Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 2 of 3)

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Managing Your Tinnitus Changing Your Thoughts
and Feelings (Session 2 of 3)
Version date June 5, 2012
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• This workshop was developed by researchers at
• The VA RRD National Center for Rehabilitative
  Auditory Research (NCRAR), located at the
  Portland, Oregon VA Medical Center
• The VA Connecticut Healthcare System in West
  Haven, Connecticut

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Materials Needed for This Meeting

• Changing Thoughts Feelings Worksheet
• Your Workbook

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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

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• These goals can be reached even if the sound of
  your tinnitus doesnt change!

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Todays Agenda

• Review and discuss the Changing Thoughts and
  Feelings Worksheet
• Review homework
• Two relaxation exercises Deep Breathing and
  Imagery
• Adding pleasant activities
• New topic Becoming aware of your thoughts
• 12 most common negative thoughts
• Practice at home identifying thoughts

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Review

• The Changing Thoughts Feelings Worksheet
• Stress Management and Relaxation Exercises
• Deep Breathing
• Imagery
• Planning Pleasant Activities

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• Look at your Changing Thoughts and Feelings
  Worksheet that you started to fill out at the
  last meeting
• If you dont have it, get out a clean Worksheet

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Take a moment to

• Find your Worksheet from last week or tear out a
  copy of the Changing Thoughts and Feelings
  Worksheet from the back of your Workbook

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(No Transcript)
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DiscussionChanging Thoughts and Feelings
Worksheet

• Was it difficult to identify a problem for 1?

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• Remember
• You can fill out a separate Changing Thoughts and
  Feeling Worksheet for each problem you marked on
  the Tinnitus Problem Checklist
• This is the same way you fill out 1 on the Sound
  Plan Worksheet with the audiologist

Example
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Discussion 2 on the Worksheet

• Did the Relaxation Exercises help you notice your
  tinnitus less? (Also review p. 43 Relief Scale)

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Skill Review Relaxation Exercises

• Why do they help?
• Many people say their tinnitus is worse when they
  are stressed
• How do they help?
• By giving you a sense of relief from tension and
  stress caused by tinnitus
• When should I use them?
• Any time you are stressed and your tinnitus
  bothers you

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Relief Scale for Relaxation Exercises
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Review of practice at homeTake a moment to
discuss Deep Breathing page 43
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Review of practice at home Take a moment to
discussImagery page 43
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Planning Pleasant Activities Distraction
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Discussion 2 on the Worksheet

• Did you plan any new pleasant activities? (Also
  review pages 46 and 47 Tracking and Listing
  activities)

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Skill Review Planning Pleasant Activities
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Review Planning Pleasant Activities

• What are pleasant activities?
• Activities you enjoy
• Activities you like to do but do not have to do
• How can they help you manage your tinnitus?
• Helps you have more positive feelings
• Distracts you from your tinnitus
• Helps you feel better overall

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Practice at home Take a moment to
discussTracking Activities page 46
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Planning Pleasant Activities Step 1
Track Your Activities
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Planning Pleasant Activities Step 2 List
of Activities
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Things to Remember

• Tinnitus is less likely to get your attention
  when you manage your stress and stay busy
• Use sound when practicing relaxation exercises
• You might not notice relaxation exercises helping
  you right awaythat doesnt mean theyre not
  helping you. Keep practicing!
• Increasing pleasant activities over weeks or
  months can help you get better at ignoring
  tinnitus

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Changing Thoughts Paying Attention to Thoughts
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Review 2 on the Worksheet

• Skill you have not yet learned to manage your
  reactions to tinnitus

New skill you will begin to learn today
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New Skill Introduction to Changing Thoughts
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(No Transcript)
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The CBT Cycle
Thoughts
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What does Changing Thoughts mean?

• First you identify thoughts or beliefs (B) you
  had just before feeling bad (C)
• Then you work on changing that thought or belief
  to something more helpful

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How can Changing Thoughts help?

• Changing your thoughts about your tinnitus (A)
  can help you change the way you feel about it (C)

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When can I use Changing Thoughts?

• Any time you feel tension or stress when you
  think about your tinnitus

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Thoughts Affect Feelings

• What you think affects how you feel
• Example Imagine your dinner guests are late
• Sometimes the way you feel is caused by the
  thoughts about the event, not the event itself

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Feelings Affect Health

• Your feelings affect your health
• Stress and negative emotions can lead to health
  problems
• During stress, hormones are released
• Too much of these hormones is bad for health
• It is important to learn to change your thoughts
  that cause negative feelings

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Feelings Affect Health
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What are Thought Errors?

• Thought Errors are negative thoughts
• They are not helpful or are unhealthy
• Sometimes people get in the habit of having
  thoughts that make them feel bad
• All people make Thought Errors from time to time
• Thought Errors make people feel sad or upset
• A different thought might make them feel better
• You can control your thoughts
• If you are aware of your Thought Errors, you can
  catch yourself and correct your thinking
• BEFORE YOU CAN CHANGE YOUR THOUGHTS YOU NEED TO
  KNOW WHAT YOU ARE THINKING

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Twelve Common Thought Errors1 All-or-nothing
thinking
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Twelve Common Thought Errors 2
Over-simplifying
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Twelve Common Thought Errors 3 Focusing on
wrong details
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Twelve Common Thought Errors 4 Jumping to
conclusions
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Twelve Common Thought Errors 5 Over-estimating
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Twelve Common Thought Errors 6
Under-estimating
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Twelve Common Thought Errors 7 Assuming the
worst
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Twelve Common Thought Errors 8 Emotional
thoughts
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Twelve Common Thought Errors 9 Should
statements
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Twelve Common Thought Errors 10 Labeling
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Twelve Common Thought Errors 11 Making things
personal
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Twelve Common Thought Errors 12 Blaming
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Practice at home

• In your Workbook (pages 50-53) write down an
  example of each of the 12 Thought Errors
• Use examples related to tinnitus
• Use other examples if you cant think of tinnitus
  examples

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Tell me in your own words

• What must you do BEFORE you can change your
  thoughts?

Describe the concept rather than giving an
example
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Practice at home - Continue to record your
progress for the first two skills Relaxation
Exercises and Planning Pleasant Activities
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Summary of Todays Homework

• Thought Errors
• Write 12 personal examples of each of the Thought
  Errors
• Changing Thoughts and Feelings Worksheet
• (back of Workbook)
• Relaxation Exercises
• Planning Pleasant Activities
• Wait to complete the Changing Thoughts section
• Relaxation
• Relief Scale for Relaxation Exercises
• Deep Breathing and Imagery
• Planning Pleasant Activities
• Step 1 Track Your Activities
• Step 2 Make a List of Pleasant Activities
• Step 3 Schedule Pleasant Activities

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Remember Continue to work on your Sound
Plan for your next session with the audiologist
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Next session

• Next session with me you will discuss steps to
  change your negative thoughts

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WAIT until the next session to complete the
Changing Thoughts section on the Worksheet
WAIT do not complete yet
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Other agenda items?
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Questions?