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Micky
 #1 
 
Hi all, ..every 7 or 8 days i have 2 good days of tinnitus where it is no longer a big issue .. and life is good..however, on the third day it returns with a huge increase in volume, very debilitating and stays this way for the next several days, i find this almost inpossible to deal with.This has been the trend now for over 2 years, and i have never been able to break the cycle of the 2 good days by extending it to 3 or even 4. Some how my brain has been programmed to turn the volume down for these 2 days .. and to re- set it with a vengence on the third and the following days after....maybe Doctor Nagler, or some folk on this forum  can offer some advice as to how i can beat this wretched cycle ..Thankyou ..Micky ..
DrNagler
 #2 
Micky, I had a similar cycle and fiound myself "living" for those "good ear days."  I think that one of the tricks to beating the cycle is to stop seeing it as a cycle - but rather view the tinnitus as a single entity.  (After all, it's tough to really really enjoy those good days when you know that a bad day is just around the corner, no?)

Let me ask you a question, though.  You wrote [in part]:

every 7 or 8 days i have 2 good days of tinnitus where it is no longer a big issue .. and life is good..however, on the third day it returns with a huge increase in volume, very debilitating and stays this way for the next several days, i find this almost inpossible to deal with.This has been the trend now for over 2 years

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

Do you see any inconsistencies in your words quoted above?

smn


Micky
 #3 

Erm, well not really Doctor Nagler, must say i'm not thinking too well at the moment due to feeling quite unwell and very loud tinnitus, maybe some one else can help me out ..but yes your right , it is hard to enjoy those 2 good days when you know whats waiting in the wings..i  would very much like some views from forum members on why i am stuck in this 2 day cycle, there must be a way out of it ..thankyou for any help ..Micky ..

CPW151
 #4 
Dr. Nagler posted: "Micky, I had a similar cycle and fiound myself "living" for those "good ear days."  I think that one of the tricks to beating the cycle is to stop seeing it as a cycle - but rather view the tinnitus as a single entity.  (After all, it's tough to really really enjoy those good days when you know that a bad day is just around the corner, no?)"
 
Thank you Dr. Nagler for an excellent post and it is encouraging to know that this cycle was one you experienced as well and beat it.  I started the post on Invasive Tinnitus (rather than Intrusive) but this may fit a bit here.  Your definition of Intrusive is defined as "when tinnitus has you."  I certainly agree with that definition and thanks to you and several I am beyond that point.  Now to work on this cycle stuff.  I do not view those loud days as "debilitating" any longer but those loud days do seem to invade in my space.  Maybe that's why a made the mistake of using that word.  Those loud days are not as enjoyable as the days when it is softer or not noticeable or better said that any activity, however quiet, it drifts into the background. 

Can you elucidate further on viewing tinnitus as a "single entity?"  Life is good and to break this cycle would probably be one of the final steps to real habituation.   I do enjoy the soft days even though I know that when I have one of those days that it simply is not there at all the next will be loud and to use maybe a new coined term - invasive.  Meaning, as I said, I'm always aware of it that day. It does not, however, change any plans for that day.  Life is too precious to give tinnitus that much power.  Thanks.

CPW


DrNagler
 #5 
Micky, maybe "inconsistency" wasn't exactly the best word.  What struck me as interesting about your post was the fact that on the one hand you say that your tinnitus is almost impossible to deal with given this cyclical pattern you describe, yet on the other hand you have been doing just that for some two years now!

Seems to me that maybe you're not giving yourself enough credit?

Tell me, what is the physical impact on you of having a condition that is almost impossible to deal with as opposed to having a challenging problem that you've been dealing with now for a couple of years?
 
It's a very important question.  Anybody want to give it a shot?

smn
DrNagler
 #6 
CPW posted:

Can you elucidate further on viewing tinnitus as a "single entity?"

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

I meant to convey the idea that one habituates to the concept of tinnitus rather than to any particular tinnitus sound or pattern of sounds.

At least that's how I have come to see it.

smn
CPW151
 #7 
I meant to convey the idea that one habituates to the concept of tinnitus rather than to any particular tinnitus sound or pattern of sounds.

That, I believe is the basis of where I was and where I am now, internalizing the concept that tinnitus is just a sound.  Therefore the process that I have taken and continuing, should at some point lead to habituation in full.  Right?

Now to take a stab at responding to your question to Micky.  You underlined the word physical.  Although tinnitus may have a physiological cause, which I believe it does and when that is found we can begin the process of a cure, it is not physical in the sense that a loss of a leg is physical.  It is a sound, different than pleasant sounds but certainly just a sound which at the level of tinnitus can not do physical harm to you.  A lot of us may have gotten tinnitus by sounds that were loud enough to cause physical damage but tinnitus itself can not be described as a physical impact - a psychological one to be sure.  And therein lies the treatment - the only one so far that has shown any significantly positive results, IMHO.

