Inner Ear and Neck - Tinnitus, Balance Disturbances and Cervicogenic Vertigo (disequilibrium and vertigo)

Treating Tinnitus, Disequilibrium and Vertigo

Tinnitus, an incurable “ringing in the ears”, balance disturbances and cervicogenic vertigo (disequilibrium and vertigo) can trigger a balance disorder creating a persistent emotional reaction. 

Consequently, individuals may experience:

  • sound sensitivity;
  • high anxiety;
  • irritability;
  • guilt;
  • shame;
  • impaired concentration;
  • sleep disturbance;
  • patterns of avoidance and social withdrawal;
  • and isolation often then further exacerbates the intensity of symptoms including those of anxiety and depression.

The brain is capable of learning to ignore some sensory input while putting more focus on others. This means clients can learn how to direct their thoughts and energy away from their chronic symptoms, and towards more pleasurable sensations, to increase a sense of calm and wellbeing. This type of mindfulness practice incorporates thought redirection until the sense of ringing or balance issues fades into the background, and clients can refocus on their day-to-day goals. When anxious or depressing thoughts cause clients to hyper-fixate on their symptoms, it can create an overwhelming sense that these symptoms are all the client is experiencing, and this is where clients often describe feeling out of control. 

Negative beliefs about one’s self; including what they are capable of, the degree to how safe their environment is, or if they are being judged by those around them, can develop when clients feel out of control and are at the mercy of their symptoms. This causes the individual to retreat to what is perceived as the safety of their home and usually enforces more isolation. Commonly, these symptoms can happen alongside anxiety, sleep, and/ or depressive disorders. We teach our clients how to challenge these thoughts, replacing them with healthier, and more adaptive thinking. It takes practice and the therapist will help guide the client both in session and between sessions for homework. This homework is developed collaboratively between the client and therapist and is based on the client’s unique strengths, challenges, life, and therapy goals.


Approaches to Therapy Treating Tinnitus, Disequilibrium and Vertigo

To help clients manage their distress and increase their engagement in meaningful and valuable activities, we use a variety of methods to lessen the impact of physical sensations on the psychological outcomes.

Our team also works closely with other health professionals such as audiologists, physiotherapists, specialized dentists, massage therapists, and chiropractors, to support the client in finding ways to co-exist with and lessen their symptoms and once more regain a sense of control in their lives.

Acceptance and commitment therapy (ACT) is an action-focused therapy approach where clients learn to accept their emotions and feelings rather than deny or avoid them. They also learn to accept their difficulties and needs as well as work on behavioural changes.

Brainspotting therapy™ (BSP) is a therapeutic process that uses specific points in the client’s visual field to access unprocessed trauma in the subcortical brain. BSP uses relevant eye positions, somatic awareness, focused mindfulness, and the therapist’s attunement to process and release the stored traumas which underlie a wide range of emotional and physical problems. It is a brain-body-based treatment that integrates well with other types of therapies. Often brainspotting is used in conjunction with bilateral sound - music or nature sounds that move back and forth between right and left ears, which balances activation of the right and left brain hemispheres and activates the parasympathetic, or calming, part of the nervous system. Brainspotting therapy was developed in 2003 by Dr. David Grand, an EMDR therapist and relational analyst.

Cognitive behavioural therapy (CBT) is a goal-oriented type of therapy that teaches the client how to first recognize and then change unhealthy ways of thinking and behaving. With the use of in-session practice and homework of skills to work on between sessions, this treatment is tailored to fit the client's goals and is a highly evidence-based collaborative psychotherapy.

Compassion focused therapy (CFT) is a type of psychotherapy that encourages individuals to be compassionate toward others as well as themselves. This type of therapy is primarily used for clients that struggle with self-criticism and self-contempt. CFT often includes exercises to practice mindfulness and appreciation. Sessions focus on examining the ways we talk to ourselves, where we might have first developed the particular tone and word choices used, and how we can make changes to how we speak to ourselves to increase self-compassion and appreciation.

It is the nature of the mind to be made up of subpersonalities or parts.  Subpersonalities are aspects of our personality that interact internally, similar to the ways in which people interact. These sub-personalities can consist of wounded parts and painful emotions such as anger and shame. Underlying the parts is a person’s core or true Self. The Self can and should lead the individual's internal system. 

Internal Family Systems (IFS) therapy helps individuals achieve balance and harmony within their internal system and subpersonalities/parts. 

Using IFS, the clinician will support individuals in developing their Self so it can be an effective leader in their internal system. When the Self is in the lead, the parts will provide input to the Self and help to elevate “wounds” so that individuals can find their natural balance. IFS is suitable for individuals, couples, and families, and it can effectively treat a variety of conditions such as depression, anxiety, panic, phobias, trauma, substance use, physical health conditions, and general well-being.

Psychodynamic psychotherapy is the oldest of the modern therapies and focuses on unconscious processes as they are manifested in the client's present behaviour. The goals of psychodynamic therapy are client self-awareness and understanding of the influence of their past on their present behaviour. 

Brief psychodynamic psychotherapy enables the client to examine unresolved conflicts and symptoms that arise from past relationships and manifest themselves in their day to day life as current struggles.  

Several different approaches to brief psychodynamic psychotherapy have evolved from psychoanalytic theory and have been used to treat many different mental health presentations.  

As the name suggests, solution-focused brief therapy (SFBT) is a short-term goal-focused therapeutic approach largely geared towards discussing solutions. There is a brief need for discussion around the problem to examine what it is and explore potential opportunities to address it, but that is not the primary focus of this approach. This approach is rooted in the here and now, with an identified future-oriented goal involving lessening the negative impacts the identified problem has in your life.

The goal of SFBT is to collaboratively identify realistic solutions in as brief of a timeline as possible. SFBT is a versatile approach that can be used in areas such as individual, couples, or family therapy addressing anywhere from high stress life events to normal life stressors.

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