Why Is There Such a Stigma About Cognitive Behavioural Therapy?

[Star64]

Knowing that they use sound torture to soften up terrorists in places like Guantanimo Bay, would having CBT before being captured help a terrorist not to crack?

I don't know John, what about ACT therapy, just accepting you might get captured and tortured might solve everything.

 

[Gman]

God created opium for a reason.

Good luck with that

 

[JohnAdams]

Good luck with that

That's where opiate painkillers come from. I don't need any but if I did I would use them without shame. We should be able to just have opium without being adulterated by the Sackler family drug empire. Opium is out there if you know where to find it.

 

[bobvann]

I believe that is 100% bullshit. That's why they purposefully stay ambiguous about whether it is volume or focus as the thing that allegedly "fades".

I have noticed that when I am busy and focused on other stuff that yes, my attention gets drawn away from the ringing. It's just when I'm trying to relax is when it's there and annoying. No amount of CBT is going to help with that.

I was not referring to using CBT, just what needs to be accomplished in general. CBT, TRT, and the newer experimental Lenire system are tools to ease into habituation. Essentially nothing actually cures tinnitus.

 

[JohnAdams]

Essentially nothing actually cures tinnitus.

If you can get steroid injections in your ear fast enough then that's a cure.

 

[BobbyH]

I have noticed that when I am busy and focused on other stuff that yes, my attention gets drawn away from the ringing. It's just when I'm trying to relax is when it's there and annoying. No amount of CBT is going to help with that.

@JohnAdams Exactly yes!!!!! This is precisely what my psychologist is helping me with. For some of us who have suffered with tinnitus for a lot of years, anxiety and depression becomes the fallout for all those years of struggling. Depression tends to keep me from wanting to be busy or focus on other stuff. All I do is lay curled up in a corner of my house ruminating about this incessant screaming in my head. My psychologist tries to give me coping skills to help me to do what you're able to do consciously.....be busy and focus on other stuff. During those times I am able to do that, I can sometimes experience a respite from my tinnitus.

Nothing in my CBT sessions is designed to help me when I'm trying to relax. If I want or need to relax, I use the tools my audiologist has provided such as my notch therapy hearing aids, using therapy signal maskers, listening to sounds designed around the 2 frequencies that my tinnitus consists of, using the Levo system device, and even using the new TinnitusPlay app provided by Tinnitus Talk. When none of that helps, I take meds that help reduce my anxiety.

And, often I just lay curled up in a corner and hope for tomorrow.

So, yes, in my experience, your statement is very correct. And, yes, I'd give almost anything if there was a cure for tinnitus because then the CBT would be able to help me recover from what would then be past trauma, the past trauma of living a life with severe tinnitus. In the meantime, I live for those brief fleeting moments when my attention gets drawn away from the ringing thanks to the tools my psychologist has taught me.

 

[JohnAdams]

if there was a cure

the body is capable of healing. the only part of our auditory system that can't heal is the cochlear hair cells. they are almost half way through trials on hair cell regeneration drugs. it may not be a perfect cure of a cure at all but it also might be, if not totally but partially. we should be organized and pushing for this to be accelerated.

 

[FGG]

the body is capable of healing. the only part of our auditory system that can't heal is the cochlear hair cells. they are almost half way through trials on hair cell regeneration drugs. it may not be a perfect cure of a cure at all but it also might be, if not totally but partially. we should be organized and pushing for this to be accelerated.

Not technically true, the brainstem can't either or the auditory nerve. As far as the rest between Frequency, Pipeline, OTO-413 and Chen we should be able to tackle most of the cochlea at least, even the stria I hope with Chen.

 

[bobvann]

Wow Bobby so sorry. I thought I was struggling but you seem to be having a harder time. The most bummer thing for me is not to be able to play drums. I can totally understand this condition is nuts and it just goes on & on... I just walk around at work using sound apps off of my phone. The psychologist's office sends me notices for additional MCBT sessions (not for free of course). I don't see the need.

 

[Telis]

I tried CBT at one point, had all this shit hooked to my head, they were trying to measure stress response, what they found is that I was almost dead as far as stress response, I can lower my heart rate to sub human rates at will most of the time. I told them to try and scream in my face and try to get me going, I was betting they couldn't get a stress response out of me if they tried, they wouldn't experiment, I can basically zone out when faced with extreme amounts of stress, my job taught me this but I'm not sure how this helps my tinnitus situation. You could slap my face and scream at me, spit at me my vitals won't change but I sure don't enjoy it.

 

[Mathieulh]

If you can get steroid injections in your ear fast enough then that's a cure.

Yeah except it's pretty darn impossible to get where I live (in France), I've tried, the best I could get was Oral Steroids.

