TRT — Jastreboff

Dr Nagler,

I’ve read the book and papers by Jastebroff and Hazlett, the below is my understanding of TRT, please let me know what I have right/ what I have wrong, etc.

The crux as I understand it is that through counseling aimed at informing a sufferer that the tinnitus signal isn’t harmful or representative of damage and through sound therapy (where appropriate) tinnitus can be reclassified (by both the conscious and subconscious mind) as a neutral stimulus and thus over time tinnitus distress decreases. I know the work relies heavily on subconscious neuronal networks and the brains ability through plasticity to adapt and habituate to non-threatening auditory stimuli. Let me know where I am wrong and how the Heller and Bergman experiment informed the engineer’s work.

Our conversation regarding TRT got "cut short" the other day and I really do want a substantive critique because if my understanding is wrong I would like to know as I believe many others on this forum have a similar view of the therapy.

Thanks,
Matt

 

We want to proactively remind everyone that civility is not only encouraged but required on Tinnitus Talk.

For some 10+ years this topic has been discussed on tinnitus forums and newsgroups. Too often it has ended up with people feeling angry or insulted.

Everyone should refer to our Netiquette.

Thank you for keeping this discussion respectful and civil.

 

Thank you for posting this and keeping the discussion open-- I'm not trying to be inflamatory... all I want is an answer to my question.

 

Dr. Nagler has made it known that he won't respond to my question, anyway it is what it is... draw your own conclusions

 

Pity. I really would like to hear Dr. Nagler's view.

 

Oh well. Thanks for keeping it civil, @Mpt.

 

Not nice to bash people, Mpt...!

Seriously though, if that is the argument from Dr. Nagler ie. "bashing the model", then I don't know what to make of Dr. Nagler's own bashing of LLLT - here is a couple of posts from the lengthy LLLT thread:

and

Apparently bashing is a one-way street then...

[Try replacing LLLT with TRT in the above quotes and see what happens...!]

 

I see.

Agreed... but this is a question of some importance, wouldn't you say...?

Let me think now...

 

me too, that's all I wanted from the beggining: I guess the central principle of "the model" is a closely held secret

 

...or business secret.

 

Not to rehash old arguments but, Apples and Oranges. TRT claims to help people habituate. Something most people on here believe is real and many have done. LLLT claims to help reduce volume of tinnitus, improve hearing, help with thing like menieres and vertigo.
I dont think its unreasonable to be more critical about one then the other. Im not saying not to be critical of things like TRT, i think its important to be critical about most things but for logical reasons.

 

True. But everytime we shine the light on TRT, specifically, Dr. Nagler seems to be in a hurry to talk about something else. Here is a quote from the Hypnotherapy thread (when I asked him if he could track down just one former patient to give testimony abouth his/her TRT experience - something which shouldn't be hard if one has been in the TRT game for a long, long time and successfully treated many, many patients):

Now to dodge Mpt's question above - which was a question raised in response to a question Dr. Nagler himself asked - seems a bit bizarre. Basically, to dodge that question is equivalent to Bill Gates declining to talk about Windows 8. I am pretty sure many people would be surprised about that...! What kind of signal does that not send?

Anyway, as Mpt said, I guess the business secret is only available to those who are willing to pay. Or, alternatively, we can just go to Dr. Nagler's own business website, and read about TRT...

http://www.atlantatinnitus.com/tinnitus-retraining-therapy.php

In all honesty, I did consider TRT at the very beginning of my ordeal last year (because that's what my doctors here in Germany advised me). I tracked down the following clinic...

http://www.charite.de/hno/tinnitus/english/retraining.html

...but found out that the treatment length was 12-18 months (and apparently I had to dedicate a full day per week for quite some time). Then I read that (natural) habituation occurs in 80% of tinnitus cases which... is roughly equal to the success rate of TRT!!! And on top of that, TRT is not exactly... ahem, inexpensive...

