Why CBT Hurts Our Cause

[Gl0w0ut]

And there are many more statements like this that you can find either on their homepage or that were said by people of the ATA or by people they invited to their podcast series. It usually boils down to the same idea: people who struggle react negatively to their tinnitus (which is why they struggle) and that's why CBT is so effective.

I think they aren't wrong about negative thinking being a root cause. However, I would encourage them to view research on a similar, analogous condition to chronic tinnitus in chronic pain. I read once that it is chronic pain that increases negative affect rather than the other way around.

I get the logic of CBT, but it pisses me off that (as you mentioned) it gets used to demilitarize our suffering and discourages research for a cure.

 

[JohnAdams]

The problem is that finite resources are going to further study CBT which could be better utilized funding studies into stuff like intratympanic injections of IGF-1, or neurotrophin-3 to treat hidden hearing loss.

 

[Greg Sacramento]

I read once that it is chronic pain that increases negative affect rather than the other way around.

True - and I am in such pain from cut nerves in mouth that no talk or coping program is going to help me. My bottom front teeth hurt the most and that has direct neuro effect.

 

[Luman]

Are there any graphs or statistics regarding money spent specifically for research into CBT for Tinnitus Distress, preferably compared to money allocated towards research for cures?

 

[Jazzer]

True - and I am in such pain from cut nerves in mouth that no talk or coping program is going to help me. My bottom front teeth hurt the most and that has direct neuro effect.

Dear Greg - you are the kindest, most selfless, most thoughtful member on this entire website.
Even with your horrific degree of suffering you never cease trying to help, advise, and guide all others towards better healthcare directions.
Your genuine knowledge is a true asset to this and any other support network.
I truly hope that others who recognise this, and who also appreciate the level of suffering you have to endure, will join me in thanking you and supporting you for all that you do.
You so deserve healing my friend, and all that I can do is wish that it could happen for you,
I love you man,
but you know that,
Dave x
Jazzer

 

[Greg Sacramento]

@Jazzer Your generosity has totally overwhelmed me and your received love will remain in my heart and memory. Thankful and grateful to have someone as amazing as you for a friend.

 

[Gl0w0ut]

Are there any graphs or statistics regarding money spent specifically for research into CBT for Tinnitus Distress, preferably compared to money allocated towards research for cures?

I couldn't find specific monetary spending, but I could probably do a head count of studies.

 

[Strife_84]

I will never take anyone's comments on life matters, as a serious one unless....they walk in my shoes on a daily basis. Unless they feel the pain I carry on a daily basis!

I hate when doctors say "well, it must be mental"

It's like their "get out of jail" - card.

I had really bad symptoms from mold exposure,the idiot wrote me SSRI-prescription.

Mental my ass. "How about I punch you in the face with my eyes closed, and tell that you must be to imagining the pain since I saw nothing causing it or causing it"

Honestly. Some doctors are real idiots. "I have pain" - "it's depression"
"there is constant noise in my head" - "depression"
"I can't sleep" - "depression"
"constantly tired" - "depression"

 

[Michael Leigh]

I hate when doctors say "well, it must be mental"

It's like their "get out of jail" - card.

I had really bad symptoms from mold exposure,the idiot wrote me SSRI-prescription.

Mental my ass. "How about I punch you in the face with my eyes closed, and tell that you must be to imagining the pain since I saw nothing causing it or causing it"

Honestly. Some doctors are real idiots. "I have pain" - "it's depression"
"there is constant noise in my head" - "depression"
"I can't sleep" - "depression"
"constantly tired" - "depression"

HI @Strife_84

I understand the frustration you feel towards some of the doctors that have seen you about your tinnitus. Whether a GP(family doctor) or in ENT. Their lack of understanding and inability to fathom how you feel must be a revelation and for all the wrong reasons. The last thing you expect is to be told: it must be mental.

The truth of the matter is that tinnitus is "mental" and most veterans and those seasoned to the condition know this. Because tinnitus is mental the majority of doctors will not understand or know how it makes a person feel unless they have experience of tinnitus.

Doctors are physicians not "Tinnitus experts". They will have knowledge of the anatomy of the Ear and know how to treat underlying medical problems associated with it or elsewhere in the body that is causing the tinnitus. In the case of "noise induced" tinnitus where there is no underlying medical problem causing it, the patient should be referred to Audiology, to see a Hearing Therapist or Audiologist that is trained in tinnitus and hyperacusis management and treatment.

