Welcome and be greeted by Bo von Schéele, professor
(with focus on psychophysiological behavioral medicine)
interested scientific, clinical and patient colleagues
NB this website focuses ”not only” on tinnitus, a frequent word representing a not well understood – from the ”permanent rustle of the wind” BUT ALSO to extremely hard to live with (and for some not) more or less ”impossible alarm(s)” – phenomena which may have many integrated biopsychosocial – cultural dysfunctional reasons/backgrounds/.., something I elaborate to some degree at this web site (a field not my professional, but try to learn what is to be find by me and learned out of a multidisciplinary perspective.
My one fight (very hard ”alarm”, which started October 2019 associated with a head trauma accident) is part of (and motivating) this website – written from a personal, clinical and scientific point of departure trying to be as constructive as possible in spite of own hard symptoms, extrapolering and refined from my own multifaceted dissertation 1986. No specialist help (so far, except primary care support) but close to solve it myself first now – will write about my solution at sub page to http://carism.se/2021-221-5 sub pages, especially the picture at the bottom of http://carism.se/2021-22/forenkla-multifaceterade-symptom-som-vagledning-for-multidisciplinara-utredningar-av-komplexa-inklusive-mycket-svara-symptom/
Perhaps also http://carism.se/projekt-carism/a-multidisciplinary-overview-of-the-tinnitus-syndrome-fields/overview-of-some-of-the-tinnitus-syndrome-approaches/
For clinicians/scientists I recommend first a brief look at a multifaceted hypothesis picture, which are updated continuously = first picture at http://carism.se/2021-22/multifaceted-hypothesis-overview/
Moreover: Before continue reading; if you expect on (or expect) well-written layout ”friendly” text – please do not read further!
But if you can accept my problems with writing (also due to accidental head trauma associated ”alarm” permitting me to write at most 10 minutes before increased alarm prevent further work at my computer) pleas read …
The reason I started this web site is that I while suffering from present impossible ”alarm”, I try to work (as much as possible my own and others reason) for finding proper multidisciplinary assessments (for hypothesis diagnoses), interventions and process/outcome measurements while realizing the we need instruments and (multifaceted) tools to intervene as well as at best prevent or shortened suffering from this, not actually (based on evolutionary basics) possible to deal with. The reason = the alarm is not habituated (which evolution has 2programmed”) but permanent dishabituated activating mine/our Reticular Ativation Systems (RAS) and Locus Coeruleus (NE).
That is, activating our orienting response which ”order” us to fight or flight.. which is not possible – you can not run from yourself! I have a lot to say of what we need but do not can get from traditional medicine as well as what we can do ourselves in terms of prototypic tools to be tailored (NB and which can not increase our symptoms if not effective interventions) … I hope you got the message, for me (just past 80) I have the advantage based on my clinical experiences with very complex patients to be my own patient (in spite of main filed is psychophysiological stress medicine) also considering those suffering in similar ways … awakening my clinical mission … may the forces be with us!
Now, for you who still read …
First, most at this website need to be updated – but 2021 | CARISM – Complex Auditory Related Integrated Systems Medicine (NB only the two sub pages!!!) will be updated and perhaps also Mostly fragmentary links on different perspective on the Tinnitus Syndromes | CARISM – Complex Auditory Related Integrated Systems Medicine may be of interests while there you find many links. As there can be around 40-60 (dependent how we count) different causes (which then most are not one but more which also can have synergy interactions increasing the complexity!). A challenge for traditional reductionistic medicine for the future … if possible if not a systems integrating biopsychosocial medicine (see e.g. www.biopsychosocialmedicine.com) paradigm is enabled to be developed!
The, as my virtual mentor (not aware of it, George Kelly, personal construct theory, 1955) did, I will also warn the reader for the below by a number of reasons where
- This is probably not what you expect, if you just focus on evidenced base knowledge (evidence | Search Results | Biopsychosocial Medicine) while most is not empirically investigated using proper methodology coping with complex systems integration
- It is done while being very ill. Suffering from (Tinnitus) Auditory Dysfunctional Syndrome Cluster Alarms very hard to cope and live with. I needed to see if there were any substantial knowledge internationally, while in Sweden this seems to be very limited (clinically useful ones).
