Stepped-Care CBT Treatment from the University of Maastricht

Discussion in 'Treatments' started by jacob21, Feb 23, 2019.

    1. gorzakus

      gorzakus Member Benefactor

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      Hearing loss ?
      Yes all over the news and on the radio here in Belgium, I can't believe this.
      Friends texting me; "you have to read this, there is a cure!"

      This is just another example of exposure therapy and it really pisses me off.

      There was a radio interview with one of the researchers, one of the questions were: "so with this treatment the ringing will go away?"

      Answer: "euhmmm no, but it's like you put on a pair of glasses and at first they will be a nuisance but after a while you get used to them."

      Ok, I heard enough.
       
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    2. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      Horrible. How come this shit gets tons of exposure but we get crickets from Neuromod? I think the problem is that the CBTers are all marketing but no substance, and the curebois are all substance and no marketing.
       
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    3. Pero1234

      Pero1234 Member

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      home theatre system + high pressure washer
      Btw... the main tv news website in Belgium posted two follow-up articles.

      1) the number of responses they got from other tinnitus patients, took them by surprise:

      https://www.vrt.be/vrtnws/nl/2019/02/26/ik-droom-van-stilte-en-de-tuut-wordt-steeds-erger-honderden/

      2) a famous radio presenter who already wrote some books about tinnitus now wrote an opinion piece about how the music industry is jeopardizing the hearing of thousands and thousands of teenagers:

      https://www.vrt.be/vrtnws/nl/2019/0...-verantwoording-afleggen-voor-pieptoon-jonge/

      Google translate is your friend :)

      Apparently nowadays 1/5 adults has tinnitus... in Belgium. And also 1/5 teens!

      I’m going to write the news channel a mail, introducing the three major tracks towards a real cure:

      - Frequency Therapeutics
      - Audion Therapeutics
      - Dr. Susan Shore / University of Michigan

      Perhaps they pick it up.
       
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    4. ajc

      ajc Member

      Tinnitus Since:
      11/2002; spike 2009; worse 2017-18
      Cause of Tinnitus:
      Loud music - noise damage
      Was it Rilana Cima, the researcher they interviewed?
       
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    5. Bob den Hartog

      Bob den Hartog Member

      Tinnitus Since:
      11/2018
      Cause of Tinnitus:
      Noice induced
      Ha, funny how the advice in those “follow up” articles are the exact opposite of what the new study claims to do. Be distracted, do not focus on the sound ;).
       
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    6. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      You got an email address for contact? Because I got some things to "contact" them about of my own.
       
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    7. gorzakus

      gorzakus Member Benefactor

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      Hearing loss ?
      Great work! But why don't you mention the Neuromod device which will be released mid-September in Belgium?
       
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    8. gorzakus

      gorzakus Member Benefactor

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      Hearing loss ?
      I have no idea, sorry.
       
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    9. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      I like how the article about the Facebook comments are pretending the comments are positive. I looked through a hundred of the top ones and most of the comments talking about this new therapy are calling its BS out. Out of touch hacks who don't represent us, screw them.

      I used to think these researchers were just out of touch on accident but no, they know better. They're actively attacking actual treatment based approaches in favor of cognitive approaches because they're scared. They know about MuteButton, they know the writings on the wall. The fact is their entire careers were basically just spawn killed because they cheaped out and decided to side with the Tinnitus Community dinosaurs like Jastreboff and his dying paradigm. I feel bad for them but they deserve this. When I contact them I'm gonna rub some phresh salt in their wounds.

      Read this article: https://www.vrt.be/vrtnws/nl/2019/0...n-uw-oor-nieuwe-behandelingsmethode-voor-tin/

      They constantly attack people who want to focus on treatment based options. They go on and on about how it's bad to treat tinnitus like the audiological problem it is, and only focus on therapy. No mincing words, they're definitely scared.
       
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    10. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      Technically they still are competing with Jastreboff (arguably even more).
       
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    11. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      Yes but competing. It's like how sword makers can compete with each other, but overall they both agree that that the invention of the gun is bad news. Temporary truce basically.

      I was just saying they sided with his crappy paradigm.
       
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    12. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      They're just trying to fit the shill narrative that palliative medicine is so good you can make competing versions of it for the same desired effect, it's meant to make the final quick bucks off tinnitus sufferers before something good like Neuromod and hearing loss regeneration comes along.
       
