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12.05.2015

Tinnitus depression coping strategies, tinnitus relief natural - Try Out

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Richard Tyler at the University of Iowa has developed some excellent teaching materials which are useful for psychologists working with tinnitus. Cognitive behavioral interventions are the most widely used psychological strategies for coping with tinnitus.
The goal of the therapy is to alter maladaptive cognitive, emotional, and behavioral responses to tinnitus and not to abolish the sound itself.
The combined approach assists patients in identifying and modifying maladaptive behavior and promotes habituation to tinnitus. In the history of tinnitus research and treatment, many attempts have been directed toward abolishing or minimizing tinnitus. Most interventions in reducing tinnitus-related distress are predicated on cognitive theories of behavior regulation. A comprehensive model for the chronification of tinnitus, including various dysfunctional cognition and behavior, is described by Kroener-Herwig [4] based on the assumptions regarding tinnitus tolerance made by Hallam and Jakes [5]. This model describes the vicious cycle of tinnitus distress and demonstrates how different cognitive, emotional, and behavioral factors interact and create positive feedback loops generating and maintaining tinnitus-related annoyance and discomfort.
Cognitive behavioral therapy was developed mainly as a treatment for affective disorders such as depression and anxiety. Relaxation methods were one of the earliest psychological treatments applied to patients with tinnitus [20].
Despite the popularity of relaxation training in clinical practice, research shows that relaxation seems to be of limited value for most tinnitus patients when used as the sole treatment [21]. Imagery techniques are used to change the negative associations related to tinnitus either by “masking” the noises or by integrating them into positive scenes. Despite all these efforts, until now no treatment has been found to successfully eliminate tinnitus permanently. It is made clear that mainly the thoughts, beliefs, and expectations about tinnitus are creating the problem. They are convinced that the tinnitus is “making” them depressed, anxious, and worried and that their ways of dealing with tinnitus are of no account. Regardless of the cause of tinnitus, “suffering” is a function of how the patient reacts to tinnitus – how he or she copes with it.


Furthermore, strategies to specifically manipulate the acoustical environment are recommended. In imagery exercises, a patient may be asked to imagine that the tinnitus is masked by the sound of a waterfall or the waves of the sea.
Tinnitus for them is an acceptable solution or “a legitimate excuse” for avoiding these situations.
The meta-analysis of Anderson and Lytthens [21] showed that psychological treatments are very effective regarding the reduction of tinnitus-related distress. Kroener-Herwig, B, Biesinger, E, Gerhards, F, Goebel, G, Greimel, KV and Hiller, W (2000) Retraining therapy for chronic tinnitus A critical analysis of its status. Hallam, RS and Jakes SC (1987) An evaluation of relaxation training in chronic tinnitus sufferers In: Proceedings of the Third International Tinnitus Seminar. Hallam, RS (1984) Psychological aspects of tinnitus In: Contributions to medical psychology pp. Andersson, G, and Lyttkens, L (1999) A meta-analytic review of psychological treatments for tinnitus.
Jastreboff, PJ and Hazell J (1993) A neurophysiological approach tinnitus: clinical implication. Wilson, PH, Henry, JL, Anderson, G, Lindberg, P and Hallam RS (1998) A critical analysis of directive counselling as a component of tinnitus retraining therapy. Martinez Devesa, P, Waddell, A, Perera, R and Theodoulou M (2009) Cognitive behavioral therapy for tinnitus. As a consequence, increasing efforts have been undertaken by behavioral scientists and psychologists to eliminate or at least ameliorate psychological symptoms associated with tinnitus. Focusing attention on tinnitus, accompanied by specific dysfunctional cognitive processes of appraisal like catastrophic thoughts and rumination, leads to negative emotional consequences. A cognitive behavioral approach was first applied in the treatment of patients with tinnitus in the 1980s [13–16].
The aim of psychological interventions is not to “cure” or to eliminate the inner noise but to reduce tinnitus-related distress and increase quality of life. This assumption can be illustrated by the fact that the majority of individuals permanently afflicted by tinnitus – even if they describe it as loud – do not feel distressed by it.


Blaming a situation or person for the onset of tinnitus will create anger and hostility (see Picture 2). The goal of the therapy is to alter maladaptive cognitive, emotional, and behavioral responses to tinnitus and not the sound itself.
Beck [2] has been most influential in introducing cognitive interventions into therapeutic strategies. Nowadays, it is one of the most widely used and accepted psychological strategies for coping with intractable disorders [17–19].
If patients are no longer bothered by their inner noises and the question of how tinnitus can be removed, they might become secondary. Nevertheless, the therapist should make it explicitly clear that he or she knows that the tinnitus is real, not imagined, and that the patient’s response to the abnormal tinnitus perception can be well understood. This is different from simple “positive thinking” or from “directive counseling,” a treatment component of tinnitus retraining therapy [22], because in cognitive restructuring the therapist and patient collaborate in identifying, testing, and challenging dysfunctional thoughts, beliefs, attitudes, or attributions [4, 23]. As long as tinnitus itself cannot be eliminated, the main intention of all therapeutic interventions is to alleviate suffering from tinnitus.
Relaxation techniques may be helpful in assisting people in learning a way of coping with tension and anxiety related to tinnitus. It is theorized that for patients with tinnitus, the source of distress is not the sound itself, but the way in which the person evaluates and interprets the sound.
Furthermore, it is commonly reported by patients that stress exacerbates tinnitus or causes a person to experience the tinnitus more intensely, and that a reduction in stress levels may reduce loudness and annoyance. Also, listening to one’s tinnitus in a relaxed state can foster habituation and retain serenity in the presence of tinnitus.



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