Sunday, April 20, 2008

Tinnitus and Chronic Illness

Tinnitus and Chronic Illness

Would you be interested in experiencing a full slate of clients, everyday? Did you know there are 40,000,000 chronically ill Americans? These people suffer from everything from chronic fatigue to chronic pain. Almost all of these chronic illnesses are essentially medically un-treatable.

Did you know there are 12,000,0000 people suffering from maddening ringing in the ears (tinnitus)? I’ve done thousands of hours of research and spent over $11,000 in developing a complete multi-modal program to help these people. Why? Because, for almost three years I was one of "those people."

I spent nearly three years in noise hell. The Emergency Broadcast System went off in my head 24 hours per day, 365 days per year. It never ceased, until finally, it remitted in 1996. Since beginning my healing process that included generally unknown techniques of hypnotherapy, a surprising selection of medications, interventions from other professionals and lots of support, I was finally made well.

When I first began publishing about my success in working with clients suffering with tinnitus, over 100 hypnotherapists in this country hung their shingle out with the goal to help those with tinnitus, only to meet with failure at every corner because of the depth, breadth and complexity of the malady. These therapists sincerely believed, apparently, that because they were able to utilize trance for pain management and other challenges facing their clients, that they were able to assist those suffering from tinnitus, hyperacusis (sensitivity to sound), environmental illness (multiple chemical sensitivity) and other chronic illnesses like chronic fatigue syndrome.

Why did this group fail? Hypnosis doesn’t work unless the therapist knows exactly what to do. Optimistic and kind therapists simply overestimate the value of what is in their tool box. Although there are therapists that can help, they are few and far between. Only a few appear willing to take the time to learn and understand the suffering of people like you and me.

What would it take for you to help this suffering population gradually improve the quality of their lives? A hypnotherapist working with a person that suffers from tinnitus and other chronic illnesses is like a neurosurgeon doing brain surgery. The neurosurgeon is the highest paid of the surgeons. They earn hundreds of thousands of dollars per year. The hypnotherapist who is willing to invest about 50 hours of personal education and $500 in training materials can learn how to have a practice that easily yields $100,000 of income per year.

I read over 1200 articles from neuroscience, psychological publications and medical studies from all over the world. I learned that long term hypnotherapy is the most powerful adjunct in reducing tinnitus volume and suffering. Adjunct means that we aren’t going it alone. We are working in cooperation with medical doctors, psychiatrists, osteopaths, and physical therapists. The complexities of tinnitus suffering are daunting at first, but once an understanding is gained on how tinnitus (and other chronic illnesses) is generated and how it can be relieved and reduced, there is hope for your clients.

Each of my clients readies him/herself for 20 hours of consultation on other therapies I’ve encouraged with other professionals, hypnotherapy with me, and a complete understanding of how their chronic illness is generated and what they must do every day in order to improve their situation. Sometimes, with the assistance of their medical doctors, their psychologists and other professionals, as a team we are able to beat the unbeatable. People who suffer from chronic fatigue, tinnitus, multiple chemical sensitivity almost all begin to heal...a large majority to the point of remission. I want you to be able to help these people too.

"....and when you open your eyes the noise will have disappeared...," and it NEVER does. It can’t. Hypnotic suggestion and post hypnotic suggestions, reading a script of beautiful metaphors, simply won’t do anything for those suffering from chronic illnesses especially tinnitus.

The difference between my work and every other hypnotherapist is simple. When I was suffering to the point of suicide, I HAD to get better or I was going to end my life. My tinnitus was as loud as a rock concert. The emergency broadcasting system was going off in my head for 24 hours per day for 30 months. I HAD NO CHOICE but to get better. My discovery, which took 30 months of research (and still continues) and thousands of dollars, was that there was not just one solution to the tinnitus (or any chronic illness) problem. It was more than emotional, more than physical, more than spiritual and more than psychological. A multi-modal approach to healing was the key.

The Chronically Ill Can Begin To Heal

The process is at times frustrating. Time passes slowly. The chronically ill client needs to make a number of commitments. Working with chronic illness including tinnitus is far more complex than quitting smoking. He/she must commit money and time and the willingness to participate in far more than hypnotherapy if he/she is to regain wellness. It can take months or years to get well, as it did for me. Many people, unfortunately will only experience minor improvement...and for a few...none at all. Most, however, will achieve significant case gain, in time.

No one seems to listen to your chronically ill client. "Nothing can be done" is what he/she’s been told. The chronically ill client can’t be helped in 15 minute visits to his/her medical doctor. Even with appropriate medications, which are necessary in working with the vast majority of chronically ill clients, the medical doctor plays only a small but significant role in the healing process. This is one area where the medical community is open to the educated hypnotherapist working with their patients. The medical doctor simply doesn’t have the time necessary to devote to the chronically ill patient, and this is where you come in.

When it becomes common knowledge that you are working with the chronically ill and especially those with tinnitus you will find yourself swamped with requests for help within the year, should you choose to follow in this most rewarding path.

The Initial Interview

When your client arrives at your door, he/she is usually despondent. I always book a 120-150 minute session for the initial interview. This first meeting will cover the following:
1. Client assurance that most people do improve with time and dramatically so.

2. A 90 minute case analysis specially designed for the chronically ill client. (Write my office for information about this special analysis procedure.)

3. The signing of a statement understanding your credentials and non-licensure status.

4. Presentation of the basic plan for therapy which will include medication from a medical doctor, seeing other appropriate professionals in conjunction with you, including an osteopath, a physical therapist, a psychologist, a psychiatrist, a TMJ specialist, an ENT, an audiologist and possibly other professionals.

5. Explanation of the various hypno-therapeutic interventions you will be using including hypnoanalysis, ego state therapy, time line therapy, focusing exercises and numerous other rarely used techniques.

6. Explanation of the fear deconditioning process which will take place to reduce tinnitus distress.

7. Explanation of the processes of auditory habituation where external sound sources in their day to day life will be utilized to help create secondary sound sources for the brain to hear.

8. Explanation of medications like antidepressants and antianxiety medications that actually reduce not only distress but volume and how they can expedite the healing process.

9. Explanation of the questions and medical tests that need to be sought from the medical community to assist in the healing process.

10. Explanation of what tinnitus (or his/her chronic illness) is caused by and how you will be addressing the causes - physical and emotional.

11. Scheduling of weekly (two hour) appointments for the next 7-10 weeks to begin the healing process.

Your First Hypnotherapy Session

Having received medical records from the client assuring that there is no tumor causing the tinnitus (via MRI or CT scan) and that the blood chemistry and glucose levels are in balance, and having eliminated all other possible medical causes (of which there are many), you can then begin your first session of hypnoanalysis. Hypnoanalysis is a powerful therapeutic modality that allows the hypnotherapist to find emotional and physical causes of various symptoms. Hypnoanalysis is a lengthy and powerful process that takes weeks with the chronically ill. During this time the client will begin to experience less distress as the hypnoanalysis desensitizes the individual to his/her malady. With luck, there will be an emotional predisposition to the individual’s tinnitus, and hypnoanalysis will eventually uncover this background. The "aha" experience or that of "insight" can often make dramatic emotional improvement in the client’s symptoms and emotional outlook which is necessary to preface physical symptom improvement.

Later Sessions

In later sessions over the coming months you will utilize other forms of hypnotherapy, continuing to pay attention to the results of the medications and other treatments that are underway. You normally will be acting as a coordinator for them. In the first few months the norm is to watch your client change from a deeply depressed or distressed state of mind to one of hope and optimism. In the ensuing months the client will begin, in most cases to experience symptomatic relief. There is no time frame that is predictable for any one case. If a client suffers from significant hearing loss, he/she will heal at a different rate than one with perfect hearing. The variables are many.

