But please read the main articles carefully and critically first!
At 16:24 30/12/1998 +0000, you wrote:
I have suffered from tinnitus for about 7 >yrs( I am 49). It first appeared the day
after I took my first tablet of a tricyclic drug called amitryptiline. I stopped taking
the drug immediately but have been left with the tinnitus ever since. I am not stressed
about it, but rather put it down to a bad mistake, knowing that I am hyper-sensitive to
drugs anyway. The idea that damage has occurred in the inner ear is therefore given
credence by this individual experience.
Sorry to upset your strong conviction, but one tablet of amitrylptylene is unlikely
to do anything. It's very harmless stuff as drugs go. I wonder if you were at all
depressed at the time, that's what the drug is prescribed for. Emergence of
tinnitus during periods of even mild depressed mood state is extremely common. See
website for emergence v persistence
Could you comment upon this? Is there any self-administered treatment that I can use?
See some of the latest email responses. It is entirely possible to use the website
info to treat yourself. Absorb the philosophies over time!
I am certainly not in a poor mental state - rather just annoyed
see the Jastreboff model (look carefully at the diagrams)
I am a teacher of Maths and not given to believing in quack remedies etc., so anything you
can suggest, backed up with hard stats would be useful
our results have been presented at major conferences and some published look at the
references on the website.
At 16:24 30/12/1998 +0000, you wrote:
Dr. Hazell,
Well here I am, about 16 months from my "T" emergence, and about 14 months from
discovering your fabulous web site. Things have greatly improved, and
>that's an understatement. My "T" (left ear only) is something I've accepted
and "made better friends with," per your Q & A pages! I'm still sleeping
>with a babbling-brook sound soother, and I still avoid total silence.
Right! but actually sound reinforcement, or the presence of sound is normal, silence
is what we manufacture, and is abnormal. So you don't have to stop!
habituation is occurring, and sometimes I go for several days barely even aware of my
friend "MR T." Other times it's a bit more present, and regarding that, I'd like
to ask a few follow-up questions, Dr. Hazell.
1) When "fully habituated" how long a quiet period can one expect? As noted,
I now have "quieter periods" that last sometimes as long as a few days. Is that
my limit? Or is it possible to achieve thru TRT, a point where "T" is quiet 90
to l00% of the time??? I'm trying to determine what is realistic, and I'm wondering if
there might "always & forever" be periods when the volume comes back up?!?
The percentage awareness following habituation can vary from 0% to 100%. The whole
point is not 'do I hear it' but 'do I react badly to it'. Don't aim for any figure, the
habituation of perception is an automatic process (following habituation of reaction, and
will be determined by your auditory system. People who ask this question sometimes still
have the idea (in the back of their mind) that the only result acceptable is 'never to
hear it again'. I don't think that applies to you, however. You seem to have done very
well with the web info
2) When quiet, mine is REAL quiet. At those times, it's EASY to live with. Why then in
your view, DOES the subconscious still need to sometimes amplify? After all, if I now know
"it's no longer a threat," why doesn't that "filtration" remain
active? In other words -- what & who is being served by those periods when
"T" is louder!
well one theory is that the security system does periodic 'checks' on 'old threats'.
Goes back, has a search for them, or focuses on them for a while if they are around, to
ask the question 'was I right to habituate this information'.The better the security
system, the more it will use this stately. This might relate to the was you react to other
things in your environment
3) One place it does seem to "get louder" is when I'm driving. Not sure if it's
because I'm less mentally distracted, or if it's because of the odd audio contrast of a
quiet-car INSIDE surrounded by whirring-road-noises OUTSIDE. Can you add or
"amplify" on this one?
this is an almost universal experience! While driving a car the brain goes into
'red-alert'. This is right and proper as we are in a life threatening situation, where
people get killed. If you measure autonomic function with biofeedback while driving the
adrenaline levels go through the roof each time the subconscious detects a red traffic
light!! Its no surpass all filters get the same 'red-alert' treatment. It's nothing to do
with car or road noise.
