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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
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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
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
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Materials Needed for This Meeting Materials Needed for This Meeting Changing Thoughts & Feelings Worksheet Your Workbook
Changing Thoughts & Feelings Worksheet Your Workbook
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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
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
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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!
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Today’s Agenda Today’s Agenda
1. Review and discuss the Changing Thoughts and Feelings Worksheet
2. Review homework Two relaxation exercises: Deep Breathing
and Imagery Adding pleasant activities
3. New topic: Becoming aware of your thoughts 12 most common negative thoughts Practice at home: identifying thoughts
1. Review and discuss the Changing Thoughts and Feelings Worksheet
2. Review homework Two relaxation exercises: Deep Breathing
and Imagery Adding pleasant activities
3. New topic: Becoming aware of your thoughts 12 most common negative thoughts Practice at home: identifying thoughts
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Review Review
The Changing Thoughts & Feelings Worksheet Stress Management and Relaxation Exercises
Deep Breathing Imagery
Planning Pleasant Activities
The Changing Thoughts & Feelings Worksheet Stress Management and Relaxation Exercises
Deep Breathing Imagery
Planning Pleasant Activities
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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
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
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Find your Worksheet from last week or tear out a copy of the Changing Thoughts and Feelings Worksheet from the back of your Workbook
Find your Worksheet from last week or tear out a copy of the Changing Thoughts and Feelings Worksheet from the back of your Workbook
Take a moment to…Take a moment to…
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Was it difficult to identify a problem for #1? Was it difficult to identify a problem for #1?
Discussion:Changing Thoughts and Feelings WorksheetDiscussion:Changing Thoughts and Feelings Worksheet
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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
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
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Did the Relaxation Exercises help you notice your tinnitus less? (Also review p. 43 – Relief Scale)
Did the Relaxation Exercises help you notice your tinnitus less? (Also review p. 43 – Relief Scale)
Discussion: #2 on the WorksheetDiscussion: #2 on the Worksheet
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Skill Review: Relaxation ExercisesSkill 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
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
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Relief Scale for Relaxation ExercisesRelief Scale for Relaxation Exercises
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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
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Review of practice at home: Take a moment to discussImagery page 43
Review of practice at home: Take a moment to discussImagery page 43
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Planning Pleasant Activities:
Distraction
Planning Pleasant Activities:
Distraction
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Did you plan any new pleasant activities? (Also review pages 46 and 47 – Tracking and Listing activities)
Did you plan any new pleasant activities? (Also review pages 46 and 47 – Tracking and Listing activities)
Discussion: #2 on the WorksheetDiscussion: #2 on the Worksheet
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Skill Review: Planning Pleasant ActivitiesSkill Review: Planning Pleasant Activities
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Review: Planning Pleasant ActivitiesReview: 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
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
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Practice at home: Take a moment to discussTracking Activities page 46
Practice at home: Take a moment to discussTracking Activities page 46
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Planning Pleasant Activities Step 1: Track Your Activities Planning Pleasant Activities Step 1: Track Your Activities
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Planning Pleasant Activities Step 2: List of Activities Planning Pleasant Activities Step 2: List of Activities
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Things to RememberThings 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
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
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Changing ThoughtsPaying Attention to Thoughts
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Skill you have not yet learned to manage your reactions to tinnitus
Skill you have not yet learned to manage your reactions to tinnitus
Review: #2 on the WorksheetReview: #2 on the Worksheet
New skill you will begin to learn
today
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New Skill: Introduction to Changing ThoughtsNew Skill: Introduction to Changing Thoughts
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The CBT Cycle The CBT Cycle
Beliefs
Emotion
Behavior& Thoughts
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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
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
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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)
Changing your thoughts about your tinnitus (A) can help you change the way you feel about it (C)
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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
Any time you feel tension or stress when you think about your tinnitus
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Thoughts Affect FeelingsThoughts 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
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
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Feelings Affect HealthFeelings 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
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
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Feelings Affect HealthFeelings Affect Health
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“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
“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
What are “Thought Errors”?What are “Thought Errors”?
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Twelve Common Thought Errors:#1 – All-or-nothing thinkingTwelve Common Thought Errors:#1 – All-or-nothing thinking
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Twelve Common Thought Errors #2 – Over-simplifyingTwelve Common Thought Errors #2 – Over-simplifying
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Twelve Common Thought Errors #3 – Focusing on wrong detailsTwelve Common Thought Errors #3 – Focusing on wrong details
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Twelve Common Thought Errors #4 – Jumping to conclusionsTwelve Common Thought Errors #4 – Jumping to conclusions
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Twelve Common Thought Errors #5 – Over-estimatingTwelve Common Thought Errors #5 – Over-estimating
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Twelve Common Thought Errors #6 – Under-estimatingTwelve Common Thought Errors #6 – Under-estimating
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Twelve Common Thought Errors #7 – Assuming the worstTwelve Common Thought Errors #7 – Assuming the worst
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Twelve Common Thought Errors #8 – Emotional thoughtsTwelve Common Thought Errors #8 – Emotional thoughts
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Twelve Common Thought Errors #9 – “Should” statementsTwelve Common Thought Errors #9 – “Should” statements
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Twelve Common Thought Errors #10 – LabelingTwelve Common Thought Errors #10 – Labeling
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Twelve Common Thought Errors #11 – Making things personalTwelve Common Thought Errors #11 – Making things personal
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Twelve Common Thought Errors #12 – BlamingTwelve Common Thought Errors #12 – Blaming
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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
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Tell me in your own words:Tell me in your own words:What must you do BEFORE you can
change your thoughts?What must you do BEFORE you can
change your thoughts?
Describe the concept rather than giving an example
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Practice at home - Continue to record your progress for the first two skills: Relaxation Exercises and Planning Pleasant Activities
Practice at home - Continue to record your progress for the first two skills: Relaxation Exercises and Planning Pleasant Activities
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Summary of Today’s Homework Summary of Today’s HomeworkThought 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 sectionRelaxation Relief Scale for Relaxation Exercises:
Deep Breathing and ImageryPlanning Pleasant Activities Step 1: Track Your Activities Step 2: Make a List of Pleasant Activities Step 3: Schedule Pleasant Activities
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 sectionRelaxation Relief Scale for Relaxation Exercises:
Deep Breathing and ImageryPlanning Pleasant Activities Step 1: Track Your Activities Step 2: Make a List of Pleasant Activities Step 3: Schedule Pleasant Activities
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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
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Next sessionNext session
Next session with me you will discuss steps to change your negative thoughts
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WAIT until the next session to complete the Changing Thoughts section on the WorksheetWAIT until the next session to complete the Changing Thoughts section on the Worksheet
WAIT: do not
complete yet
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Other agenda items?Other agenda items?
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Questions?Questions?