Hypnotherapist as Cheerleader

It’s true that during the healing process your client will experience setbacks and difficult days when he/she loses hope. You become the most important person in his/her life at times like this. You become cheerleader, biggest fan and supporter. You keep him/her going.

Then One Day.... will get the greatest phone call you will ever receive...this week..."I can’t make it today, I have to...." I love this phone call. The person is feeling better. He/she is beginning to heal and doesn’t have time to see you, the instrument of his/her healing. This phone call is what I look forward to with every client. It is always my goal to eventually say good-bye and hear the words of thanks and relief from my clients. It may have taken six months or two years but it is wonderful.

If every practicing hypnotherapist in America were to have a full schedule of 100 clients per year we couldn’t even begin to assist the most difficult cases or those who are suffering the most. Please, think about helping those only you, with just a little education and experience, can help to heal. What would the quality of your life be if you could start changing lives, one by one? How would you feel about yourself if you could see the faces of your clients as they cry with tears of joy because of the work and dedication you have given to them? I think you already know. I know I do.

Kevin Hogan suffered from tinnitus for 30 months. He sees approximately 100 clients per year with tinnitus, hyperacusis, chronic fatigue, multiple chemical sensitivity and other chronic illnesses. He has become a resource for thousands of sufferers across the world in assisting them to find help.

Looking For More Articles on Tinnitus Treatment? Visit Kevin Hogan Website.

Body Language Expert, Motivational Speaker, Influence, Persuasion, Sales Training

Friday, April 18, 2008

Phone Therapy For Depression (Part 2)

The patients and therapists never met face to face, only over the phone, said Ludman. Patients weren't always easy to reach by phone, and the therapists worked hard to reach them all. Therapists followed a structured protocol for psychotherapy. They encouraged the patients to identify and counter their negative thoughts (cognitive behavioral therapy), pursue activities they had enjoyed in the past (behavioral activation), and develop a plan to care for themselves.

"The patients participated more fully in psychotherapy and completed more sessions than do most depressed people in the community," said Ludman. Nationally, only about half of insured patients receiving depression treatment make any psychotherapy visit, and less than a third make four or more visits. By contrast, in this study, three in four patients completed at least six phone therapy sessions. This is striking, she added, because the study did not include people who were already in counseling or planning to be.

"Giving psychotherapy to people with depression who were not seeking therapy may help them significantly," said Ludman. Depression symptoms, including feeling discouraged and avoiding other people, can prevent people from seeking help. One in four depressed people who make appointments for in-person therapy are no-shows. "They slip through the cracks," she added.

Few of the patients who received phone-based therapy--even fewer than those who did not receive it--sought in-person therapy. "This suggests the phone-based therapy met their needs, without whetting their appetite for more," said Ludman. Phone-based therapy is more convenient and acceptable to patients than in-person psychotherapy, she said.

Next, Ludman said, the researchers plan to explore the combination treatment's cost-effectiveness and impact on work and home life. They also want to compare the effectiveness of phone-based treatment with that of in-person visits.

The National Institute of Mental Health funded the study. The other authors are Greg E. Simon, MD, MPH, and Michael Von Korff, ScD, senior investigators at Group Health Center for Health Studies; and Steve Tutty, MA, now a doctoral student in clinical psychology at Brigham Young University in Provo, Utah.

More Articles Coming Soon!

Wednesday, April 16, 2008

Phone Therapy for Depression? (part 1)

The great thing about studies is you find out what works and what doesn't, and often the results surprise you. And sometimes they demand that professionals and the astute make changes in the way they do business and in their life.

Therapy by phone is something I found remarkably effective when I worked with people who suffered with severe tinnitus. This study isn't about tinnitus though, it's about deprsesion.

Know what was discovered?

When people receive brief telephone-based psychotherapy soon after starting on antidepressant medication, strong positive effects may continue 18 months after their first session. So concludes a Group Health study in the April Journal of Consulting and Clinical Psychology.

This paper describes one more year of follow-up since a 2004 Journal of the American Medical Association (JAMA) report on the same random sample of Group Health patients.

"With close to 400 patients, this is the largest study yet of psychotherapy delivered over the telephone," said Evette J. Ludman, PhD, senior research associate, Group Health Center for Health Studies, the paper's lead author. "It's also the first to study the effectiveness of combining phone-based therapy with antidepressant drug treatment as provided in everyday medical practice."

Long-term positive effects of initially adding phone-based therapy included improvements in patients' symptoms of depression and satisfaction with their care, said Ludman. At 18 months, 77 percent of those who got phone-based therapy (but only 63 percent of those receiving regular care) reported their depression was "much" or "very much" improved. Those who received phone-based therapy were slightly better at taking their antidepressant medication as recommended, but that did not account for most of their improvement. And effects were stronger for patients with moderate to severe depression than for those with mild depression.

"We were surprised at how well the positive effects were maintained over time," said Ludman. "As with weight control, maintaining improvement is the hardest part of treating depression."

As is usual in clinical practice, the patients' primary care doctors diagnosed their depression and prescribed their antidepressants. Half of the patients also received eight sessions of telephone psychotherapy during the first six months, then two to four "booster" sessions in the second six months as well as medication follow-up and support from masters-level therapists.

Was it important to meet face to face?

To Be Continued... Check back soon!

Tuesday, April 15, 2008

Tinnitus: Looking Back and Looking Forward

I remember the day I woke up and the tinnitus was gone. It was Christmas time in 1995. After 30 months of living in hell it was silent that morning. The maddening noise would be completely gone for 8 months before recurring in August of 1996. Since then, it would come back perhaps a few times per month for a couple of hours at a time. (Usually at bedtime after a long and stressful day.)

By 1996, my life had taken a massive turn away from selling and into a life of seeing clients with tinnitus and helping them in my role of psychotherapist/hypnotherapist. It was indeed something I never intended to do, but when I “went silent” everyone wanted the answer for their situation. In response to the thousands of phone calls, e-mails, faxes and letters, I started writing articles and posting information about tinnitus relief on my website at Tinnitus FAQ. This article is the first update I’ve made to that information in over three years.

The purpose of this article is to share with you conclusions about tinnitus therapy and treatment based upon my experience with hundreds of clients and thousands of consultations and correspondences over the past six years. It’s not my intention to answer every question about tinnitus nor to give you a new scientific theory. This article tells you what I know is helping people turn the volume down. I’m also going to share with you some speculation as to future research and where more answers may be.

Where does tinnitus originate?

There is still a lot of question as to “where” tinnitus exists in the human body. The initial thought that many people have is that it is in the ear somewhere. There is no doubt in my mind that in some people, this is true. Perhaps otoacoustic emissions from the ear send noisy signals to the brain and that is tinnitus. Perhaps. The truth is, that in some cases that is indeed possible. There is one thing we can be certain about. In all cases tinnitus is experienced in the brain and interpreted by the brain. In other words, like physical pain, tinnitus is interpreted and to some extent generated in the brain. My experience of doing years of psychotherapy and hypnotherapy with people who suffer from tinnitus is that it can and often does go away with the right program, the right treatment plan.

Imagine that there are hundreds of highways in your brain (there are billions, but if you can imagine a map of your country with all of the interstate highways visible, that’s enough to understand this useful metaphor). These highways, when interconnected, form memory and allow you to think and create. There are probably no other thought centers in the body. There are probably no other creative thinking and centers in the body. The neural circuitry, the highways are where it’s all at.

Think of someone you love. Think about them in great detail. What they look like, sound like, maybe how they feel. Just do this for a moment before continuing.