4) Louder Sounds don't necessarily make me worse, but certain sounds that "sound
like" Tinnitus can make it louder. Example: Loud p.a. speaker,
certain musical frequencies, loud stadium. Why is this?
because the subconscious deals with threatening sounds, and 'sounds like' threatening
sounds in the almost the same way. The more like your tinnitus, the greater the reaction
and visa versa. This is called 'generalisation' in psychology, and can be measured
experimentally.
5) Do you think I need a more formal retraining program to INCREASE my progress, or should
I simply keep on this very course?
you seem to be doing fine! We estimate 10-15% of those using the website only,
can habituate. Seems like your are in that group. However we have to say that formal
TRT with a trained professional works fastest!!
Finally, may I say again what a PROFOUND difference you and your site have made in my
life. One of the greatest aspects of your work is THE HOPE IT
GIVES - to those of us who "desperately" need it. I can relate to people who
feel "desperate" -- that was ME, only 14-months ago! I don't feel that way
now! And that's because your work has provided me a reason and a method to completely turn
things around.
Well, only one letter like yours would make you website worthwhile. Fortunately we
have received hundreds! Carry on the good work. I shall put this up on the website for
others to see (anonymously of course!)
At 16:24 30/12/1998 +0000, you wrote:
Dear Dr. Hazell,
I've been researching treatment for tinnitus for my sister, who has been so diagnosed and
has suffered with it for many years. She is now 32 and the problem seems to be getting
worse as she ages. Do you know of any physicians with TRT training in Ireland. My sister
lives in Dublin.
Indeed I do! Kay Walsh cochlear@indigo.ie She
came on our last training course!
At 20:26 27/12/1998 +0100, you wrote:
I´m a 21 old student from Berlin/Germany. I read your article about the
tinnitus-retraining-therapy. I would like to tell you about my experience! It´s three
months ago that I first noticed that I have a sound in my ear. At first it was on my left
ear, some time later I noticed that it was also on the other ear. I was afraid about it,
although the sounds were not that loud, but they changed from time to time. I noticed them
just when it was very quite. I have to say that the time before this was not the best of
my life. I had a lot of stress, had a lot to do at university. When I was on Holiday, I
had suddenly nothing to do. I got depressions, was afraid of everything. This time last
about two weeks, then I began to recover. The on September I got the sounds on my
ears. I´m surely that it has to do with the stress I had. What I want to know, if
there is some place here in Berlin/Germany where the doctors also practice with the
retraining therapy. I also would like to know how to treat my tinnitus, because the
doctors here cannot tell me something how to handle it. What I noticed now is that when I
do some relaxing( like muscle relaxing (Jacobson)), the sounds disappear almost, but then
I think about them,and then they are back! Could you tell me something about relaxing
exercises?
the effect of relaxation on tinnitus is only temporary, because although it reduce the
level of autonomic activity, commonly in 'overdrive' in tinnitus distress, it does not
change the conditioned response to tinnitus. You have to get rid of the conditioned
aversive response, before the effect becomes permanent and that needs retraining - have
another look at the Jastreboff model in greater detail. There is an account in German if
you prefer.
At 09:32 21/12/1998 +0000, you wrote:
Hello Sir,
I have just discovered your web site and found it most interesting. I have two questions
for you, I have been prescribed Vastarel20mg (trimetazidine) 3 times daily for two months
following a diagnosis for T. Is this drug still used in the UK as an attempt to reduce T?
sorry never heard of it being used; I've just reviewed the world literature, so the
answer is not to my knowledge!
( incidentally after six weeks on trimetazidine, I am not sure of any change in my
condition...) Also I am a PPP member, can your treatment (TRT) be covered by medical
insurance.
yes, everything except instruments, up to the level of your scheme
At 09:31 21/12/1998 +0000, you wrote:
1) You place great emphasis on the processing by the brain of various auditory stimuli.
I have pulsatile tinnitus which has been fully investigated but no aetiology has been
established. It strikes me that our minds have a mechanism for turning off sounds e.g.
heartbeat.
exactly the filters we are talking about
Could it be that in some people this mechanism breaks down and we become aware of
somatosounds? Could the problem of pulsatile tinnitus in my case be due to this?
yes somatosounds (causing intrusion) are essentially a state of hyperacusis, or
hypersensitivity to our body sounds. Emergence of somatosounds occurs when our filters
tune to these sounds, just like tinnitus. Although in some cases there may be a change in
the body sound too, retraining works, even though the body-sound remains the same.
