Why Is There Such a Stigma About Cognitive Behavioural Therapy?

[Jack Straw]

I hope people who are struggling do try CBT. It is not going to cure your tinnitus, but it can help you react differently to it and make it not create a fight or flight feeling. It has been theorized that if we have a better reaction to our tinnitus and remove the anxiety, over time we habituate to it better.

Again not a cure, but it can help somewhat.

 

[Ed209]

I often wonder how you are able to post with screaming tinnitus, horrible pain, and some of your other issues. I have screaming tinnitus today and spinal problems. I do have a lot of stressors going on right now that may or may not be related to my tinnitus. Being I had some mental disorders prior to my tinnitus that is a possibility.

Dishing out money for talk therapists doesn't sound too appealing to me. I guess if you have insurance and they are in-network it may not cost much, just a small co-pay I suppose. I'm sure the therapists will gladly take your money. You could just as well read some Kindle books relating to your condition, but maybe human interaction is needed in some cases. Maybe CBT talk therapy is free in the UK under your NHS? Totally different in the US. Individual health insurance is very high. Some people go without health insurance here hoping nothing serious happens to them potentially costing them hundreds of thousands of dollars.

I feel bad for you Ed that you have so many conditions you are dealing with. Tinnitus alone is bad enough for most people. I suppose this forum is good and bad. It's addicting and I still see a lot of arguments. I've heard some people mention forums being a time hog as well. I suppose it's good for venting if nothing else. I guess we are all looking for support and a way to manage our condition if possible until a possible cure is developed. That may be a long wait.

Cheers, buddy. I honestly wasn't after any violins or anything like that, but sometimes I feel I have to defend my position because of some of the comments I receive. I get the impression that some members think that I just surf through life on cloud nine or something which isn't true. I can't explain how I deal with everything, sometimes I don't, but I think it's got a lot to do with the coping mechanisms I learned during my surgeries. Some of the stuff I went through was horrendous; real life and death stuff, and I was completely discontent with life. I just wanted to end it all. When my first surgery failed, I had to have another major operation, to which I developed a serious infection that resulted in my stitches expanding followed by a load of putrid infectious pus pouring out of me like a tap. I nearly passed out at how gross it was. I could see all my ribs and stuff. After that I needed further surgeries and I was depressed as hell. I recently had to have another procedure on my chest that resulted in me getting Sepsis which nearly killed me all over again . As the years progressed I suppose I began to learn how to cope with adversity which I believe helped me to deal with my tinnitus and things like the calcific tendinitis I have in my shoulders (which can be excruciating). Once that flares up I don't sleep at all. Then when I thought I had enough problems I started ejaculating blood and my ophthalmologist told me I'm a glaucoma suspect . I sometimes had to laugh at the absurdity of it all. This year I spent a good portion of time going in and out of hospital either for myself or my mom and dad.

The reason I can write these posts is because I'm kind of numb to my tinnitus. I can't explain it but it kind of just washes over me even though right now it's insanely loud because I have a head cold. I think the other reason is that our brains just can't be hyper-vigilant and concerned about too many problems at the same time. Some of them have to go to the back of the bus.

There are others on here who are far worse off than me, so I try to count my blessings as best I can. That's all we can do. Just like Winston Churchill said, "if you're going through hell, keep going."

 

[Lane]

It's only when you step away from the insular thought patterns - that can develop on forums - that you can see how irrational some of it is.

Interesting choice of words (insular thought patterns). I've heard them referred to as "mind waves". I'm guessing there are other words that could be used as well. I think these kinds of thought patterns are something everybody should be aware of and keep in mind, as it's all too easy to fall prey to a "herd mentality". Insular thought patterns can be especially influential when articulated by seemingly honest and intelligent people. Charismatic leaders (of all colors and stripes) seem to be quite aware of this phenomenon, and learn how use it to their advantage. (But oh the karma).

 

[Ed209]

Interesting choice of words (insular thought patterns). I've heard them referred to as "mind waves". I'm guessing there are other words that could be used as well. I think these kinds of thought patterns are something everybody should be aware of and keep in mind, as it's all too easy to fall prey to a "herd mentality". Insular thought patterns can be especially influential when articulated by seemingly honest and intelligent people. Charismatic leaders (of all colors and stripes) seem to be quite aware of this phenomenon, and learn how use it to their advantage. (But oh the karma).

Did you watch the episode about cults on Explained (Netflix show)? It goes over these very same points. No matter how much of a free thinker one believes they are, when one is exposed to the same ideas within a group over a period of time, their thoughts and beliefs will gradually start to align with the majority.