Your “conscious self” just took an off ramp of reading this article to an image or sound or feeling or all three to someone you love. The “driver of your car,” the “you” of whoever you are went from reading this article to someone you love. It literally lit up an entirely different set of circuits and neural pathways in your brain.

Some of these highways have tinnitus “on them.”

Some of these highways do not have tinnitus “on them.”

Those two statements are certain. They are not hypotheses nor are they theories. Those statements are facts.

It’s also interesting to note that there is some evidence that some cases of tinnitus are caused by an instability of the structure of the cells in some parts of the brain.

Using different kinds of hypnosis I can report to you the results of years of experience with hundreds and hundreds of clients. (I am also drawing on case studies by my colleagues like Ron Stubbs, Dianne Olson and others.)

  1. In regression hypnosis, when clients are directed to times in their life when tinnitus wasn’t present, almost all clients do not hear their tinnitus while in trance.* This can be for periods of time up to two hours during our session work. During these two hours, most clients are not hearing their tinnitus at all. Their “selves” are driving themselves along highways that do not have tinnitus “on them.” This is consistently true. At least 70% and maybe as many as 90% report this experience.

    *Trance refers to a focused state of attention where the client is only attentive to what they are directed to be attentive of. There is nothing mysterious about trance. If you cry at the end of It’s a Wonderful Life with Jimmy Stewart and Donna Reed, you were in trance because you dissociated from the real world and bought into the world of the Bailey’s and the evil Mr. Potter.
  2. In regression hypnosis, when clients are regressed to describe incidents of serious events where tinnitus volume is loud and distressing they almost always experienced increased tinnitus and distress. Upon relating these incidents many times in trance, the anxiety and helplessness of the client reduces and often the client experiences little or no anxiety to loud tinnitus while in trance.
  3. When clients are “brought out of trance” and are attentive to everything else in the world, their tinnitus tends to be louder (although this is not always true) for an hour or two then remits significantly, often to levels that are substantially quieter than when the client walked in the office.
  4. Long term results show significant gains in almost all cases. Now, this is a sticky point here. Clients who faithfully do their homework and practice all of the different focusing and self hypnosis exercises we assign do substantially better than those who fly into town for three days, leave and do nothing at home. Personal responsibility is critical.
  5. Meditation for people with moderate to severe tinnitus has proven largely ineffective.
  6. Hypnosis that relies on relaxation and calming techniques has almost no value when contrasted to guided imagery. But…
  7. Imagery is a distant second place when contrasted to the long term results of the hypnotic interventions of #1 and #2 above.
The Goal of Tinnitus Therapy

We have yet to have a documented case where a client improved dramatically after one session of hypnotherapy or psychotherapy. Generally speaking 15 hours of therapy or more is necessary. This should be obvious as it takes a long time to get those big 8 lane highways in the brain to atrophy into dirt roads that are rarely traveled. That is the goal of therapy by the way. The objective and focus of the therapist is always to a) desensitize the client to the sound of tinnitus and b) to teach the client how to focus on other experiences in life (past, present or future) that do not have “tinnitus on the highway.”

The good news is that most cases of tinnitus, regardless of cause improve with time, with therapy and lots of successfully completed homework.

The bad news is that there aren’t a lot of therapists out there that understand how to work with people who suffer from tinnitus.

More Good News: Approaches that Work

Clients continue to respond favorably to medications like Zoloft, Effexor, and Paxil. (antidepressants)

They also tend to respond as well or better to Xanax and Ativan. (anti-anxiety medications)

Clients have also reported positive results with Neurontin and Klonopin. (anti-convulsants)

In fact, the number of medications that help tinnitus sufferers reduce volume and suffering is so great that it is a shame that the FDA (to my knowledge) still hasn’t approved medications for tinnitus sufferers.

A medication that reduces the fear response will help extinguish the fear response to tinnitus and thus the amount of attention paid to tinnitus. (Thereby shrinking the 8 lane highway into 6 or 4 or fewer “lanes.”) Long-term use of anti-anxiety medication is probably warranted for most severe cases and the resulting fewer suicides and long term positive change will likely supercede the minor side effects and remote possibilities of addiction to said medications.

Those medications that reduce depression, obsession and compulsive behaviors will also continue to help those suffering with tinnitus. The SSRI’s tend to be most effective in my experience but other medications certainly can help as well.

The Osteopath

Many people call and come complaining that their tinnitus is exacerbated by pressure on their forehead, different head positions and teeth clenching. When I hear this I immediately refer the person to an Osteopath.

For some reason, osteopathic treatment (intracranial sacral therapy) still seems to be effective in helping the majority of my clients that report these exacerbating elements. I can’t explain all of the reasons why, though I do have hypotheses. The human body generally responds well touch and feelings of connectedness. Perhaps there is some of this mind/body response in the client’s experience. Perhaps the human body can become so stressed and distressed that it changes brain chemistry. Perhaps the sphenomandibular ligament that connects the area of the ear drum to the jaw is causing some kind of pressure in the ear, like plucking a guitar string.

One client named John was planning to come to Minnesota to work with me a couple of years ago. I sent him to a local D.O. (doctor of osteopathy) and he never needed to fly here because regular treatments by his D.O. were all he needed for elimination of tinnitus. (I’ve had similar situations with clients I did telephone consultations with that I suggested other treatments like Prozac, Zoloft and Xanax.)

Auditory Habituation

Tinnitus Retraining Therapy is a fancy phrase for auditory habituation. I’ve talked with many people who have improved by using sound generators. I’ve spoken with many others that couldn’t stand to have the little noise makers in their ears. What I have found nearly universal in acceptance by clients is listening to classical music, environmental sounds and new age music that both soothes and creates a secondary sound source for attention. Auditory habituation is a “must” in terms of tinnitus recovery and remission.

I strongly suggest all of my clients play music in the background all day long or at least keep a television on. Anything that provides about 50 decibels of sound will do the trick. For the people with severe hyperacusis, they will need to start at 40 decibels and work their way up over time to fifty decibels.

These Usually Don’t Help

As time has gone by, I have seen fewer cases of people improving from any kind of tinnitus sound with Ginkgo. For some time I thought ginkgo might be a significant part of the therapeutic regime for most clients. Today, I suggest clients talk to their medical doctor about ginkgo but I can’t recommend it evangelically as I did 5 years ago.

I’ve also seen very few cases of people improving with homeopathic remedies and acupuncture. None of the bogus drops and mail order “medications” showed any improvement that I could find.

Changes in diet rarely seemed to help anyone in my experience. The same is true for clients who have taken herbal potions and remedies.

The Future

In the long term, “they” almost certainly won’t find a single cure for tinnitus because tinnitus has so many etiologies (causes). Tinnitus is experienced in so many different ways that it seems like aggressive multimodal treatment programs will continue to be in the best interest of the “average tinnitus sufferer.” What these clients will find is that tinnitus can be greatly reduced in most cases through desensitization and alternative attention therapies.

For years I have advocated a multi-modal approach to tinnitus therapy and that has proven to be right on the mark. For the average client suffering with severe tinnitus, I recommend the following in order of importance.

  1. Talk to your doctor immediately about starting a fairly long term treatment plan with low doses of anti-anxiety medications like Xanax, Klonopin or Ativan.
  2. Talk with the same doctor about starting a fairly long term treatment plan with moderate daily use of SSRI medications.
  3. Listen to music or the television all day as background noise. Avoid silence and extremely loud places. If you can’t do this, see an audiologist and buy a pair of sound generators that are comfortable for you to wear.
  4. Begin hypnotherapy with someone who has a great deal of experience with tinnitus.
  5. Begin psychotherapy with someone who has a great deal of experience with tinnitus.
  6. Begin using self hypnosis tapes for alternative attention and focusing practice. Use the tapes every day. (We can help you with this: See our catalog.
  7. See an osteopath for 5 sessions. Usually after 5 sessions you know if this is one of the keys for you. Hint: Those clients with the best success are those whose tinnitus is much louder when they are lying down on the floor or in bed.
  8. Avoid support groups and other people who want to talk about their tinnitus all day long. Once you have an action plan, avoid others (unless you are a therapist or doctor!) who want to focus on their tinnitus. Tinnitus in some respects, is an “attention disorder.”
  9. Start living a life that is rich and filled with the things you love to do, today! If that tinnitus were a wake up call to happiness, today would be the day to answer the call.

