recommended, but instead I was meeting with one of her colleagues at the clinic." In the future when I recommend Dr. Paula Schwartz, I will make sure to tell the patient to specifically request Dr. Schwartz. Thank you for your feedback. I appreciate it.

stephen nagler

 

[RCP1]

@marqualler

Thats great you're feeling better. A score of 10/104 is pretty much a situation where you are in control and not being affected too much with your Tinnitus.

I had the opposite experience to you when I attended the clinic in London. I saw the lady recommended and the initial counselling session made me feel about 20% better almost instantly.

I don't see why the presentation on Jastrebroff's work is a red flag - Surely this is the basis for TRT and you must have known this.

In any case I have had several counselling sessions since then and they have settled my subconscious and kept me on the road to habituation.

I am back working 5 days a week and am socialising and living life practically as before. I'd say 90% back to normal.

TRT gets a bad press in my opinion and people are only interested in quick fixes and tangible relief mechanisms.

TRT takes a while as it involves steering the vast vessel that is the subconscious in a certain direction.

It takes perseverance and belief that it will work.

I fully believe I am on the right road.

All the best to those who tread down this path. It is definitely worth a go.

R

 

[Dr. Nagler]

It takes perseverance and belief that it will work.

I loved your entire post, RCP, and take issue only with the single sentence quoted above. For me personally, anyway, I never believed TRT would work ... until it did. I figured that with my luck, I'd be in the 15% or so who do not do well. I just did TRT anyway because the model made sense to me, and I had nothing to lose by giving TRT my very best shot.

Best to you and to all -

stephen nagler

 

[attheedgeofscience]

I loved your entire post, RCP, and take issue only with the single sentence quoted above. For me personally, anyway, I never believed TRT would work ... until it did. I figured that with my luck, I'd be in the 15% or so who do not do well. I just did TRT anyway because the model made sense to me, and I had nothing to lose by giving TRT my very best shot.

@Dr. Nagler since your company is set up as a for profit entity, but donating all profit to charity, it wouldn't really matter (to yourself) if you gave away a couple of free TRT courses, right? Have you considered e.g. donating a free full length TRT course to a person such as @marqualler - it would benefit tinnitus sufferers all around the world to hear his experience from the session (and TRT course).

 

[Dr. Nagler]

Dr. Nagler since your company is set up as a for profit entity, but donating all profit to charity, it wouldn't really matter if you gave away a couple of free TRT courses, right? Have you considered e.g. donating a free full length TRT course to a person such as marqualler - it would benefit tinnitus sufferers all around the world to hear his experience from the session (and TRT course).

Tinnitus knows no socioeconomic boundaries. Because of that sad truth, I treat 18% of my patients at no charge whatsoever. These are individuals who are truly destitute and have no insurance coverage or other resources. Actually I have done that for years - even as far back as the 1980's when I was in surgery practice.

In terms of your suggestion that I treat somebody from the board free "to hear his experience from the session," I already did that once - years ago. The fellow even set up a website to describe his experience. The website is woefully out of date and now filled with ads, but if you are really interested and can get past the ads, go to: http://tinnguy.tripod.com/index-1.html

stephen nagler

 

[attheedgeofscience]

Tinnitus knows no socioeconomic boundaries. Because of that sad truth, I treat 18% of my patients at no charge whatsoever and have even arranged for them to get their devices free.

Your generosity knows no boundaries, Dr. Nagler. You truly are the most self-less person, I have ever come across.

In terms of your suggestion that I treat somebody from the board at no charge "to hear his experience from the session," I already did that once - years ago. The fellow even set up a website to describe his experience. The website is woefully out of date and now filled with ads, but if you are really interested and can get past the ads, go to: http://tinnguy.tripod.com/index-1.html

No, I am not really interested, Dr. Nagler. I am interested in someone (now) going through your TRT course (it doesn't matter that a 2nd person goes through your course for free since you make no money from the treatment in any event, right?). You are the expert. No one knows TRT better than you do (except perhaps Dr. Jastreboff). It would be great to have someone keep a journal of the experience, and reporting in every month or so as to how they are doing. Think about the publicity value you would get! If TRT works so great (as you say it does), people will be coming to your clinic en masse!

