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Murasaki53
 #1 

Folks, I need a better strategy for dealing with spikes, for those days when the tinnitus is already nearly at its peak and that journey to work and the working environment exacerbate it still further. Or itfs the weekend and anything Ifve got planned is going to be either an exercise in futility or too scary to contemplate. For me, a spike also means that a hissing, sizzling, squealing noise in my left ear that I am especially averse to becomes prominent.

 

When I think back over the last year, a lot of the time when Ifve been doing well is because there have been a few more quiet days in sequence than loud ones. A lot of my posts have also been with spikes in mind and that also means that any good advice Ifve received is often buried in a thread I canft remember the title of. By creating this thread I'll therefore know where to find it.

 

Ifm also aware that when people vent, a lot of the time this is because their tinnitus is spiking so perhaps others will benefit as well.

 

Here are some typical thoughts I have during spikes:

 

1. eSpikes are so loud, grating, frequent and downright horrible that Ifll never get used to themf

 

2. eTinnitus of this kind (reactive/competitive) cannot be habituatedf

 

3. eHow can anyone function with a sound like the hiss of a live rattlesnake going through their head all day?f

 

4. 'Therefs no way I can face doing X because of the tinnitus and besides going out will make it much worse. Therefs no way Ifll enjoy doing X with the tinnitus this loud.'

 

5. eLife is not worth living when there are so many days when the tinnitus is like this.f

 

Ifm going to start the ball rolling with CBT style challenges to these thoughts:

 

With 1, 2 and 3, I know that there are people out there who have habituated spikes and tinnitus that ramps up in surrounding noise. Ifm just not confident I can. Maybe theyfre stronger than I am. On the other hand, maybe itfs also a matter of patience and giving oneself time.

 

With statement 4 Ifm aware of one or two things I did in the last year that were just about enjoyable. But I also know of lots of other things (attempts to read books/watch films etc.) that were derailed by the rattlesnake. Perhaps a little more persistence might be required though.

 

With 5 I can think of things that make life worth living. But spikes make such a large debit entry in my life that I find it really hard to stack anything alongside that outweighs them, even love of family, friends and work. This is a particularly tough one for me because these attachments arenft as extensive for me as they are for others. For this one, Ifve therefore been wondering whether to approach a cognitive therapist to look into this issue more deeply as there are limits to what can reasonably be explored in a forum of this kind. Nevertheless, I decided to include it in the list just in case someone does have a view on this.

 

So as you can see, Ifm finding it hard to challenge these thoughts Ifve listed so I'm wondering how others might deal with them.

 

It would also be interesting to read what thoughts come up for other people during spikes and how they approach them.

 

Any ideas anyone has would be greatly valued.

 

 

dustie
 #2 
there's a lot to think about in your post (which i'm glad you wrote because the issues you raise are important), and no doubt i'll have more thoughts about it than these, but here are two for now, and they're questions:

when you wrote last week that while in the kitchen with music on, you stopped being aware of your tinnitus during one piece that you especially liked, did that happen during a spike?

and (especially about your number 5) have you not seen a  therapist at all for help with tinnitus and/or the other issues you alluded to in your life?   i'm asking because, if not, it sounds like you might have a lot to explore and a lot to gain if you find a therapist you "click" with.  (as you know, i'm saying this from my standpoint as a person helped very much a few times in my life by therapy, not as a medical person who "knows" you need it.)

i'm also wondering if on your own you have worked on problems related to tinnitus on paper, by writing down your thoughts and challenging them literally on paper.   i found cognitive therapy worksheets, from my depression hospitalization several years ago, really essential to my getting well, while in the hospital but also for many months afterward; it was all too much to try to sort out only in my mind and retain there.   the act of thinking out the challenges to my obsessive thoughts by using those worksheets, writing down my answers, and looking at them outside my head helped the whole thing to become an active process, and one with structure.

the cbt-for-tinnitus book that sp recommends (sorry, i can't think of the name at the moment) -- do you have it?   it sounds helpful in the way the worksheets i used (and still do sometimes) were and are helpful.

dustie
p.s.  i counted wrong -- i had more than two questions for you! 