Monday, April 14, 2008

Tinnitus, Pain and Visual Delusions: Repairing Perception Problems

You hear it (tinnitus), feel it (pain), see it (visual delusions). But you probably don't have to have these experiences.

12 years ago I woke up with tinnitus. 70-80 dB of h*ll. Talking with a dozen doctors and reading tons of medical literature boiled down to one thing: You are stuck with it. Get used to it.

Not possible. There was NO way I could live with the jet engine 24/7. In addition to medications and a whole slew of lifestyle changes, I started studying the brain. I got caught up by buying every textbook I could find on neurology, psychobiology and neurobiology.

I'll tell you one thing: We know 100 times more about the brain today than we did 12 years ago, but...the doctors still tell people there is nothing that can be done.

They tell that to people who taste metal, see delusions, have schizophrenia (paranoia w/delusions), feel chronic pain and have the nightmare of them all: tinnitus. And they are wrong.

It became clear that the brain has a "plasticity" to it. No, you can't reshape it like a piece of clay or silly putty, but the analogy was useful as I fought through the daily listening to the emergency broadcasting system.

The fact that the brain has this sort of "ability to change" at the cellular level was useful in constructing ideas to get rid of the tinnitus. Lots of the ideas failed. Some helped. Eventually, it worked.

The research that is now out confirms that most people's tinnitus is generated and "heard" in the brain, not the ear. Chronic pain doesn't need to be chronic, because the cells that store the chronic pain can be changed, and so on. None of this is easy or even simple. It takes a pretty complex set of changes to get the brain to not pay attention to tinnitus and then to simply not remember it. It takes time.

I've helped a lot of people accomplish this. Thousands who suffer with tinnitus. Fewer with chronic pain (like fibromyalgia). None of the standard methods of psychotherapy, hypnotherapy or any therapies worked. But by making changes to what actually changes what cells record, turned out to work.

Phantom limb pain experiences were the clincher for my persistence. Just the concept that someone could have a hand that burned or hurt or both...and the hand had been blown off or shot off 20 years before...that told me that it was possible to reverse-engineer the sensation, the perception and change it.

Today, this piece of research was released and it helps to explain in logical fashion what I discovered 10 years ago...but only could guess as to why....

Scientists have made the first recordings of the human brain's awareness of its own body, using the illusion of a strategically-placed rubber hand to trick the brain. Their findings shed light on disorders of self-perception such as schizophrenia, stroke and phantom limb syndrome, where sufferers may no longer recognize their own limbs or may experience pain from missing ones.

In the study published today in Science Express online, University College London's (UCL) Dr Henrik Ehrsson, working with Oxford University psychologists, manipulated volunteers' perceptions of their own body via three different senses - vision, touch and proprioception (position sense).

They found that one area of the brain, the premotor cortex, integrates information from these different senses to recognize the body. However, because vision tends to dominate, if information from the senses is inconsistent, the brain "believes" the visual information over the proprioceptive. Thus, someone immersed in an illusion would feel, for example, that a fake limb was part of their own body.

In the study, each volunteer hid their right hand beneath a table while a rubber hand was placed in front of them at an angle suggesting the fake hand was part of their body. Both the rubber hand and hidden hand were simultaneously stroked with a paintbrush while the volunteer's brain was scanned using functional magnetic resonance imaging.

On average, it took volunteers 11 seconds to start experiencing that the rubber hand was their own. The stronger this feeling, the greater the activity recorded in the premotor cortex.

After the experiment, volunteers were asked to point towards their right hand. Most reached in the wrong direction, pointing towards the rubber hand instead of the real hidden one, providing further evidence of the brain's re-adjustment.

Dr. Henrik Ehrsson says: "The feeling that our bodies belong to ourselves is a fundamental part of human consciousness, yet there are surprisingly few studies of awareness of one's own body."

"Distinguishing oneself from the environment is a critical, everyday problem that has to be solved by the central nervous system of all animals. If the distinction fails, the animal might try to feed on itself and will not be able to plan actions that involve both body parts and external objects, such as a monkey reaching for a banana.

This study shows that the brain distinguishes the self from the non-self by comparing information from the different senses. In a way you could argue that the bodily self is an illusion being constructed in the brain."

Disorders such as schizophrenia and stroke often involve impaired self-perception where, for example, a woman might try to throw her left leg out of bed every morning because she believes the leg belongs to someone else. Misidentification or unawareness of a limb arising from damage to the premotor cortex from a stroke is not uncommon.

Phantom limb syndrome is a disorder which can arise after amputation. Remedies that trick the brain into believing the limb has been replaced, for example by using a mirror to reflect the opposite healthy limb onto the amputated limb, exploit the brain's mechanism of self-perception.

Learn More About Tinnitus Reduction (Ear-ringing) Click here!

Sunday, April 13, 2008

Tinnitus Treatment: A New Understanding Brings Hope For Tinnitus Relief and Your "Cure"

by Kevin Hogan

(This article is excerpted from the book, Tinnitus: Turning the Volume Down (Revised & Expanded)

Tinnitus, "the noise," is running through your brain on hundreds of highways called neural pathways. These neural pathways are roads between brain cells. The "intersections" in the brain’s highways are called synapses.

These intersections don’t actually touch each other. The open space between the cell arms is called the synapse. The highways are made up of axons and dendrites (which you really don’t need to know all that much about). One cell (neuron) sends information to another cell by sending an impulse from one cell to the next via a neuro-transmitter, much like a cellular telephone call. The phones aren’t connected by wires. We’ll talk a little more about these neurons and neurotransmitters in a moment.

It is also useful for you to understand about how people get depressed, feel stressed or become panicked or experience anxiety, and, how all of this relates to tinnitus.

Research into tinnitus suffering shows that what we call SPADE (an anacronym I coined in 1995 to consist of at least one of the following: stress, panic disorder, anxiety, depression, and/or emotional challenges) tend to predispose people to tinnitus (and of course other somatics as well). SPADE is a significant set of variables in determining who will experience suffering from tinnitus and who will not. SPADE is most likely a significant variable in who experiences tinnitus after exposure to loud noise or other physical stimuli. The emotional part of our brain, it appears, is critical in both the experience, suffering and relief from tinnitus.

There may be a stigma that goes with this line of thinking. If we acknowledge an emotional component to the onset and later suffering of tinnitus, we acknowledge that it is at least tangentially something that could be mistaken as a "mental illness." Because such terms are useless in the healing process, we will not concern ourselves with such labels. You can call anxiety a "brain cold" and "depression" a case of the "mind flu." The name doesn’t matter, getting better does. Our objective will always be the reduction and/or elimination of tinnitus. Period.

Tinnitus suffering is positively correlated to all the elements of SPADE.

For now, consider the insidious relationship between brain chemistry and stress, stress and depression, and all of these emotional states and tinnitus.

In SPADE, "the first factor" seems to be stress.

