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You wake up in the middle of the night to loud, horrific, shrill sounds of bells clanging like fire trucks are parked outside.
You get out of bed to see what rudely interrupted your sleep. Nothing is awry in the house; nothing is stirring. You look outside the window, but the night is dark and still. The sounds, however, persist.
I covered my ears, but it made no difference. It was so loud. I wanted to run out of the house.
Sheryl C. (alias) is a real-life example of the above scenario. For her, the noises turned into music later in the night. She heard songs from her childhood; Christmas carols, musicals, and patriotic songs. They came in fragments and switched at random, sometimes at mid-bar, as if broken records were turning on and off. The songs went on for months.
It is common to have a song stuck in your head. Especially if you’re a musician like Sheryl C. Yet, as described by neurologist Oliver Sacks in his book Musicophilia, the songs permeating her head were much more than that.
For one, the longevity of the songs. They are constant and intrusive and only pause when she is mentally engaged but immediately resume when she is not. Second, the music has a startling quality of actual perception. Almost like it comes from an external source like a speaker or tv but not your mind. The illusion of perception baffled Sheryl considering she’d suffered progressive deafness for 15 years.
Dr. Oliver Sacks takes an interest in Sheryl’s case, and with his guidance, discoveries are made. Initial exams reveal there is nothing psychologically wrong with her. Quite the contrary, her brain scans show heavy activation in the same brain regions as someone who is actually listening to music. What she hears is real. Real to her. Dr. Sacks concludes what she experiences is not imaginary, not psychotic, but “real and physiological.” She suffers from Musical Hallucinations (MH).
What causes you to hear things that aren’t there? So much so that even with deafness, your brain processes sounds like they exist?
The answer seems to be in the question. Deafness deprives the brain of external auditory stimulation. If you ask Dr. Oliver Sacks, this leads to the brain creating its own activity. In Sheryl’s case, her mind took her past musical experiences and turned them into musical hallucinations.
This concept may not be foreign if you’ve ever tried a sensory deprivation tank. Studies show that isolation tanks can cause people to feel psychosis-like experiences, including hallucinations, due to sensory deprivation.2
About Musical Hallucinations
As you may know, the absence of light is darkness. In that same way, the absence of external sound can create musical hallucinations.
Research has found that musical hallucinations most commonly occur in people who experience hearing loss. About 10% of hard-of-hearing patients claim to have experienced MH. Other causes include brain injuries, medicine, and psychotic disorders. Depending on the cause, MH can last from weeks to years, and the elderly are more likely to have this condition.
In some cases, people can experience musical hallucinations at a tolerable level and go about their everyday lives. But most people find MH disabling. They can disrupt daily activities and be bothersome during sleep. These disturbances can lead to anxiety and/or depression.3a
The German composer Robert Schumann from the mid-1800s captures the distress of possible MH. For Schumann, it probably began with tinnitus, as he describes hearing a constant single musical note, which prevented him from talking or thinking. The debilitation eventually led him to lose his job as a conductor. After a few years, the intrusive note transformed into full symphonic pieces that play one after another. The Ghost Variations, WoO 24, is an example of a hallucinate song in which he claims angels dictated the melody. In his case, MH was probably due to psychotic disorders. Studies show he possibly had bipolar disorder and chronic depression.4
Not Tinnitus, Not Earworm
Musical hallucinations differ from tinnitus. Tinnitus is limited to sound perception of a constant ringing or buzzing. MH involves activity in brain regions responsible for music and language processing, resulting in more complex hallucinations such as musical content.
Musical hallucinations should not be confused with earworms or musical imagery either. Unlike them, musical hallucinations deal with the misperception of hearing external sounds that are not there.
MH can mislead people into blaming their surroundings. A mildly deaf patient recalls.
“I came to hate them… it was like some crazy neighbor continually putting on the same record.”
People have sometimes gone as far as calling the police on “noisy” neighbors or moving houses.3b
In most cases, people with MH are infiltrated with the music of their childhood. These songs aren’t pleasant and don’t have much significance or meaning. Sometimes, these hallucinated songs play and switch depending on the person’s mood or state.