Since @marqualler does not qualify to your standards for lack of coverage, I suppose someone such as @Shadgirl might be a good candidate?

The Cleveland Clinic in Ohio. It has a tinnitus management clinic but my family cant spare the money or the trip over there. I cant drive. I live in Ohio. They don't understand how bad it is or how desperate I am for some help. Worse yet this happens with everything I need from them. They only give me health of there attention and my other siblings take priority. But I really need to know more. I'm about ready to end it all. My dreams, my independence, maby my life if this gets any worse... Have you ever heard of anything like that? Sorry to bug you. I know your having trouble yourself but I'm desperate.

 

[Robb]

Tinnitus knows no socioeconomic boundaries. Because of that sad truth, I treat 18% of my patients at no charge whatsoever. These are individuals who are truly destitute and have no insurance coverage or other resources. Actually I have done that for years - even as far back as the 1980's when I was in surgery practice.

In terms of your suggestion that I treat somebody from the board free "to hear his experience from the session," I already did that once - years ago. The fellow even set up a website to describe his experience. The website is woefully out of date and now filled with ads, but if you are really interested and can get past the ads, go to: http://tinnguy.tripod.com/index-1.html

stephen nagler

Dear @Dr. Nagler,
Sorry for falling with the door in the house how we say in Holland. I am now having T for 1,5 years after a slap on my ear, resulted in a perforated eardrum etc.
My T after the event has gone down to a more bearable level. I tried AM-101 and had at least two single injections of it in second round. However my T is still present and might is a bit more annoying present from time to time and I feel i want to start TRT.

What can you recommend me?

Just simply;
- what kind of device or type of TRT? As I my T seems to be at a broadband white noise tone of 16,5kHZ which seems according to audionotch.com guys not treatable with their solution.
- if i go sleep at the moment i have no masking device, should i use masking devices? (will this slow process of T moving/settling in brain?)
- is it necessary for me to keep at day background noises? (will this slow process of T moving/settling in brain?)


A BIG THANKS

THANKS!

 

[Dr. Nagler]

Your generosity knows no boundaries, Dr. Nagler. You truly are the most self-less person, I have ever come across.

Jakob, I have patiently and respectfully replied to your inquiries about my practice. That all stops now with your sarcastic comment above. You are going on "Ignore," which is where I should have put you long ago.

stephen nagler

 

[Dr. Nagler]

Dear Dr. Nagler
Sorry for falling with the door in the house how we say in Holland. I am now having T for 1,5 years after a slap on my ear, resulted in a perforated eardrum etc. ...

Hi Robb -

This would be a perfect question for the Doctors' Corner. Please ask it over there, and I'll try to get to it in the next day or so.

All the best -

stephen nagler

 

[Robb]

No stress

 

[attheedgeofscience]

Jakob, I have patiently and respectfully replied to your inquiries about my practice.

No, you haven't. You are as evasive (as always). Why don't you offer one person free TRT (when your clinic is in any event set up with a one dollar salary draw?). I am not asking you to do this for me; I am asking you to do it for the rest of the tinnitus community. Thanks.

attheedgeofscience
24/MAR/2015.

 

[MarioT]

I have to admit, I am rather sceptical concerning the efficacy of TRT. Although the neurophysiological model of Jastreboff sounds like a plausible approach, my scepticism is mainly based on the fact that it is a rare find to read any testimonial or positive experience of patients that underwent this treatment. Besides Dr. Nagler I also have not noticed any other true advocate of TRT on this forum either. This hardly correlates with the supposed reported success rate of 80%-85%.

I apologize in advance in case my point has been made and discussed before (I didnt read all the previous posts on this thread).

Please feel free to correct me if I am wrong.