In 1993, Dr. G. W. Brown wrote that he discovered 84% of a large sample of depressed patients had experienced severe stress in the preceding year compared to 32% of control subjects. Drs. Anisman and Zacharko have suggested that the depletion of certain neurotransmitters (e.g., of dopamine, serotonin, and norepinephrine) that are associated with stress may leave an individual sensitized to subsequent stress and thus less capable of coping with it. They view the inability to cope effectively with stress as a major predisposing factor in depression. (Biopsychology, 1997, Allyn and Bacon Press)

Important studies involving patients with tinnitus reveal that depression precedes a significantly large numbers of tinnitus cases. People not suffering from depression develop tinnitus that produces suffering less regularly.

Therefore for at least a significantly large percentage of the patients suffering from tinnitus, we know that many were predisposed to tinnitus by depression and before that severe stress. Further, we know from various drug studies that anti-anxiety medications (Xanax) and anti-depressants (Pamelor) have been showing to reduce tinnitus volume in a significant number of patients. (76% and 43% respectively compared to 4% for a placebo.)

Anti- convulsants like Klonopin have also been shown to be successful in reducing tinnitus in large numbers of patients. Klonopin is regularly prescribed for individuals who suffer from anxiety, epilepsy and/or related seizures. Anti- anxiety and anti-depressant medications in general seem to help tinnitus sufferers reduce tinnitus volume and distress in significant numbers.

The beneficial effects for tinnitus reduction and distress reduction by these medications offer us our first clues as to the causes and potential elimination of tinnitus.

For many people with tinnitus, negative emotional experiences play a pivotal role in onset, suffering, and later, relief from tinnitus. Severe tinnitus challenges the emotional stability of even the most resilient individual. Tinnitus is far more than a simple hearing disorder. Tinnitus is a complex intermingling of deficient brain chemistry, phantom auditory perception, cell receptor damage, and/or negative emotional experiences (among other variables). Tinnitus sounds may be similar from person to person, but the cause, onset, volume and experience of that tinnitus can be very different. One modality of reducing tinnitus may work for some but it is becoming clear that a multi-modal approach to tinnitus reduction is going to be indicated for most individuals. (Effective therapy normally can include some or all of the follwing: auditory habituation, medication, osteopathic treatment and hypnotherapy.)

Stress, depression, panic disorder, and anxiety are like fertilized soil for a farmer. The farmer planting the crops can be likened to the physical stimulus that causes the tinnitus and makes it persist (grow) when in most people, without the fertile soil, it only lasts a period of time. Once the tinnitus is "planted" in the brain of stressed or depressed individuals, it grows and soon plateaus in volume.

The brain initially becomes aware of this noise and initially does not like the noise. The part of the brain that probably detects the potential negative impact of this noise is the amygdala. It does this by comparing the sound of the noise to other noises the brain has experienced in the past then determines whether action should be taken or not against the sound. (Unfortunately the amygdala cannot help us take action at reducing the noise.)

As the brain becomes accustomed to having the noise around, the noise is accepted as part of the daily experience of life. Tinnitus is often perceived as a threat to survival and the amygdala demands that it be found when the conscious mind notices it is "not there." (Have you noticed that when you awaken from a nap your tinnitus volume increases? For many, this is your brain’s way of trying to keep you alive. The tinnitus is as persistent as breathing and like breathing it will make sure the noise is detected if the brain has the tinnitus correlated to a survival issue in one manner or another.)

The brain does not think that tinnitus is "good." It simply is a survival issue. An intruding sound has been detected and a "sound loop" is created in the neural pathways that keeps the tinnitus perception intact. Long after the physical stimulation for the tinnitus is gone (a loud concert for example), the tinnitus persists. The brain continues to find the noise. This is what is meant when it is said that tinnitus is psychosomatic in nature even though the tinnitus onset was physical. Psychosomatic means that their is a significant emotional cause or relationship with a physical medical problem. In tinnitus, this is often but not always the case. You will soon discover that this relationship works to your advantage when you begin your daily regimen to reduce tinnitus volume and distress. Tinnitus in many people is like a paradoxical memory. With skillful therapeutic intervention, the brain can sometimes "forget" the tinnitus. Sometimes the forgetting is for minutes or hours. Sometimes the forgetting is for days or years. This is good news for the sufferer.

The continuation of noise (persistent tinnitus) is often not "necessary." If there is no evidence of significant sensorineural hearing loss, then the probability of tinnitus remission is significantly increased. The brain can be re-wired and re-programmed to stop playing the endless looping of tinnitus tapes. (Those with sensorineural hearing loss can also experience remission of tinnitus, but in our clinical experience, it is less often.)

More Articles Coming Soon!

Saturday, April 12, 2008

Tinnitus FAQ's

  • What about biofeedback and relaxation techniques?

Biofeedback is a subfield of hypnosis. Who relaxes or can relax when you have severe tinnitus?? I certainly couldn't. Most of my clients can't. Biofeedback is useful in stress reduction and there is evidence that shows that biofeedback, while less effective than hypnosis, is more effective than Elavil in tinnitus reduction. For people with mild to moderate tinnitus, relaxation oriented self hypnosis is very helpful. Most people with severe tinnitus can't come close to relaxing which is why I developed the Tinnitus Reduction Program. (See below for details.)

  • What about acupuncture?

Not proven to help. (Though good for headaches according to recent research.)

  • What about other herbs?

Not proven to help. Save your money.

  • # What about vitamins and minerals?

Magnesium and zinc may help people deficient in these areas. Calcium might help. (It helps a lot of things believe it or not!) There is some reason to believe that B-Vitamins can help us cope with stress better. For most: Highly over rated, very expensive, and very likely won't help.

  • # What about ear drops, and all of the remedies sold on the internet?

You mean the scams? They are ALL scams. Want a list of tinnitus scams? Type in tinnitus at google and look at the right hand column. All but two that I looked at today were a rip off. PLEASE save your money. If they have a remedy, they must have a double blind placebo study. Ask for it. (It doesn't exist.) Don't ask for testimonials. Ask for a double blind placebo study performed by an independent group. Again, there are none. Period.

  • # What about chiropractic?

Maybe...For tinnitus, I would advise you to see a Doctor of Osteopathy (D.O.)

  • # What about psychotherapists?

Same as hypnotherapists. Most are great people that just don't have the laser beam specialized knowledge to help tinnitus sufferers.

  • What about medical doctors?

Most are just not knowledgeable about how to help tinnitus sufferers. I can't tell you how many times I've read a letter from a physician stating that the patient's tinnitus has no medical basis and therefore, there is "nothing more I can do". This is all preposterous. The medical doctor is one signature away from most people being 1/2 as loud in 90 days. There are MANY medications that can help you. Your medical doctor isn't obligated to work with you and you aren't married to your medical doctor. Become a proponent of getting well and seek the help of those who will help you. (Ask your doctor to stop off here for 10 minutes! Good doctors will take the time for you.

If you don't like your therapist or doctor, dump them. You need someone who will help you long term. Tinnitus isn't a sore throat or an ear ache. It's work. If they help you, keep them. Your M.D. should be knowledgable, willing to learn FROM YOU... what you are learning and that you are willing to perform some trial and error. Treating tinnitus isn't just science. There's quite a bit of artistry in the long term process. It isn't just hypnosis or Xanax or TRT. It's a long term relationship in a lot of most cases.

  • # Jack Vernon of the ATA told you agree?

Jack Vernon is the person who talked with me 13 years ago. Jack and I have spoken only that one time. Jack is very knowledgable about tinnitus. His approach is somewhat different in some respects. In others, we are very similar. If you have talked with Jack, follow his recommendations... Great human being.
  • I've been thinking about suicide.

If a person has severe tinnitus and is suicidal, they should see a psychiatrist or medical doctor, get treated both therapeutically and pharmacologically, then call me after the above criteria have been met. This is my most common client. I've been where you are. It stinks. Remember: You will improve if you do those things that lead to improvement.