 

[Bartoli]

But to be able to give our positive energy to these efforts, we need all of your help. The least everyone can do is try to think before submitting a post. "Would I talk like this to the person I'm writing to if they were in front of me?". That's a good first step.

You nailed it!

 

[PeteJ]

Yes. It seems to me a good measure of what CBT seeks to reduce (i.e. how obtrusive your experience of tinnitus is)

Seems to you? I found many of the questions to be pretty useless.

 

[Kvothe]

Seems to you? I found many of the questions to be pretty useless.

That's interesting, how so? I find the questions get at exactly what I want to change about my experience of tinnitus.

I don't want tinnitus to put me in a place of existential despair. Unfortunately, I can't access CBT right now. I can't find a practitioner who has office hours outside of my own (sometimes very extended) work schedule. But if others have success with it, that makes me happy. And I encourage other people to try it out, too.

For now I'm relying on my faith and Jordan Peterson's 12 rules to keep my mind fixed on success. Rule 1 is "stand up straight with your shoulders back." It's hard to do with the sound of a dentist's drill in your ear all day! I think the THI questionnaire gets at some of the obstacles tinnitus presents to such success.

I don't just want to maintain my life with tinnitus. I want to get promoted at work. I want to have more children. I want to be a friend to all and someone people look up to. I will not let this stupid "eee" stand in my way, and I'm not waiting on a cure.

 

[TheDanishGirl]

Fair enough, but I want to point out that your second sentence is not directly linked to anxiety, in the sense that you could still have improved your anxiety and exhibit this behavior. Suicidal ideation doesn't require anxiety.

At any rate, I'm sorry that you didn't feel like it helped you. I am not here to argue about your assessment. I don't expect it to help everyone. You can legitimately be in the set of people who haven't seen any tangible benefit from it.

I don't feel my anxiety is lessened in any way from the CBT (or the depression for that matter). I agree that suicidal ideation does not require anxiety, BUT I do think one must be in a great deal of anguish whether mentally and/or physically to contemplate ending one's life. Always.

 

[Sironketchup]

I still do not get it what CBT wants for us.

I've been having therapy for 6 months and have even been in a psychosomatic clinic for 6 months.

More than "focus on other stuff" and when you can't sleep "focus on you feet" wasn't there.

Honestly, CBT for tinnitus in 3 words: "Give a fuck!".

CBT and ACT in the clinic were more used to manage the depression, and there might be some use.

But I'm tired of fighting this never ending depression due to my head screaming 24/7.

It's an insult.

 

[PeteJ]

That's interesting, how so? I find the questions get at exactly what I want to change about my experience of tinnitus.

I don't want tinnitus to put me in a place of existential despair. Unfortunately, I can't access CBT right now. I can't find a practitioner who has office hours outside of my own (sometimes very extended) work schedule. But if others have success with it, that makes me happy. And I encourage other people to try it out, too.

For now I'm relying on my faith and Jordan Peterson's 12 rules to keep my mind fixed on success. Rule 1 is "stand up straight with your shoulders back." It's hard to do with the sound of a dentist's drill in your ear all day! I think the THI questionnaire gets at some of the obstacles tinnitus presents to such success. The questionaire only provides generic answers.

I don't just want to maintain my life with tinnitus. I want to get promoted at work. I want to have more children. I want to be a friend to all and someone people look up to. I will not let this stupid "eee" stand in my way, and I'm not waiting on a cure.

Answer them and then what?

THERE IS NOTHING THAT CAN BE DONE.

If I answer it's really loud and intrusive, so what? I can't help how I react. How about I shoot a gun in your ear and play a recording of cicadas in your ears at the highest volume level possible? Then you might have some idea what I have. Are some psychologists going to reduce the volume? No. I react naturally to it because my fucking ear really hurts and the tinnitus is inhumane and insanely loud!!!! Humans are not designed to have loud ringing tones 24/7. I bet these psychologists wouldn't react any differently. They have no idea how the torment is since they don't have severe tinnitus.

Severe tinnitus is rarely part of the context in these studies thus the data is based on a potentially inaccurate measurement. The questionnaire only provides generic answers.

 

[Ed209]

Answer them and then what?

THERE IS NOTHING THAT CAN BE DONE.

If I answer it's really loud and intrusive, so what? I can't help how I react. How about I shoot a gun in your ear and play a recording of cicadas in your ears at the highest volume level possible? Then you might have some idea what I have. Are some psychologists going to reduce the volume? No. I react naturally to it because my fucking ear really hurts and the tinnitus is inhumane and insanely loud!!!! Humans are not designed to have loud ringing tones 24/7. I bet these psychologists wouldn't react any differently. They have no idea how the torment is since they don't have severe tinnitus.