 

[Viking]

For general information: In Italy there were 3 doctors who tryed the TRT for free on some patients and they discover another neurophisiological rule; if a patient PAY.... probably the TRT work, if they don't pay, thwy will abandone the program. In poor words they want say that trt is a big placebo based on animal sistem of alarm deconditioning. This is not valid for humans or not for all humans. About my personal experience with a long TRT, and i don't want to criticize Dr Nagler, this approach have worsened my tinnitus and not only for me. I'm in continous contact with others persons that i had meet in the clinic where trt is offered. We are a small number of people, 18 have completed the 36 months necessary to obtain some relief, 4 has abandoned after 8 months, other 4 after 1 month due to tinnitus exacerbation. Total 26 persones. No one of those suffers has obtained a minimum of relief, and we have buyed the textbook of Jasterboff to understand better with help of neuropsichiatrist what he and his collegue suggest. In conclusion after approximately 10 years of personal study we have concluded that this approach is not therapy. Also in neuropsychiatry, both public and private, it is not approved. There aren't REAL evidence of its effectiveness. The national health system, which is willing to pay me even the intervention in Switzerland and all my therapies outside Italy, does not fund trt because there are no scientific basis for saying that this approach is effective. There is some astute audiologist, who, having failed to get a job in public structure, have opened a few private practice audiology for the "cure of tinnitus." None of the patients surveyed said they had obtained relief. All were "shipped" after a few months by a psychologist or a prescription of SSRI drugs. We are still looking for a credible track of 85% of success in deconditioning, vaunted by Jasterboff and colleagues. In most cases, controlled groups, the best of success of the process of deconditioning were obtained AVOIDING the sound masking and exposing people to "normal" life. All those who have been subjected to sound masking, have focused attention chronically on their tinnitus that gradually became more and more stronger to request a psychotherapeutic support constant and inability to work, someone have developed hiperacusys.

 

[attheedgeofscience]

The website is woefully out of date and now filled with ads, but if you are really interested and can get past the ads, go to: http://tinnguy.tripod.com/index-1.html

@Dr. Nagler since you apparently are not interested in helping out with a testimonial of another patient (besides the one you are referring to from some +10 years ago), I would like to highlight the following (other) testimonial from a patient of yours (a balanced view is only fair, right?):

Freddie posted:

I think this is becoming an advertising thread for one therapy.
Sorry, thats the way I see it.
Freddie.

****************

The way I see it is that somebody posted a request for testimonials regarding a particular therapy, and another person (I in this case) responded.

Moreover, I went out of my way to stress at the outset that such testimonials are by their very nature biased:

To quote: " Please do bear in mind that all testimonials - pro and con - by their nature represent a high degree of bias. It's just impossible to be objective when you are so intimately involved with the process."

Here's another testimonial - also biased. It was just copied to me from another Internet site. I do hope that it satisfies any concerns Freddie might have about this being an "advertising thread" for one therapy.

smn

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

From Ron:

It is 6:12AM. I'm awake because my tinnitus is so damned awful loud that I cannot sleep. It is frustrating and depressing.

I decide to check in here, and have a glance at the TSMB. What I see there makes me sick to my stomach!

I post the following for the *desperate* tinnitus sufferer out there, the person willing to try ANYTHING in search of relief, for I do not desire to see their minds brain-washed and their wallets emptied through a modern day form of *snake-oil* which is running rampant in this country and overseas!

A thread was started, *Is there any Good News On the Horizon?* (ON THE TSMB BOARD)

Within the blink of an eye, good ole *Dr.* Stephen Nagler turns the thread into a 12 page ( I printed it out!) *roundabout* advertisement for Tinnitus Retraining Therapy.

Why am I posting any of this here? Simple really. This board was indirectly started (in part) due to Nagler's cyber disturbed behavior on TSMB and other boards, and the majority of the participants here are mostly refugees from the TSMB at the present time.

I cannot post on the TSMB, Nor do I have ANY more desire to ever post there again. (Unlike the very disturbed megalomaniac Stephen Nagler, and his faithful lapdog, James Chinnis.) who MUST have a venue for spewing their pseudo-science on a daily basis.

However, I will continue to state my views on both TRT and one Dr. Stephen Nagler for the record. Why? Because I think he is a very very sick man, and I have FIRST HAND experience with him. These are just my opinions, but opinions based on COLD HARD FACTS, and FIRST HAND EXPERIENCE.

