Managing Your Tinnitus: What to Do and How to Do it (Session 1 of 2)

1. Managing Your Tinnitus: What to Do and How to Do it(Session 1 of 2)

2. This workshop was developed by researchers at the VA Rehab, Research & Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR), located at the Portland, Oregon VA Medical Center

3. Introductions • Please share your name and what you hope to get out of today’s workshop

4. Can Tinnitus be Cured? • “Cure” = eliminate or reduce the tinnitus • No cure yet – research underway • It can’t be cured, but you can learn to manage your reactions to it • [Note: “managing tinnitus” really means “managing reactions to tinnitus” – you can’t change the sound of the tinnitus, but you can change how you react to the sound]

5. Goals of Tinnitus Management (All Methods) • Emotional reactions are reduced • Stress is reduced • Little if any attention is given to tinnitus • Tinnitus does not affect any life activities in a major way • Further help is not needed or wanted

6. These goals can be reached even if the sound of your tinnitus doesn’t change!

7. Goal of Today’s Workshop • Develop an action plan for using sound to manage your reactions to tinnitus – a “sound plan”

8. Ground Rules… • Time is limited, so we will focus on learning to use sound to manage reactions to tinnitus • Feel free to ask questions about using sound to manage tinnitus • Questions about other topics will be answered at the end of the meeting

9. Review the Tinnitus and Hearing Survey • If you do not have a completed Survey in front of you, please fill one out now • (Stop here until everyone has completed the Survey)

10. I Completed the Tinnitus and Hearing Survey—What Does it Tell Me? • Tinnitus problems and hearing problems are often confused • Hearing problems are often blamed on tinnitus • The Survey helps you know: • How much of a problem is due to tinnitus • How much is due to hearing problems

11. Section A • Today we will focus on learning how to manage tinnitus (Section A) problems • We will not learn how to manage hearing (Section B) or loudness tolerance (Section C) problems

12. Volunteers? • It is helpful to discuss your own responses on the Tinnitus and Hearing Survey • If you’re comfortable, please share your responses with the group

13. Next You Will Make a “Sound Plan” to Manage Your Reactions to Tinnitus • We will use the Sound Plan Worksheet as a guide to making your “Sound Plan”

14. Take a moment to… • Tear out a copy of the Sound Plan Worksheet from the back of your Workbook

15. How do I fill out #1 on the Sound Plan Worksheet?

16. #1 on the Sound Plan Worksheet • The first step in completing a Sound Plan Worksheet is to write down a bothersome tinnitus situation • We will begin with the Tinnitus Problem Checklist

17. Take a moment to… • Fill out the Tinnitus Problem Checklist (p. 29 in the Workbook) • Make sure each situation you choose is a tinnitus problem and not a hearing problem • (Stop here until everyone has completed the Checklist) Example

18. Group Discussion • Please share your most bothersome tinnitus situation with the group • Be sure that it is a tinnitus problem (Survey Section A) and not a hearing problem (Section B) • (Stop here until everyone has shared their most bothersome tinnitus situation)

19. Take a moment to… • Write the “most bothersome” situation from the Tinnitus Problem Checklist at the top of the Worksheet (#1)

20. How do I fill out #2 on the Worksheet?

21. Three types of sound We’ll begin by learning about three typesofsound to manage tinnitus

22. What is SoothingSound?

23. Soothing Sound • What is it? • Sound that makes you feel better as soon as you hear it • How can it help? • By giving you a sense of relief from tension and stress caused by tinnitus • When can it help? • Any time your tinnitus bothers you

24. Relief Scale (for Soothing Sound) Let’s try it! • While you listen to the sound, choose the amount of relief you feel • Choose either 0, 1, 2, 3, 4, or 5 • Be ready to share your rating with the group

25. Raise your hand if you felt no relief from the stress or tension caused by your tinnitus

26. Raise your hand if you felt slight relief from the stress or tension caused by your tinnitus

27. Raise your hand if you felt mild relief from the stress or tension caused by your tinnitus

28. Raise your hand if you felt moderate relief from the stress or tension caused by your tinnitus

29. Raise your hand if you felt nearly complete relief from the stress or tension caused by your tinnitus

30. Raise your hand if you felt complete relief from the stress or tension caused by your tinnitus

31. Soothing Sound: Things to Remember • The sound you just heard is more soothing to some people, and less soothing to others • Your job is to find sounds that are soothing to you • It might take time and patience to find the sounds that are most soothing and helpful for you

32. Martha • When Martha reads at home, she plays soothing music • The sense of relief she feels from the music makes it easier for her to concentrate • This an example of using soothing sound

33. Tell me in your own words: What is the purpose of Soothing Sound? Explain the concept rather than giving an example HINT:

34. What is Background Sound?

35. Background Sound • What is it? • Any sound that is neutral (not soothing, not interesting, and not annoying) • How can it help? • Reduces contrast to make it easier to ignore your tinnitus (we’ll explain!) • When can it help? • Any time

36. Imagine a Lit Candle in a Dark Room • The candle is the only light in the room • There is sharp contrast between the bright candle and the dark room • The candle naturally attracts a lot of attention

37. Turn on the Lights! • This is the same lit candle, but with the lights on • The contrast between the candle and the room has been reduced • The candle is just as bright as before, but attracts less attention because now there is other light in the room along with the candle

38. Same Candle – Different Backgrounds This same idea works for tinnitus…

39. Imagine “Tinnitus” in a Quiet Room • The tinnitus is the only “sound” • There is sharp contrast between the tinnitus and the quiet room • The tinnitus naturally attracts a lot of attention

40. Turn on the Sound! • Same tinnitus, but in a background of sound • The contrast between the tinnitus and the quiet room has been reduced • The tinnitus is just as loud as before, but attracts less attention because of the background sound

41. Same Tinnitus – Different Backgrounds

42. Tinnitus Contrast Activity Let’s try it! • Spend a few moments listening to your tinnitus in quiet • Then, with the background sound turned on, notice the reduced contrast • Reducing contrast makes it easier to ignore your tinnitus

43. Background Sound:Things to Remember • Tinnitus is less likely to get your attention when you add background sound • You might not notice background sound helping you right away—that doesn’t mean it’s not helping you • Using constant background sound over weeks or months can help you get better at ignoring tinnitus • Never use sound that is irritating or annoying to you to manage your reactions to tinnitus

44. Janet • Janet keeps a tabletop fountain running on her desk • The background sound from the fountain makes it easier for her to ignore her tinnitus • This is an example of using background sound

45. Tell me in your own words: What is the purpose of background sound? Describe the concept rather than giving an example HINT:

46. What is “Interesting Sound”?

47. Interesting Sound • What is it? • Sound that keeps your attention • Sound that involves active listening • How can it help? • Shifts your attention away from your tinnitus • When can it help? • When you do not need to concentrate on something else • When you want to relax or sleep

48. Attention Scale Let’s try it! • While you listen to the sound passage, choose the percent of attention focused on the passage • Choose either 0, 25, 50, 75, or 100% • Be ready to share your rating

49. Raise your hand if 0% of your attention was focused on the passage

50. Raise your hand if 25% of your attention was focused on the passage