Why Is There Such a Stigma About Cognitive Behavioural Therapy?

[linearb]

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

All I'm arguing is that the actual data we have on humans is not very strong, that there are clear potential risks, and that therefore more study is needed and it's understandable that doctors concerned about being sued may be reluctant to offer such drugs. I've also advocated that I think patients should have access to them.

None of that seems controversial to me, but I think it's the most short and simple distillation of my view on this, so if you want to disagree, you're very welcome to. Studies about SSHNL and animal studies won't convince me that there's equivocal data about the best protocols for doing this in humans. We needn't agree, though.

 

[bobvann]

Actually I have taken Dexamethasone orally in the "freak out stage days." Never really did much.

 

[JohnAdams]

clear potential risks

The risk of developing chronic tinnitus seems like more than a reason to offer IT dexamethasone injections during the acute stage.

 

[linearb]

The risk of developing chronic tinnitus seems like more than a reason to offer IT dexamethasone injections during the acute stage.

This can lead to scarring of the tympanic drum, which I have and have been told by multiple MDs is a possible factor in the HF loss I have there.

 

[JohnAdams]

This can lead to scarring of the tympanic drum, which I have and have been told by multiple MDs is a possible factor in the HF loss I have there.

If your ENT isn't incompetent then there should be no risk. The last time I got my ears looked at the ENT couldn't ever tell I had any IT injections and I've had around 100.

 

[Juan]

Just out of interest, what's with all the hate towards CBT on this site? I agree it can be expensive, but it's proven to be effective at reducing some people's suffering and I don't see what's bad about that. As far as tinnitus goes, there's no proven treatment (yet), and there's certainly no cure, so all we have are ways to help one deal with the torment.

CBT is evidence-based, so to dismiss it out of hand seems silly to me. Either one believes in the principles of science or one doesn't, surely? When one starts selecting how and when to believe in science and cherrypicks parts of it to confirm a belief, but also dismisses other parts, then I begin to see some cognitive bias at play. If a treatment came out that had an equal amount of scientific evidence, demonstrating that it could objectively lower tinnitus volume, then I'm sure many would have a lot more faith in what the data would have to say.

To me, this is no different to how flat Earthers operate. They cherrypick their theories whilst ignoring basic science that proves beyond a doubt that the Earth is a globe.

To be objective about something is to be as neutral as possible and to follow what the data has to say, and that's whether it proves or disproves one's beliefs.

I think in the end tinnitus or hyperacusis sufferers realise that they are stuck with the problem and that it will not go away, and also realise that their financial situation and the jobs they perform may change, so they need to be financially cautious. That being said, people come to the conclusion that CBT and other snake oil therapies are just a scam and a waste of money and time, so why waste money?

 

[bobvann]

I think in the end tinnitus or hyperacusis sufferers realise that they are stuck with the problem and that it will not go away, and also realise that their financial situation and the jobs they perform may change, so they need to be financially cautious. That being said, people come to the conclusion that CBT and other snake oil therapies are just a scam and a waste of money and time, so why waste money?

My newfound favorite saying "Snake Oilists". I've just passed 2.5 years. My own health authority has scammed me... All we have is get past the distorted thinking aka mentally "wax on wax off" our way out of it... Like I keep telling people who keep saying that all we have to do is replace distorted thoughts with rational ones. Wow what is all the need for research for?

 

[linearb]

I think in the end tinnitus or hyperacusis sufferers realise that they are stuck with the problem and that it will not go away, and also realise that their financial situation and the jobs they perform may change, so they need to be financially cautious. That being said, people come to the conclusion that CBT and other snake oil therapies are just a scam and a waste of money and time, so why waste money?

CBT doesn't actually have to cost anything; if it does then you are paying for talk therapy and coaching which is a separate issue.

Just applying basic principles to improve one's own quality of life need not cost anything; these techniques were developed by a rich history of people staring at walls silently, and exactly because there is no magic to any of it, these techniques are now well documented and can be easily learned at a library or website.

The hard part is putting the work in and applying the principles as you go about every waking minute of your day, more than learning anything complicated.