I have suffered with tinnitus since 1996. SEVERE tinnitus. I first heard of Nagler when I found the alt.support.tinnitus usenet board in 1996. He was just another tinnitus sufferer looking for advice on what was once a great great board.

A former colorectal surgeon (supposedly) he found good ole Pawell Jastreboff, who was pushing a "treatment" called Tinnitus retraining Therapy.

Within months, he opened his own ***Tinnitus Clinic*** in Atlanta, Georgia. It is my firm opinion (now) that he felt he had stumbled upon a goldmine by advertising his *clinic* on a public usenet *support* board, and felt it would last a lifetime.

Quote:AN INTERESTING NOTE: I have NEVER in 7 years, seen any other "TRT Practioner" advertise his or her *Clinic* on any tinnitus support board ANYWHERE! Gee, I wonder why?

I was desperate. Extremely desperate! I was easily snared by the promise of "Two Days In Atlanta, A Lifetime of Relief" as Nagler advertised. I arranged an appointment with him, and in 1997 my wife and I flew from New York to Atlanta for three days. Between the airfare, hotel, and the close to $4,000.00 fee for "treatment", we were in the area of a $5,000.00 investment!

I shudder thinking about that first "meeting" in his office. This little dweeb of a man sitting there with a gold plaque on his desk that read "NO LONGER AN ISSUE".

That night in our hotel room, my wife said, "Honey, I'm behind you on your decision, but this seems like a complete scam to me?" I replied, "It's all I've got left right now."

The next day, I was given a series of hearing tests by his audiologist, a Norma Mraz. (who eventually left his employ for reasons that I will not discuss now) The same old tests I have had at least 6 times previously in New York.

I was then shuffled into another room, where Nagler had a three ring binder filled with ear anatomy diagrams nicely sealed in plastic sleeves. It was like I was buying aluminum siding or a new pool for my house for Christ Sakes!

He explained how the ear works, "here is the inner ear, here is the middle ear, here are the bones of hearing, blah blah blah! Jesus, I could have given the same "presentation" myself. Lord knows that I know HOW the ear works having gone through a stapedectomy just a few months before with one of the best ear surgeons in the world. My wife just sat there rolling her eyes.

This was the "directive counseling" part of the "therapy" What a complete joke.

I was then given two behind the ear white noise generators, and told to wear them at the lowest volume in BOTH ears, even though my tinnitus was in one ear only. These were about $2,500.00.

I was told that by wearing these for a maximum of up to TWO YEARS, my brain would ***cleave*** the tinnitus signal, and accept it as *normal*. Jastreboff has created a whole set of new words and "catch phrases" in his little scam masquerading as a "scientifically proven" treatment.

That's about it as far as my "treatment" is concerned. I was told to go home and come back in six months for a "follow up" . Nagler then said he was clever at coding the insurance forms to sneak my claim past my insurance company. AETNA at the time. Thank Christ, they were fooled, and picked up the majority of it. They No LONGER do! There is a site on the net that explains there policy with regards to TRT.

It can be found here:

www.aetna.com/cpb/data/CPBA0406.html

I remember Nagler telling me specifically, "Ron, you have to take a ***Leap of Faith*** with me on this "treatment"
Ever hear of a *Faith Healer*? Snake-Oil, Faith Healing? Are you all getting the picture now? It's a scam designed to prey upon the desperate. It is no different than people flying to third world countries in a desperate attempt to *cure* their cancer!

Remember the film, Man on the Moon, with Jim Carey as 70's comedian, Andy Kaufman? AT the end of the film, Carey as Kaufman visits a mexican *cancer clinic* where his cancer is *removed* via slight of hand techniques, using an animal organ as the *removed cancer*

Tinnitus ***Retraining Therapy* is nothing short of the same type of "voodoo" "treatment"

It is simply an absurdly expensive PLACEBO, wrapped in fancy self-created jargon and terminology, having NO, I Repeat N O basis in science whatsoever.

My ENT's, and my world famous otologist, Dr. Simon Parisier, of Manhattan Eye Ear and Throat Hospital in New York City have a good laugh over the entire scam.