 

[Mathieulh]

the body is capable of healing. the only part of our auditory system that can't heal is the cochlear hair cells. they are almost half way through trials on hair cell regeneration drugs. it may not be a perfect cure of a cure at all but it also might be, if not totally but partially. we should be organized and pushing for this to be accelerated.

Some parts just don't heal, if I chop off my hand, it's not suddenly going to regrow a new one.

 

[Bartoli]

CBT is just thinking logically about your own emotions. I never understood why people need help doing that.

When tinnitus strikes it's easy to let it consume you. Your thought pattern gets distorted. It's a downward spiral. Some people need and outside perspective and help to climb back out. There's plenty of stories like that in the success stories thread. Regaining some control over your life and addressing distorted thinking can make a big difference. The people for whom it has worked would probably still prefer a cure, but I think once you've been down because of tinnitus, to bounce back from it can seem damn near a miracle and it makes all the difference.
To say you don't understand why people would need help from a professional to address their emotional state and thought patterns really just ignores the need for any sort of psychological help for any sort of mental illness.

 

[JohnAdams]

Some parts just don't heal, if I chop off my hand, it's not suddenly going to regrow a new one.

Interesting.

 

[linearb]

I was not referring to using CBT, just what needs to be accomplished in general. CBT, TRT, and the newer experimental Lenire system are tools to ease into habituation. Essentially nothing actually cures tinnitus.

errrrr, sorry but I don't think you understand anything about what leniere is trying to do

bimodal is NOT habituation and does not depend on psychological process to work. It's trying to rewrite abberant synaptic connections at the DCN level and it's been very conclusively shown to do just that in animal imaging studies.

I think it works, used it at UMich. I trust UMich, unsure about Leneire for a number of reasons. But in general I think this tech is more real than vaporware, as far as there's definitely an effect -- just needs to be understood better, better protocols, etc. It's not anything like TRT or Levo or Zen or literally any other tech out there, though

 

[all to gain]

I think it works, used it at UMich. I trust UMich, unsure about Leneire for a number of reasons. But in general I think this tech is more real than vaporware, as far as there's definitely an effect -- just needs to be understood better, better protocols, etc. It's not anything like TRT or Levo or Zen or literally any other tech out there, though

Going off thread, but will UMich's device be useless for non somatic tinnitus?

 

[JohnAdams]

Yeah except it's pretty darn impossible to get where I live (in France), I've tried, the best I could get was Oral Steroids.

Absolute insanity.

 

[JohnAdams]

Not technically true, the brainstem can't either or the auditory nerve. As far as the rest between Frequency, Pipeline, OTO-413 and Chen we should be able to tackle most of the cochlea at least, even the stria I hope with Chen.

Robert Jackler said that when the hair cell regenerates that the auditory nerve regrows and reconnects to the supporting cell.

 

[linearb]

Absolute insanity.

it's relatively dangerous, compared to spotty efficiency data, meaning that the ratio of adverse effects to happy outcomes in what research does exist, justifiably makes medical providers nervous about doing what's basically an off label use.

I generally think people should have final say over what treatments they get, but it's complicated. There are a lot of people who might, in the first months of tinnitus, opt to have their auditory nerve cut for the ~35% chance this cuts out the tinnitus in addition to making them deaf.

personally, I know that my tinnitus is partially related to eardrum scarring, and that even tiny scars from injection sites will expand over time, so I don't want anything poking into my ear unless the data is super, super equivocal

 

[FGG]

Robert Jackler said that when the hair cell regenerates that the auditory nerve regrows and reconnects to the supporting cell.

The peripheral axons do but not the body of the auditory cranial nerve.

 

[JohnAdams]

spotty efficiency data

Emperor,
The efficacy data is not spotty at all.

 

[JohnAdams]

The peripheral axons do but not the body of the auditory cranial nerve.

Do we need to be worried about that dying? I thought that in cases of noise trauma it just kills the hair cell and fries the synapses right at the cochlea.

 

[FGG]

Do we need to be worried about that dying? I thought that in cases of noise trauma it just kills the hair cell and fries the synapses right at the cochlea.

Most of us don't need to worry about that, no.

 

[JohnAdams]

Most of us don't need to worry about that, no.

You had me worried there. Whew!

 

[bobvann]

When tinnitus strikes it's easy to let it consume you. Your thought pattern gets distorted. It's a downward spiral. Some people need and outside perspective and help to climb back out. There's plenty of stories like that in the success stories thread. Regaining some control over your life and addressing distorted thinking can make a big difference. The people for whom it has worked would probably still prefer a cure, but I think once you've been down because of tinnitus, to bounce back from it can seem damn near a miracle and it makes all the difference.
To say you don't understand why people would need help from a professional to address their emotional state and thought patterns really just ignores the need for any sort of psychological help for any sort of mental illness.