We have countless patients who have proved this point in our TRT programme. See also
hyperacusis article
>
2) If no obvious cause can be found for pulsatile tinnitus what would be your best guess?
Could hardening of the arteries (age related hardening, not atheroma) cause it
There is no proven relationship between atheroma and tinnitus. As both occur more
often in older people there will be a weak indirect relationship
At 10:01 17/12/1998 +0000, you wrote:
My sister is suffering of tinnitus for about two years. She was diagnose hyperthyroidism
for about the same time. Could the two problems be related
even if the thyroid problem has been treated?
they are probably directly connected. Having an over active thyroid is undoubtedly a
stressful situation, results in a variety of autonomic symptoms (e.g. affecting heart rate
, metabolism, activity etc.) and one would expect, from a study of the Jastreboff model
that tinnitus might emerge at this time.
She is a semi-professional singer in a large vocal group. Could that very noisy
environment be the source of the tinnitus, and if so, is she facing
the very hard decision to quit?
in my management, this is practically never an indication to give up music. In a very
noisy music situation it is sometimes advisable to wear musician's earplugs. measurements
of noise levels at work would be a guide to this. Giving up what you really wanted to do
simply induces more stress and can make the tinnitus worse. Unfortunately it is often the
advise given by uninformed professionals.
Can these repeated sound traumas increase the tinnitus and if so, is it a permanent damage
?
please read the web site, and understand that tinnitus is not the results of damage,
but of changes in the central auditory pathways. loud noise certainly can damage the inner
ear and eventually cause hearing impairment, and although this increases is the risk of
tinnitus emergence, it does not predicted it.Our studies also showed that
severity of tinnitus was not related to hearing level.
Is there any device existing, specific for musician, to protect them from exacerbating the
tinnitus??
Musicians earplugs, but these must be professionally fitted
My last question is about the evolution of the disease?? Can it be stable for the
rest of her life or does she have to expect deterioration as the years go by ? She is a
little bit panicked about this and need to be reassured.
I think you really have to understand the model, and then all these questions answered
for you. Although this takes some time and effort, and it is important for you to
understand the diagrams attached to the main article, it is well worth doing.
I am a French Canadian doctor from Quebec and I apologise for my poor English.
I do not detect any errors!
At 06:52 14/12/1998 +0000, you wrote:
I have had tinnitus for 18 months. In the beginning, feelings of total despair and of a
living hell (sometimes, it still is). I became an expert on alternative therapies (my
'headless chicken' days).I was given a masker by a hearing therapist 12 months ago, and
told to turn it up when necessary. After reading about TRT, it was I who told the
therapist how it should be used.
bravo!
I know that my tinnitus is linked to, and exacerbated by, my stressful personality (which
I am attempting to do something about). I understand and have a belief in Jastreboff's
neurophysiological model of the causes of persistent tinnitus, as I know that I constantly
monitor my tinnitus, whether consciously or unconsciously. But if the aim is habituation
of my reactions to, and perceptions of, tinnitus, can this be achieved by having the above
belief and wearing my white noise generator, or is it essential to have one-to-one
directive counselling?
according to email from the website about 20% manage to do it alone!
Jastreboff says such things as: 'TRT requires an extensive amount of time for one-on-one
interaction by highly-trained personnel; even the use of the best devices will not be
successful without proper counselling; TRT seems easy but in reality is highly complex.'
Your opinion in the 'Quiet' magazine seems to say much the same.
We have to define what is necessary to produce the results we publish; not everyone
needs all of this#
So, can my audiological filters be 'reset' without this psychological treatment
(unavailable locally)? Am I wasting my time without this input and merely partaking in
coping strategies?
absolutely not! you seem to have a good grasp. The hardest thing to remember without
expert help is the time scale...it takes a long time and progress is gradual.
I understand that my co/pre-existing anxiety might mean that TRT takes longer for me, but
I at least need to know if I am on the right road. Thanks for your research and
accessibility. T know that someone is out there trying to help is a a great comfort in the
dark days.
good luck
Page under construction: more coming in the next few days