William Shatner & Habituation

Oh, now I get it. The problem is mine. I understand what happened, and I'll need to watch out for that sort of thing in the future. My apologies for the confusion.

 

fuck the Habituation. I choose reborn

 

@Dr. Nagler I am grateful for your explanation about how stress that was handled well before tinnitus is being added to the stress of intrusive tinnitus. It makes a lot of sense as to why things seem more stressful with intrusive tinnitus, even with stress management techniques. In addition to stress making tinnitus louder, what causes tinnitus to go up overnight while sleeping? I can go to bed with really low noise and be awakened in the middle of the night by really high noise. How does one habituate to this situation? Your expertise is much appreciated.

 

I have always felt it to be due to the role of the reticular formation in tinnitus perception. The reticular formation is a primitive structure in the brain stem. It's a "vital sign monitor." When you wake up, the RF checks to see whether or not you are alive! It looks for heartbeat, respirations, blood pressure, temperature - basic bodily signs. It does not care whether or not these signs are good or bad - just that they are present. And as far as the RF is concerned, tinnitus is part of "expected" body function in an individual suffering from severe intrusive tinnitus. So when you wake, your RF checks to see whether or not tinnitus is present. And if it doesn't immediately find the tinnitus, the RF seeks it with a vengeance - - especially in the post-nap state, when there has been inadequate REM sleep and when, therefore, the RF is on already "high alert" that something might not be quite right. Theoretically - very theoretically - this RF hyperactivity in seeking tinnitus, which in a person with severe intrusive tinnitus it equates with life, results in temporarily markedly augmented tinnitus perception.

Actually, what happens is that you wake up in the middle of the night on your own and then almost instantaneously discover really high noise - because you have not had adequate REM sleep, and your RF is "doing its thang," as we say in the South. At least that is how I have come to understand it.

Let me get this right. You have paid a veritable shitload of $$$ for TRT, but in all your TRT counseling "Dr. Sixth Letter O" never bothered to address that very important issue. Really? Uggh. So what sort of sound therapy are you currently doing?

 

Dr. Nagler,

Personally, I have a deep respect for your posts on this site and its many forums. I often read your comments and enjoy your sincerity and commitment to genuinely trying to help others. Even the ones who try to argue with you....

I find myself, that at times I bounce back and forth between what I would generally characterize as "habituating" and "coping." I live in Michigan and wonder if there are any TRT therapists you could/would recommend that are nearby. Or perhaps it doesn't matter if they are in my backyard, as I understand some of the treatment can be done remotely, etc. Thanks for your support!

Duane

 

Thank you, Duane. That means a lot to me.

See, that's something I really don't understand at all. I know that my writing style can at times be somewhat challenging and maybe even occasionally biting. But if I were stuck in the bottom of a rattlesnake pit and the fellow who was stuck down there with me managed to climb his way to safety, my own response would be: "How the hell did you do that - show me the way." The last thing I'd be doing is arguing with him.

So go figure.

Actually all but the very first visit can be accomplished via phone or Skype. The closest person to your location whom I would unconditionally recommend is Dr. Paula Schwartz in Edina, Minnesota. (There are some other folks in her clinic who see tinnitus patients, but Dr. Schwartz is the one you want.) If you like genuine Philly cheesesteak sandwiches, then by all means head to the Philadelphia suburb of Bala Cynwyd and see Dr. Gail Brenner. She, too, is superb. There's also a guy in Atlanta, but I'd probably stay away from him. Too challenging and biting for my taste!

All the best with it.

 

@Dr. Nagler I agree with Duane. I, too, have a deep respect for your posts and enjoy your commitment to sincerely trying to help others.

To answer your question, I am not currently on any sound therapy. My tinnitus situation seems unusual, which I plan to write to you about off the Board. It seems entirely different from anyone's about which I have read here or anywhere.

By the way, my husband did ask "Dr. Sixth Letter O" for a refund, partial or otherwise, when I decided to discontinue treatment. She refused and claimed to have contacted her attorney.

 

What could be more stress-inducing than something screaming in your ear 24/7 without a break and knowing that it will NEVER stop until you DIE? Relaxation is impossible.

And if you have reactive T it's basically game over. You can't treat a severe physical ailment (reactive T) that does NOT give you a break with psychology.

You'll never find a patient with such a nickname 'cause you/we cannot beat T. T beats us. There are no treatments that affect/change T. As you said, all you can do is try to change you.

 

Thank you.

TRT is all about reaction. The psychoacoustical characteristics of the tinnitus (loudness, pitch, timbre, etc.) are largely irrelevant in that specific regard.

I guess "Dr. Sixth Letter O" didn't explain that either.

OK. Enough about the alphabet. What's done is done. I sure had enough false starts in my own search for relief (expensive false starts at that!)

 

Sure you can.

It will if you let it; that's for sure.

Right. In 2015 there aren't.

... which is precisely how you beat T!