  • How did you come to know so much about tinnitus when the rest of the world seems lost?

I had severe tinnitus for 2.5 years, finally figured how to get better with the unwavering assistance of Chris Coleman, Director of Hope for Hearing in California and others...Today I have no tinnitus. (I only do therapeutic consultation work with people who have tinnitus, and those consultations are coming to an end.)

My LONG TERM experience from beginning to elimination or substantial reduction with tinnitus sufferers is second to only a very few: I work with some of the most severe cases of tinnitus sufferers in the United States.

  • Why write the book?

It's not possible to answer 20-30 e-mails and letters per day any more. Now someone can go to and for next to nothing get the basic answers I would give. Please, read the book first, then e-mail. Your questions will be much more fine tuned after reading the book. (You're going to waste $10,000 on scam approaches if you haven't already, please, spend $20 or go to the library for heaven's sake.)
  • Do you hate getting all the e-mails?

No, I hate not being able to help and answer everyone personally. I spend 1-2 hours daily corresponding with whoever I can get to in the email box. It is not possible to do more, so forgive brevity if I can respond to you. People aren’t "bothering me." I do get down because I am not a non-profit organization with a staff of people to answer all the inquiries. Sometimes it makes literally me cry when I have to choose between my kids and my e-mail. I will always help but you need to be patient. Please do read the book and begin your self therapy as soon as possible.

  • How can I get a copy of your book Tinnitus: Turning the Volume Down?

You can go to Tinnitus: Turning the Volume Down (Revised & Expanded)

If you'd like to read an excerpt from the book, click HERE

Thursday, April 10, 2008

Tinnitus Treatment and Therapy FAQ

· What do people experience when they take anti-depressants and anti- anxiety medication?

Some people experience a locational change in their tinnitus. (That's the first very good sign I look for, by the way.) Some people experience a temporary increase in volume, which we would expect, and now I simply let the MD’s I work with know that this is actually likely and also almost certain to be temporary (a few days). Anti-anxiety's most common side effect seems to be drowsiness in my clients. Antidepressants most common side effect seems to be sexual reduction of pleasure which happens to about 4 in 10 of my clients.

What is most important is how it changes the brain in the long term. Antidepressants will reduce the amount of obsessing and compulsive checking to see if tinnitus is louder, quieter, different...or just to listen. I suggest measuring your tinnitus five times daily. Other than that, put attention externally. If you do this you are on the right road. Anti-depressants are likely to be a CRUCIAL piece of getting well. Get past the first 1-5 days of increased noise and you win.

Be stubbornly patient.

· Tinnitus is causing me disability. I can't function. Will you help me get compensation for medical purposes?

No. You want to get back to work or to some other work as quickly as possible. (A few days at most.) The people who get well from tinnitus are the people who are most grossly absorbed in major projects that require "spinning a lot of plates." This is part of the lifestyle changes we talked about earlier...

· What about ginkgo biloba?

My rule of thumb is this: If you have tinnitus that varies in volume during the day or is pulsatile, you may want to try ginkgo for a few months. Like the medications, it will take time to "kick in." Two, three months even before results begin. You should know there is no actual evidence to support ginkgo as a therapeutic tool for tinnitus. I am favorable to the use of it because of my personal experience and a few anecdotal reorts from clients. It's expensive. If money is an issue there are better places to invest in your tinnitus reduction. If money is no issue, I would (and did) see what happens over a few months.

Looking For More Articles By Kevin Hogan? Check Out Kevin's Website

Wednesday, April 09, 2008

Tinnitus Treatment and Therapy FAQ

What about anti-depressants?

I think after Mark Sullivan, I was the first person to wave the anti depressant flag. Of course! In my opinion, an excellent choice for moderate to severe tinnitus suffering, if there are no contraindications. Some people say to start with Pamelor, but I would disagree and go with the SSRI’s like Zoloft, Paxil, Effexor, Celexa or Lexapro. Please read that last sentence again. I've had a lot of email from people who didn't get it right the first time.

Some of my clients have experienced tinnitus elimination with Prozac. But, prozac may have a small tinnitus side effect that is larger than placebo, granted not significant, but I’m conservative. I’d start with Zoloft or Lexapro, but I’m not an MD. MD's have no problem prescribing anti-depressants because they are not "tracked" thus you will have no problem here.

Pamelor has a proven track record. (I no longer encourage using it because of significant side effects.) The vast majority of my clients who have used tricyclics do get benefits from the tricyclics and even more from the SSRI’s... and of course you don't use them at the same time.
BUT Pamelor also has more impressive side effects than SSRI's and say, Effexor which is very helpful and has few side effects.

Antidepressants probably don't cause tinnitus to go down by themselves. It appears two things happen with these medications. First the "anti-OCD" effect of the medication seems to cause people to "quit checking" their tinnitus. Secondly, the medications do succeed in reducing depression which can be profound...and allow the person to return to normal life as quickly as possible.

NOTE: For most people that are going to improve, tinnitus will INCREASE when you take an antidepressant for the first few days or maybe even week or two. It comes back down. (You can try and keep the volume up by attending to it and avoiding the other things necessary to cause reduction!) This means the medication is doing it's job in the brain. Don't become upset when the volume increases. Assume it will. The medication is "plowing snow from the highways" in your brain. It takes time to clear paths so they are neat and clean. Give it a few days. I remember these few days myself...they drove me nuts and weren't easy...and they were worth every second.

More FAQ's Coming Soon!

Tuesday, April 08, 2008

Tinnitus Treatment And Therapy FAQ

· Does Xanax cause tinnitus?

Xanax does not cause tinnitus. It has a negative tinnitus effect. In clinical trials for panic disorder, for example, 7% of people who take Xanax report they had tinnitus vs. 11% taking a placebo. Effectively this means that the brain is just as able to create a nocebo as it is a placebo effect. Xanax in low doses is a safe and effective starting point for your tinnitus reduction program.

Anyone who tells you Xanax causes tinnitus, benefits from you continuing to have tinnitus.

· I read in a new book that Xanax (benzodiazapenes) reduce brain plasticity and reduce the effectiveness of habituation (TRT).

Garbage. Xanax (alprazolam) will cost you a grand total of $100 for the first year, if you require it for that length of time. Even if you use the medication for two years before your tinnitus is remitted or much quieter, that's under $200!!! Generators will run you about $3000. Generators sound like many people's tinnitus and actually can cause more harm than good.

Xanax/Klonopin/Ativan helps most people get dramatic reduction in volume and sometimes remission, without further treatment. Not profitable for "providers"...and it will give you your life and sanity back. People who haven't had tinnitus cannot comprehend this. I've read authors who think they know what they are talking about...and haven't a clue.

Whenever you see someone try and scare you that an inexpensive, virtual side effect free, and proven method for reducing and/or eliminating tinnitus and the distress it causes is terrible...ask what their motivation is for causing the fear first...THEN figure out what's in it for them if they succeed in scaring you.

Reality: Anti anxiety medications (including Klonopin, Ativan, Xanax, etc.) help most people. They don't interfere with any successful therapy. Period.

· Jack Vernon says only Xanax XR helps in reducing tinnitus, that alprazolam is not effective. What is your opinion?

My opinion is I find it hard to believe Jack told you that. What you probably read/heard was that Xanax XR is a more efficient option. (it's time released so you only take it once daily, can reduce headaches, etc.) Alprazolam vs. Xanax XR overall, very little difference if any will be seen as long as the alprazolam is taken consistently every 8 hours. Now, if a doc has you on alprazolam just once or twice per day, you bet. You'll get headaches and tinnitus fluctuations.

Blog Updated Daily! Stop by again soon for more FAQ's!

Or If You're Looking To Read More Article on Tinnitus Click Here!