CPW

DrNagler
 #8 
CPW posted [in part]:

Therefore the process that I have taken and continuing, should at some point lead to habituation in full.  Right?

...........

CPW, I think it is unlikely that the process you have taken and continue to take will at some point lead to habituation in full.

I surely have not habituated "in full," because that would mean I am never aware of my tinnitus unless I purposely listen for it and it never bothers me at all.

The fact is that I am largely unaware of my tinnitus, and it rarely bothers me to any appreciable degree.  I should add that there are some compromises I have made along the way to make things more manageable.  (I changed careers, for instance, so my hours would be more predictable, I could be assured of being able to rest when fatigued, I could avoid the extreme stress of all-night trauma surgery, etc.)

So, getting back to your question, I believe that at some point you may be able to achieve what I have described in the above paragraph.  In fact, you may already be there - or very close!   But I do not think it wise for anybody who has severe intrusive tinnitus to expect that at some point he or she will habituate "in full."  I'm not saying that it can't happen.  I'm only saying that it's not a very practical goal.

In my opinion.

smn
Micky
 #9 
Dr. Nagler said in part ..
Tell me, what is the physical impact on you of having a condition that is almost impossible to deal with as opposed to having a challenging problem that you've been dealing with now for a couple of years
====================================
Hi Dr Nagler, the physical impact it has on me is to cause depression and this has always been the same ..i hear the noise and and have a huge adverse reaction to it, mainly because of it's loudness, as when its not too loud it dosent really bother me at all, but let me tell you Dr Nagler, ive known soft tinnitus, medium tinnitus, loud, and dam loud tinnitus , and when it's dam loud like it is today after my 2 good days i'm in a heap..ive had tinnitus for 10 years now, but iv'e only been caught up in this 2 good days cycle for the past 2 years or more ..when its soft it is not a challenge, and has no physical impact on me at all..theses are the days i want more off and thats why i ask you for help ..thankyou ..Micky ..
CPW151
 #10 
 "I believe that at some point you may be able to achieve what I have described in the above paragraph.  In fact, you may already be there - or very close!   But I do not think it wise for anybody who has severe intrusive tinnitus to expect that at some point he or she will habituate "in full."  I'm not saying that it can't happen.  I'm only saying that it's not a very practical goal.

In my opinion.

smn"

 
Been accused of a bunch of things but wise probably isn't one of them. 
As for practical, I'm surprised that I can even spell the word.  But if I never get "completely" there I can testify that life, for the most part is enjoyable again.  Lehman Bros. is one of those less enjoyable parts!  Think I will keep my goal but not be too disappointed if it never happens completely. I have come too far, thanks primarily to your advise to let what may never happen get me down. 

CPW



DrNagler
 #11 
Micky, the link below will give you an idea of where I was trying to go with my question regarding the potential physical impact your of telling yourself that you have a condition that is "almost impossible to deal with."

See:

http://www.websitetoolbox.com/tool/post/stringplayer/show_single_post?pid=24480740&postcount=87

smn
Micky
 #12 
Dr Nagler thankyou for the link, which i have read..i do think though that the brain is an immensly powerful organ and very hard to trick.. trouble is once you have learnt something and it has been memorised and catalogued, then it becomes an even greater task to unlearn it, in a very short time the brain i think would become hard wired, and thats my problem in trying alter the 2 good days a week phenomenom maybe to 3 or 4 ..i actually haven't a clue where to begin ..Micky ..
DrNagler
 #13 
Micky posted [in part]:

the brain i think would become hard wired, and thats my problem in trying alter the 2 good days a week phenomenom maybe to 3 or 4 ..i actually haven't a clue where to begin

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

Micky, I don't think there is any place you can begin that will predictably change the two-good-day phenomenon into a three-or-four-good-day phenomenon.

So I would like to respectfully suggest that you consider not going about it that way.

You see, we commonly think that when our tinnitus gets better, we will feel better.  And while that might be true, it is also true that when we feel better, our tinnitus will get better - over time.  At least that has been my experience.

So, let me refer you to my "Letter to a Tinnitus Sufferer" - and see if you can actually put the suggestions outlined in that letter into action for yourself.  It's really worth a try, in my opinion.  Why?  Because the principles in the letter hold true regardless of whether or not there is a cyclical nature to one's tinnitus!

smn
Micky
 #14 
Dear Dr Nagler, many thanks for the link which is a very intresting  read, may i ask if you still experience the quote below which i just took from your letter to a tinnitus sufferer, if this is the case, i am full of admiration if not a tad envious..Micky ..
 
