Hi all

I had my first "TRT" session at the Royal National ENT hospital on Gray's Inn Road yesterday. I was expecting to be given in-ear sound generators and follow the approach that people like Bob T are benefitting from. However, it was quite different (I think).

The Hearing Therapist explained that the current approach to habituation at the Royal National is: Mindefulness. This is kind of CBT-related, but has its roots in buddhism. I almost couldn't believe that something so apparently esoteric is being offered as mainstream medicine. I have to say, however, I am approaching it with a very positive and open mind. I've posted links for those who are interested and, of course, I will report back.

In summary, here are the key points of the approach / session:

1. Met with the hearing therapist for about 90 mins. Totally unrushed, very friendly (very un-NHS like). A detailed picture of my physical and mental health prior to T was captured (I developed T from Scuba diving)

2. I am to meditate everyday, starting at 2 minute sessions. I have to specifically tune-in to my T and acknowledge and record what feelings come up in a non-judgemental way.

Here's some of the more radical stuff:

3. I will not be getting in-ear noise generators and I should AVOID using other sound enrichment (eg. My Oasis sound card, sound pillow etc)

4. I am to consider RE-INTRODUCING any of the T triggers that I have cut out of my life. For me that means

- I will re-introduce drinking (a safe level of) alcohol. I severely cut down on booze since I believe it makes my T worse. I was very surprised by this but happy of course

- I am to start going out again to the noisy (somewhat) bars that I used to hang out in before I got my T and not to use earplugs. I shouldn't go gigs however, or heavy pounding clubs or do things where my hearing could actually be damaged.

It was explained that even if some alcohol and going out to bars caused a T spike, I was asked to try and continue working through, run my life as normal as possible and continue with my cycle of meditation.

5. I was also asked to consider keeping off T forums for a while as well reading ahead too much. Rather to start this meditation process and try and be "mindful" as much as possible and just see what comes up rather than having too many pre-conceived ideas. Actually I will still visit this board to answer any questions and report progress, but I'm going to avoid the endless searching for medical solutions that I previously used to do.

I am really interested if anybody else has come across this approach. I checked to see whether I was on a special program or something and I was told no. They apparently feel there is a sufficient evidence base building up to use Mindfulness as the initial approach.

Anyway - off to do my meditation. I have to say it is very relaxing. As for results - well we'll see.

Wish me luck - Jason

http://callierlibrary.wordpress.com/2008/01/17/tinnitus-rehabilitation-a-mindfulness-meditation-cognitive-behavioural-therapy-approach/ (external link, opens new browser window)

http://en.wikipedia.org/wiki/Mindfulness (external link, opens new browser window)

Sorry forgot to say: I have a follow-up appointment in 4 weeks time, where I guess we'll tackle what has come up so far.

Overall, it was explained that we will meet every month to start with. This would continue for about a year (with hopefully longer lags in between sessions). Basically, it seems like a highly tailored approach and if I needed support beyond a year then it appears this would be available.

I have to say I am very happy indeed with the support framework etc and I just really hope that it works on a "technical" level.

Jason

Sounds very interesting and totally different from what most people experience on TRT. I have my first appt on 24th April.

How are you coping with sleeping. I use a sound pillow but to be honest sometimes I don't bother and just try to forget the T and it does work.

Hi Sarah

Good luck with your first TRT session. Where are you having it? I wonder which type you'll have? Anyway, hopefully we will be able to post our experiences so others can see the different approaches.

Sleep? Ah that used to be my worse. I have tried everything going from sound pillows to hypnotherapy. In the end the only thing that worked is Amitriptyline. I take 75mg every night and sleep better than ever before. I hope to come off it as my "TRT" progresses.

The best of luck but you arent describing TRT ! what do the Hospital call this treatment?

Hey there

That's right it's definitely not TRT as we know it, hence the quotation marks. The hospital calls it "Mindfulness" or "Mindfulness Meditation" and it's run at the Hearing Rehabilitation centre (where I assume they used to do TRT). I am very happy to explore the approach, although it appears new to us. Of course I'm super keen to know if anybody else has tried it.

It's obviously quite new. I'll dig down a little more at my next session. I specifically asked about traditional TRT and was told the Royal are no longer using that approach as their starting point, but they do borrow some elements. I also checked that this wasn't some kind of trial or special programme.

I'm really looking forward to recording my experiences so we can all see how similar or different it is, results etc.

Finally is there anybody else who's using the Royal and isn't doing this form of therapy?

Cheers - Jason

Hey Jason

This is CBT (Cognitive behavioral therapy). It's exactly the treatment that I've been having for the past five months. It's supposed to be the latest theory on Tinnitus therapy. The lack of in-ear noise generators and other sound enrichment is the key to it, the theory being how can you habituate to your T when you partially mask the noise. The idea is you confront your T, bring it into your life and accept it fully. It's based around positive thinking and seeing the T for what it is, an utterly harmless noise. Only when you confront it, can you start to let it go.

My therapist also suggested I start drinking again (in moderation) and not worry about all the triggers that I previously thought worsened my Tinnitus. In general, try to get on with my life in exactly the same way I did before T struck. And yes, I gave up all the sound enrichment and night time masking months ago.

I think that that CBT doesn't properly take into account the effects of variable T and works better if your T is a constant volume. If your T varies like mine does, it is really hard not to compare it from day to day and therefore hard to ignore completely and habituate fully.

And it's plain to me that if you can live with your T during the day without any masking, then you can sleep as night without meds. And if you can get 7 hours of drug-free sleep, you are always going to cope better.

Jim

I should add that I did my CBT in Bristol, which is where I live.

Dear Jim,
How you describe your CBT is really interesting, because although I didn't go for the counselling I do genuinely believe that one of my big breakthroughs in dealing with T was by forcing myself to listen to it and confront my fear about it. I even used to talk to it - now I ignore it! Incidentally I grew up in Bristol - Downend near Filton - they tested concorde over our house! Whereabouts in bristol are you? Oh I nearly forgot how is your most recent spike has it calmed down? Louise

Hi Jason

Yes I will post my TRT experience. I am having it at reading, berkshire and they do the traditional method I believe.

I take 5mg diazepam and started an AD called dopsulein 75mg which has a sedative and you take at night. I will see GP next week as I don't want to be on diazepam too long and only started it on 14th March.

Keep up the good work Jason and enjoy your first drink. I am not drinking while taking the diazepam and not had any alcohol since beg feb when it first started.

Sarah