 

[fishbone]

The hard part is putting the work in and applying the principles as you go about every waking minute of your day, more than learning anything complicated.

Application of knowledge, can be time consuming and at times it's hard to form consistent habits.

 

[Lane]

Application of knowledge, can be time consuming and at times it's hard to form consistent habits.

@fishbone -- I've heard it generally takes about 21 days to form consistent habits, where things become more unconscious than conscious. It's always sounded about right to me.

 

[fishbone]

@fishbone -- I've heard it generally takes about 21 days to form consistent habits, where things become more unconscious than conscious. It's always sounded about right to me.

This is all possible, *IF the person is willing to do it

 

[Tybs]

This is all possible, *IF the person is willing to do it

Environment is also an important factor. Having a stable background and supportive people around can really turn the tide.

 

[fishbone]

Environment is also an important factor. Having a stable background and supportive people around can really turn the tide.

Having a supportive environment is VERY important, but your willpower to succeed no matter what, is crucial.

I did not have supportive environments, in many of my BIGGEST afflictions. All I had was the willpower to achieve my objectives and move forward....

 

[Lane]

This is all possible, *IF the person is willing to do it

It seems most people aren't. Just a casual observation.

 

[fishbone]

It seems most people aren't. Just a casual observation.

You are absolutely right. I use to be one of those people as well. I always had the willpower in me, but I use to not dig for it at all. It was when affliction came around, that was when I had to make the proper changes and move forward...

I am a firm believer in channeling negativity/affliction into something positive. Taking one force and turning it into another.

 

[bobvann]

It's interesting Michael states something like hearing protection will not help due to sound vibrating through bone. I have experienced spikes due to this so it kind of makes sense, but has not altered my tinnitus. The same people who advocate for "distorted thoughts" to be challenged, state that the theory is only fed by fear and distorted thinking.

 

[JohnAdams]

This is why there's a stigma, because the people leading the tinnitus medical community are completely insane.

"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."

https://link.springer.com/article/10.1007/s00106-019-0633-7

That flow chart says you will recover if you just accept tinnitus and stop avoidance behavior. First off, yes, it is perfectly clear to many of us that we have a decreased tolerance for noise and that we should definitely avoid situations that we know will spike our tinnitus. Secondly, wtf do they mean by "recovery"? Tinnitus goes away? Nonsense. This paper is the European guideline for tinnitus and was produced by Derek Hoare, Rilina Cima (Ms. Tinnitus distress is a spider phobia), and one of the contributors is Berthold Langguth (Mr. I work for Neuromod and was also a principal investigator for their clinical trial).

These people are part of the ESIT, the ones that publish meaningless articles about women vs men's suicide rates, personality types and tinnitus, etc.

They are telling us to engage in destructive behaviors that can make our situations much much worse.

 

[JohnAdams]

I can't believe you wasted your time looking this stuff up.

I remembered this from 7th grade English class. I can't believe you waste your time being an establishment shill. To each his own I guess.

 

[threefirefour]

This is why there's a stigma, because the people leading the tinnitus medical community are completely insane.

"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."

View attachment 34169

https://link.springer.com/article/10.1007/s00106-019-0633-7

That flow chart says you will recover if you just accept tinnitus and stop avoidance behavior. First off, yes, it is perfectly clear to many of us that we have a decreased tolerance for noise and that we should definitely avoid situations that we know will spike our tinnitus. Secondly, wtf do they mean by "recovery"? Tinnitus goes away? Nonsense. This paper is the European guideline for tinnitus and was produced by Derek Hoare, Rilina Cima (Ms. Tinnitus distress is a spider phobia), and one of the contributors is Berthold Langguth (Mr. I work for Neuromod and was also a principal investigator for their clinical trial).

These people are part of the ESIT, the ones that publish meaningless articles about women vs men's suicide rates, personality types and tinnitus, etc.

They are telling us to engage in destructive behaviors that can make our situations much much worse.

Jastreboff also encourages using earphones. The cult of acceptance acts destructively I'm sure this is why so many of these people end up having a worsening.

 

[xyz]

"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."

https://link.springer.com/article/10.1007/s00106-019-0633-7

We are about to enter the third decade of the 21st century and still have these pseudo science articles on T. This is just ridiculous.