Often these medical professionals have tinnitus ( as my Hearing Therapist) and therefore, will have an understanding on how the tinnitus is affecting you. This is particularly useful with tinnitus counselling. Whether it is incorporated into TRT or CBT. Good quality counselling with a person that understands tinnitus, can help remove and demystify the negative thinking that is often associated with tinnitus. In addition to counselling, medication and sound therapy can help and all can be combined to form part of a treatment programme.

Family doctors are not "counsellors" neither are ENTs, as this is not their area of expertise. Some could improve their bedside manner. Whilst they may not have understanding of tinnitus they could at least show some compassion towards their patient that feels depressed and emotional by the effects of tinnitus. The most doctors can do is is prescribe Antidepressant and refer a patient to the medical professionals I've mentioned for tinnitus treatment and management.

Michael

 

[Strife_84]

@Michael Leigh

I was talking in general about doctors. They prescribe SSRIs too easily these days.

 

[Michael Leigh]

I was talking in general about doctors. They prescribe SSRIs too easily these days.

Yes I agree and with tinnitus they do this too...

 

[Autumnly]

Disability and Biomediation - Tinnitus as Phantom Disability
Mack Hagood

"In the case of tinnitus, I have found that tinnitus sufferers tend to be more attracted to technological solutions on sale in the marketplace than to approaches designed to lessen suffering through acceptance of tinnitus as a part of one's embodied experience. These individuals believe they are supposed to be free of the defect of tinnitus and search for a technology that will take it away, despite the fact that emotional acceptance of tinnitus is the actual differentiator between suffering and not suffering from its sound."

I wonder why no one takes this condition seriously. The idea that tinnitus can only be debilitating if we see it as a threat and that it can't be debilitating on its own is harming us immensely. These people truly believe that tinnitus is only debilitating if we react negatively towards it, thus you only need to change your attitude towards it and you'll be fine. We have to speak up against those misconceptions.

 

[DaveFromChicago]

Thanks very much for posting this, Autumnly :
Out of all of the infuriatingly stupid rationalizations for TRT /CBT acceptance this has to be the ultimate worst.
I recently read a very good definition of communication: it is "the transference of understanding."
Mack Hapgood is so incomprehensively clueless and downright, cruelly stupid that I do not believe
that I could even remain in the same room with him given such a woefully misguided, insensitive point of view.
I could only imagine him telling Jonas Salk that there was no necessity for developing the polio vaccine, since the perception and "processing" of paralysis was the only key issue.

 

[Luman]

The chief objection to CBT for Tinnitus, when properly applied by qualified practitioners, seems to be the idea it negatively impacts the motivation to find a cure.

From my perspective, CBT for Tinnitus can help many of us acquire coping skills, which may lower stress due to the symptoms and ideally, we will habituate faster.

Unfortunately, the overwhelming majority of CBT therapists know nothing about tinnitus.

 

[Autumnly]

The chief objection to CBT for Tinnitus, when properly applied by qualified practitioners, seems to be the idea it negatively impacts the motivation to find a cure.

That's because CBT for tinnitus is oftentimes based on certain misconceptions that imply we don't need medical treatments for tinnitus as CBT is good enough (which again is based on the idea that tinnitus in itself can't be debilitating because it's only debilitating if your react negatively towards it, thus you only need CBT and there's no actual need for medical treatments).

An example would be Mack Hagood that I quoted saying tinnitus suffering stems from not emotionally accepting the condition - even though there are many people with severe tinnitus who have accepted their condition but that doesn't make it any less debilitating, it can make it somewhat easier to cope with but it's nonetheless debilitating.

People like him truly don't see the need for medical treatments as they already see advocating for medical treatments as a sign of negativity and an unwillingness to accept the condition which is further proof to them as to why we can't habituate. The only difference between a person with bothersome and non-bothersome tinnitus for them lies in how someone reacts to the tinnitus.

 

[Ken219]

CBT

Sadly but the acronym 'CBT' is becoming the cure for weight issues, smoking, it is catchy Cognitive behavioural therapy.

 

[CMIH]

I disagree that CBT hurts any "cause". It's not as if tinnitus researchers are going to stop researching because CBT exists anymore than they are going to stop because there are "white noise" devices and apps.

 

[KotaDomowa]

@Autumnly Such texts as the one from the quote are disgusting! : /

Dammit ... No amount of psychological gibberish will make me stop wanting my beloved silence. It will not make me stop missing the silence, be mourning for silence. This is not a question of a distorted approach, it is a fact: we have all lost something very valuable here.

And unfortunately, for many people, the loss of silence is just one of the many problems that tinnitus causes.

