CBT for Tinnitus tools | Example CBT for Tinnitus Tools - CBT for Tinnitus

CBT 4 Tinnitus

CBT for Tinnitus
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You will learn to use many CBT tools whether you choose to work one to one with me in my clinic in Clitheroe, Lancashire UK or online, or you use the online CBT for Tinnitus E-Programme Part One and Part Two.

CBT (Cognitive Behavioural Therapy) and (Cognitive Behavioral Therapy - USA) in essence, teaches that our actions (behaviour/behavior) come about because of our mindset - how we "think". The content of our thoughts that come from our beliefs lead us to "feel emotions".

Where Do Beliefs Come From?

Beliefs come from "meaning" we attach to any given thing. For example, being distressed because of tinnitus, somewhere inside you there is a sense of "threat" to your wellbeing. Often "threats" are not so much real as they are predicitions. 'Prediciting the future' is an extremely common "Cognitive Distortion" most of us do when we're not comfortable about something. It is but one of a number of Cognitive Distortions (others include All or Nothing Thinking, Catastrophizing, Maximizing the Negative, Minimizing the Positive, Self Blaming, Other Blaming etc etc)

Here is a tool that may help you understand more easily: Meaning in Tinnitus (Psychology Tools)
Meaning in Tinnitus

Can you see which of the 3 completed columns are rational and which are irrational?

Column 1 - (Event) Being awoken in the middle of the night to a loud banging and feeling scared/afraid - rational or irrational? It is an understandable and RATIONAL response

Column 2 - (Event) Hearing a ticking of a clock and feeling upset/bothered/angry - rational or irrational? Most people would consider this an IRRATIONAL response

Column 3 - (Event) Hearing a ticking of a clock and feeling normal/nothing - rational or irrational? Most people would consider this a RATIONAL response

Column 4 - (Event) Have a go at filling in each of the entries about something you experience about your tinnitus. Decide for yourself whether you consider it RATIONAL or IRRATIONAL?

What makes each or any of these RATIONAL or IRRATIONAL?

You have no doubt spotted the answer - it is the MEANING attached to the event

Rational Emotive Behavioural Therapy (REBT)

REBT was the first "Cognitive Behavioural/Behavioral Therapy" devised in the 1950s by Albert Ellis.

Nowadays, "CBT" is more an umbrella term for the cognitive therapies as they have developed, evolved and become numerous, especially in more recent times. There is ACT (Acceptance & Commitment Therapy) and MBCT (Mindfulness Based Cognitive Therapy) being just two of them.

Here is how REBT works:

ABC Theory

A - Activating event - an event that happens
B - Beliefs - the belief you have about the event that happens
C - Consequence - the emotional response to your belief

The Three Musts of Irrational Thinking

  • The beliefs that end up in negative emotions, according to Ellis, are a variation of three common irrational beliefs
  • The three basic "MUSTs" are based on a demand: either a demand of ourselves, of others or of the environment. They are:

  1. "I must do well and win others' approval or else I am no good"
  2. "Others must treat me fairly and kindly and in the way I want them to treat me. If they do not treat me this way, they are not good people and they deserve to be punished"
  3. "I must always get what I want when I want it. Likewise I must never get what I don't want. If I don't get what I want, I am miserable"

If we don't realise "MUST 1", we likely feel anxious, depressed, shameful or guilty
If we are not treated fairly as in "MUST 2", we usually feel angry and may act violently
If we don't get what we want as in "MUST 3", we may feel self-pity and procrastinate

The Second Phase of REBT - Disputing or Challenging the "MUSTs" Irrational Beliefs and Changing Our Behaviour/Behavior

Initially we QUESTION our irrational beliefs, for example:

  1. "Who says if I don't win someone else's approval I'm no good?"
  2. "Where is it written that everyone is kind and treats others fairly?
  3. "Why do I have to be absolutely miserable if I don't get something I want? Why shouldn't I just feel slightly annoyed or irritated instead of miserable?"

Three Major Insights of REBT

According to Ellis:

  1. When individuals understand and accept that the main cause of emotional reactions are their beliefs about an event instead of the event itself. That is, we don’t just get upset from an event. We upset ourselves because of our irrational beliefs
  2. When people acquire irrational beliefs, if they do not deal with them, they “hold” onto the beliefs and it’s what continues to upset them in the present. That is, these individuals still wholeheartedly believe in the “three musts.”
  3. Ellis made it clear that understanding these insights does not make us inherently “better.” That is, understanding these beliefs and having insights into how they effect our emotional responses is not enough to “cure” us. In reality, the best way to get better and stay better through REBT is to continually work on recognizing our irrational beliefs, disputing them, changing our irrational “musts,” and transforming negative emotions into more positive ones. Simply put, the only way to get better is through the hard work of changing our beliefs. It takes time and practice.

Here is an external source explaining the difference between CBT and REBT Difference Between

REBT and Tinnitus

An example:

ABC Theory

A - Activating event - an event that happens: I think: "It's almost bedtime"
B - Beliefs - the belief you have about the event that happens: "I won't be able to get to sleep AGAIN because of this *****!!! tinnitus!"
C - Consequence - the emotional response to your belief: "Angry, upset, frustrated....."

Which of the THREE MUSTs are being used?

  1. "I must do well and win others' approval or else I am no good"
  2. "Others must treat me fairly and kindly and in the way I want them to treat me. If they do not treat me this way, they are not good people and they deserve to be punished"
  3. "I must always get what I want when I want it. Likewise I must never get what I don't want. If I don't get what I want, I am miserable"

The one most obvious here is number 3. However, it could also include number 2: "It's unfair I have tinnitus - no one understands how bad my tinnitus is and that it stops me from sleeping. They ought to try living with this horrible noise!"

Have a practice yourself, especially thinking around the ABC Theory.  



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