Severe tinnitus is rarely part of the context in these studies thus the data is based on a potentially inaccurate measurement. The questionnaire only provides generic answers.

For the love of God, Pete, please don't take this the wrong way, but here goes: from reading your posts, you may be making matters worse because of the extreme emotional state that you're in. I've noticed you saying that you've had better days, so there's a very real chance that your anxiety and depression may be exacerbating your symptoms. If I were you, I'd try to tackle those first because there's every chance your tinnitus and ear pain could recede, especially if your distress is creating physical symptoms such as TMJD. Your ear pain could be the result of you clenching really hard at night and one of the primary reasons for this is stress and anxiety. You may be stuck in a vicious cycle. I'm not saying your tinnitus will magically vanish overnight, but I think you stand a good chance of bringing it under your control along with your emotions if you try and treat it.

I urge you to seek help from a Dr again, even if you have to wait a year. Look at it this way, while you wait you could try other things like fasting, a vegan diet, an exercise program, etc. Also, go and see your dentist (if you haven't already) and get an opinion on whether you're suffering from bruxism, and if you are, get yourself a mouth guard made.

If in the following year you are still in a bad way - after trying everything that's in your power - then you'll still have your specialist appointment to attend where you can look at other options such as drugs and/or counselling, CBT, etc. If you're at rock bottom, you have nothing to lose but everything to gain.

 

[JohnAdams]

Severe tinnitus is rarely part of the context in these studies thus the data is based on a potentially inaccurate measurement.

Also, I never see them taking pitch into consideration either. It's as if their therapy is one size fits all.

 

[Kvothe]

How about I shoot a gun in your ear

Yikes. You have made the Cain and Abel subtext of our dialogue suddenly, very literal.

I hope you find peace in your life.

 

[JohnAdams]

a vegan diet

This is not going to help with tinnitus.

 

[Ed209]

This is not going to help with tinnitus.

A vegan diet is anti-inflammatory and can improve one's overall health and well-being. Attempting to do just about anything that can help improve the functioning of our body is a step in the right direction and is much better for us than ruminating and obsessing over our problems. I understand how difficult this is, though, as once we hit rock bottom it can take all the will in the world just to get out of bed. However, if one secludes themselves from life, and attempts to do nothing, then they risk magnifying the issues they are facing rather than improving them.

There is no benefit to looking for a problem in any potential solution.

I hope Pete can go down the diagnosis route, because he may have an underlying cause as a few of his symptoms are a fit for TMJD. At this point, I can't see how this forum can possibly help him any further. He has to want to try and help himself.

 

[JohnAdams]

A vegan diet is anti-inflammatory and can improve one's overall health and well-being. Attempting to do just about anything that can help improve the functioning of our body is a step in the right direction and is much better for us than ruminating and obsessing over our problems. I understand how difficult this is, though, as once we hit rock bottom it can take all the will in the world just to get out of bed. However, if one secludes themselves from life, and attempts to do nothing, then they risk magnifying the issues they are facing rather than improving them.

There is no benefit to looking for a problem in any potential solution.

I hope Pete can go down the diagnosis route, because he may have an underlying cause as a few of his symptoms are a fit for TMJD. At this point, I can't see how this forum can possibly help him any further. He has to want to try and help himself.

I'm all about the anti-inflammatory diet. That's good but you don't have to adhere to a dogmatic black and white no meat lifestyle. You can eat seafood and adhere to an anti-inflammatory diet.

 

[Ed209]

I'm all about the anti-inflammatory diet. That's good but you don't have to adhere to a dogmatic black and white no meat lifestyle. You can eat seafood and adhere to an anti-inflammatory diet.

I was going to write anti-inflammatory diet, but I changed it to a vegan diet as they are pretty much the same thing. But yea, that point stands. Any anti-inflammatory diet is still worth trying. Good food can really make a difference in how we think and feel.

PS: I'm not vegan btw.

 

[Tom Cnyc]

Also, I never see them taking pitch into consideration either. It's as if their therapy is one size fits all.

It's almost as if there isn't a cure for tinnitus.

The only problem with CBT is that it's expensive.

Having a person to vent to that isn't otherwise involved in your life and has to legally stay quiet about what you tell them is cathartic and if it's affordable - literally everyone should give it a run whether or not they have tinnitus.

It's insane how hard people rally against the idea of therapy in this group because it can't cure an incurable ailment.

No fucking shit it can't.

 

[PeteJ]

Also, I never see them taking pitch into consideration either. It's as if their therapy is one size fits all.

