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Positive psychology in Tinnitus Management

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Step 1

Watch this video before starting the module

Module ID iCBT for Tinnitus self-help, Module number 6
Title Positive psychology in Tinnitus Management
Author

Dr. Hashir Aazh
(Tinnitus and Hyperacusis Team-lead at the Royal Surrey County Hospital)

Collaborators

Professor Brian C.J. Moore
(Department of Psychology, University of Cambridge)

Dr Fiona Seaman-Thornton
(Clinical Psychologist at the Royal Surrey County Hospital)

Duration 60 pages

Terms and conditions: By accessing this module you consent to (1) adhere to Copyright regulations (i.e., not to reproduce or copy any parts of this programme without written permission from the author), (2) you understand that we do not keep any identifiable information but anonymised data will be used for service improvement and research, (3) the email address you provide will be used for forwarding you the assessment reports, CBT information and worksheets relevant to your iCBT treatment and future communications in order to inform you about research updates, new services, future events, and tinnitus-related news (4) Like most websites we use cookies to deliver a personalised service, (5) For full information about our policies click on the relevant links here: Terms and conditions, Copyright, Privacy policy, Cookies policy, Medical information disclaimer.


Audio version of the module

This is the audio recording of Dr Hashir Aazh reading out loud the text of this module and offering some further explanations. You may listen to this audio recording before, during, or after completing this model. This is a supplementary feature that is aimed to improving your learning experience.

Positive Psychology in Tinnitus Management

The aim of this module is to help you develop acceptance toward the experience of tinnitus. It may be hard to accept tinnitus, as there is nothing nice about it. The idea of this module is to use the power of positive psychology in generating optimism, which is important for improving mental health.

We have learned in the past modules that we can all experience thought distortions which include tendencies to focus more on negative experiences, discount positive experiences, and over-generalise negative thoughts in relation to ourselves, others, and the future. It can be helpful to remind ourselves of our strengths and what we are doing well, to try to find a more realistic, balanced perspective. Research studies have shown that realistic optimism is one of the qualities that makes people resilient. Resilience is a critical factor that can help you in developing acceptance towards tinnitus.

Objectives

By the end of this module, you should be able to:

  • Describe how acceptance can help you in managing your tinnitus
  • List common human character strengths and virtues
  • Identify your own character strengths and discuss how they can help you in acceptance of tinnitus
  • Use your character strengths in generating optimism and resilience

Why doesn’t my tinnitus fade away into the background?

Our brain should habituate to tinnitus or put it into the background with the passage of time. However, tinnitus-related anxiety and annoyance prevent the natural process of habituation. There are several research studies indicating that the processing of emotionally significant stimuli in the brain is enhanced in comparison with the processing of neutral stimuli. This means that when tinnitus induces negative emotions, such as anxiety, fear, annoyance, anger, or guilt, then it is more likely to be perceived and to remain the focus of attention than if it does not evoke negative emotions.

In the next page you will learn about the role of acceptance in reducing the distress caused by tinnitus.

Acceptance and tinnitus

Acceptance in this context means acknowledging the presence of tinnitus without attempting to change or stop it. Obviously, most people who experience tinnitus do not wish to have tinnitus and have a great desire to get rid of it. This is a very natural human reaction to unpleasant feelings or situations.

What hinders the process of habituation to tinnitus?

As there is no definitive “cure” for tinnitus or a known reliable method to reduce it, the desire to avoid or stop tinnitus is considered as an unfeasible goal. Setting out to avoid or reduce tinnitus and failing to do so is likely to lead to development of self-defeating cycles of negative thoughts and feelings and behaviours that hinder the process of habituation. This negative cycle can be broken by acceptance of tinnitus and promoting more flexible ways of managing it (i.e., with the use of the CBT skills you learned in this iCBT programme).

What if I don’t want to accept my tinnitus?

It is only natural to want to get rid of tinnitus. The idea of acceptance to many people means being defeated. It is only reasonable to aspire to do whatever you can to help yourself and get rid of an irritating condition, tinnitus. I have had some patients who took years to realise that the path of acceptance was the way forward.

What if I don’t want to accept my tinnitus?

It is up to you! Would you prefer to spend your time and resources in finding ways of dampening down your tinnitus? Or would you prefer to accept tinnitus and have the opportunity to lead a satisfying life and not let tinnitus stop you from enjoying the things that you have? If the former, then I respect your choice. If the latter, then continue with this module.

