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Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 1 of 3)

Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 1 of 3). Version date: June 5, 2012. This workshop was developed by researchers at: The VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), located at the Portland, Oregon VA Medical Center

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Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 1 of 3)

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  1. Managing Your Tinnitus: Changing Your Thoughts and Feelings(Session 1 of 3) Version date: June 5, 2012

  2. This workshop was developed by researchers at: • The VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), located at the Portland, Oregon VA Medical Center • The VA Connecticut Healthcare System in West Haven, Connecticut

  3. Introductions • Please share the following with the group: • What is tinnitus like for you? • Do you also have hearing loss? • How we should communicate as a group? • How do you deal or “cope” with your tinnitus?

  4. Remember: Tinnitus cannot be cured • “Cure” = eliminate or reduce the tinnitus • No cure yet – research underway • It can’t be cured, but you can learn to manage your reactions to it [Note: “managing tinnitus” really means “managing reactions to tinnitus” – you can’t change the sound of the tinnitus, but you can change how you react to the sound]

  5. Remember: Goals of Tinnitus Management (All Methods) • Negative emotional reactions are reduced • Stress is reduced • Little, if any, attention is given to tinnitus • Tinnitus does not negatively affect any life activities in a major way • Further help for tinnitus management is not needed or wanted

  6. These goals can be reached even if the sound of your tinnitus doesn’t change!

  7. Goals of Today’s Workshop • Understand what “CBT” means • Learn about stress and tinnitus • Learn two relaxation exercises: • Deep Breathing • Imagery • Learn about “distraction” (by keeping your mind off of your tinnitus using pleasant activities) • Start using the Changing Thoughts and Feelings Worksheet

  8. Introduction to Cognitive Behavioral Therapy (CBT) • Tinnitus is not a mental health disorder • CBT is used to change thoughts, behaviors, or emotions • CBT helps you think more positively about your tinnitus • CBT also helps people who have pain and other health problems

  9. The CBT Cycle & Thoughts

  10. The CBT Cycle • Behavior, emotions, and thoughts/beliefs are related • If you change one of these then you can change all of these • Behavior or thoughts can lead to negative feelings about tinnitus • TODAY: You will work on behaviors that can help you think more positively and help you feel better

  11. Ground Rules… • Time is limited, so we will follow the agenda • We will stay focused on learning ways to manage reactions to tinnitus

  12. Today’s Agenda • Changing Thoughts & Feelings Worksheet • Discuss stress and tinnitus • Learn and practice two relaxation exercises: Deep Breathing and Imagery • Learn to plan pleasant activities

  13. Take a moment to… Tear out a blank Changing Thoughts and Feelings Worksheet:

  14. Use this Worksheet to take notes while you learn skills to manage your reactions to tinnitus Use a new Worksheet for each bothersome tinnitus situation This Worksheet help guide you as you practice the new skills What you put on the Worksheet will change as you figure out what works best for you Learning How to Use theChanging Thoughts & Feelings Worksheet

  15. How do I fill out #1 on the Changing Thoughts & Feelings Worksheet?

  16. #1 on the Changing Thoughts & Feelings Worksheet • The first step in completing a Changing Thoughts and Feelings Worksheet is to write down a bothersome tinnitus situation • You already identified a bothersome tinnitus situation last week when you met with the audiologist using the Tinnitus Problem Checklist on page 29 • Does everyone have a bothersome tinnitus situation to write for #1?

  17. Remember from first Workshop with audiologist the Sound Plan Worksheet: 1. One bothersome tinnitus situation

  18. How do I fill out #2 on the Changing Thoughts & Feelings Worksheet?

  19. During the workshops with the mental health provider, you will learn the CBT skills shown on #2 of the Worksheet

  20. Today you will learn these two CBT skills to manage your tinnitus:

  21. #3 on the Worksheet • Write down details about the skill you will use to manage your reactions to tinnitus

  22. #4 on the Worksheet • After you try the skill, write down how helpful that skill was in helping you feel better

  23. #5 on the Worksheet • Write down a comment describing how you feel after trying this skill