 

[bobvann]

Same with the tinnitus group I just left. They kept saying live your life like you don't have tinnitus. Giving that same advice to someone suffering extreme hyperacusis I thought WTF!

 

[JohnAdams]

Jastreboff also encourages using earphones. The cult of acceptance acts destructively I'm sure this is why so many of these people end up having a worsening.

This is why MPP is so important.

 

[PeteJ]

Same with the tinnitus group I just left. They kept saying live your life like you don't have tinnitus. Giving that same advice to someone suffering extreme hyperacusis I thought WTF!

I was told that exactly by an audiologist. She looked like she recently graduated. I think they all have the same conclusions for tinnitus and that is scary.

I don't want to imagine what people with severe hyperacusis goes through.

 

[linearb]

Same with the tinnitus group I just left. They kept saying live your life like you don't have tinnitus. Giving that same advice to someone suffering extreme hyperacusis I thought WTF!

You're upset that advice aimed at people with run of the mill tinnitus isn't applicable to people with a much more rare and severe condition?

I raged at my dentist when my TMJ splint didn't fix my knee pain.

 

[bobvann]

Either that or it can be the equivalent of having an open wound and told "It's ok poke the stick right in there."

To get back on topic CBT Oil...

 

[all to gain]

This is why there's a stigma, because the people leading the tinnitus medical community are completely insane.

"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."

View attachment 34169

https://link.springer.com/article/10.1007/s00106-019-0633-7

That flow chart says you will recover if you just accept tinnitus and stop avoidance behavior. First off, yes, it is perfectly clear to many of us that we have a decreased tolerance for noise and that we should definitely avoid situations that we know will spike our tinnitus. Secondly, wtf do they mean by "recovery"? Tinnitus goes away? Nonsense. This paper is the European guideline for tinnitus and was produced by Derek Hoare, Rilina Cima (Ms. Tinnitus distress is a spider phobia), and one of the contributors is Berthold Langguth (Mr. I work for Neuromod and was also a principal investigator for their clinical trial).

These people are part of the ESIT, the ones that publish meaningless articles about women vs men's suicide rates, personality types and tinnitus, etc.

They are telling us to engage in destructive behaviors that can make our situations much much worse.

No way is tinnitus a benign signal. I will never accept that. That damn horrible noise is a sign that something major has gone down.

 

[JohnAdams]

You're upset that advice aimed at people with run of the mill tinnitus isn't applicable to people with a much more rare and severe condition?

I raged at my dentist when my TMJ splint didn't fix my knee pain.

You just invented that scenario. Good job. You're a true warrior. I hope you get paid for your efforts.

 

[linearb]

You just invented that scenario. Good job. You're a true warrior. I hope you get paid for your efforts.

Generally yes but I'm on vacation; thanks for asking!

 

[Harley]

You're upset that advice aimed at people with run of the mill tinnitus isn't applicable to people with a much more rare and severe condition?

I raged at my dentist when my TMJ splint didn't fix my knee pain.

I think he is upset, that these people make absolutely no effort to explain, that there is also a severe end of the spectrum, to which none of this applies.

Anyone who holds any power to form opinions on the subject of tinnitus should at the very least mention this in passing, because a failure to do so is just plain irresponsible on their part.

The very last thing we need, is any more reinforcement of the "one size fits all" type of ignorant misconceptions, which are already running pretty strong, even without their "help".

I'm not quite sure, why this particular point is so hard to understand by so many.
By leaving out this important information, they are effectively throwing the most vulnerable sub-group under the bus.

Those people need real medical solutions.
They don't need any more pep talk!
They just need everyone to know, that they are out there, waiting for a cure (or at least a real treatment).

 

[Cape crusader]

I did 13 months of CBT once a week and just told my therapist let's end this last week. The last few sessions we were talking about movies and food!!

Did it help over the months? Maybe a little.

He was bright and knew I was screwed with tinnitus and really wanted me to accept, adapt and try so hard to do things I like. Let's put it this way, I'm a bit better now than 13 months ago near the beginning of my tinnitus. But I may have been with CBT or without.