Title: Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 3 of 3)
1Managing Your Tinnitus Changing Your Thoughts
and Feelings (Session 3 of 3)
Version date June 5, 2012
2- 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
3 Materials Needed for This Meeting
- Changing Thoughts Feelings Worksheet
(from last meeting) - Your Workbook
4Remember 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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6 Todays Agenda
- Review and discuss the Changing Thoughts and
Feelings Worksheet - Review
- Relaxation Exercises
- Adding Pleasant Activities
- 12 common Thought Errors
- New topic Changing Thoughts Step-by-Step
7 Review
- The Changing Thoughts Feelings Worksheet
- Stress Management and Relaxation Exercises
- Deep Breathing
- Imagery
- Planning Pleasant Activities
- 12 common Thought Errors
8- 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
9Take 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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11Discussion Relaxation Exercises
12Discussion Planning Pleasant Activities
134 and 5 on the Worksheet
- Take a moment to discuss Did the Relaxation
Exercises or Planning Pleasant Activities help
you feel better?
14Things 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
15Discuss Introduction to Changing Thoughts
16Review
- What is Changing Thoughts?
- First you identify thoughts you had just before
feeling bad - Then you work on changing that thought to
something more helpful - How can Changing Thoughts help?
- Changing your thoughts about your tinnitus can
help you change the way you feel about it - When can I use Changing Thoughts?
- Any time you feel tension or stress when you
think about your tinnitus
17 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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19 The CBT Cycle
Thoughts
20Review 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
21 Feelings Affect Health
22 Review Thought Errors Paying Attention to
Thoughts
23Review 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
24Review of Practice at home
- In your Workbook (pages 50-53) you wrote down
your own examples of each of the 12 Thought
Errors - Take a moment to discuss
- (see next 2 slides for definitions)
25Twelve Common Thought Errors
- All-or-nothing thinking When you see things in
only two categories - Over-simplifying When you see one bad event as a
never-changing pattern - Focusing on wrong details When you pick out a
single detail and focus on it - Jumping to conclusions When you make assumptions
that things will turn out badly even though you
dont have facts to support them - Over-estimating When you think things are more
important than they really are - Under-estimating When you think things are less
important than they really are
26Twelve Common Thought Errors
- Assuming the worst When you think something is
much worse than it really is - Emotional thoughts When you think that your
emotions show the way things really are - Should statements When you say should or
shouldnt to try to get yourself to do hard
task - Labeling Attaching a bad label to yourself or
others - Making things personal You see yourself as the
cause of some negative event when you arent
responsible - Blaming You blame others for your problems or
blame yourself for other peoples problems
27Todays new skill on the Changing Thoughts and
Feelings Worksheet
New skill you will begin to learn today
28New Skill Use this guide to help youChange
Thoughts Step-by-Step
29Changing Thoughts Step-by-Step
- Step 1 Event (A)
- Identify what was going on when you started
feeling bad - What happened?
- Note Sometimes it is hard to remember the event
that was happening that made you feel bad until
later. If this is the case for you, go to the
second step and come back to this step later.
30 Example Changing Thoughts
- Step 1 Event.
- Identify what was going on when you started
feeling bad - What happened? My tinnitus isnt getting any
better
31Take a moment to Complete Step 1
32Changing Thoughts Step-by-Step
- Step 2 Thoughts (B)
- Now try to write down a thought you had just
before you started feeling bad or upset - What was the first thought that came into your
mind? - Note You may have had many thoughts just before
you started feeling bad. If you had more than
one thought, pick the one that made you feel the
worst.
33 Example Changing Thoughts
- Step 2 Thoughts
- What was the first thought that came into your
mind? - Why cant anyone help me?
34Take a moment to Complete Step 2
35Changing Thoughts Step-by-Step
- Step 3 Feelings (C)
- Write down any bad or upsetting feelings you
are/were having. - For example, sad, angry, jealous, or disappointed
36 Example Changing Thoughts
- Step 3 Feelings
- Write down any bad or upsetting feelings you had
37Take a moment to Complete Step 3
38Changing Thoughts Step-by-Step
- Step 4 Evidence for
- Examine the thought you described in Step 2.
- Write down evidence that this statement is true
where it says Evidence For on the Changing
Thoughts Exercise. - Note Our thoughts often have some truth to
them, but some have many more errors. Write
down what is true about the thought in
the Evidence For box.
39 Example Changing Thoughts
- Step 4 Evidence for
- Write down evidence your thought in Step 2 is
true
40Take a moment to Complete Step 4
41Changing Thoughts Step-by-Step
- Step 5 Evidence Against
- Again, examine the thought you described in Step
2 - Identify evidence that this statement is not
true. In the next box where it says Evidence
Against write down the reasons the thought may
not be true. - Note You may be able to identify this thought
using the 12 Thought Errors from the list.
You can have more than one error in a single
thought.
42 Example Changing Thoughts
- Step 5 Evidence against
- Write down a new more helpful thought about the
event
43Take a moment to Complete Step 5
44Changing Thoughts Step-by-Step
- Step 6 New Positive Thought
- Write down a new more helpful thought about the
event - This step requires a lot of practice to feel more
natural - Note Sometimes it helps to say statements that
apply to many things. Some people call these
mantras. - New thoughts should be (1) brief, (2) easy to
remember, (3) true to
you, (4) apply to your life, and (5) helpful
45 Example Changing Thoughts
- Step 6 New Positive Thought
- Write down a new more helpful thought about the
event
46Take a moment to Complete Step 6
47Changing Thoughts Step-by-Step
- Step 7 Feelings (C) when you think the new
thought - As you practice, pay attention to how you feel
when you have positive thoughts
instead of negative thoughts
48 Example Changing Thoughts
- Step 7 Feelings when you think the new
thought - Pay attention to how you feel when you have
positive thoughts instead of negative thoughts
49Take a moment to Complete Step 7
50Changing Thoughts Step-by-Step
- Step 8 Picture yourself in the future
- Look at the negative thought from Step 1 again
- Think of a time in the future when you might have
that thought again - Picture yourself thinking the positive thought
from Step 6 instead
51 Example Changing Thoughts
- Step 8 Picture yourself in the future
- Look at the negative thought from Step 1
- Think about the positive thought from Step 6
instead
52Take a moment to Complete Step 8
53Changing Thoughts Step-by-Step
- Do the Changing Thoughts Exercise on page 56
- Write down these steps on a small piece of paper
so you can do use the steps anytime - When you feel bad or when something bad happens,
use the Changing Thoughts Exercise to feel better - Sometimes you can feel better about your tinnitus
if you just change the way you think about it
54Practice at home
- Practice using the Changing Thoughts Exercise
- Continue to use the Changing Thoughts and
Feelings Worksheet - Relaxation Exercises
- Planning Pleasant Activities
- Changing Thoughts
- Use the skills that work for you to manage your
tinnitus!
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56Other agenda items?
57Questions?