William Shatner & Habituation

Habituation worked for William Shatner.

https://twitter.com/WilliamShatner/status/589127074813612032

 

hi stink,
i am an old star trek fan and yes i am aware of his tinnitus situation,thanks for the post !

 

Sure, habituation by definition would work for everyone once its achieved. But unfortunately not everyone habituates and in some instances, I'm not sure if they can. I'd be the first to admit if I had H, or distortion or anything else, I couldn't see myself habituating.

 

i have met him but just briefly, i did not have tinnitus then so i did not think to ask about it but yes it would be nice for a celebrity to raise awareness more, i agree ! i know he has talked about it on a few talk shows though

 

William Shatner and I were both patients of Dr. Pawel Jastreboff's back in the mid-1990s. He was a few months before me. I have not spoken with him personally, but my understanding is that he was in very bad shape. Sometimes you just can't do it (habituation) alone and need help. Shatner and I were both fortunate to have found somebody who was very good at precisely that: assisting people suffering from severe intrusive tinnitus in the habituation process.

stephen nagler

 

Glad both of you were able to find the help you need. But when I was speaking of not everyone being able to habituate, I was meaning people who have more than tinnitus. I think tinnitus can be habituated (but like you said, perhaps not alone). But I'm not so sure about H. I have to admit, I'd be scared to death if my ear literally hurt every time I heard a noise level sound.

 

I absolutely understand. That's why you need to treat the hyperacusis first using a desensitization protocol. Usually takes six to eight weeks.

 

Where is he talking about habituation in his tweet? cant see it. can only see other peoples posts. Plus he didnt just habituate did he - he went to:

so he had help. And probably early on as well when it first started. He also had the money to go there.

 

don't you see it?

 

http://www.seattletimes.com/lifestyle/easing-the-torment-of-tinnitus/

" In 1996, Shatner traveled to the University of Maryland and met with Dr. Pawell Jastreboff, who introduced him to TRT."

Stink, this is a little embarrassing since you not only bit @Dr. Nagler 's head off, but also accused him of lying. Especially when all I did was Google, "Shatner TRT" and this came right up.

Furthermore, tweets on Twitter are limited to something like 180 characters. They are hardly meant to ever be a source of exhaustive info on anything!

 

Interesting. I thought Shatner saw Dr. Jastreboff in Baltimore for TRT a few months before I did. But I saw him in 1995, so I guess I was wrong about that.

 

Comic con 2012 MTL - William Shatner speaks...

 

@Dr. Nagler hi, i watched the video on you tube and yes you are correct that William Shatner did do TRT. It also seems correct that he went to the University of Maryland Medical Centre in 1996 and met with Dr Jastreboff then.

Here is a comment (at the end) by Dr Jastreboff re Shatner and TRT:

Not everyone gets a bad vibe from all the noise. In remote regions of
China, tinnitus is welcomed as a sign of wisdom. In parts of Turkey, it
portends good luck. And, according to Jastreboff, certain religious
sects in India feel that tinnitus is an intimate message from the very voice
of God. William Shatner, who is not from India, sought out
Jastreboff. “He came in very discouraged,” says Jastreboff. “He was very
close to a suicidal state. He blames the breakup of his second marriage to
tinnitus — I’m not sure about that, but he was in very, very bad shape
indeed. He went through my treatment, and he’s fine now.”

Basically this says then that wherever he did it and in whatever year (which was yes 1996), you were not lying and William Shatner did do TRT and it did help him carry on successfully with his life - which after all is the main point. He does not say this in the you tube video but it is mentioned as part of the article found at 3.08...but he does say that he sought help and found it and there is help out there for T sufferers. This was back then when only TRT was available.

TRT is still widely practised internationally with good results. Now in France there is a new treatment which involves the use of an anti epileptic drug (small doses, no side effects) to deal chemically with the hyper active neurons, then depending on the patient it can be coupled with TRT white noise generators (specially adapted to each individual) and possibly as well TRT counselling to deal with the emotional aspects of it.

Shatner tweeting habituation may mean that he had TRT AND has also habituated to it after all these years. In other words, the TRT worked for him back then and now together with the passage of time so has habituation. What is wrong with that?

I have a friend who was in a bad way with T which started last year for him and he started doing TRT recently. He has confirmed to me that in two short months it has saved his life and he is now back to normal working and taking care of himself and his family.
Just thought it worth adding these things to the conversation.

I want to do it as well but am waiting for my first appointment consultation at a T clinic in May (in France). It seems that the white noise generators really do the business to help get rid of it or rather push it to the back of the mind so it is not consciously there all the time. I am trying to see if I can get the drug as well...........