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    13. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      Yeah this is exactly what I thought and definitely is true for TDT. All these researchers forcing it out to market ASAP to make money while they still can before MuteButton.

      But these guys are different. What made me step back and go "holy shit... Screw these guys" was the fact now they're actively trying to get it as part of the NHS. Why is that bad? Because it basically institutionalizes their soon-to-be obsolete practice, and makes it harder for MuteButton and hearing regeneration to come into mainland Europe. Funny how they're trying in Netherlands, Germany, Belgium, and France but they're not even bothering with the UK because they know it's compromised.

      Basically they're going to screw over many tinnitus sufferers in Western Europe by making it harder for MuteButton to become part of the NHS, and if people have to pay out of pocket for it they're more likely to just go for this shit.
       
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    14. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      They may have a mindset that reducing tinnitus volume is virtually impossible, take example Dr. Nagler, Jastreboff, and Michael Leigh, these guys hold a very pessimistic attitude towards treatment options and have openly be honest about it.

      They expect Neuromod to fail or be a gimmick.
       
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    15. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      That's definitely a possibility but it's based on TDT which is an extremely new subparadigm. Basically the treatment approach that says instead of telling people to not care about tinnitus that they must completely submit to it, and try to like it. It's less than a year old.

      So why did this study based on that one come to fruition so early? Because they rushed it to market. It makes sense that they would have rushed it to make money while they still can.
       
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    16. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      Yes but I don't believe Neuromod will be the holy grail, once hearing regeneration comes to pass the goose will be cooked.
       
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    17. threefirefour
      Rebellious

      threefirefour Member Benefactor Hall of Fame

      Location:
      California
      Tinnitus Since:
      5/15/16
      Cause of Tinnitus:
      140dB B R U H moment
      Yeah absolutely once we actually cure tinnitus is when we have checkmate. But Neuromod is the beginning of the end. And progress will happen rapidly with all the neuromodulation going to hit market following Neuromod.

      It does more than just give tinnitus sufferers their first reliable treatment, it shows everyone that the CBT paradigm has come and gone.
       
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    18. Daniel Lion
      Ape-like

      Daniel Lion Member Benefactor

      Location:
      SE Asia
      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Noise trauma, hearing loss
      Music to my damaged ears. You're giving me hope brother, your words have made my day, well it's evening here. Thank you...
      ...maybe in a few years we could have a convention, celebrate, and have it super quiet... it would be surreal. Your optimism means a lot.
       
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    19. Bob den Hartog

      Bob den Hartog Member

      Tinnitus Since:
      11/2018
      Cause of Tinnitus:
      Noice induced
      And have a minute of silence for the death of hyperacusis. :).

      Or more.
       
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    20. Jazzer

      Jazzer Member Benefactor Hall of Fame

      Location:
      UK
      Tinnitus Since:
      1/1995
      Cause of Tinnitus:
      Noise
      ?Perhaps?
       
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    21. DaveFromChicago

      DaveFromChicago Member

      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Headcold/Flu
      This last-of-an-era CBT "therapy" is very reminiscent of the recommended treatment for various psychological conditions such as bipolar, depression, anxiety, etc. up until the late 80's.

      Psychotherapy contended that focusing on neutralizing and accommodating yourself to these conditions was the prescribed treatment. Then, when the pharmacological revolution started in 1987 (with the introduction of Prozac), this treatment has been marginalized and now nearly nonexistent. No psychiatrist in the Chicago area would, for example, treat depression with such outdated long term CBT talking therapy for the established reason that much depression is caused by biochemical brain imbalances and has nothing to do with your "attitude" towards it.

      I find it in fact rather insulting that these CBT proponents expect me to ignore the accumulating evidence that tinnitus is entirely caused by the brain's reaction to nerve/tissue damage. I got this condition from a head cold; a viral particle probably migrated down the eustachian canal and launched a Vietcong level assault on the Aural nerve. This condition is therefore going to persist regardless of my emotional state.

      It is ludicrous to expect me to eliminate this condition by simply concentrating on willing it away. (Imagine suggesting to someone with spinal nerve damage that he could learn to walk again just by neutralizing the traumatic emotional reaction to such an injury).

      There is an entire panoply of such CBT proponents online (the most insufferably obnoxious of whom is that Julian Cowan Hill).

      Let's hope that real research yields a truly effective treatment in the near future.
       