Some people basically offers getting past the "distorted thinking" & promotes habituation. It does help some and good on them! I even mentioned it to my MCBT therapist in those terms when I 1st met with him. MCBT still did not help. Some say it could of been the therapist. He was the one recommended for Tinnitus locally. I have my doubts that it was really his forte.. I refuse to fork out any more $$ to modern day charlatans & snake oilists.

Thanks for the clarification in regards to the Lenire system. User feedback is quite mixed just like any other form of treatment. Plus one needs deep pockets right now to be able to try something that *may* help. Again no accountability or recouping one's costs if it fails. If it evolves comes available locally and still having a time of it why not...

Salut Mathieu

 

[bobvann]

Want to see a good segment on MCBT and snake oilists? Watch this season of Ray Donovan!

 

[linearb]

Emperor,
The efficacy data is not spotty at all.

[Citations needed], my little ad hom spewing buddy


Someone is going to post exactly what i am calling spotty and say it's equivocal and I'm going to be amused

 

[JohnAdams]

[Citations needed], my little ad hom spewing buddy


Someone is going to post exactly what i am calling spotty and say it's equivocal and I'm going to be amused

I guess you're smarter than the researchers at Vanderbilt University.
"These findings indicate a positive effect from steroid perfusion in this patient population."
https://www.ncbi.nlm.nih.gov/pubmed/17202923

And this:
"Patients with low-mid frequencies ISSNHL had favourable hearing improvements with either complete hearing recovery or significant partial hearing recovery if ITM was administered within eight weeks after onset of HL."
https://www.tinnitustalk.com/attachments/intratympanic-dexamethasone-methylprednisolone-pdf.33953/

 

[linearb]

I guess you're smarter than the researchers at Vanderbilt University.
"These findings indicate a positive effect from steroid perfusion in this patient population."
https://www.ncbi.nlm.nih.gov/pubmed/17202923

And this:
"Patients with low-mid frequencies ISSNHL had favourable hearing improvements with either complete hearing recovery or significant partial hearing recovery if ITM was administered within eight weeks after onset of HL."
https://www.tinnitustalk.com/attachments/intratympanic-dexamethasone-methylprednisolone-pdf.33953/

Not at all, do you know what ISSNHL is? Both of these studies concern SSNHL and not noise-induced loss. ISSNHL by definition precludes noise trauma, and also implies some process other than gradual age induced loss.

I believe I've posted both of these on here myself at some point. I have consistently said that more study is needed in this area but that the best studies showing efficiency relate to SSNHL and not noise trauma, and then secondly that the best data for noise trauma comes from some US and Israeli military studies where steroids were in some cases administered prior to trauma or within minutes following.

The applicability of SSHNL-related tinnitus onset to noise trauma, is, likewise, something that needs more study, but at face value neither of these studies seem that useful to your typical noise trauma patient. When I have my server box put back together I can send you the studies I do have on noise trauma and either transtympanic or oral sterioids; I believe I've got a dozen or so.

I don't think this is a question of "is there any effect"; there's enough (in some cases conflicting) studies to think there is an effect of some kind. Efficiency and safety vs serious adverse side effects is another story.

 

[JohnAdams]

Not at all, do you know what ISSNHL is? Both of these studies concern SSNHL and not noise-induced loss. ISSNHL by definition precludes noise trauma, and also implies some process other than gradual age induced loss.

I believe I've posted both of these on here myself at some point. I have consistently said that more study is needed in this area but that the best studies showing efficiency relate to SSNHL and not noise trauma, and then secondly that the best data for noise trauma comes from some US and Israeli military studies where steroids were in some cases administered prior to trauma or within minutes following.

The applicability of SSHNL-related tinnitus onset to noise trauma, is, likewise, something that needs more study, but at face value neither of these studies seem that useful to your typical noise trauma patient. When I have my server box put back together I can send you the studies I do have on noise trauma and either transtympanic or oral sterioids; I believe I've got a dozen or so.

I don't think this is a question of "is there any effect"; there's enough (in some cases conflicting) studies to think there is an effect of some kind. Efficiency and safety vs serious adverse side effects is another story.

You continue to nay-say the efficacy of topical steroids in acute hearing loss. This is basically the only thing out there that could be preventing people from developing chronic tinnitus and people like you along with the BTA are fighting against it.

"Dexamethasone exerts reliable therapeutic effects when used to treat NIHL."
https://www.ncbi.nlm.nih.gov/pubmed/25894725

The SOC is oral steroids, and topical is even more potent. Why are you arguing about this?