After Stage 1

After Stage 1

One week after enrolling on the course

Each Stage is released to you weekly. 

It takes at least a week for the changes you will be making to take place - from the practical exercises beginning at Stage 1, and then from Stage 3 onwards, also the concepts and different way of thinking involved.

The process in the CBT for Tinnitus E-Programme has evolved through what now amounts to some 30 years in clinical practice, and over those years with some TEN THOUSAND patients:

  • NHS Tinnitus Clinics for the first 17 of those years, and then 

  • Since 2010, with patients all over the world using Zoom video platform - the same one I will be using with you during your Tinnitus E-Programme course 

Use the process as I have set it out in this course and it will work for you too.

You don't need to be burdened by pages and pages of reading materials. In fact, where tinnitus distress is significant, most people couldn't cope with that anyway. It will soon become clear to you why as you progress through the course.

Stage 2 is therefore still straightforward, and is there to help understanding about how making changes is a process, and cannot be rushed. Physiological changes need to take place (throughout your Autonomic Nervous System) and I want to be sure that you feel comfortable about expectations you have for yourself.

Before we bring about a change, we need to pass through a "transition" stage - where we are moving from to where we are going! From how we feel now to how we want to feel. Stage 2 begins to prepare you to move through that transition phase.

As well as the relatively short reading pieces in each of the Stages, I use diagrams for clarification in most of the materials. We all learn differently, some of us can learn from reading text alone, whereas others benefit from seeing drawings and representations in diagram form, as well as video. 

Whenever I find additional materials that aid your learning, this course is updated with those materials.

Two weeks after enrolling

After 2 weeks, the vast majority of people begin to notice changes in how they feel physiologically.

Blood flow is improving throughout the body - including most significantly blood flow to the neocortex (specifically the PFC - pre-frontal cortex).

Stage 3 focuses on the significance we attach to sounds. For example, most human beings feel calm when they hear nature sounds like sea waves. 

It is also in Stage 3 where I start to introduce the cognitive element of the process. Cognitive means 'thinking', 'understanding'. It's about the "meaning" behind our thoughts and beliefs. There are a couple of exercises to try out to test the "meaning" behind what your thoughts and beliefs are about your tinnitus, for example. Examples are there to help you with this. Stage 3 takes "meaning" further, in to self-talk and everyday language we use, and then introduces Part 1 (of two parts - the second is in Stage 4) of taking in to account a 'Costs & Benefits Transaction', introducing PERSPECTIVE: a problem-oriented perspective vs a recovery-oriented perspective.

Here is an out-take from the section, used as an example to link MEANING to the Costs & Benefits Transaction:

Itism of tinnitus

Weekly SITREP

It is very important that you use the process in this programme AT YOUR OWN PACE. Any process must fit the individual. Processes fail when there is an expectation for individuals to fit a process. Were you to be attending appointments at a clinic, you would go through the process at a pace that suits your needs. The weekly SITREP is an email that you send in each and every week. Details about the SITREP, when and how to use it are on the CBT for Tinnitus E-Programme website. Click the button for details:

Weekly SITREP

Your 1-1 using Zoom

1-1 appointments are carried out using Zoom. 

The optimum time for your first 1-1 with me is 4-6 weeks after starting the course. You can use the Booking Form for your preferred day and time of day

I have worked remotely since 2012, so even if meeting up on a screen is new to you, it isn't to me.  

You do need a good internet connection, which most of us have nowadays, and you can use a computer with camera, microphone and audio, a tablet or a smart phone.

Most one-to-ones are around 60-90 minutes (average 1 hour 20 minutes).  We will have been in touch by email and via your logs and Progress Checks so I'll have a good idea about your needs by then, plus you will have completed a Mini-history.

Additional 1-1 appointments

There may be a need for additional 1-1 time to the one appointment you are entitled to as a user of the Tinnitus E-Programme. These appointments cost £120.00 or £340 for 3 appointments. 