What can help me to accept my tinnitus?

It might be surprising to realise that in my view nothing can help you to accept your tinnitus. Unless you can think of something positive about it (I can’t!). If you can think of some positive features attributed to tinnitus, then please use the space below to list them.

In the next page I will explain how acceptance might work with tinnitus.

How might acceptance work with tinnitus management?

I think it may be difficult to accept tinnitus. However, it may be much more achievable if you aim to accept “you”. In the other words, accepting everything that you have including your tinnitus instead of trying to accept tinnitus without acknowledging the wider context.

Is “you” acceptable to you?

In this module, the focus is to explore positive aspects of your life along with the aspects that you are not happy about. This can help to build a full picture of you at this stage in your life so you can decide whether “you” is acceptable to you.

In the next few pages we start exploring positive character strengths and virtues that you have. Then we will move on to other aspects of your life in order to build a full picture of you.

Character strengths and virtues

According to Peterson and Seligman, there are 6 common human strengths and virtues as listed below:

  • Temperance
  • Transcendence
  • Wisdom and knowledge
  • Courage
  • Humanity
  • Justice

In the next few pages we will discuss these one by one.

Temperance

Temperance is defined as voluntary self-control. For example, keeping away from revenge by forgiveness and mercy, preventing being spoiled in self-importance by modesty, being prudent instead of reckless, and diminishing anger and greed by self-control.

Temperance

Do you have any of the following within you? Choose a number between 0 and 10.

Ability to forgive
Prudence (e.g., practicality)
Modesty
Self-control

Temperance

For “Ability to forgive”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Ability to forgive”, you gave yourself 0. Does this truly reflect how you have been throughout your life? e.g., never forgiven anyone? If this is not true and you have the ability to forgive within you then I suggest that you go back to the previous page and re-enter the scores. If you think it is true and you never had the ability to forgive then use the space below to type what can help you to move from 0 to a higher number.

Temperance

For “Prudence”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Prudence”, you gave yourself 0. Does this truly reflect how you have been throughout your life? e.g., being reckless and having no common sense or sense of caution? If this is not true and you have some “Prudence” within you then I suggest going back to the previous page and re-entering the scores. If you think it is true and you never had “Prudence” then use the space below to type what can help you to move from 0 to a higher number.

Temperance

For “Modesty”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Modesty”, you gave yourself 0. Does this truly reflect how you have been throughout your life? e.g., being boastful? If this is not true and you have some “Modesty” within you then I suggest going back to the previous page and re-entering the scores. If you think it is true and you never been modest then use the space below to type what can help you to move from 0 to a higher number.

Temperance

For “Self-control”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Self-control”, you gave yourself 0. Does this truly reflect how you have been throughout your life? e.g., not able to control yourself? If this is not true and you have some “self-control” within you then I suggest going back to the previous page and re-entering the scores. If you think it is true and you never had self-control then use the space below to type what can help you to move from 0 to a higher number.

Temperance

So overall, do you think that you have “temperance”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

This exercise is one of the positive psychology interventions that is designed to increase your happiness through identifying and appreciating your key strengths.

Use the space below to type your 5 most pronounced strengths, and ideas for how you could use them more often over the next week.

Transcendence

Transcendence means “going beyond”. For example going beyond any possible human knowledge. Examples of this virtue are having hope, spirituality, humour, gratitude, and appreciation of beauty and excellence.

Transcendence

Do you have any of the following within you? Choose a number between 0 and 10.

Hope
Spirituality (religiousness, faith, purpose)
Gratitude
Appreciation of beauty and excellence (awe, wonder, elevation)
Humour

Transcendence

For “Hope”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Hope”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Transcendence

For “Spirituality”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Spirituality”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Transcendence

For “Gratitude”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Gratitude”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Transcendence

For “Appreciation”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Appreciation of beauty and excellence”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Transcendence

For “Humour”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Humour”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Transcendence

So overall, do you think you have “Transcendence”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

This exercise is one of the positive psychology interventions that is designed to increase your happiness through identifying and appreciating your human virtues and strengths.

Use the space below to type a letter of gratitude to a person who has been very kind to you, but who you have never properly thanked. If you would like to, you can then print and post the letter or deliver it in person.

What if I don’t do my exercises?

