Blog posts are usually quite short, but sometimes you need to go a bit deeper to be effective. Here we go…
CBT is cognitive behavioural therapy. As with all therapies of the mind, it’s best done with someone who really knows their stuff. You might find a cheaper practitioner who has a lot of confidence and will “have a go”, but please don’t pay to be their practice patient. Look on the British Psychological Society for a trained practitioner.
The fundamentals. Thinking influences how you feel. It really does, but how do I convince you of that?
Here’s an example (teach what you know, my boy is 13 right now!): your teenage son is late home for dinner. If you think “he might have had an accident or been kidnapped”, you will likely feel anxious, fearful, upset. You might start watching the clock, and every time you look at the clock, the minutes stretch out and you start picturing the things that could have gone wrong.
You might think: it’s a fine, dry night and he’s with his best friend. They probably lost track of time.
You might think: he’s late for dinner. I’ll put his in to keep warm, set an alarm for 60 mins so I don’t lose track of time. I’ll have to have a word with him later about remembering his watch.
You might think: he’s doing this on purpose, he’s not following the rules and he doesn’t care about me and my feelings. He always does this. One day he’ll realise I’m right and he’ll go under a bus or get kidnapped, and then he’ll realise the hell I’m going through, and it’ll be too late because… and so on. Now you’ve made yourself into a victim of this event, and you’re mentally cataloguing all the past times you’ve been upset too. When he comes through the door, he’s going to get a real going ever and wish he’d never come home at all!
There are so many ways you can think about what is happening. So many initial reactions, and also so many ongoing ways to think about the same event. Each of these thoughts and the associated pathways of thinking will have you feeling different ways.
CBT recognises that our body responds to our thoughts, and it is not “woo-woo” or alternative, it’s just science. Stop the thoughts, stop the feelings that follow on and grow.
Are you convinced? Do you think you might feel differently? I hope so, because only psychopaths can think about their son being in an accident and truly have no emotion about it. The rest of us have a reaction of some kind.
Some of us are prone to going to the worst case scenario every time. Sometimes we right ourselves, think kidnapping and then immediately correct it to something more realistic. I’ve never quite got out of the habit of thinking “disaster!”, but I have had CBT and I will now capture that thought and challenge it. I’ll replace it with something that’s more likely, and more balanced.
The CBT process involves a worksheet normally, and tracking your negative thoughts. You’ll then work through them with your practitioner. I was having wasp phobia when I went, and it was ruining a lot of nice barbecues, let me tell you. I would see a wasp, about six feet away, think it would sting me, and then either sweat/panic/stay put while staring at it, or I would run off to the other end of the garden - until another of the evil, yellow things popped up behind me. As I was also going deaf, I would let myself picture a future where I couldn’t hear them and - without any kind of early warning system - they would be able to sting me all summer long.
So my worksheet was pretty grim, and it does make me feel a bit childish to look back on it, but I was in a pattern of thinking that I couldn’t escape. Fear, heart racing, can’t communicate properly because I’m watching the bushes. Full on horror.
My worksheet involved rating how much I believed my own thought (90% sure I’m going to get stung).
It then involved looking at how rational that thought was (I’d never even been stung by a wasp in my life).
It involved replacing the thoughts with something more rational (the wasp is happily eating a bit of sausage, it’s not even looking my way. Chances are strong it will fly off onto that guy’s sweet cider next, since wasps are not attracted to sweating, middle-aged ladies. They tend not to sting unless they are threatened, and I’m not threatening it. So on and so forth.
Then, we look at how much we believe the new, replacement thoughts. Actually I did believe the new thought, 100%. I believed, after thinking about it, that my chances of being stung were slim to none.
And CBT worked these scenarios over and over again, until I see a wasp now and think very little about it at all. If it’s literally in my face, I might not be particularly happy, but neither is anyone else, really. I’m having pretty standard reactions to wasps now.