Monday, April 07, 2008

Tinnitus Treatment and Therapy FAQ

· What do you think of neuromonics?

I don't know. It seems to have identical results that I've experienced with using iPods and mp3 players. It just seems spendy to me. Why not use the iPod/mp3 player for the same period and see if that does the trick. (It probably will.) You can always utilize more expensive therapies later. I like to stick with what I know works.

· Should I have the ______ surgery for my tinnitus?

Before doing anything that can give you permanent the things that work. Except for tumor removal, I have never seen a client that needed surgery, experimental or otherwise, for tinnitus alone. It simply is a risk that is not likely necessary.

I wouldn't let anyone with a knife or needle near my head to "treat" tinnitus. Other things you bet. You have to dig all the way to the superior auditory cortex to get to the tinnitus for most people....

· What do you think of Xanax? Will I become addicted? Will it get rid of my tinnitus? Does Xanax cause tinnitus?

Did you know that your doctor can't prescribe Xanax to treat tinnitus? No can do. It's for treating anxiety which can be easily caused by tinnitus. Make sure you get that straight. Don't ask your doctor for a medication she can't prescribe for the wrong problem...Xanax is for anxiety.

For me, it was a miracle drug. It saved my life. (Me and thousands of others.) Took several months to "kick in" for me personally. Five or six. For most people I've worked with it takes about 1-3 months, and that makes sense. If a person has severe tinnitus or hyperacusis and there are no contraindications, it's the most logical starting point. One study shows about 3/4 of people using Xanax experience almost a halving in the noise volume at the end of the third month of usage. That's faster, on average, than any other option you have right now. It mirrors my experience with clients....I've read of addiction, devastation and destruction. I've yet to see it in thousands of clients. If you have profound tinnitus, Xanax (and medications like it) will probably save you from something far worse than the remote possibility of addiction.

Xanax doesn't appear to directly cause tinnitus to reduce in volume. What appears to happen is Xanax reduces the fear response and causes the body to be calm (or even tired). That calm "state" or "response" is ocnditioned to the tinnitus and eventually there is no need for the brain to attend to the sound. It becomes background and more often than not, the volume comes down as a secondary and not a primary effect.

Don't ask your doctor for Xanax for your tinnitus. She can't do that. Xanax is for anxiety reduction. Read that sentence again. Then your doctor can prescribe safely (for her, not you). Don't ask your doctor to do something that could get them in trouble. Xanax is for anxiety reduction.

Could you become addicted? I wish it would have been a consideration for the brother of one of my clients. Both had severe tinnitus. Their doctor wouldn't prescribe Xanax, the noise became so horrifying the man committed suicide. The woman (my client) went to bat for herself and worked with another doctor and me. Today she is almost completely silent. The risk of addiction is almost zero, the danger of suicide for many is ever present. And as noted earlier, Xanax without a support system, especially friends, family, medical... will help, but be realistic. The human animal needs connections with others and tinnitus takes time...and compassion. Addiction: As soon as my first client in 11 years has experienced it, I will announce it here.

Caveat: Whenever a doctor prescribes a medication to be "taken as needed," then you have the birth of potential addiction. Xanax should be taken regularly and consistently so addiction doesn't stand a chance.

To Read More About Tinnitus Click Here!

Sunday, April 06, 2008

Tinnitus Treatment and Therapy FAQ

· How does someone become a client of yours?

You can try and get a teleconsult with me (or someone I have complete confidence in) to put you on track. Set up a teleconsult (email me, please don't call). Sometimes this 90 minutes is what someone needs to get the information and right approach that will change the rest of their life. I look at where you have been, are and what you can do now, and with who. In some cases I'll do a follow up or two with someone if necessary. Specifics that you can't get in a FAQ. I've trained a protege whose results are essentially equal to my track record. In all likelihood, I will encourage you to speak with her in a teleconsult.

· What do you think of masking therapy?

It's fine....I suggest the "habituation" approach in constrast to "masking". There are days when masking is very attractive but on whole, habituation is probably a better route in my opinion.

· What do you think of vinpocetine for tinnitus reduction?

Possible. Certainly not necessary to go this route prior to the work we will do, but it is an option. There are no studies but I have had some positive anecdotal reports from clients.

· What do you think of the Zoloft study where everyone improved and many had remission from just Zoloft?

12 years ago I began to encourage people to look at Zoloft. In the medical community no one paid attention...not for a DECADE. THEN they started to figure it out... It's a logical choice because of it's anti-obsessional, anti depressive, and slight anti-anxiety effects. When the study showed everyone improved, I had no explanation, as that is very rare indeed. My personal experience with my clients with SSRI's in general and Effexor has been excellent.

· What do you think of habituation for tinnitus and hyperacusis?

Habituation means, that the tinnitus no longer bothers you in any way. Remission, if it's going to happen will happen AFTER habituation.

Habituation is an obvious necessity for EVERY person that has tinnitus. My definition of habituation might be different than others though. People who fail in TRT habituation that come to see me failed because they shockingly didn't like another sound of tinnitus in their ears/head. There are a lot more ways to habituate tinnitus than with a pair of Starkey’s.

Pleasant classical music, environmental sounds and babbling brooks pumped into my head 24 hours a day for two years did me a world of good. That’s where I suggest everyone start, except those who can’t wear headphones for various reasons. And please don't think other kinds of auditory stimulus won't help, they will. My experience simply has been best with what I've noted above.

The vast majority of people won't need more than an iPod to habituate.

Habituation is more difficult but by no means impossible when the person has hyperacusis. Hyperacusis is VERY beatable. Most people recover with little sensitivity later. Interesting, though hyperacusis starts as more difficult to deal with (from my point of view as consultant), it tends to yield first!

Check Back Soon For More FAQs!

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Friday, April 04, 2008

Tinnitus Treatment and Therapy FAQ

  • Can you recommend a doctor/therapist locally here in my country, city, state?

    I used to make recommendations. I sent people to famous clinics with names anyone would recognize. All I got were a bunch of hurt tinnitus sufferers. So no, I won't recommend someone, especially "locally" or "near you."

    Tinnitus is not a sore throat that anyone can help you with. It's the most complex issue a person can suffer from because there is essentially no external data to work with and the distress levels are often maddening.... Just about everyone I referred to therapists and doctors in the 90's wrote back and told me after a couple of months that they were making no progress. Their doctor/therapist wouldn't help or didn't know what to do. Worse: A lot of people blew thousands of dollars for nothing. Now I tell people:

    DO go see your doctor. She CAN help you. ...She may not know what to do because she simply wasn't trained in tinnitus reduction work. If you have severe tinnitus, prepare to travel for a three day session, perhaps with someone I've trained and coached. Locations: Seattle (Ron Stubbs), Jennifer Battaglino in NY, and in Tennessee (Bob Bayliss). That's it at the moment. In England, contact Mair Llewellyn at the Tickhill Clinic. My friend Terry Watts in London has experience as well. So please, don't ask me for a referral, except to these people with a proven track record. Talk to your medical doctor FIRST.

    If you have a tumor or other physically observable cause, you need to get that taken care of FIRST.

    Read this FAQ. See your doctor ask her for help. Take it to your doctor. Ask your doctor to visit this page. I work with a lot of physicians, internists, audiologists, ENT's, even nurse practitioners, and other great people. If they (or anyone) give you the cold shoulder, go to another doctor who will do everything in her power to help you. No one but you is inside of your head.

    Therapists, doctors, one knows what severe tinnitus is like until they have had it. So for the most part, ...sorry to say...they will possibly give you marginal advice....

    Ask them to help you and YOU take control of your therapeutic tasking and future. It's your life and believe me, if they haven't experienced this...they have NO CLUE what it is like to be in YOUR HEAD.