As for LLLT, well, I am not the "salesman" of LLLT. I am just someone who shared my experience (objectively). I never claimed that LLLT worked for my tinnitus. But it certainly has improved my hearing. The audiograms in the attachment should be well known by "regulars" of this forum! Now, in terms of tracking down people who have benefitted from LLLT - that is something I have done on behalf of the members of this forum: there are several testimonials in my introduction. And that's more than Dr. Nagler was willing to do for his own product...!

 

I think ill take my leave from this thread as i dont want to get to sucked into it but i do want to say and obviously most know that Dr.Naglers someone i have a lot of respect for and appreciate what hes done for the thread, also i probably dont know enough about TRT to really debate the subject or offer to much in terms of insight.

@attheedgeofscience Even though i dont agrree with you all the time I greatly appreciate you sharing with us the very unique experiences you've had in dealing with tinnitus, and the perspective and insights you bring to the thread.

 

Hey guys, TRT is not the cause of your problems.

 

I apologize if you already answered this but after your improvement from LLLT did you get your audiograms from more then one place? Or was it just from the Dr W clinic? I don't mean for this to come off wrong but I'd be totally sold if you went to multiple unrelated audiologists and had the the same dramatic improvement. I'd also like to thank you for being a great source of information and inspiration on here.

 

See this:

https://www.tinnitustalk.com/threads/am-101-tactt1-results-released.1994/page-20#post-38164

https://www.tinnitustalk.com/threads/my-introduction.1862/page-3#post-60477

 

I guess THE NAGLER deleted his post where he said that he chose not to answer my question for reasons that were very important to him personally... really strange

 

care to answer?

 

@Mpt Too bad he won't respond, but I don't understand how this can be a trade secret for business purposes (and profit); maybe I'm just naive but I learned how to habituate on my own. I didn't have anyone usher me through a process or train me how to do any of this. Am I just 'street smart'? I seriously doubt it.

IMO, guarding this kind of information is analogous to guarding special breathing patterns for professional swimmers -- sooner or later (likely sooner) every swimmer will figure it out on their own. How do you 'guard' information that is discoverable by all? However, I guess at one time radar technology was a secret too.

I must be missing something...

 

There are no "trade secrets" in TRT, Mark. Everything that has to do with TRT has been published and is readily accessible for all who might be interested.

As far as "business purposes" go, to the best of my knowledge there is nothing nefarious going on either on the instrument manufacturing side or with TRT clinics. There most certainly is not in my clinic. In fact, Mark, I'd be more than willing to reveal my business model here if it's all that important.

I suspect that you are being misled - but it ain't by me!

Dr. Stephen Nagler

 

care to answer my very basic question (that was in response to your question of me)-- I am legitimately curious I'm not trying to enrage you

 

Dr. Nagler
No, I don't think you are misleading me; nor is anyone else. It's just an impression I got after reading some curious threads. No worries here...

Mark

 

I'm not sure what threads you are talking about, Mark, but to the best of my knowledge everything about TRT is out in the open and transparent. If I may ask, where and how did the issue of "trade secrets for business purposes" come up (like you mentioned in your Post #19)?

Thanks -

Dr. Stephen Nagler

 

I believe you are being ignored @Mpt

 

Oh. That explains the source ... and why I did not see it. Thanks.

Friends, there may be any number of reasons for a tinnitus sufferer to consider or not consider TRT (or CBT or MBCT or TAT or PTM or NTT or a variety of other approaches, including just waiting to see what happens). These are highly personal decisions. But the idea that there are "trade secrets" in TRT or that something nefarious might be going on business-wise is not only ludicrous, it really brings to question the motives of those who would raise such issues. A while back I chose to put a couple of members of this board on "Ignore" for that very reason: dubious motives. I do not see their posts or PMs. And if a question of theirs is indirectly brought to my attention, I do not respond.

I know of no tinnitus treatment protocol anywhere that is more transparent than TRT - warts and all. And as far as business practices go - like I said earlier, I would even go so far as to reveal my own clinic's business model right here on this board if it will serve to dispel these sorts of ugly rumors.

Best to all who are of good heart -

Dr. Stephen Nagler