Murasaki53
 #3 
Hi dustie,
               I do have the CBT book. But what I've not done is to work my way through it systematically. So that's something I'm going to have to do.
I'm also looking into working with Laurence McKenna (the UK CBT/Tinnitus authority). As it happens I've finally managed to track down his contact details today.

I'm also working with a psychotherapist of a different type. With her I'm coming to understand that my core beliefs about life itself are much more negative than I've realized. Which isn't exactly a recipe for success when it comes to a challenge like tinnitus.

I'm also a bit of a control freak. Which puts me at a bit of a disadvantage where tinnitus is concerned because we have no control over the noise itself.
Hence my ongoing problem with spikes.

As far as listening to music is concerned, that was a fairly loud ear day that I managed that.

Thanks for suggestions dustie. I always find your posts just so well-balanced and insightful that it's hard to believe that you ever had a problem with depression.
stringplayer
 #4 
Mura, I know that you are doing TRT and have both hearing loss and tinnitus.

It may sound like a dumb question at this point - but of the two, which is the greater concern to you?

sp

aQuieterBreeze
 #5 
Hi Mura,

I wonder -
Do even those loud spikes settle back down, after a bit?
(I think you have said that they do)

Thank you for posting what you did, and letting us know more about what you are going through.
I hope that things get better for you soon.
Please remember that though some things can take awhile, (to get better)
Sometimes even small steps - in a positive direction can really add up.
Wishing you much brighter days,
aQuieterBreeze
dustie
 #6 
mura, your answers show that you're pursuing some very possible ways of helping yourself -- i see plenty of reasons for hope there.   (and i see from sp's post that you're doing trt, too.)   cbt is mostly a step-by-step process, i believe, so if you have yet to go through that book systematically, no doubt potential is there that you haven't tapped into yet.   and good for you for tracking down "the UK CBT/Tinnitus authority." (!)   that must take quite a bit of perseverance and motivation.   are you planning to be evaluated by him soon and/or work with him for some time?

you say "As far as listening to music is concerned, that was a fairly loud ear day that I managed that."   to me that's a sign that you can develop the power/freedom to "tune out" your tinnitus, more than you may think when you're discouraged.   if it happened without your even trying, the capacity has to be there, yes?

you say you're learning via therapy that your core beliefs about life itself are much more negative than you've realized.   i think that realization is the first (and giant) leap toward challenging those core beliefs, and possibly changing some because of the challenges -- in whatever ways feel true to you as you examine them more.   i'm sure you're right that dealing with tinnitus requires a less negative mindset than you've discovered you have.   it's certainly true that plenty aspects of life are difficult and cause sorrow.   no way around that.   but whether to let those times color all of life, that's the question.

people sometimes feel funny about challenging core beliefs, as if it means challenging who they fundamentally are and were meant to be. i don't know if you feel that way, but i have, many times.   and most every time i discovered that my beliefs weren't actually "me" -- that beliefs change, even naturally, and who we are at heart is beyond even what we think of as beliefs.

ah, a control freak, eh?   i do see that as an initial disadvantage where tinnitus is concerned.   the first major epiphany i had after suffering awfully with tinnitus for a while, finally, was that i had zero control over it and, so, what can i do about it now?   the answer of course was that i couldn't do anything about it, i could only do something about me.   whether it's a longer route, i don't know, but i completely believe that anyone, including control freaks, can *surrender* to that fact and make a good life beyond it.   we've seen it on this board, if you think about it. . . .

i appreciate very much what you said about my posts, mura. but i have indeed had a problem with depression (runs in the family), as well as panic disorder -- interwoven throughout my life and at times very acute.  most of the time at this point these things are well under control and i tend to be a "glass-half-full" type of person.   if there is any insight in any of my posts, attribute it to the great help i've been fortunate to find during hard times.   that help includes rob's fantastic responses to me when i first posted many months ago on the TSMB, and this board.   

dustie


Rob_in_Denver
 #7 
OK, Mura

Here are my suggestions for some "thoughtful" counter-insurgency against those spikey thoughts (and I have had them, too!).  Tinnitus may seem to be a formidable foe, but it is no match for the protean power of your mind!
 

1. eSpikes are so loud, grating, frequent and downright horrible that Ifll never get used to themf

 

There is no evidence that because these spikes are bothering me now, that I will never get used to them.  This is an example of "catastrophizing." 

