Ingrid, UK
Interim review written at first repeat stage (Stage 6), 21 weeks after enrolment
Tinnitus Functional Index (TFI) reduced from 67.6% (category 4: big problem) > 22.4% (category 2: small problem)
Q: Do you recommend others to use the CBT for Tinnitus E-Programme?
A: "I would definitely recommend the course to people. I had no idea you needed to embrace relaxation techniques. I had shied away from tinnitus forums as I did not want to engage with others that had it and there was such a range of mixed messages online and with GPs, Audiology, ENT. I was so pleased to find someone who understood the issues that I and many others were having, and the course means that I am tackling tinnitus distress at my own pace."
Q: What benefit have you experienced using the relaxation element of the course so far?
A: "Prior to the course I was not a user of relaxation/meditation and have been really surprised that it has had such an impact on me. I still struggle to do part 1 of the breathing exercise but have really tried just to do the 2 minutes anyway at regular times. I have put a reminder on my phone for mid morning as this is the one I forget with work getting in the way. I have also nodded off to the relaxation half hour sessions which has amazed me. I have also got really good at doing the heavy arms and legs Autogenics programme and really feel the heaviness especially in my arms."
Q: How has the neuroscience-based learning about the amygdala, autonomic ladder and brain plasticity helped you to relate to your experience of tinnitus, anxiety and stress?
A: "I was aware of brain plasticity from previous courses but it has been really helpful to apply this to my experience of tinnitus. Knowing that there is potential for different routes through the brain has helped to believe that tinnitus distress is not hardwired and can be changed by me! The amygdala's role in identifying threats and bringing about fear and anxiety has been really helpful to understand and the need to calm the amygdala down as if it is a physical health wound to our body. The visual colour coded ladder was reassuring as I have not been in the grey zone and understand the importance of the relaxation exercises to move up the ladder."
Q: What have you learned from the costs & benefits transaction work (used from stage 3)? Estimate how much you have already adjusted from having a problem-oriented perspective towards a recovery-oriented perspective (e.g. 2/10 > 7/10 indicates an improvement of 5 so far)
A: "I have tried to work hard in this area of the course with the CBT input as I do not find it easy to do. I feel I was likely to react badly to tinnitus as I am sensitive to external noise, smells and touch of some things so sensory issues and then tinnitus came along and caused tinnitus distress. I have looked back on these areas and made notes to remind myself of cognitive distortions and sections around problems v recovery. I think I was a 1/10 before and currently a 7/10."
Q: You are likely to have had your first 1-1 by now. Did you benefit from your 1-1 and if so, how?
A: "It was good to finally meet with Debbie. It was really helpful to run through some of my concerns such as if I should be wearing hearing aids and to get reassurance that my pace was ok, as it was the pace that I needed to go at. Debbie was very relaxed which made me relaxed - it made me think about my own job and how I can help put vulnerable people that I meet more at ease. It was good to be on the other end for a change and has made me more aware of people's anxiety and how to reduce this during the course of a meeting."
Q: What is your own impression of your progress to date?
A: "I feel the course has a great structure to it which you can go at your own pace. There is no danger of me romping through with some of the material not yet available to me. It is beautifully written, clear and simplifying often complex subjects with options to explore and read further if you so wish. I like the mix of reading, videos and diagrams - something for everyone."