Exactly. Some of us are on the same page. What does that mean?

 

[PeteJ]

For the love of God, Pete, please don't take this the wrong way, but here goes: from reading your posts, you may be making matters worse because of the extreme emotional state that you're in. I've noticed you saying that you've had better days, so there's a very real chance that your anxiety and depression may be exacerbating your symptoms. If I were you, I'd try to tackle those first because there's every chance your tinnitus and ear pain could recede, especially if your distress is creating physical symptoms such as TMJD. Your ear pain could be the result of you clenching really hard at night and one of the primary reasons for this is stress and anxiety. You may be stuck in a vicious cycle. I'm not saying your tinnitus will magically vanish overnight, but I think you stand a good chance of bringing it under your control along with your emotions if you try and treat it.

I urge you to seek help from a Dr again, even if you have to wait a year. Look at it this way, while you wait you could try other things like fasting, a vegan diet, an exercise program, etc. Also, go and see your dentist (if you haven't already) and get an opinion on whether you're suffering from bruxism, and if you are, get yourself a mouth guard made.

If in the following year you are still in a bad way - after trying everything that's in your power - then you'll still have your specialist appointment to attend where you can look at other options such as drugs and/or counselling, CBT, etc. If you're at rock bottom, you have nothing to lose but everything to gain.

I never have good days. Just brief and unexplainable fluctuations which only last a few minutes. But, they are noticeable because I instantly pray that the volume stays at that and often, the tones reduce in number or seem to. It's less intrusive in comparison. I pray and I am not even religious. It's all for naught, though, because it doesn't last long.
I try very hard not to get anxious or too down for precisely that reason - in case that exacerbates the tinnitus somehow. But, it doesn't seem like it helps either. It's always loud.
I wanted to read these TMJ books, try CBD oil, curcumin and some other things I can't recall right now but I have to wait until I get the money for it.
I may seem ok albeit irritated when I post but trust me, I feel like I am being tortured - by severe loud tinnitus tones in my brain and left ear pain both.
I like the description some people use, "screaming tinnitus" because the tones are crazy in tempo. You're an audio engineer? What is that called?
The 'cicadas' type of noise but I think it is even worse now.

Speaking of the dentist, I need two more fillings and then I can hope to get a $400 mouthguard. The last dental experience was brutal. I didn't get the recommended breaks and although I don't think I got worse, I had a horrible spike the next day and I have put off a subsequent appointment. My tinnitus is through the roof 99% of the time. How does one habituate to this shit? It's not normal. It's inhumane. In those movies, in which prisoners are tortured in a room with loud sounds on constantly, that's the only analogy I can think of.

 

[Bndsmheowqhe]

I'm not quite sure how you're coming to this conclusion after several people have explained that their issues are with the way CBT is being promoted and what it's promising...

For example, let's talk about Rilana Cima from the University of Maastricht who created a CBT for tinnitus program. Here she says again that it's the fear of the tinnitus resulting in avoidance behavior that can make the condition debilitating.

• "In the study we thought, what if we try to intervene in this avoidance behavior and we expose patients to their tinnitus sounds," said Rilana Cima, the study's lead author and a clinical psychologist at Adelante Centre of Expertise in Rehabilitation and Audiology in the Netherlands. "If you expose people to something they're afraid of, they actually habituate to this stimulation."
  
• The Fear Avoidance (FA) Model as applied to tinnitus (Cima, 2013) proposes that in people with bothersome tinnitus, fear of tinnitus is a product of catastrophic misinterpretations of the tinnitus sound and that it subsequently leads to safety behaviours that are not functional in the long term, and contribute to avoidance, disability and emotional distress. source

Consequently, she compares tinnitus distress to a phobia since it's only your irrational thoughts and emotions towards the tinnitus that are the issue according to her. I'm not saying Cima's statements don't apply to anyone but they don't apply to everyone and it would be important to mention that.

• 'I am a psychologist and started looking at pain and phobic symptoms. Exposing to it helps people get rid of a phobia, just think of a spider phobia. ' Thus, Cima et al. Developed an exposure-based treatment. "Many people with tinnitus are going to mask the sound, they are going to use noise." source

Dyon Scheijen, who works with her, said they can "ensure recovery" through CBT for tinnitus alone:

• "With tinnitus, a signal is given every time:" This is not good for you ". If we can change that with cognitive behavioral therapy and allow the sound, we will ensure recovery " source

Not sure what her goal was with this statement:

• "Tinnitus is often associated with festivals, but it is actually used to scare young people." source

And this is just ridiculous:

• The study had so much impact that a colleague from Cima wrote that the end of "therapeutic nihilism" is now was finally in sight. source