 

2. eTinnitus of this kind (reactive/competitive) cannot be habituatedf

 

Says who?  How do you know that?  You are not habituating to it now, but in what sense does that mean that you won't ever?  There are plenty of people with loud, "reactive" (although that is not a good word for many reasons) tinnitus that have habituated just fine.  Why should you be any different?

 

3. eHow can anyone function with a sound like the hiss of a live rattlesnake going through their head all day?f

 

Aha!  Well, if you think of it as like the hiss of a live rattlesnake, I can understand having difficulty in functioning.  Rattlesnakes are dangerous, so the sound of their hiss is a warning you should not ignore!  How about thinking of it as the sound of an old and broken steam radiator in the next room? My tinnitus sounds like a hiss most of the time, and that is what comes to mind in my case.  A lot easier to function with that image in one's mind than the thought of a rattlesnake about to strike!

 

4. 'Therefs no way I can face doing X because of the tinnitus and besides going out will make it much worse. Therefs no way Ifll enjoy doing X with the tinnitus this loud.'

 

Black and white thinking.  I can only enjoy doing something if the tinnitus is gone.  Really?  Why is that?  The truth is you have decided that you won't enjoy anything unless the tinnitus is gone.  It's your decision.  Why not put it to the test? The reality is that the tinnitus will distract you somewhat (maybe a lot in the beginning), but it will not eliminate your ability to truly enjoy activities or events that you like.  And the more you refuse to give in to the negative, self-imposed premise that it will block your enjoyment, the less you will find that it does!  Trust me; it works!

 

5. eLife is not worth living when there are so many days when the tinnitus is like this.f

 

More black and white thinking.  You need to tell yourself this:  Today the tinnitus is getting me down, but I won't always feel this way.  Even if I do now.  Even if I have my doubts that I will ever get beyond this feeling because the tinnitus is so bothersome now.  It will not always be this bothersome, and I will feel better.  My life is filled with blessings and happiness and one day they will crowd out this awful feeling.  I will feel better.

 

I am betting on you, Mura!

 

Best regards,

 

Rob in Denver

 

Murasaki53
 #8 
Many thanks for the helpful suggestions and points people have made and for the time and energy you have put into posting these responses. 

It's particularly useful to read the example of applied CBT provided by Rob in Denver. I'd never have come up with something like that myself so it is obviously going to take practice.

I'm also pleased that Bbec is getting something out of this thread and I know that one other forum member who also has difficulty with spikes is following it with interest.

Again, dustie, the wisdom inherent in your last post obviously reflects the hard work you've put in to dealing with anxiety and depression. In response to your query, I see TRT and CBT as complementary but I'd like to work with Laurence Mckenna on this very issue of spikes.

sp,
     in response to your question, the tinnitus bothers me a great deal more than the hearing loss.
stringplayer
 #9 

Mura posted:

sp,
     in response to your question, the tinnitus bothers me a great deal more than the hearing loss.


.............

Then I think you might want to revisit the issue of wearing broad band sound generators for your TRT with Jacqui.  You've got a great pair of hearing aids there, and they'll be just as great in a year as they are right now.  Meanwhile, why don't you see if Jacqui will fit you with a pair of broad band sound generators to wear instead.  (You can get them on a trial basis to see if they appeal to you.)

The idea here is that once you have habituated the sound of the devices, your spikes will be occurring against an (unnoticed) noise background, and since we detect sensory signals by contrast instead of by absolute magnitude, the spikes will tend to impact you less.  Maybe in that way, it will be easier to apply the excellent ideas offered elsewhere in this thread.

Just a thought.

sp

[PS - Many TRT clinicians would have put you in Category 1 instead of Category 2, using broad band sound generators from the start.  I myself never really understood why Jacqui made you a Category 2, but I'm sure she had her reasons.]