  24. Today’s Agenda • Changing Thoughts & Feelings Worksheet • Discuss stress and tinnitus • Learn and practice two relaxation exercises: Deep Breathing and Imagery • Learn to plan pleasant activities • Other topics suggested by the group

  25. Stress and Tinnitus

  26. Many people say stress makes their tinnitus worse • Reducing stress can help your tinnitus • Think of stress as a “challenge” instead of a “threat” • Healthy living will help you manage stress • Things you can do to reduce stress: • Plan ahead for stressful events • Exercise and eat right • Get enough sleep • Meditate or learn yoga • Do relaxation exercises – there are many kinds

  27. Today’s Agenda • Changing Thoughts & Feelings Worksheet • Discuss stress and tinnitus • Learn and practice two relaxation exercises: Deep Breathing and Imagery • Learn to plan pleasant activities • Other topics suggested by the group

  28. Why learn relaxation exercises?

  29. Relaxation Exercises: Why do they help? • They help you take a break from stress • They slow down your breath and heart rate • They distract you from your tinnitus

  30. Relaxation Exercises: How do they help? • By slowing down your body • By helping you get your mind off of your tinnitus • By helping you feel relaxed and calm so you: • Feel a sense of relief from tension and stress caused by your tinnitus • Think more clearly • Feel better over

  31. Relaxation Exercises:When should I use them? • Any time you feel stressed or tense • Practice everyday between group sessions • Share with the group next session

  32. How to prepare before a Relaxation Exercise • Find a place where you won’t be disturbed • Tell others you need privacy • Loosen tight clothing or change clothes • Sit with feet flat on the floor or propped up • Place your hands in your lap or on chair arms • Turn on soothing sound or soft music • Avoid silence when practicing relaxation exercises

  33. Relaxation Exercise #1:Deep Breathing - A Step-by-Step Guide Step 1: Prepare using the information above. Step 2: Put one hand on your stomach and one on your chest. Notice which hand moves. Move your stomach hand more for a deeper breath. Step 3: Close your eyes or focus on a thing in the room. Step 4: Breath through your nose for 3 seconds – count in your head “one-two-three.” Step 5: Hold that breath for 2 seconds (count “one-two”) & release the breath for 3 seconds (count “one-two-three”). Step 6: Repeat Steps 4 and 5 for five to ten minutes. Step 7: When you are done, think about where you are, wiggle your hands and feet, and open your eyes.

  34. Deep Breathing Let’s try it! • When you are done, choose the amount of relief you feel • Choose either 0, 1, 2, 3, 4, or 5 • Be ready to share your rating with the group

  35. The Relief Scale:

  36. Raise your hand if you felt no relief from the stress or tension caused by your tinnitus

  37. Raise your hand if you felt slight relief from the stress or tension caused by your tinnitus

  38. Raise your hand if you felt mild relief from the stress or tension caused by your tinnitus

  39. Raise your hand if you felt moderate relief from the stress or tension caused by your tinnitus

  40. Raise your hand if you felt nearly complete relief from the stress or tension caused by your tinnitus

  41. Raise your hand if you felt complete relief from the stress or tension caused by your tinnitus

  42. Deep Breathing Track your progress on this chart

  43. What is Imagery? • Imagery is imagining you are some place calming and peaceful • Some people call this their “happy” place • Choose a place that feels safe to you • Think about each of your 5 senses to get a good picture of the place: • Sight • Smell • Sound • Touch • Taste

  44. Imagine… Picture a safe, calming, and peaceful place

  45. Relaxation Exercise #2:Imagery - A Step-by-Step Guide Step 1: Prepare as you would for any relaxation exercise. Step 2: Take several deep breaths. Step 3: Choose a calming and peaceful place to imagine. Imagine the place as you close your eyes or focus on a thing in the room. Do this for five to ten minutes. Step 4: When you are done, think about where you are, wiggle your hands and feet, and open your eyes.

  46. Imagery Let’s try it! • When you are done, choose the amount of relief you feel • Choose either 0, 1, 2, 3, 4, or 5 • Be ready to share your rating with the group

  47. Raise your hand if you felt no relief from the stress or tension caused by your tinnitus

  48. Raise your hand if you felt slight relief from the stress or tension caused by your tinnitus

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