One last question @Dr. Nagler if possible........this has been bugging me for a while so wonder if it is okay to ask you now? Recently you sadly had a bit of a set back with your level of T and started to use your white noise generators again. Long and short of it is that you have gotten back on track really quickly - well done!
You said that you went to a therapist for TRT counselling too as it is not possible to self administer the speaking part of the therapy. I have been wondering how that works as you must know the therapy backwards and so could recite it to your therapist. In that case, how can it help you to receive speech counselling therapy from another person when you know it from Z - A........I mean you must have all the answers to every question put by a T patient.....just curious and wondered if you would mind explaining this to me........of course if you would rather not explain then I totally understand as this is private for you. Thanks.......

 

Regarding the topic, Mr. Shatner, which is mentioned in the thread title, the video below...

William Shatner speaks about his tinnitus

...which features him, was one of the first that I watched some two weeks into my ordeal back in early May, 2013. I haven't watched it since (even now), but I recall that it was a good bit more inspiring than the "average stuff" that can be found out there.

The video is of course produced by the ATA, and along with a couple of other videos, they have, I feel, managed to get some good awareness going over the years. It does take a bit of effort to find a celebrity willing to engage in this kind of work.

attheedgeofscience
19/APR/2015.


Tags: @marqualler

 

Right. It is ludicrous to think that I would make something like that up. But this is the Internet. If @Stink says I made something up, somebody else is bound to believe him. And so it goes. Now he is claiming that Shatner "didn't like TRT." And somebody will probably believe that as well, in spite of the fact that Shatner has appeared with Dr. Jastreboff publicly on a number of occasions and in spite of the fact that Shatner has become a major financial supporter of Dr. Jastreboff's foundation. Go figure. It's the Internet, and Stink is probably just having a bad hair day.

TRT facilitated Shatner's habituation. He started TRT in 1996 and thanks to TRT by 1997 he was aware of his tinnitus less than 5% of the time, which is how things have remained for him to this day.

That's what happens when TRT patients have a relapse, as can rarely occur. They re-habituate very quickly. It's not like they have to start from scratch. More like re-learning to ride a bike.

Right. You cannot counsel yourself in TRT. You simply cannot anticipate all the tweaks involved and bumps in the road by reading a book.

Glad to. When I first did TRT back in 1995, I did not know a thing about it. That's why I went to Dr. Jastreboff, who at the time was the only TRT clinician in the US. So I did the TRT sound therapy and TRT counseling under his guidance. When a TRT patient has a relapse, however, all that is needed is the sound therapy. There is no need for additional counseling. That said, it is always a good idea just to "check in" to get your bearings. So even though I am now an experienced TRT clinician (and have even taught TRT courses with Dr. Jastreboff in the US and abroad), I did exactly that when I myself had a relapse twenty years after TRT. I contacted Dr. Jastreboff and met with him for an hour or so - over a couple of beers, actually. Also, two other TRT clinicians (Jacqui Sheldrake in the UK and Gail Brenner in Philadelphia) heard about my situation "through the grapevine" and contacted me to chat and lend me their support. But there really wasn't any additional counseling involved - not with Dr. Jastreboff nor with Jacqui nor with Gail. Like I said, all that is necessary when any TRT patient relapses is a few weeks of sound therapy.

Hope this helps.

stephen nagler

 

Here is an interview with William Shatner: http://www.howsyourhearing.org/AudiologyToday/ATWilliamShatner.html

Here's a particularly interesting part of the exchange:

AT:Very interesting�what treatments have you found successful?

WS: The only treatment that I have found success with for me is habituation.

AT: Like tinnitus retraining therapy [TRT].

WS: Exactly�I wore the noise maskers, and they said "wear them for four to eight hours a day." I wore them for 24 hours a day. I never took them off�even when I went to sleep at night. After three months, I began to lose my fears somewhat. Ultimately, I went to see Dr. Jasterboff at the University of Maryland, where he was at the time.

This is all easily looked up with a Google search if anyone were interested in checking it out for themselves. The point here is that William Shatner is saying that habituation is the goal. How you reach the goal is less important than actually reaching it. But the bottom line is that it is very careless to reply so harshly to someone and accuse them of lying when all it takes is a simple Google search to find the truth.

 

@Dr. Nagler , do you have a TRT specialist in the NE area (washington DC) you can recommend? Finding people who sell maskers is easy but I can't find anyone who does the whole protocol.

Also, can TRT be effective for someone like me who has already suffered for years and years?