 

@Dr. Nagler
I have read many of your posts since the year I have been on here. You remind me of myself, direct, honest and to the point. Many people take it as arrogance or unsympathetic. Though I have never posted you directly, you should be comended for all you do on this forum, the help and insight you give is invaluable. I believe many people are struggling so much that can't see the wisdom you are imparting, and though I understand some have harsh words for you that you do not deserve. I just wanted to let you know how important your help is and I hope you will continue, as hard as it can be sometimes. I don't mean to bring religion in to it, but I will say a prayer of thanks for you for all you have done and continue to do out of the kindness of your heart. God bless you and your family.
Much respect,
Kevin

 

Perfect description of what we go through. Can only be made and understood by someone who knows severe T himself.

T caused by stress (health anxiety) and on top of stress, vertigo and migraines I got this crazy sound in my head. I would say, my existing stress level of 90-100% was doubled by T. It was pure surviving.
Doing better, but still a long way to go reducing stress formula "T + Life" as low as possible.

 

Amen to that prayer and the thankful heart to Dr. Nagler, bro.

 

Direct. And to the point.

 

Thank you so much, Kevin, for all your kind and heartfelt words. This has not been a very good week for me (nothing to do with tinnitus), and your timing could not have been better!

 

The most impressive communication skill I've observed was from a person sitting in a control room talking to one of his subordinates through a radio. It went like this:

"Guard 14. I'm warning you. I'm watching you. If you don't do what I tell you, you'll be in trouble."

As an ex-journalist and fiction author, I consider myself as suitable as anyone to decide what good communication skill is, and this little piece had it all.

 

@Dr. Nagler I second @kevin b and @billie48 You are to be commended for all that you do on this forum. Your insights have been extremely helpful and validating.

Is TRT the same for reactive tinnitus, as far as the psychoacoustical characteristics being irrelevant? Is it possible to habituate to a noise that is constantly changing? Is it possible to habituate to a noise that is vascular and always pulsing? It seems like most people have a baseline from which they habituate. What if there is no baseline and it is a moving target?

 

@Vincent R Just for clarification, about which piece are you speaking? The one you quoted from ATEOS or the one about the control room?

 

The one from @Max_fcktr of course...

 

The latter. I guess there's a lot of work to be done with my own communication skill since you had to ask

 

You are all most welcome.

If by "reactive tinnitus," you mean tinnitus that gets significantly louder upon exposure to noise, the answer is yes. That's because TRT addresses one's reaction to tinnitus rather than the tinnitus itself.

Yes. Same reasoning as above.

Ditto.

Ditto.

Just one clarification. in "reactive tinnitus," the success rate of TRT is lower than the typical 85% if the exacerbations routinely last more than twenty-four hours.

 

@Dr. Nagler I am a bit confused. How can you have an exacerbation if there is no baseline?

 

Martin, the two words in your post that stand out more than any of the others are Doing better. Doing better is good, yes? It's not yet great, but it is definitely good.

 

Because in TRT (which was part of the premise of your original question) the focus is on reaction. So whether or not your tinnitus itself is a moving target is irrelevant.

 

@Dr. Nagler Very interesting. The person claiming to do TRT counseling with me did not explain any of this. Am I understanding correctly, that with TRT the tinnitus itself is irrelevant no matter what? What if the tinnitus is reactive to the sound therapy itself? I appreciate your time.

 

I guess the operative word there would be "claiming."

Yes, provided it has been established that the tinnitus is not caused by any of the very few things that are a threat to health or life.

Well first you have to figure out why the tinnitus is reactive to the sound therapy. Like is it a form of misophonia or possibly a winding-up phenomenon. Maybe it's six-week syndrome. Several possibilities there. But whatever it is, it can be addressed within the framework of TRT. In all these years I have had only one TRT patient who could not tolerate the sound therapy, who indeed actually got worse. But that was because of my own screw-up; I missed the diagnosis. And to this day some 15 years later I still feel bad about it.

 

Admit it. Mine was good too: otherwise you wouldn't have thought of that quote of your own - not mention taking the bother to actually write the post!

Of course, the quote from @Max_fcktr was the best of all three. Only (minor) point to reconsider might be the lack of subtlety involved...

Otherwise A+ as they say...

 

I'll try to answer without over analyzing. Peoples sense of humour sometimes reflect something within their personality, and the keyword here may be clarity. You don't strike me as a person who appreciate muddy thinking, so it makes sense that you noticed a post with great clarity when it comes to intent and conclusion. Indeed, the post carried no deadweight at all. That's what caught my attention.

 

That's for sure...

Not forgetting the fact that @Max_fcktr has had some 100 posts of his deleted. Although (most) of them did stray well into the further regions of the 'profanity spectrum', and while most of them would also not display any significant literary finesse, his posts did most certainly convey the essence of the argument (and content)!

I sure did have a good laugh back in the day when @Max_fcktr was more active here on TinnitusTalk. Not sure he would make a good candidate for Team Awareness and public relations, though...