Younger Generation
While the elderly are the most commonly affected group, there are a few cases of music hallucinations in younger generations. One example brought up by Dr. Oliver Sacks in Musicophilia is Michael. Michael would hear one song after another, and they would get louder and distorted if he were in a negative mood or tired. Michael’s hallucinations were persistent. At best, he could suppress or, to some extent, replace them by hearing or playing familiar music or by using a white-noise generator. If not replaced, the hallucinations would be excruciating in what his mother calls’ acoustic agony.’ He summarizes his experiences perfectly with the following reaction: “Take it out of my head. Take it away!”
Peter Tchaikovsky, a renowned Russian composer from the Romantic period, probably experienced musical hallucinations at a young age. When he was 6, he left a party and was found agonizing in his room due to music his mind could not escape.5
“Oh, this music, this music! Save me from it! It is here, in here..” pointing at his forehead, “It will not give me any peace.”
Tchaikovsky and Michael share something in common besides musical hallucinations; they are both blessed with musical talent. Michael loves creating music and has perfect pitch. He also has incredible music memory and could play the same piece years later.
Young people who have experienced brain injuries are also vulnerable to musical hallucinations.
Treatment
Musical hallucinations seem to be rare. There hasn’t been enough research conducted to identify the problem and treatment, making identifying the treatment much more difficult. However, there is hope. Musical hallucinations can fade over time, and in some cases, medications can help lessen the severity.
Masking the Tunes
In a newer study, scientist Sukhbinder Kumar and co-scientists from Newcastle University have provided a novel approach to treating MH. Instead of removing the hallucinations, they’ve found ways of masking the tunes. They discovered with one patient that listening to Bach would mask her hallucinations and continued to provide relief for up to a minute and a half after the piece had ended. Research on masking and alternative self-help relief methods can help doctors better understand how they work and how our mind makes sense of the world.6
Are They More Common Than We Think?
As mentioned before, the rarity of musical hallucinations is a problem for research and treatment options. But they may be more common than we think. Only a small minority of people with MH report them, and many are hesitant to come forward due to their concerns about how they might be perceived. It’s important to know that MH is an actual condition; if you are suffering from it, you are not alone. Coming out and expressing your experiences can shed more light on the phenomenon. There is plenty of neurological evidence to support the existence of MH. If you recognize these symptoms, seek professional help.
References:
- Sacks, Oliver. Musicophilia: Tales of Music and the Brain. First Vintage Books, (2007)
- ^ Daniel, Christina, and Oliver J. Mason. “Predicting Psychotic-Like Experiences During Sensory Deprivation.” BioMed Research International, vol. 2015, Hindawi Limited, 2015, pp. 1–10. Crossref, https://doi.org/10.1155/2015/439379
- ^ a b Jan A. F. Coebergh, R. F. Lauw, R. Bots, I. E. C. Sommer, J. D. Blom “Musical hallucinations: review of treatment effects” Frontiers in Psychology, 16 June 2015. https://doi.org/10.3389/fpsyg.2015.00814
- ^ Cari Elizabeth O’Neil and Dr. Stephen D. Lindeman. “The Music of Robert Schumann: Correlation with His Mental and Physical Health” BYU–Journal of Undergraduate Research, 2013. http://jur.byu.edu/?p=6285
– Greenberg, Robert. Great Masters: Robert and Clara Schumann–“Their Lives and Music, Lecture Eight: Madness. The Teaching Company, 2002 - ^ Greenberg, Robert. Great Masters: Tchaikovsky–His Life and Music, Lecture 1: Introduction and Early Life. The Teaching Company, 2000
– Russell, Peter. Delphi Masterworks of Pyotr Ilyich Tchaikovsky (Illustrated). Delphi Classics, Apr 1, 2018 - ^ Kumar S, Sedley W, Barnes GR, Teki S, Friston KJ, Griffiths TD. “A brain basis for musical hallucinations” Cortex, 2014. https://doi.org/10.1016/j.cortex.2013.12.002