Murasaki53
 #10 

That's an excellent thought sp. I've also wondered whether I'd be better off with WNGS. The only problem is the additional expense of the sound generators but I'll look into it with Jacqui.

stringplayer
 #11 
If they make a substantial difference, I suspect that the expense will be worth it.  At least that's how I looked at the purchase when I made it for myself.  Besides, maybe Jacqui will be willing to forego some of the mark-up - since it will be your second purchase from her ... and since you will ultimately be a life-long hearing aid patient of hers.

sp
dustie
 #12 
Quote:
Originally Posted by Rob_in_Denver

3. eHow can anyone function with a sound like the hiss of a live rattlesnake going through their head all day?f

 

Aha!  Well, if you think of it as like the hiss of a live rattlesnake, I can understand having difficulty in functioning.  Rattlesnakes are dangerous, so the sound of their hiss is a warning you should not ignore!  How about thinking of it as the sound of an old and broken steam radiator in the next room? My tinnitus sounds like a hiss most of the time, and that is what comes to mind in my case.  A lot easier to function with that image in one's mind than the thought of a rattlesnake about to strike!


this post has something for everyone, certainly including me.   my favorite is the rattlesnake association vs. the broken steam radiator association.   it seems like such a small thing, but it's not.   a lot of people -- maybe most -- do the rattlesnake-type thinking fairly often.   one reason it's tempting is that it's colorful and dramatic, you know?   it's creative and carries a whimsical punch.   emphasis on punch, though!   i kept journals for years that were full of this stuff and sometimes still get a laugh reading them.   but it's best to save creativity and drama for the millions of other types of opportunities to use them, and i've found there are many, fortunately.

thanks for this, rob in denver.

dustie
 
Murasaki53
 #13 
The Henry and Wilson book also has a section on imagery and tinnitus that I only just realized was there today.

For example, the tinnitus I can hear right now could be described as 'a horrible squeal'. In fact, this is the way I have described it to myself. But I can also imagine the same sound as being a bit like seagulls circulating on a sunny beach. Which is a more benign description and one that can take a little of the sting out of the way tinnitus is envisaged.


stringplayer
 #14 
Bbec posted:

Just wondering what the rest of my life will be like if I never get better.

........

Why engage in that type of thinking at all?

sp
stringplayer
 #15 
Bbecposted:

ummmmmmmmm......because my life stinks right now because of the tinnitus.

..........

You have tinnitus.  But how can you look at those two children of yours and say that your life stinks?

You can't.  SO STOP IT.  Capeche? 

sp
dustie
 #16 
Quote:
Originally Posted by Murasaki53
The Henry and Wilson book also has a section on imagery and tinnitus that I only just realized was there today.

For example, the tinnitus I can hear right now could be described as 'a horrible squeal'. In fact, this is the way I have described it to myself. But I can also imagine the same sound as being a bit like seagulls circulating on a sunny beach. Which is a more benign description and one that can take a little of the sting out of the way tinnitus is envisaged.



there ya go.   great example.


pt
 #17 
Mura, another example similar to the seagull example is to shift your baseline. Think of your spikingly bad tinnitus as baseline, rather than your lower tinnitus as baseline. That way, when the volume is lower, you come out ahead. Instead of having a spike and feeling that your tinnitus is especially bad, you get to have it lower and feel that it is especially good.
stringplayer
 #18 
Peach posted:

Mura, another example similar to the seagull example is to shift your baseline. Think of your spikingly bad tinnitus as baseline, rather than your lower tinnitus as baseline. That way, when the volume is lower, you come out ahead. Instead of having a spike and feeling that your tinnitus is especially bad, you get to have it lower and feel that it is especially good.

..........

Peach, I cannot argue with that strategy.  Whatever works, I guess.

The goal, of course, is not to view your baseline at all in terms of tinnitus.  Otherwise tinnitus is calling the shots, no?

sp

dustie
 #19 
peach, that's a brilliant perception/idea!   reading it, i realized that at some point that baseline shift happened for me.   i don't know when it happened, or how, but it did, and it's part of why i feel so much better than i used to.   only i didn't recognize it and so wouldn't have had any idea how to express it, as you did so well.

dustie


aQuieterBreeze
 #20 
Hi Peach,

I like the seagull example better - and that one makes alot more sense to me.

With my sensitivities to sound and also with tinnitus spikes-
It really helps when setbacks, (or spikes)  happen,
 for me to remember that I have been through it before, and I have gotten better.
But that is just me, we are all different-- and that is just how I prefer to view things.

edited by aQuieterBreeze
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