- This web site material you can find if just very little while most is still in my documents while I have not got time to insert it.
- As I now (2021-02-27) restart work (stopped when I was attached by this hard temporary permanent alarms October 2018) with two extensive projects, I will not have time to complete the tinnitus syndrome work I have stated at carism.se – therefor I will suggest (psychologists) interested three doctoral dissertation;
- careful examinations program identifying amongst 40-60 different dysfunctions for each tinnitus patient,
- do an overview of existing different kind of treatment – with general and with specific focus related to the above – that is, connect examination to existing relevant treatment approaches (this dissertation), and
- further development of a new kind of psychophysiological treatment systems approach I have created and further develop until I am satisfactory well.
- Much below need updates, e.g. http://carism.se/projekt-carism/urgent-needed-knowledge-and-practice-development-different-kinds-of-tinnitus/ while I have quite much to update, including how it could be done while clinicians is still working out of actual paradigm and gradually change, as I have done, see Paradigm | Biopsychosocial Medicine
- Some pages are locked, requested password can be asked for at firstname.lastname@example.org
- And, very important; When I started this website hard suffering from extreme blastings and high frequent knife cutting oscillating sound – suddenly October 2019 – I thought it was ear function related. This explains the title CARISM Complex Auditory Related Systems Medicine, although Systems Medicine Auditory as main host. BUT, now beginning of 2021, I began understand based on – what I am glad to learn about – a very fast international development within the a even more complex multidisciplinary domain where ear dysfunctions might not even be a part of an individual symptoms, especially those very to extreme hard symptoms. See e.g. http://carism.se/projekt-carism/a-multidisciplinary-overview-of-the-tinnitus-syndrome-fields/overview-of-some-of-the-tinnitus-syndrome-approaches/ ”red marked” in the content list!
- Now 2021 April this website cover very little compared with that is waiting to be inserted. If or when I get time to do it …
- Most important (written 2021-06-23); The frequent use of the not well understood TINNITUS may be contra productive and misleading! If you refers to ”ringing” (tinnitus derives from the Latin word tinnire, meaning to ring) or ”ear murmuring” it may be ok, but very much complex auditory related symptoms can be very different between and within people more or less permanent or variable sometimes easy to see what change or not possible to identify including also its sources, which can be very, very complex and multifaceted!
- Equal important (written 2021-06-23) is ”tinnitus is not curable” is not only wrong it can also result in nocebo effects, preventing cure. Correct is to say ”at present we do not understand the syndrome including how to treat effectively” perhaps also while we do not really have on comprehensive multidisciplinary examination approach to platform our clinical intervention approaches!
Most is from 2019-2020 (some ok still) but perhaps start with 2021?
(Text early 2020 but probably (!) still ok for me)
The purpose with just started ”CARISM – Complex Auditory Related Integrated Systems Medicine” – is to try to find new clinical/methodological ways in a keen clinical field needed to be improved, where (probably?) not very few are suffering very, very much not noticed/understood in health care. We aim to take innovative ideas and see how they can be used in very complex multifaceted, knowledge based and empirical falsified/validated at traditional nomothetic based as well as ideographic levels.
As we have worked with psychophysiological stress medicine to integrate Eastern and Western medicine using psychophysiological parameters a priori predicted at singel case levels we will now expand to a more systems integrating methodology meeting both clinical ideographic and scientific nomothetic demands as well.
Importantly we need to have instruments and tools to bring Eastern and Western competences together using best available knowledge, knowledge based experiences in a best responsible methodology enabling an expanded biopsychosocial toolbox and its validation at clinical levels as well!
Here now ideas will be presented for elaboration of how it can be refined for individual tailoring and its possible outcome measurement approaches at different stage of development. The idea is also (not only!) to enable individual adjustment where the “patient as an educated reasonable competent resource and coworker in own rehab” (a biopsychosocial medicine manual from 1986 further elaborated) can be one of a number of applications.
More is to come …. I hope ..