Managing your tinnitus changing your thoughts and feelings session 2 of 3
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Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 2 of 3). Version date: June 5, 2012. This workshop was developed by researchers at: The VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), located at the Portland, Oregon VA Medical Center

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Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 2 of 3)

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Managing your tinnitus changing your thoughts and feelings session 2 of 3

Managing Your Tinnitus: Changing Your Thoughts and Feelings (Session 2 of 3)

Version date: June 5, 2012


Managing your tinnitus changing your thoughts and feelings session 2 of 3

  • This workshop was developed by researchers at:

    • The VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), located at the Portland, Oregon VA Medical Center

    • The VA Connecticut Healthcare System in West Haven, Connecticut


Materials needed for this meeting

Materials Needed for This Meeting

  • Changing Thoughts & Feelings Worksheet

  • Your Workbook


Remember goals of tinnitus management all methods

Remember: Goals of Tinnitus Management (All Methods)

  • Negative emotional reactions are reduced

  • Stress is reduced

  • Little, if any, attention is given to tinnitus

  • Tinnitus does not negatively affect any life activities in a major way

  • Further help for tinnitus management is not needed or wanted


These goals can be reached even if the sound of your tinnitus doesn t change

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


Today s agenda

Today’s Agenda

  • Review and discuss the Changing Thoughts and Feelings Worksheet

  • Review homework

    • Two relaxation exercises: Deep Breathing and Imagery

    • Adding pleasant activities

  • New topic: Becoming aware of your thoughts

    • 12 most common negative thoughts

    • Practice at home: identifying thoughts


Review

Review

  • The Changing Thoughts & Feelings Worksheet

    • Stress Management and Relaxation Exercises

      • Deep Breathing

      • Imagery

    • Planning Pleasant Activities


Managing your tinnitus changing your thoughts and feelings session 2 of 3

  • Look at your Changing Thoughts and Feelings Worksheet that you started to fill out at the last meeting

  • If you don’t have it, get out a clean Worksheet


Managing your tinnitus changing your thoughts and feelings session 2 of 3

Take a moment to…

  • Find your Worksheet from last week or tear out a copy of the Changing Thoughts and Feelings Worksheet from the back of your Workbook


Discussion changing thoughts and feelings worksheet

Discussion:Changing Thoughts and Feelings Worksheet

  • Was it difficult to identify a problem for #1?


Managing your tinnitus changing your thoughts and feelings session 2 of 3

Remember:

  • You can fill out a separate Changing Thoughts and Feeling Worksheet for each problem you marked on the Tinnitus Problem Checklist

  • This is the same way you fill out #1 on the Sound Plan Worksheet with the audiologist

Example


Discussion 2 on the worksheet

Discussion: #2 on the Worksheet

  • Did the Relaxation Exercises help you notice your tinnitus less? (Also review p. 43 – Relief Scale)


Skill review relaxation exercises

Skill Review: Relaxation Exercises

  • Why do they help?

    • Many people say their tinnitus is worse when they are stressed

  • How do they help?

    • By giving you a sense of relief from tension and stress caused by tinnitus

  • When should I use them?

    • Any time you are stressed and your tinnitus bothers you


Relief scale for relaxation exercises

Relief Scale for Relaxation Exercises


Review of practice at home take a moment to discuss deep breathing page 43

Review of practice at home:Take a moment to discuss Deep Breathing page 43


Review of practice at home take a moment to discuss imagery page 43

Review of practice at home: Take a moment to discussImagery page 43


Planning pleasant activities distraction

Planning Pleasant Activities:Distraction


Discussion 2 on the worksheet1

Discussion: #2 on the Worksheet

  • Did you plan any new pleasant activities? (Also review pages 46 and 47 – Tracking and Listing activities)


Skill review planning pleasant activities

Skill Review: Planning Pleasant Activities


Review planning pleasant activities

Review: Planning Pleasant Activities

  • What are pleasant activities?

    • Activities you enjoy

    • Activities you like to do but do not have to do

  • How can they help you manage your tinnitus?

    • Helps you have more positive feelings

    • Distracts you from your tinnitus

    • Helps you feel better overall


Practice at home take a moment to discuss tracking activities page 46

Practice at home: Take a moment to discussTracking Activities page 46


Planning pleasant activities step 1 track your activities

Planning Pleasant Activities Step 1: Track Your Activities


Planning pleasant activities step 2 list of activities

Planning Pleasant Activities Step 2: List of Activities


Things to remember

Things to Remember

  • Tinnitus is less likely to get your attention when you manage your stress and stay busy

  • Use sound when practicing relaxation exercises

  • You might not notice relaxation exercises helping you right away—that doesn’t mean they’re not helping you. Keep practicing!