 
===================================
  That’s pretty much where I am now, even though my
tinnitus hasn’t changed a bit!  It still sounds like a cross between an ear‑splitting teakettle and a roaring jet turbine.  Every single day.  All day long
===================================
Murasaki53
 #15 
DrNagler posted:

I had a similar cycle and fiound myself "living" for those "good ear days."  I think that one of the tricks to beating the cycle is to stop seeing it as a cycle - but rather view the tinnitus as a single entity. 

I recall that you experienced a major turning point in your own habituation process about 14 months in. May I ask whether the 'trick' you mentioned above was something you learned before or after that turning point?

This is a fascinating thread, incidentally.
DrNagler
 #16 
Micky asked whether the following describes my current situation:

That’s pretty much where I am now, even though my
tinnitus hasn’t changed a bit!  It still sounds like a cross between an ear‑splitting teakettle and a roaring jet turbine.  Every single day.  All day long.


...........

Yes.  In fact my ears are absolutely SCREAMING right now, but it's 10:30AM where I am ... and the only reason I know it is because I just checked in an effort to answer your question.  Moreover, I also know my ears are screaming that within a few minutes, I'll be unaware of my tinnitus again.  So the fact that I happen to be aware of it now causes me no distress.  And interestingly, if it did cause me distress, I'd likely continue to be aware of it.  That's why habituation of reaction generally precedes habituation of pderception.

smn

DrNagler
 #17 
Murasaki asked:

I recall that you experienced a major turning point in your own habituation process about 14 months in. May I ask whether the 'trick' you mentioned above was something you learned before or after that turning point?

...........

I think it was all part of the conscious and subconscious insight I gained along my "tinnitus odyssey" that allowed me to reach that turning point.

smn

DrNagler
 #18 
Bbec asked:

Is is true that some will only be able to habituate reaction and not perception?

...........

No.

Remember, habituation is a process and not a state.  It is virtually impossble to habituate reaction to any appreciable degree without beginning to habituate perception as a consequence.

smn
CPW151
 #19 
Bbec asked:

Is is true that some will only be able to habituate reaction and not perception?

...........

No.

Remember, habituation is a process and not a state.  It is virtually impossble to habituate reaction to any appreciable degree without beginning to habituate perception as a consequence.

smn

 
OK Dr. Nagler, now that you busted my bubble on post#8 can you further explain this response to Bbec.  I obviously and erroneously it seems  have been under the impression that while habituation is certainly a process it leads to the point that one is never bothered by it.  Hear it sometimes but never bothered (a negative reaction) to it and therefore you reach a level or state of habituation.  Your comment above while seemingly quite clear and precise goes right over my head.  Showing my ignorance I guess but it's better to do that and learn than to keep your mouth shut.  So again, can you go into a little further explanation of your statement.  Thanks.

CPW
DrNagler
 #20 
CPW posted:

OK Dr. Nagler, now that you busted my bubble on post#8 can you further explain this response to Bbec.  I obviously and erroneously it seems  have been under the impression that while habituation is certainly a process it leads to the point that one is never bothered by it.  Hear it sometimes but never bothered (a negative reaction) to it and therefore you reach a level or state of habituation.  Your comment above while seemingly quite clear and precise goes right over my head.  Showing my ignorance I guess but it's better to do that and learn than to keep your mouth shut.  So again, can you go into a little further explanation of your statement.  Thanks.


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

CPW, habituation is a process.  In the TRT cosmos that process has two component processes, Hp (Habituation of Perception) and Hr (Habituation of Reaction).

If one were to achieve 100% Hp (i.e., never ever aware of tinnitus unless it is purposely sought), Hr would be an irrelevant factor - because if you never ever hear it, why even consider whether or not it would bother you if you did??!!

Well, I do not believe that 100% Hp is achievable by somebody who has at one time truly suffered from intrusive tinnitus.  Or if it is achievable, it is very rare.  I think that you can come close, but I don't think that 100% Hp (or even close to it) are realistic goals to set for yourself.  Rather, I think that a realistic goal would be to achieve meaningful relief to your great satisfaction.

So, if 100% Hp is not achieved, what about Hr?  Can we ever get to the point where when we are aware of our tinnitus, we are not in the least bothered by it.  And again I think that the 100% standard (or even close to it) does not represent a realistic goal.  The goal should be the achievement of meaningful relief to your great satisfaction.

The other side of the coin has to do with how to begin the process of Hp.  And Hp cannot begin without at least to some degree addressing the aversive response to tinnitus - in other words without at least starting on the road to Hr.  That in large part is what this board is about - because the more one understands about his or her tinnitus, the better equipped one is to travel along the Hr road.  Hp?  It pretty much follows along on its own, although it does help to avoid silence, at least at the beginning.

I do not for one moment believe that TRT is the only way to facilitate habituation, but I have taken the liberty of using TRT terminology in this thread because the Hr/Hp model seems to me to be a good way to break things down and make sense of it.

smn

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