 

[JohnAdams]

If there were zero emerging technologies to restore hair cells and synapses, then yes, CBT and TRT would be acceptable because that would be the ONLY thing to help. BUT, there are years of animal studies showing treatment with NT-3, BDNF, and 7,8 DHF can restore lost synapses and the use of gamma secretase inhibitors, notch inhibitors and GSK-3 inhibitors to regenerate lost hair cells. These types of things will help very many of us.

 

[Autumnly]

Good to know we can all reduce the tinnitus volume by changing the "emotional relationship" to our tinnitus.

 

[ajc]

Good to know we can all reduce the tinnitus volume by changing the "emotional relationship" to our tinnitus.

@Mack Hagood

 

[JohnAdams]

View attachment 30233

Good to know we can all reduce the tinnitus volume by changing the "emotional relationship" to our tinnitus.

I have seen the enemy.

 

[PeteJ]

Actually, it is suited for all kinds of sufferers because tinnitus sufferers of all kinds of severities are prone to irrational thinking.

The only thing to keep in mind is that it is not meant to help you with your tinnitus symptoms. It's important to have the right expectation. Instead, it is meant to address your irrational thoughts, irrespective of your tinnitus symptoms.

What absolute bullshit. What irrational thinking? So, everyone who has severe t is only rational if they 'put up' with it?

I think the people who agreed are out to the lunch, too.

You are the irrational ones.

 

[PeteJ]

Tinnitus is a physical phenomenon. Not mental or cognitive. The reaction is a result of an abnormal physical phenomenon which is why all the potential treatments or cures will be a physical one, not mental.

People may have cognitive reactions because of it but treatments like CBT or TRT only treat symptoms or part of the issue which is insufficient.

IMHO, there's practically nothing that can be done. Just hope you improve and do the best you can.

I don't think 'giving up' is irrational because it is abnormal to have loud, high pitched ringing whether in your head or ears.

That's not a cognitive problem, it's a physical problem - relating to some auditory and neurological condition combined.

The hope is 'curing' the auditory one will lead to the neurological part adapting to produce a positive change and affect.

 

[Ken219]

I wouldn't use the words 'irrational thoughts'. The thoughts are fear, scared! Don't try to minimize the sounds. I have a spike every 5-10 years when I feel it is loud. I don't react today as I did in the early days (years). I do habituate but it takes months of agony.

 

[Strife_84]

View attachment 30233

Good to know we can all reduce the tinnitus volume by changing the "emotional relationship" to our tinnitus.

I don't know if you are sarcastic or not, but my tinnitus doesn't change volume. It only changes volume if I am in silence, or listen to something.

I've been depressed, happy, angry, scared, brave, sad... The volume is always the same...

 

[Autumnly]

I don't know if you are sarcastic or not, but my tinnitus doesn't change volume. It only changes volume if I am in silence, or listen to something.

I've been depressed, happy, angry, scared, brave, sad... The volume is always the same...

Was definitely being sarcastic! I've had severe tinnitus for years without any quiet days or moments and it's really harmful and simply false to imply that everyone's brain will either turn down the volume or tune out the tinnitus if a person reacts in a certain way towards it. Unfortunately, this misconception is being propagated a lot.

 

[BobbyH]

I don't see a psychologist that treats me with CBT because I thought he could do anything about my tinnitus. I see the psychologist to stay alive. My tinnitus has driven me to the point that I arrived at that place where I was looking for a way to end it permanently.

Am I still suffering with tinnitus? Yes
Has the psychologist helped my tinnitus? No
What has the CBT done then? Kept me alive for another day.

Can't do a damn thing to make my tinnitus better although I do have a great audiologist that has given me some coping skills. The CBT helps me to live because my tinnitus drove me to despair and wanting to die to put an end to living with tinnitus.

 

[Jazzer]

Tinnitus is a physical phenomenon. Not mental or cognitive. The reaction is a result of an abnormal physical phenomenon which is why all the potential treatments or cures will be a physical one, not mental.

Tinnitus is not a mental issue, nor a psychological issue.
It is created as a result of the physical damage to nerve fibres and nerve cells on the cochlea.

Any other way of looking at it is totally 'cockeyed!'

 

[Strife_84]

Was definitely being sarcastic! I've had severe tinnitus for years without any quiet days or moments and it's really harmful and simply false to imply that everyone's brain will either turn down the volume or tune out the tinnitus if a person reacts in a certain way towards it. Unfortunately, this misconception is being propagated a lot.

I agree. I don't know why they put it that it's mental. I saw audiologist yesterday and she also said "if you are stressed or so, you will hear it louder"

I was not in mood to start arguing with her. These volume changes, at least for me, has nothing to do with my mental state.

I guess it's part of "it's must be depression" - type diagnosing.

"it just seems louder because you're depressed". I hate when doctors think they know my body better than I do...