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
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

    • 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



Today s agenda
Today’s Agenda tinnitus doesn’t change!

  • 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 tinnitus doesn’t change!

  • The Changing Thoughts & Feelings Worksheet

    • Stress Management and Relaxation Exercises

      • Deep Breathing

      • Imagery

    • Planning Pleasant Activities



Take a moment to… you started to fill out at the last meeting

  • 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: you started to fill out at the last meetingChanging Thoughts and Feelings Worksheet

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


Remember: you started to fill out at the last meeting

  • 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 you started to fill out at the last meeting

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


Skill review relaxation exercises
Skill Review: Relaxation Exercises you started to fill out at the last meeting

  • 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 you started to fill out at the last meetingRelaxation Exercises


Review of practice at home take a moment to discuss deep breathing page 43
Review of practice at home: you started to fill out at the last meetingTake 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: you started to fill out at the last meetingTake a moment to discussImagery page 43


Planning pleasant activities distraction
Planning Pleasant Activities: you started to fill out at the last meetingDistraction


Discussion 2 on the worksheet1
Discussion: #2 on the Worksheet you started to fill out at the last meeting

  • 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 you started to fill out at the last meeting


Review planning pleasant activities
Review: Planning Pleasant Activities you started to fill out at the last meeting

  • 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: you started to fill out at the last meetingTake a moment to discussTracking Activities page 46


Planning pleasant activities step 1 track your activities
Planning Pleasant Activities you started to fill out at the last meeting Step 1: Track Your Activities


Planning pleasant activities step 2 list of activities
Planning Pleasant Activities you started to fill out at the last meeting Step 2: List of Activities


Things to remember
Things to Remember you started to fill out at the last meeting

  • 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


Changing Thoughts you started to fill out at the last meeting

Paying Attention to Thoughts


Review 2 on the worksheet
Review: #2 on the Worksheet you started to fill out at the last meeting

  • 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 you started to fill out at the last meeting


The cbt cycle
The CBT Cycle you started to fill out at the last meeting

& Thoughts


What does changing thoughts mean
What does “Changing Thoughts” you started to fill out at the last meetingmean?

  • 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” you started to fill out at the last meetinghelp?

  • 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?” you started to fill out at the last meeting

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


Thoughts affect feelings
Thoughts Affect Feelings you started to fill out at the last meeting

  • 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 you started to fill out at the last meeting

  • 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 you started to fill out at the last meeting


What are thought errors
What are “Thought Errors”? you started to fill out at the last meeting

  • “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: you started to fill out at the last meeting#1 – All-or-nothing thinking


Twelve common thought errors 2 over simplifying
Twelve Common Thought Errors you started to fill out at the last meeting #2 – Over-simplifying


Twelve common thought errors 3 focusing on wrong details
Twelve Common Thought Errors you started to fill out at the last meeting #3 – Focusing on wrong details


Twelve common thought errors 4 jumping to conclusions
Twelve Common Thought Errors you started to fill out at the last meeting #4 – Jumping to conclusions


Twelve common thought errors 5 over estimating
Twelve Common Thought Errors you started to fill out at the last meeting #5 – Over-estimating


Twelve common thought errors 6 under estimating
Twelve Common Thought Errors you started to fill out at the last meeting #6 – Under-estimating


Twelve common thought errors 7 assuming the worst
Twelve Common Thought Errors you started to fill out at the last meeting #7 – Assuming the worst


Twelve common thought errors 8 emotional thoughts
Twelve Common Thought Errors you started to fill out at the last meeting #8 – Emotional thoughts


Twelve common thought errors 9 should statements
Twelve Common Thought Errors you started to fill out at the last meeting #9 – “Should” statements


Twelve common thought errors 10 labeling
Twelve Common Thought Errors you started to fill out at the last meeting #10 – Labeling


Twelve common thought errors 11 making things personal
Twelve Common Thought Errors you started to fill out at the last meeting #11 – Making things personal


Twelve common thought errors 12 blaming
Twelve Common Thought Errors you started to fill out at the last meeting #12 – Blaming


Practice at home
Practice at home: you started to fill out at the last meeting

  • 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: you started to fill out at the last meeting

What must you do BEFORE you can change your thoughts?

Describe the concept rather than giving an example


Practice at home - you started to fill out at the last meetingContinue 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 you started to fill out at the last meeting

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: you started to fill out at the last meetingContinue to work on your Sound Plan for your next session with the audiologist


Next session
Next session you started to fill out at the last meeting

  • 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
WAIT you started to fill out at the last meetinguntil the next session to complete the Changing Thoughts section on the Worksheet

WAIT: do not complete yet


Other agenda items
Other agenda items? you started to fill out at the last meeting


Questions
Questions? you started to fill out at the last meeting


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