I did try however, really! I TRIED to take the "leap of faith" after my considerable investment of both time and money. I even said at one time that I thought it was helping to some degree. I was only deluding myself. My ever changing ear noise must have had a good laugh at my *expense* Literally.

Fine. I wrote it off to a life experience. I've been screwed before, and probably will be screwed again before I'm pushing up daisies in some cemetary.

However, Nagler continued to ply his *trade* on AST, to the extent of overstepping whatever little sanity he may have possessed at one time.

BTW: I was told by Nagler to: "Stay away from AST and other tinnitus support boards while undergoing "therapy", for they are all a bunch of sick and depressed people that will hinder my habituation!"

Seven years later, I now realize that this meant, "you may say something to hurt business!" (IMO)

ANyway, I did not "stay away" from AST, and watched Nagler become a complete and utter fool on AST. He tried to take control of every conversation, as he self proclaimed himself the "WORLD'S LEADING AUTHORITY ON TINNITUS!"

TRT was the answer, and by golly, he would literally threaten people that just so happened to disagree with him.

His downfall was when he threatend a former poster, Steve Conlon, who happened to be on a social security disability. He threatened that Steve had not tried "EVERYTHING" (TRT) to help him cope with his tinnitus, and that he would go to a judge because he was not happy that Steve was collecting SS due to tinnitus, when he could be slinging hamburgers or something like that.

I'll post his famous "What I Intend To Tell The Judge" speech from the archives of alt. support.tinnitus in a separate thread.

That was just his biggest faupaux in the cyber tinnitus community. Former readers of AST know his whole sordid history.

He relentlessly attacked so many posters on AST, in an attempt to control the directions of the threads, I would not stand for it, and became very vocal, to the extent of being downright crude in an attempt to straighten his foolish ass out.

He then went to the extent of "threatening to reveal my "records" from his clinic! That was the final straw! I'll post that threat in a separate thread.

I reported him to the Georgia State Medical Board, in a 20 page document. He says he was "cleared" of any charges I brought against him.

Maybe so? However, his *snake-oil* clinic mysteriously shut-down only a few weeks after my complaint was reviewed by the Georgia State Medical Board?

He is a very mentally deranged, lonely, pathetic, little manipulative failure of a man, desperate to make some kind of a "mark" in his life.

He was bounced from the TSMB dozens and dozens of times. He hounded them relentlessly for bouncing him, and they kept giving in and allowing him back.

Does this seem like even slightly "normal" behavior from anyone? Particularly someone that holds a degree in medicine? I should think not.

Again, why do I post this here? Because my FIRST HAND take on this man will not be given airplay on the censored TSMB, and newbies and veteran tinnitus afflicted persons have a RIGHT to hear my opinions based on COLD HARD FACTS!

Hopefully we will eventually get more refugees from the TSMB that would like to hear both sides of the story from someone that has FIRST HAND experience with that man and the snake-oil "therapy" that he relentlessly promotes till this day, even though he no longer practices it!!!

Go figure?

BOTTOM LINE: Trt is (IMO) complete rubbish, a costly PLACEBO designed to empty the wallets of desperate tinnitus sufferers.

To those who feel they have had success with TRT: I salute you! You have found a PLACEBO that worked for you. God Bless.

To Those Contemplating TRT: May I suggest you contact Pawell Jastreboff. He offers a three day course in the "therapy" You too can become a TINNITUS RETRAINING PRACTIONER! It is cheaper than becoming a client of a TRT practioner too! About $2500.00 last time I checked? You even get a certificate, so that you can open your own *Tinnitus Clinic* Need I say more?????

Why be a victim of snake-oil, when you can become a *purveyor* at far less cost?

Check my other threads that back up my years of observations stated in this tome.

Kindest Regards

Capt. Ron Yoli
Merritt Island, Florida, USA

PS: Yes, Tinnitus is still "AN ISSUE" in my life. It has been for 7 long years, and will likely continue to be until a real cure is found... Not just some whipped up placebo therapy concocted by a university "researcher" living on grants from non-profit organizations

Source: http://tinnitussupport92262.yuku.co...ere-any-good-news-on-the-Horizon#.VRHx-PnF98H