  • Increasing pleasant activities over weeks or months can help you get better at ignoring tinnitus


Managing your tinnitus changing your thoughts and feelings session 2 of 3

Changing Thoughts

Paying Attention to Thoughts


Review 2 on the worksheet

Review: #2 on the Worksheet

  • Skill you have not yet learned to manage your reactions to tinnitus

New skill you will begin to learn today


New skill introduction to changing thoughts

New Skill: Introduction to Changing Thoughts


The cbt cycle

The CBT Cycle

& Thoughts


What does changing thoughts mean

What does “Changing Thoughts” mean?

  • First you identify thoughts or beliefs (B) you had just before feeling bad (C)

  • Then you work on changing that thought or belief to something more helpful


How can changing thoughts help

How can “Changing Thoughts” help?

  • Changing your thoughts about your tinnitus (A) can help you change the way you feel about it (C)


When can i use changing thoughts

When can I use “Changing Thoughts?”

  • Any time you feel tension or stress when you think about your tinnitus


Thoughts affect feelings

Thoughts Affect Feelings

  • What you think affects how you feel

  • Example: Imagine your dinner guests are late

  • Sometimes the way you feel is caused by the thoughts about the event, not the event itself


Feelings affect health

Feelings Affect Health

  • Your feelings affect your health

  • Stress and negative emotions can lead to health problems

    • During stress, hormones are released

    • Too much of these hormones is bad for health

  • It is important to learn to change your thoughts that cause negative feelings


Feelings affect health1

Feelings Affect Health


What are thought errors

What are “Thought Errors”?

  • “Thought Errors” are negative thoughts

  • They are not helpful or are unhealthy

  • Sometimes people get in the habit of having thoughts that make them feel bad

  • All people make Thought Errors from time to time

  • Thought Errors make people feel sad or upset

    • A different thought might make them feel better

  • You can control your thoughts

  • If you are aware of your Thought Errors, you can catch yourself and correct your thinking

  • BEFORE YOU CAN CHANGE YOUR THOUGHTS YOU NEED TO KNOW WHAT YOU ARE THINKING


Twelve common thought errors 1 all or nothing thinking

Twelve Common Thought Errors:#1 – All-or-nothing thinking


Twelve common thought errors 2 over simplifying

Twelve Common Thought Errors #2 – Over-simplifying


Twelve common thought errors 3 focusing on wrong details

Twelve Common Thought Errors #3 – Focusing on wrong details


Twelve common thought errors 4 jumping to conclusions

Twelve Common Thought Errors #4 – Jumping to conclusions


Twelve common thought errors 5 over estimating

Twelve Common Thought Errors #5 – Over-estimating


Twelve common thought errors 6 under estimating

Twelve Common Thought Errors #6 – Under-estimating


Twelve common thought errors 7 assuming the worst

Twelve Common Thought Errors #7 – Assuming the worst


Twelve common thought errors 8 emotional thoughts

Twelve Common Thought Errors #8 – Emotional thoughts


Twelve common thought errors 9 should statements

Twelve Common Thought Errors #9 – “Should” statements


Twelve common thought errors 10 labeling

Twelve Common Thought Errors #10 – Labeling


Twelve common thought errors 11 making things personal

Twelve Common Thought Errors #11 – Making things personal


Twelve common thought errors 12 blaming

Twelve Common Thought Errors #12 – Blaming


Practice at home

Practice at home:

  • In your Workbook (pages 50-53) write down an example of each of the 12 Thought Errors

    • Use examples related to tinnitus

    • Use other examples if you can’t think of tinnitus examples


Tell me in your own words

Tell me in your own words:

What must you do BEFORE you can change your thoughts?

Describe the concept rather than giving an example


Managing your tinnitus changing your thoughts and feelings session 2 of 3

Practice at home - Continue to record your progress for the first two skills: Relaxation Exercises and Planning Pleasant Activities


Summary of today s homework

Summary of Today’s Homework

Thought Errors

  • Write 12 personal examples of each of the Thought Errors

    Changing Thoughts and Feelings Worksheet

    (back of Workbook)

    • Relaxation Exercises

    • Planning Pleasant Activities

    • Wait to complete the Changing Thoughts section

      Relaxation

  • Relief Scale for Relaxation Exercises:

    Deep Breathing and Imagery

    Planning Pleasant Activities

  • Step 1: Track Your Activities

  • Step 2: Make a List of Pleasant Activities

  • Step 3: Schedule Pleasant Activities


Remember continue to work on your sound plan for your next session with the audiologist

Remember: Continue to work on your Sound Plan for your next session with the audiologist


Next session

Next session

  • Next session with me you will discuss steps to change your negative thoughts


Wait until the next session to complete the changing thoughts section on the worksheet

WAITuntil the next session to complete the Changing Thoughts section on the Worksheet

WAIT: do not complete yet


Other agenda items

Other agenda items?


Questions

Questions?


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