TRT: How Can I Get TRT?

[Mark K.]

Hi Dr. Nagler:
I live in Honolulu Hawaii and I'd like to start TRT, however I don't think its offered here in Hawaii. How can I get started if its not offered in my area? Is there an online therapy? Or do you know someone you can recommend here in Hawaii? Is there anything I can do on my own to begin some type of TRT techniques? I'm seeing a therapist who will be talking to me about "mindfulness" this week. I'm also using the Widex Zen hearing aids, and I'm actively trying to tell myself this thing is not a threat.

Any suggestions on how I should pursue TRT here in Hawaii?

Thanks,
Mark K.

 

[Dr. Nagler]

Hi Dr. Nagler:
I live in Honolulu Hawaii and I'd like to start TRT, however I don't think its offered here in Hawaii.

To the best of my knowledge, it isn't.

How can I get started if its not offered in my area?

You would need to travel for the initial visit; all the follow-up can be done long distance via phone or Skype.

Is there an online therapy?

There is no on-line TRT.

Or do you know someone you can recommend here in Hawaii?

No. As it happens I myself have a patient from Hawaii, a surgeon who lives in Honolulu. But I know of no knowledgeable and experienced TRT clinicians practicing in Hawaii.

Is there anything I can do on my own to begin some type of TRT techniques?

Excellent question. But other than familiarizing yourself with what TRT is and is not

(see, for instance, https://www.tinnitustalk.com/threads/thoughts-on-trt.7863/),

there is little you can do in that regard. For instance, there are no "exercises" in TRT, although one website incorrectly suggests otherwise.

I'm seeing a therapist who will be talking to me about "mindfulness" this week.

Great, just be aware that mindfulness has nothing to do with TRT. Neither, for that matter, does CBT.

I'm also using the Widex Zen hearing aids

Fine, but Zen tones are contraindicated in TRT.

I'm actively trying to tell myself this thing is not a threat.

That strategy may work for some, but in all honesty, it never appealed to me. For a person with severe intrusive tinnitus, their tinnitus is a hungry lion in their bedroom. Telling yourself that that a hungry lion in your bedroom is not a threat really does not get you too far. In TRT counseling this phenomenon is explained in terms of the "upper loop" and "lower loop."

Any suggestions on how I should pursue TRT here in Hawaii?

If you are serious about pursuing TRT in Hawaii, I'd consider contacting Dr. Paula Schwartz in Edina, Minnesota. She is the closest TRT clinician to you whom I feel comfortable recommending unconditionally. As noted earlier, an initial in-person visit would be required anywhere you do TRT. Another possibility would be Dr. Gail Brenner in Philadelphia, or Jacqui Sheldrake in London. Or I guess if you really want to scrape the bottom of the barrel, there's me in Atlanta.

Of course, as an alternative you might consider an approach other than TRT.

Thanks,
Mark K.

You are most welcome. I hope this response helps more than frustrates.

Dr. Stephen Nagler