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

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Title: Anatomy of a Randomized Clinical Trial for Tinnitus Author: vhaporkaelic Last modified by: vhaporzauggt Created Date: 9/2/2005 6:51:56 PM Document presentation ... – PowerPoint PPT presentation

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


1
Managing 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

4
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

5
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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

9
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

10
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11
Discussion Relaxation Exercises
12
Discussion Planning Pleasant Activities
13
4 and 5 on the Worksheet
  • Take a moment to discuss Did the Relaxation
    Exercises or Planning Pleasant Activities help
    you feel better?

14
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

15
Discuss Introduction to Changing Thoughts
16
Review
  • 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

18
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19
The CBT Cycle
Thoughts
20
Review 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
23
Review 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

24
Review 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)

25
Twelve Common Thought Errors
  1. All-or-nothing thinking When you see things in
    only two categories
  2. Over-simplifying When you see one bad event as a
    never-changing pattern
  3. Focusing on wrong details When you pick out a
    single detail and focus on it
  4. Jumping to conclusions When you make assumptions
    that things will turn out badly even though you
    dont have facts to support them
  5. Over-estimating When you think things are more
    important than they really are
  6. Under-estimating When you think things are less
    important than they really are

26
Twelve Common Thought Errors
  1. Assuming the worst When you think something is
    much worse than it really is
  2. Emotional thoughts When you think that your
    emotions show the way things really are
  3. Should statements When you say should or
    shouldnt to try to get yourself to do hard
    task
  4. Labeling Attaching a bad label to yourself or
    others
  5. Making things personal You see yourself as the
    cause of some negative event when you arent
    responsible
  6. Blaming You blame others for your problems or
    blame yourself for other peoples problems

27
Todays new skill on the Changing Thoughts and
Feelings Worksheet
New skill you will begin to learn today
28
New Skill Use this guide to help youChange
Thoughts Step-by-Step
29
Changing 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

31
Take a moment to Complete Step 1
32
Changing 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?

34
Take a moment to Complete Step 2
35
Changing 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

37
Take a moment to Complete Step 3
38
Changing 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

40
Take a moment to Complete Step 4
41
Changing 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

43
Take a moment to Complete Step 5
44
Changing 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

46
Take a moment to Complete Step 6
47
Changing 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

49
Take a moment to Complete Step 7
50
Changing 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

52
Take a moment to Complete Step 8
53
Changing Thoughts Step-by-Step
  • How to use every day
  • 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

54
Practice 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!

55
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56
Other agenda items?
57
Questions?
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