 

I really like Dr. Gail Brenner in Philadelphia. She is bright, knowledgeable, experienced, compassionate, honest, and - well - incredibly nice. I have known Gail for some 18 years now, and I recommend her unconditionally. Although Philly is a bit of a distance from DC, all of the follow-up can be accomplished by telephone. Only the first visit must be done in person.

It is really best to have the input of your TRT clinician in terms of choosing wearable broadband sound generators. Not all "maskers" are suitable for TRT. And in some cases such devices are not needed at all!

I have had three patients who suffered for more than twenty years prior to starting TRT and who then habituated to their great satisfaction, relief, (and joy!) within twelve months. So the short answer is ... yes.

stephen nagler

 

His said he used white noise sound generates for like 24 hours...He must have it really bad..He's got millions so much easier for him really. I mean, if I had millions, I could build in speakers in my bed to create a noise which masks my tinnitus...Plus, I'd could call Autifony and say, y'all gonna give me some drugs here's a million dollars lol

 

I have met Mr. Shatner and we had a private conversation about our tinnitus and I can tell you that he did do TRT.

 

Dr. Nagler, been trying my best to habituate on my own. Some better days but still challenging.
I am ready to do TRT. How do I know if it is real TRT or a modified program? Thank you.

 

Excellent question.

OK. I'll give you the long answer first ... and then the short answer.

The long answer and the short answer both start out the same. Recall that the habituation-based tinnitus protocols (e.g., TRT, NTT, CBT, TAT, PTM) are all designed to facilitate a process (habituation) that tends to occur naturally - provided that there are no barriers in the way. So the first thing I would do is spend some time going over the "Overcoming Obstacles to Habituation" piece I wrote a while back and really applying the principles therein in the hopes that you can jumpstart your own habituation and not have to be concerned about any of the alphabet soup of habituation-based protocols.

Assuming that does not get you where you want to go, then here's the long answer. The problem is that there really isn't any standardization in TRT. But that is pretty much true to a greater or lesser degree with all tinnitus treatments. So regardless of which approach you choose, you really have to do your due diligence. Which means you have to call a lot of tinnitus clinics and ask to speak to the tinnitus clinician there about your particular situation. If you cannot get a return call in a reasonable amount of time, then cross that clinic off your list of possibilities ... because in tinnitus, communication is 90% of the battle. When you do get that return call, briefly explain your situation and ask if the tinnitus clinician thinks he or she might be able to help you. If the answer is yes, then here are the questions you will want the clinician to answer before you make that first appointment:

· What is the approach the clinician is recommending and why?
· What type of training has the clinician undergone in the use of that approach?
· How long has the clinician been using the approach?
· How many tinnitus sufferers has the clinician treated with the approach?
· What is the clinician's success rate using the approach?
· How does the clinician define and measure success?​

Note that the questions do not apply just to TRT! It may be that during your process of due diligence you will find a better fit for you than TRT. The goal is habituation. TRT is certainly not the only way to get there!

So that's the long answer. The short answer has to do with the fact that you are only a six hour drive from Philadelphia. So if you don't want to bother with the due diligence piece and if you are sure that TRT is for you, then read my Post #28 in this thread, and make an appointment with Dr. Gail Brenner!

Hope this helps.

stephen nagler

 

Thank you so much, I looked her up and will be contacting her office in the morning. I am ready, gave it my best shot for couple of years. Tried many expensive treatments and medications with side effects, no luck and was doing some CBT but not with a tinnitus expert.
Already did a mapquest print out, talked to hubby and will make it a mini vacation. Will keep you posted on my journey. Glad you are here for us.

 

Excellent. I hope it all goes well.

Reading through this thread, it is quite apparent that some here do not agree with you in that regard. But if even a handful feel as you do, then that makes it all worth it for me.

stephen nagler

 

With such obvious success and a long career and with many patients and not forgetting being a former head of the ATA, I do find it difficult to understand why you cannot find a single former patient willing to share their testimony on TinnitusTalk directly:

I also find it difficult to understand why someone could not run a free-of-charge anecdotal experience of their treatment with you, as you - besides Jastreboff - are the very authority on TRT and also treat 18% of your clients free-of-charge in your $1-salary draw clinic:

TinnitusTalk would be the perfect place to "recruit" a couple of volunteers, don't you think (especially considering that approx. 75% of the member base is American)?

Perhaps it has something to do with the following account from a former patient of yours?

www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-6#post-102045

Here is what that former patient of yours wrote (in part):

Whatever the reason, instead of talking about how great TRT is, why not walk-the-talk, instead of just the usual talk-the-talk? Team Trobalt delivers. And free-of-charge. So why can't you?

attheedgeofscience
19/APR/2015.