  • I have tinnitus: what should I do?

    1. If you’ve had tinnitus less than two years, you need to see your doctor for an MRI. I have seen cases where a person became deaf due to incorrect medical treatment. I am not a big fan of CT scans (radiation, esp. for younger people, but if you've had tinnitus less than two years and you can't afford an MRI, then a CT scan is an option. An MRI will reveal more about the brain to the astute professional though, so, I’d opt for an MRI. Either test will find a tumor and anyone who has been in this business has seen the results of what can happen when an MRI is not given and the worst case happens.

      Both of my clients who had tumors had more typical tests when their tumors apparently were in their infancy. Call me overly protective of my clients, or promoting unnecessary tests, I won’t see ANYONE who hasn’t ruled out tumor with 100% certainty. 2 in 1000 or however many people I’ve seen in the last few years is two too many. Don’t worry, it will almost certainly come back negative and you will feel great once it’s over!

    2. Then have a blood chemistry performed. Are you diabetic? Are you hypoglycemic? Is there an imbalance we need to be aware of? See if getting this area of your life in balance reduces tinnitus volume. There's always a chance...

      Find out if you are zinc deficient or anemic. Zinc deficiency does happen sometimes among my elderly clients but has never occurred in one of my under-50 clients. I’m not a mineral expert, just find out and if you’re in need of supplement, ask your medical doctor what to do. Beware: There's a lot of supplements on the market that have too much zinc or other metals that can CAUSE tinnitus. Only take zinc if your doctor tells you that you are deficient and need to....

    3. Get an audiological work up and spend some time with your ENT. It makes complete sense to get checked out thoroughly. Find out where your hearing loss is, if you have any. About half of my clients have some minor hearing loss. (I'll be frank: I see no correlation between hearing loss and moderate to severe tinnitus OR hyperacusis. None.) Never assume your tinnitus is being generated in your "hearing system."

      Get all the tests you need. It’s your life and your hearing and your suffering. I wouldn’t pay a lick of attention to anyone who says, "Oh it doesn’t matter, it probably isn’t X". Nonsense, find out what it IS.

    4. Do you work in silence or in a loud environment? Both are going to wreak havoc on tinnitus. Too quiet, you need to add sound until your daily environment is around 50dB plus or minus. Same with your nightly environment. If you’re a farmer or a construction worker or in an occupation where you are exposed to noise all the time, start wearing ear protection now. But NEVER stay in silence for extended periods. Whistle if you have to. The brain must have alternative auditory stimulus if at all possible to help expedite your tinnitus to reduce in volume and distress. If you are deaf, and a lot of my clients are, then you must learn to do external focusing and self hypnosis, regardless of medications.
    FAQ's Are Updated Daily, check back soon!

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    Thursday, April 03, 2008

    Tinnitus Treatment and Therapy FAQ

    For Previous Articles Please Scroll Down...

    · Can hypnosis cure my tinnitus?

    Hypnosis with the tinnitus skilled therapist (5 in the USA?) in conjunction with a well designed management and reduction program just might do that, but hypnotherapy isn't magic. Most people associate hypnosis with "relaxation," or "suggestion."

    Forget it. You're going to relax with 80 db going off in your head?

    If that is proposed or purported, go elsewhere. And certainly don't see someone because "they are local." In the United States, to my knowledge, only Ron Stubbs (WA), Jennifer Battaglino (NY) and Bob Bayliss (TN) are successfully working with people to this point. These guys (and Jennifer) have a proven, rock solid track record. A few others who knew what they were doing became overwhelmed and burnt out. Therapists (doctors, husbands and wives...) aren't trained for tinnitus. (Who is?) Sometimes people who do hypnotherapy for a living think that hypnosis will magically turn down noise, today...Rarely, does it work that way.

    Unfortunately most therapists (of any kind) have no significant experience in helping people with tinnitus short or long term. (One session of suggestion based hypnosis is like taking one Xanax. It will do almost nothing.)

    The Good News: There are studies that have been duplicated several times that note that over 69% of people using (long term) well designed self hypnosis programming experience long term significant reduction in tinnitus volume. I took that research and first stubbornly used it to help myself get well, then made available to the public just such a program. (After 11 years I just expanded this program as well.)

    But why would we only utilize one modality? Whenever possible, think multi-modal. If self hypnosis is of interest to you, yes, I did create The Tinnitus Reduction Program and there is info at the bottom of the FAQ.

    Special Note: You don't need to be a guinea pig to test anyone's treatment method. If you do single track therapy you will come to me in two years telling me how much you regret it. I hear this...every day.

    · Do you recommend a combination of Neurontin and Klonopin for Tinnitus?

    It appears that Neurontin combined with a benzodizapene will help the majority of people with tinnitus. Abraham Shulman conducted a study with good follow up that had decent results. And when it comes to research, I trust everything he publishes. My belief is that some dosage of Neurontin combined with a low dose of Klonopin perhaps (0.25-0.5 mg three times per day) might cause significant improvement in the majority of people who suffer.

    Whether the results will be as good as those of Xanax alone I certainly don't know. I have had clients report positive and negative results. If Xanax didn't have the desired outcome after say, six months, I probably would be very supportive of this regime as a back up plan in the realm of medication for treatment.

    More FAQ's coming soon!

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    Wednesday, April 02, 2008

    Tinnitus Treatment and Therapy FAQ

    · What was the most important part of your healing process?

    Support from my wife was very important. Xanax, Zoloft and Osteopathy. It was perhaps Ginkgo that got rid of one pulsatile sound, self hypnosis eventually took the place of sleeping pills and helped the habituation process...and frankly, was far more successful than I thought possible. If I had to pick one aside from support and *major lifestyle changes,* it would be Xanax... but all were very important. People who "try" only one or two with little more than guesswork to go on rarely get well.

    Lifestyle changes, refers to changes in what your thinking process is as you go through the day. When you begin the process of getting well you literally move to a lifestyle of thinking about things "outside of yourself." Sounds odd, but that is the core factor in getting well. These kinds "lifestyle changes" are overlooked by just about everyone, but without adopting them your chances at improvement are small. Very small.

    It's funny. People always ask about the medications, and rightfully so, but really getting well is about significant changes in how your day is spent, what you do day and's more complex than even a few things. Getting well is like putting a jigsaw puzzle together. It usually works, it just takes time and effort.

    · What is tinnitus and why can't anyone seem to help?

    Tinnitus is any noise or set of sounds heard that is generated in the ear, hearing system, or brain. Most people who experience severe or moderate tinnitus, that we've worked with, experience tinnitus that is generated in the brain even when the original cause was sound or otoxic drugs. If you haven't figured it out yet, everyone from medical doctors to alternative practitioners look in the ear for tinnitus.

    That's a good place to start. most cases, it simply isn't there. It's not being generated from there and it's a waste of time after a few things are ruled out to keep looking in an empty box and hoping to find something.... That's why they "can't do anything." Had they known to look in the right place they would have found it.

    It's in the brain. ENT's have told you for years, "There's nothing I can do, you'll have to learn to live with it." The reasons there is nothing THEY can do is because they currently aren't prepared to deal with problems that occur in the brain... the way, tinnitus is not a big brain "malfunction." More often than not it is a persistent memory (most cases in my experience) much like phantom limb pain.

    All that said, remember that the people I've worked with over the past decade are people who are moderate to severe. Most contemplate suicide and are severely anxious or depressed. I only speak from my personal experience and the thousands of people I've worked with.

    Anyone who treats severe tinnitus as a disorder of the ear when testing shows nothing dramatically wrong with hearing (i.e. total deafness), will indeed fail in helping the person who suffers.

    More FAQ's coming soon!

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