All those days out where I could have been enjoying the sunshine, I wasn’t. I was thinking about wasps, and building up my panic, drawing it out until it filled hours of my thoughts. Ugh. Well, we are where we are and there’s no point dwelling on that. And that’s another good thing that CBT has done for me, because I instinctively identify unhelpful thoughts automatically now. Yes I still have them. Everyone does, but how we respond next is crucial to our wellbeing and happiness.
I’ve observed dogs, and - pardon me - learning-disabled folks and often noted just how happy they are. Our default feeling is quite often ‘relaxed verging on happy’. If we let it be.
Six weeks of CBT and I changed, for good. Now I have another talent of spotting unhelpful or catastrophic thinking patterns in others too. I’m not a psychologist and I don’t try to fix them myself, but I do refer people on for CBT. What I do myself is give them the realistic view of what tinnitus is, what it isn’t, and how it’s likely to pan out. Without this information, and without my audiological assessment, you don’t get too far down the worksheet. You’re a bit stuck when you get to the replacement thoughts, and so is your psychologist because they know diddly squat about tinnitus. For all they know, it’s a progressive disease that ends in louder, louder, ever louder tinnitus.
I can fix your rational thoughts about tinnitus, and it only takes me a couple of hours to do that, which is why I don’t charge for an ongoing period. If you’re not fixed immediately, chances are you have these thought errors, which CBT works brilliantly on. Or you’re depressed/have generalised anxiety and the cart is coming before the horse. Either way, you might also need someone who isn’t me to get you straight, on top of my consultation.
If you cannot access my consultation, take some time to read through everything I’ve written online (Quora, Facebook and this blog), you’ll likely get it for free. I’m not great at hiding my intellectual property.
Please, please, please don’t let tinnitus ruin your life. It simply isn’t worth it. The basic truth about tinnitus is that it’s not all that bad. Unfortunately it’s an example of something that has a psychological component. It can be made worse by your feelings. It can be made louder by your feelings and your own biological stress response. This means that it can, and does, ruin lives. People become stuck in a cycle:
Notice tinnitus due to a trigger
Feel stress symptoms
Have a negative thought - usually one that is out of proportion
Back to point 1, rinse and repeat until the tinnitus is all they can focus on.
Sadly for me, I’m not very good at self promotion. Otherwise I would be all over YouTube with bright fonts telling you I can cure your tinnitus. I can’t tell you that, but I can tell you that I have a remarkable amount of experience, I’m reasonably priced, and no one has ever walked out of my session feeling bad. Realistically, you might need additional work with a psychological practitioner, but many don’t. I’ve had people just “click” during the session. It’s about 50/50, based on my anecdotal experiences, but I can’t tell you which one you’ll be.
If you’re in the UK, the good news is that CBT is readily available and on the NHS. I’ll also work with your CBT practitioner if it’s needed, if they don’t understand tinnitus.
You have a way out, and we can strip away the distress you feel from your tinnitus, leaving behind just the actual condition itself. Actual tinnitus is something that millions (billions?) of people have with no issue whatsoever. Yours is no different, trust me. If you’re hearing it constantly and you’re hearing it over the top of environmental sound, you have an element there that needs input from a professional.
For some reason, people don’t trust that when I say it’s no different, maybe because they’re expecting me to lie?
Maybe I’m doing it to sell hearing aids? I do sell hearing aids but I have made precisely two sales of hearing aids to people who I met through tinnitus. I only sell them in a five mile radius of my office, you see.
Maybe… but there’s something “off” about Sally. She must be up to something. You’re probably responding to my autism. There is something off about me, but it’s not that. My prices are one-off and advertised. I don’t get referral fees from psychologists. That would be conflict of interest and I just don’t.
So, if you want me to help you, I absolutely can, but there are others who can also help. Either way please do consider challenging yourself. Your conceptions about mental healthcare may need a brush-up to allow you to succeed. It might just improve your whole life. You might be enjoying picnics, or whatever you wanted to do before tinnitus made your life a misery.
All the best,
Sally
Comments