Juha, Finland
Final review post-completion
Tinnitus Functional Index (TFI) reduced from 59.6% (category 4: big problem) to 20.0% (category 2: small problem)
In your own words, please leave your review of the Tinnitus E-Programme - thank you:
"My tinnitus started suddenly, with many loud and fluctuating tinnitus sounds. I also had physical health problems, which complicated the situation. My stress and anxiety levels got up and my nervous system was in a state of nearly constant over-arousal, or when I got tired and exhausted, in a state of paralyzing under-arousal. Instead of habituating I was sensitizing to the tinnitus sounds. Although I am a healthcare professional, I knew hardly anything about tinnitus and even less about effective ways of managing tinnitus distress. Trying to find relief to my predicament, I read books, watched videos, and searched for answers practically everywhere. While I found some helpful information, I felt something was missing.
Then, finally, I noticed this programme. Having read the course introduction, materials, and reviews on the webpage, I was relieved and convinced: this might really work! In her case study video (CBT for Tinnitus E-Programme, A Case Study) Debbie said that the last thing to do with tinnitus is to battle against it. I couldn’t agree more. Fighting with tinnitus, or trying to escape it, which is not possible in the long run, keeps your nervous system in a fight, flight or hypoarousal state. What is needed is a programme like this which helps your nervous system become more balanced and which ultimately rewires your brain’s neural pathways so that tinnitus sounds fade into the background.
With the help of this programme and Debbie’s support, encouragement and, if needed, gentle pushing, I’ve made remarkable progress. Now most of the days tinnitus has only little effect on me, and I again enjoy doing things, for example reading fiction, which were difficult or impossible for me after the tinnitus onset. There are occasionally some more challenging days, but I have now excellent tools, especially the recovery perspective and the relaxation exercises – I still do the breathing, the physiological and the autogenic exercises daily – which help me also handle those days."
Do you recommend others to use the Tinnitus E-Programme and if so, please say why:
"This course treats not only tinnitus distress but also co-occurring anxiety, trauma reactions and depressive symptoms, which is a huge advantage and a unique feature of this programme. This programme is built on an exceptionally comprehensive combination of CBT, neuroscience, and trauma psychotherapy perspective, and it targets and utilizes both the bottom-up (the limbic system, especially the amygdala, and the autonomic nervous system) and the top-down (cognitive, the cerebral cortex) processes and mechanisms. I highly recommend this programme, both as a person with tinnitus and as a clinical psychologist and cognitive psychotherapist – it provides a first-class ticket to an excellent and effective tinnitus habituation journey!"
PLEASE NOTE Regarding Juha's Review: Comment from Debbie Featherstone (Hearing Therapist & Psychotherapist) who provides the CBT4T (CBT for Tinnitus E-Programme):
"All reviews are gratefully received as they help new, potential users of the CBT4T programme to benefit too. Juha's review means a great deal to me professionally, as he is a highly qualified, experienced clinical psychologist, advanced level cognitive psychotherapist, trainer and clinical supervisor. Thank you Juha!"
Juha's Review written at stage 6 (of 12) 12 weeks after enrolment
Tinnitus Functional Index (TFI) 59.6% > 36.4% (category 4: big problem > category 3: moderate problem)
Q: Do you recommend others to use the CBT for Tinnitus E-Programme?
A: "Yes, I would highly recommend this course. If you have tried (or read about) cognitive behavior therapy (CBT) for tinnitus distress before and it didn’t help, don’t be discouraged. This course is exceptionally well planned and organized, and the process is long enough (12 stages, at least 12 weeks, usually more) to make the change possible. The course aims to help not only with tinnitus distress but also with the anxiety, the trauma reactions and the depressive symptoms, which are often part and parcel of the situation. That and the combination of neuroscience, trauma psychotherapy perspective and CBT makes this course unique."
Q: What benefit have you experienced using the relaxation element of the course so far?
A: "Before I started this course, I was worried that relaxation might be difficult for me. Trying deliberately to relax has previously often had an opposite effect: I became more tense. I was quite experienced in the meditation practice, where the intention is not to relax but to notice what is happening and just be with it, but after the tinnitus onset even the meditation was challenging – now there was too much to notice. The relaxation exercises used in this course have been different and more helpful than I expected. Especially I’ve liked the physiological relaxation exercises and the short breathing exercises, but all the exercises have been useful. The relaxation exercises have helped my mind and body to calm down and to restore better balance of the nervous system. The brief relaxation exercises are done several times each day, which helps physiological and psychological effects to cumulate, and it also keeps the change process and recovery perspective actively in your mind."
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: "The neuroscience-based learning has been immensely helpful. It has helped me to understand the mechanisms of tinnitus distress and the ways to promote change at deeper, neurophysiological and neuropsychological, levels. Debbie has chosen valuable information and explained well how it relates to the tinnitus distress. By doing the exercises and the practices, you are forming and strengthening new neural connections and pathways that help you to habituate to tinnitus. Keeping that in mind gives a lot of hope and motivation during the difficult times which are an inevitable part of the change process."
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: "The Costs & Benefits Transaction perspective has been elucidating. You end up choosing and getting stuck in the problem-oriented perspective so easily, as if that perspective itself, not you, is making the choice. Fortunately, it’s possible to strengthen the recovery-oriented perspective and by doing that to activate the underlying neural circuitry, which brings change (different “firing and wiring”) also in the brain. At the beginning of the course, I was recovery-oriented maybe at the level of 4/10, now I’m maybe at the level of 7/10, so there is still work to be done. At the conscious level the change in the perspective comes faster than at the automatic/implicit (unconscious) level."
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: "Yes I did. It was important to discuss with Debbie and get support and guidance from her. The email support has also been a valuable part of the course. Debbie has always answered quickly to my questions when I’ve been uncertain or worried about how to proceed in the course. It’s reassuring to know that Debbie is there, willing and capable of providing help when needed. Debbie’s expertise in the neuroscience-based CBT approach to tinnitus distress is exceptionally comprehensive."
Q: What is your own impression of your progress to date?
A: "I’ve made progress since starting this course in April 2023. There have been ups and downs, the progress is not linear, as Debbie reminds, but I’m feeling and functioning much better than I did before the course. I’ve had some physical health problems which have had a negative effect, but this course has also helped coping with them."