Here's how the European guideline for tinnitus talked about exposure therapy:

• This way the patient experiences that the tinnitus sound is harmless, not dangerous, and listening to it in silent environments will not lead to catastrophe. They also learn that the aversive consequences are not always triggered. These experiences lead to a "neutralisation" of tinnitus by adaptation of fear expectancies; consequently, the tinnitus becomes less intrusive and bothersome, the more they engage in exposure. source

Lastly, this is off-topic but remember that the European guideline also says this:

• Simply put, patients should not avoid activities they think may make their tinnitus worse. Patients should not be putting their life on hold. Tinnitus does not have to control their life. source

How in the world do you want to raise genuine awareness and show your patients you understand their struggles if you say things like that? There are millions who are severely debilitated by tinnitus and you're telling them "tinnitus does not have to control their life"?

Another big issue with Cima's statements is that she never says that tinnitus can be debilitating in itself and she's given talks before how it's not the tinnitus but your emotional reaction to it that makes it debilitating. In the interview with Hazel, Cima also said she believes the new European guideline will help everyone.

Many people are not debilitated by tinnitus because they're scared of it, they're debilitated by the tinnitus itself. It's irresponsible not to mention that there are different reasons as to why tinnitus can be debilitating.

Let's not forget that their bible (the DSM) listed homosexuality as a Personality Disturbance until 1980. Mental Health practitioners have a history of being wrong about a lot of things.

 

[JohnAdams]

Let's not forget that their bible (the DSM) listed homosexuality as a Personality Disturbance until 1980. Mental Health practitioners have a history of being wrong about a lot of things.

Don't forget about Oppositional Defiance Disorder. Are your parents abusive/idiots? Are your teachers psychologically abusive? Do you live in an oppressive society with a tyranical government? Well, if you disagree with them you must have ODD.

 

[Bndsmheowqhe]

Don't forget about Oppositional Defiance Disorder. Are your parents abusive/idiots? Are your teachers psychologically abusive? Do you live in an oppressive society with a tyranical government? Well, if you disagree with them you must have ODD.

Let's not forget their enthusiasm for medicating young males and labeling them as defective for exhibiting normal behaviors that they consider to be "problematic".

 

[JohnAdams]

Let's not forget their enthusiasm for medicating young males and labeling them as defective for exhibiting normal behaviors that they consider to be "problematic".

I am a victim of this.

 

[Bndsmheowqhe]

A vegan diet is anti-inflammatory and can improve one's overall health and well-being. Attempting to do just about anything that can help improve the functioning of our body is a step in the right direction and is much better for us than ruminating and obsessing over our problems. I understand how difficult this is, though, as once we hit rock bottom it can take all the will in the world just to get out of bed. However, if one secludes themselves from life, and attempts to do nothing, then they risk magnifying the issues they are facing rather than improving them.

There is no benefit to looking for a problem in any potential solution.

I hope Pete can go down the diagnosis route, because he may have an underlying cause as a few of his symptoms are a fit for TMJD. At this point, I can't see how this forum can possibly help him any further. He has to want to try and help himself.

A raw vegan diet might be beneficial because of the nutritional benefits but just being a regular "Vegan" isn't necessarily a healthy way of eating.

 

[Bndsmheowqhe]

I am a victim of this.

There is a significant anti-male bias within the mental health profession.

 

[Jack Straw]

What a bunch of bullshit.

The OG anti CBT preacher lol

Still don't understand why you bash it when it helps people, but to each his own.

 

[fishbone]

The OG anti CBT preacher lol

Still don't understand why you bash it when it helps people, but to each his own.

We can't please everyone

 

[JohnAdams]

It is wrong to call this a treatment for tinnitus.

It is a treatment for psychological problems related to having chronic stress.

If CBT is a treatment for tinnitus then it is a treatment for everything.

 

[Jack Straw]

It is wrong to call this a treatment for tinnitus.

It is a treatment for psychological problems related to having chronic stress.

If CBT is a treatment for tinnitus then it is a treatment for everything.

Tinnitus causes stress. Stress causes fight or flight response, which can cause tinnitus to be worse. It also is harder to habituate to something that is causing immediate stress and anxiety. This includes chronic pain as well.

By using CBT it reduces stress and reduces the increased tinnitus caused by stress. It also allows the brain to habituate better.

this makes tinnitus less bothersome and less intrusive over time because your brain can, to a certain extend, tune it out. This isn't a cure, but it gives people the ability to live their life on a better level than previously.

habituation doesn't fix or solve the problem, but it does exist and can help some people deal with it.