Additional 1-1 appointments are requested by people when they find they need a bit of extra help with using the CBT tools such as the Meaning Adjuster and/or Thought Records in the second half of the course, or when they come to use the Core Belief work in Stage 11; or when there are issues IN ADDITION to tinnitus distress, for example, an unresolved sleep problem (most commonly already resolved after the initial few weeks of the course), a vestibular balance problem (help is available for vestibular rehab), or unresolved pre or co-existing anxiety (including GAD, OCD) and/or depression.

CBT for Tinnitus E-Programme 12 - with ONE appointment

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How does the CBT for Tinnitus E-Programme work?

  • Intro
  • After Stage 1
  • Stage 4 onwards
  • Website, Blog and Reviews
  • Research underpinning CBT for Tinnitus

The Amygdala

  • Bottom>Up, Top>Down Brain Action
  • An Example
  • Neuroscience, Trauma & The CBT for Tinnitus E-Programme
  • Are there exceptions for benefiting from using CBT?
  • To conclude
  • IMPACT STATEMENT

Sleep - Optional section (available from Stage 1)

  • Information about sleep
  • Professor Colin Espie
  • Sleep Diary
  • Professor Matthew Walker
  • Professor Matthew Walker - TED Talk Sleep is your Superpower
  • Professor Matthew Walker - This is how you sleep better

Stage 1

  • Before you begin Stage 1
  • Why are your Clinical Measures Important?
  • Please commit to completing your measures
  • Complete and Send in your Mini-history

Stage 1 Practical

  • Stage 1 Practical
  • How to carry out the breathing exercise
  • Breathing Exercise Instructions1
  • Physiological Relaxation & Relaxation Logs

Tinnitus Explained

  • Common Triggers
  • The Brain and Tinnitus
  • Tinnitus & the Autonomic Response
  • How tinnitus is managed
  • Hyperacusis - heightened sensitivity to sound
  • "What is the association between tinnitus and hyperacusis?" by Professor David Baguley
  • Weekly SITREP & Use your 1-1 appointment

Stage 2 and how to pace your progress

Delayed 7 days

  • Progress Check 1
  • Before you begin Stage 2
  • Stage 2 Practical
  • The Autonomic Ladder
  • How Change Works
  • Maslow's Hierarchy & Human Function
  • Weekly SITREP

Stage 3

Delayed 14 days

  • Progress Check 2
  • Stage 3 Practical
  • The Neuroscience Behind Change
  • An Important Understanding for a Successful Outcome
  • The 3 Levels of Hearing
  • The Significance of Sound
  • What Stress Does
  • Meaning in Tinnitus
  • Weekly SITREP

Stage 4

Delayed 21 days

  • Progress Check 3
  • Stage 4 Practical
  • Cognitive Fusion
  • Negative Thoughts
  • The Tension Cycle
  • What are your negative thoughts?

Stage 5

Delayed 28 days

  • Progress Check 4
  • Stage 5 Practical
  • Objective vs Subjective Thinking
  • Setting Your Goals
  • Meaning Adjuster

Stage 6

Delayed 35 days

  • Progress Check 5
  • Stage 6 Practical
  • Cognitive Reframing
  • Mid-term Measures
  • Brain Plasticity - optional reading

Stage 7

Delayed 42 days

  • Stage 7 Practical
  • Taming Tinnitus
  • Continue Practice Reframing
  • Mid-term Progress & Feedback

Stage 8

Delayed 49 days

  • Stage 8 Practical
  • Change the mind to change the brain to change the mind
  • Continue Reframing

Stage 9

Delayed 56 days

  • Progress Check & Repeat Clinical Measures
  • Stage 9 Practical
  • The Beck Thought Record for Reframing
  • Change the Mind to Change the Brain to Change the Mind

Stage 10

Delayed 63 days

  • Stage 10 Practical
  • Reframing Practice
  • Neuroscience Research - Tinnitus
  • Tinnitus and the Power of Prediction | Dr Will Sedley1
  • Measuring your progress

Stage 11

Delayed 70 days

  • Stage 11 Practical
  • Core Beliefs Identification
  • Identify New Core Beliefs
  • Reframing Practice

Stage 12

Delayed 77 days

  • Completing this process
  • Final Progress Check
  • Completing the process