 

@Dr. Nagler do you have a recommendation for someone in massachusetts? who may not be impossible to get into with all the marathon victim research?

 

Chris, I have heard very good things about Dierdre Anderson in Newburyport. I met her once, and she seemed quite knowledgeable. I cannot recommend her, however, because I only recommend tinnitus clinicians whom I have actually personally seen "in action" counseling patients, and Dierdre does not meet that particular threshold. But that said, you might call her, explain a bit about your situation, and see if she thinks she can help you. Perhaps ask her the same set of questions I listed in my response to @Leah above. That should give you a pretty good feel for it.

All the best -

stephen nagler

 

@attheedgeofscience why do you bother to ask him questions or reply to him directly when you know he has you on ignore and won't see your posts?

 

I will leave it, as an exercise, for you to figure that out (just as with the logical fallacies from the other day).

(Hint: this is public forum).


As for my post in this thread...

www.tinnitustalk.com/threads/william-shatner-habituation.9224/page-2#post-108572

...it contains facts i.e. "axioms of truth" from which other truths can then be established (which is quite useful in some instances).

Dr. Nagler will tell you that TRT is only for tinnitus sufferers of the most severe cases:

However, that still leaves you - the patient - to pick-up a bill of over $400*...



...for a first consultation even if it may not result in TRT being "prescribed" to the patient (at a cost of $4000). And such consultations are "standard" within the TRT community. You can find a disappointing account of that here:

1. www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-6#post-101724
2. www.tinnitustalk.com/threads/tinnitus-retraining-therapy.43/page-6#post-102086

And here is the reason why such consultations are disappointing:

Needless to say, many people on this board know I am critical of psychotherapies for the treatment of tinnitus and therefore these members (apparently) assume that I am biased. But the above accounts were not written by me. Just remember that!

Given that I bring objective facts to this board, I am initially amazed at how little critical follow-up reflection that takes place in relation to my posts on TRT. The only responses I tend to get are from people like your yourself and/or @linearb suggesting that I am biased or pursuing a witch hunt against Dr. Nagler (or TRT). However, given the lack of self-interest the tinnitus community has in its own progress and well-being, and as clearly evidenced in the "Let's Make TV News"-thread, this display of lethargy is of course much more understandable.

attheedgeofscience
20/APR/2015.


* Source: www.atlantatinnitus.com/office-visits.php

 

As many of you know from my postings, I have a huge problem with the lack of standardization in TRT. It really puts tinnitus sufferers at a disadvantage, and I absolutely hate that!

So regarding TRT, because of the lack of standardization I can only tell you how I personally see things rather than how things are done across the US and around the world. And in my own clinic I use a 1 to 10 scale. Every prospective patient is interviewed over the phone by me prior to being offered an appointment. There is no charge at all for this interview, which can last 30 minutes or more; it is how I screen my patients so that I do not waste their time (or mine) with an initial three-hour office visit. Part of the interview includes an in-depth discussion of what TRT is and what TRT isn't. Part of the interview includes an explanation of habituation. Part of the interview includes a frank discussion of what can be reasonably expected after undergoing TRT, with particular attention to various methodological weaknesses in published TRT studies. Part of the interview includes a discussion of the cost of TRT (which is where those individuals who are out of work and are significantly financially disadvantaged are considered for free treatment). And part of the interview includes the aforementioned 1 to 1o scale. I ask the prospective patient to grade his or her tinnitus, where 1 is "I have tinnitus, but my tinnitus does not bother me in the least, and I really don't care about it one way or the other," and 10 is "I have tinnitus, and my tinnitus has totally and irrevocably destroyed my life." Individuals who grade their tinnitus 9 or 10 get appointments for TRT if they have tried or at least seriously considered other approaches and are still interested in TRT. For those with a score of 8 or below I explain why they should look at other options including simply giving things more time. I refer them to a paper I wrote on "Self-CBT" and point them to a number of additional resources as well, including my "Overcoming Obstacles to Habituation ..." post. (By the way, this is where The Hub that @Markku, @Steve, and others are developing could really come in handy by having all the resources in one place.) So using this "pre-appointment phone interview approach," all of my TRT patients are 9s and 10s (i.e., they are all very, very serious cases) save for a couple of 8s. I also have one 7 and one 6, both physicians who were insistent on going ahead with TRT in spite of my urging them to hold off and look into CBT, etc.

Thus, when @Danny Boy writes: "I'm guessing it [TRT] can't work for very, very serious cases" I must strongly disagree ... because those are pretty much the only cases I see for TRT, and the vast majority of them do just fine.

stephen nagler