Some people choose to not to do the exercises. This is very understandable as they may be feeling overwhelmed by their tinnitus, lack of sleep and perhaps the distress it causes. They may feel hopeless and not convinced that carrying out the assignments can make any difference. Of course there are many people who choose to complete these exercises and feel that these are crucial to the success of therapy.

Research shows that people who do the CBT assignments improve far more than those who do not.

Would you like to improve the management of your tinnitus and enjoy your life fully despite hearing tinnitus? If your answer is yes, then I need you to complete the exercises given to you in this module.

Wisdom and knowledge

Wisdom means the quality of having life experience, knowledge, and good judgement. The qualities under this category comprise: creativity, curiosity, open mindedness, love of learning, and having perspective.

Wisdom and knowledge

Do you have any of the following within you? Choose a number between 0 and 10.

Creativity (originality, ingenuity)
Curiosity (interest, novelty-seeking, openness to experience)
Open-mindedness (judgment, critical thinking)
Love of learning
Perspective (wisdom)

Wisdom and knowledge

For “Curiosity”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Curiosity”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Wisdom and knowledge

For “Curiosity”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Curiosity”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Wisdom and knowledge

For “Open-mindedness”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “open-mindedness”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Wisdom and knowledge

For “Love of learning”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Love of learning”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Wisdom and knowledge

For “Perspective”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Perspective”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Wisdom and Knowledge

So overall, do you think you have “Wisdom and Knowledge”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

This exercise is one of the positive psychology interventions that is designed to increase your happiness through identifying good things in your life.

Make a note of 3 things that went well each day for a week. Include what you did to bring this good thing about.

Courage

Courage means strength in the face of pain or grief. Courage means the ability to be brave and persistent, and have vitality and authenticity.

Courage

Do you have any of the following within you? Choose a number between 0 and 10.

Authenticity (ability to be authentic, genuine, and truthful)
Bravery (ability to be brave)
Persistence (perseverance, industriousness)
Vitality (zest, enthusiasm, vigour, energy)

Courage

For “Authenticity”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “authenticity”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Courage

For “Bravery”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “bravery”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Courage

For “Persistence”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “persistence”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Courage

For “Vitality”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “vitality”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number?

Courage

So overall, do you think you have “Courage”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

This exercise is one of the positive psychology interventions that is designed to increase your happiness through identifying your strengths.

Use the space below to type about an instance in your life that shows you at your best. Review the story daily over the next week and consider which of your strengths were involved.

Humanity

Humanity is the quality of being humane, able to love, be kind, and socially intelligent.

Humanity

Do you have any of the following within you? Choose a number between 0 and 10.

Love (having the capacity to love something or someone)
Kindness (generosity, nurturance, care, compassion, altruistic love, and niceness)
social intelligence (common sense, emotional intelligence, and personal intelligence)

Humanity

For “Love”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Love”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Humanity

For “Kindness”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Kindness”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Humanity

For “Social intelligence”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Social intelligence”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Humanity

So overall, do you think you have “Humanity”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

Ask somebody that you trust if they could list your most important strengths from their view.

Use the space below to type them. Use one of them in a new and different way every day for a week.

Justice

Justice is fairness in the way people are treated. Social responsibility (citizenship), fairness and leadership are among the aspects of justice.

Justice

Do you have any of the following within you? Choose a number between 0 and 10.

Citizenship (social responsibility, loyalty, teamwork)
Fairness
Leadership

Justice

For “Citizenship”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Citizenship”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Justice

For “Fairness”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Fairness”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Justice

For “Leadership”, you gave yourself XX. Why XX not 0? Use the space below to type the reasons that you didn’t give yourself 0.

For “Leadership”, you gave yourself 0. Does this truly reflect how you have been throughout your life? If this is not true then I suggest going back to the previous page and re-entering the scores. If you think it is true then use the space below to type what can help you to move from 0 to a higher number.

Justice

So overall, do you think you have “Justice”?

If you were going to put a price tag on this quality, what would that be?

Priceless

Exercise

Put these on one side of the scale and tinnitus on the other.

  • Temperance
  • Transcendence
  • Wisdom and knowledge
  • Courage
  • Humanity
  • Justice

  • Tinnitus

Which side is heavier in your view? Tinnitus or all the human virtues and character strength? Choose from the drop down menu below.

Tinnitus bothers you a lot but do you consciously enjoy possessing these priceless strengths and virtues?

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