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    22. Manny
      Dead

      Manny Member Benefactor Hall of Fame

      Location:
      United States
      Tinnitus Since:
      1/2018
      Cause of Tinnitus:
      central gain << NIHL
      Nah, the question is, what came first the chicken or the egg.
      Is Jastreboff of the opinion that reducing tinnitus volume is virtually impossible, and therefore he pushes TRT?

      Or is it rather that he pushes TRT, and therefore is of the opinion that reducing volume is impossible.
      Who knows but um, take a guess.
       
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    23. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
      The chicken-like ancestor but that also came from an egg.
       
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    24. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      Bildschirmfoto 2019-03-11 um 09.29.26.png

      A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

      "Even though the tinnitus is continuously present, the involuntary response is trying not to hear it, and trying to be minimally confronted with the tinnitus sound (avoidance). Patients do this by trying to control their sound environment, not thinking about it, directing their attention elsewhere, and consequently increasing their monitoring and awareness of their tinnitus. Consequently, cognitive resources are depleted, leading to task interruptions, more avoidance (safety-seeking), and eventually disruptions in functional activities. In the long term, severe disability ensues, disrupting all life domains and leading to severe dysphoria."

      "Exposure therapy for tinnitus patients entails exposing them to their tinnitus sound, the interceptive sensations associated with the tinnitus, as well as their moment-to-moment narrative. To provide an appropriate context, exposure is performed in quiet circumstances. This way the patient experiences that the tinnitus sound is harmless, not dangerous, and listening to it in silent environments will not lead to catastrophe. They also learn that the aversive consequences are not always triggered. These experiences lead to a “neutralisation” of tinnitus by adaptation of fear expectancies; consequently, the tinnitus becomes less intrusive and bothersome, the more they engage in exposure."
      :rolleyes:
       
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    25. gorzakus

      gorzakus Member Benefactor

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      Hearing loss ?
      No,
      Are you interested in this?
      It's for sale for 42 euro?
       
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    26. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      Yes, because just judging from those parts it's really bad and I want to know just how bad it is. So far it just boils down to "it's a matter of perception".
       
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    27. gorzakus

      gorzakus Member Benefactor

      Tinnitus Since:
      02/2018
      Cause of Tinnitus:
      Hearing loss ?
      You can buy the article apparently but I wouldn't give a cent to such research.
       
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    28. Terminator

      Terminator Member

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      Sound trauma
      Lots of stupid people exist here in the Netherlands or actually savvy people who see new business opportunities. Regardless if it helps you or not. I am used to it already but just want it gone completely (both issues but tinnitus first).
       
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    29. Manny
      Dead

      Manny Member Benefactor Hall of Fame

      Location:
      United States
      Tinnitus Since:
      1/2018
      Cause of Tinnitus:
      central gain << NIHL
      What cruel, greedy people. Yes, cruel.
       
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    30. Autumnly
      Wishful

      Autumnly Member Podcast Patron Benefactor Hall of Fame Advocate

      Location:
      Germany
      Tinnitus Since:
      July/August 2013
      Cause of Tinnitus:
      Noise induced
      A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

      Haven't read everything yet but so far they don't mention tinnitus loudness, intrusiveness, reactivity or pain or loudness hyperacusis even once while talking about habituation. It's all just about not seeing the tinnitus as harmful and dangerous and you'll be fine. This is bad. This is really bad.
      • Monitoring tinnitus
        If life is planned around tinnitus it is given much importance, and this prevents the patient adapting to it. Simply put, patients should not avoid activities they think may make their tinnitus worse. Patients should not be putting their life on hold. Tinnitus does not have to control their life. Each time the patient tries to “monitor” their tinnitus they are guiding their attention to it; there is, however, no evidence that this would make tinnitus worse. They should be advised to engage in normal activities when they notice themselves trying to monitor their tinnitus.
        fear-avoidance-model.png
      How can they be allowed to write something like this? How? Millions of people are suffering severely and these people are allowed to say that it's not the tinnitus it's just those people's perception of it?

      Edit: I just wanted to say, I had hope for this paper. A part of me had truly hoped they'd talk openly about tinnitus being a spectrum and include stories of all severity levels. But severe cases are not being mentioned. The message to me seems clear: tinnitus cannot be debilitating, CBT is enough. I don't even know if we can even do something about this. If we send those researchers an email, will we be seen as trolls? Will they think we're just out to get them? Would they even be open to discuss this?
       
      Last edited: Mar 16, 2019
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