Musical Ear Syndrome
 

The Phantom Voices, Ethereal Music & Other Spooky Sounds Many Hard of Hearing People Secretly Experience

© 2005 by Neil Bauman, Ph.D.

Marilyn woke with a start, her heart pounding. It was the middle of the night. "I thought people were calling to me," she explained. "I became truly frightened when I realized that I was deaf and should not be able to hear voices."

"My wife hears music that is not there," Harry writes. "The first song she heard was Silent Night sung by a very good choir of mostly men. It came in quite loud. A day later it was the Vienna Waltz over and over again so clear it was like being at a musical production."

"I would often lie half awake in the quietness of the early morning and hear a phantom radio," Dick recalls. "A guy would be talking like they did in the 50s. Kind of a monotone voice and all the advertisements like they did back then. It always sounded so real."

"Late at night when I don't have my hearing aids on," Carolyn relates, "I am absolutely sure I hear trucks and bulldozers working right outside our bedroom windows. We are the only ones living on our little country lane. There's no traffic of any kind outside my bedroom windows. My husband swears there are no noises at all."

"Years ago," Sherry remembers, "when my dad would take me flying in his little two-seater wind-knocker airplane, I used to hear strange music. The music sounded like the full Mormon Tabernacle Choir. Since I was quite young, I thought it was angels singing."

Julie's father-in-law mainly hears loud music when alone in his apartment, oftentimes in the middle of the night. Julie explains, "He has taken to knocking on the downstairs landlady's door at 3 A.M. telling her to turn the music down. I have been with him a few times when he heard the music, but I couldn't hear a thing."

"I was afraid I was going nuts when I thought I was hearing things in my head after my CI surgery," Heather remembers. "On the morning after the surgery, I was hearing what sounded like music from a radio. I heard that every day from my surgery until I was hooked up. It almost drove me nuts. Yet, I never said one word to anyone about it because I didn't want them to think I was crazy."

What do these people have in common? They are all hard of hearing, and they all hear strange phantom voices, ethereal music or other spooky sounds that no one else hears. Nor are they alone. Thousands of other hard of hearing people "hear" similar phantom sounds, yet they never tell a soul because they are afraid of the dreaded "H" word. They are terrified someone will discover their "shameful" secret—that they experience auditory hallucinations.

Hallucinations—the very word conjures up visions of phantom voices, padded cells and professionals in white coats talking in hushed tones. This is because almost everyone associates hearing hallucinations with "going crazy" and mental illness such as schizophrenia. It's time to dispel this myth.

What Are Hallucinations?

According to Stedman's Medical Dictionary, hallucinations are "the apparent, often strong, subjective perception of an object or event when no such stimulus or situation is present." Put another way, hallucinations are phantom sensory phenomena in the absence of real external sensory stimuli.

Hallucinations may be visual (seeing), auditory (hearing), olfactory (smelling), gustatory (tasting) or tactile (feeling). Therefore, hallucinations are simply seeing, hearing, smelling, tasting or feeling sights, sounds, odors, tastes, or sensations that no one else around you perceives.

Although hallucinations may occur with any of the five senses, auditory hallucinations are by far the most common kind of hallucination. A person is hearing auditory hallucinations when he or she hear noises, music, sounds or voices that no one else hears because these phantom sounds are generated in the person's brain, not externally.

Two Kinds of Auditory Hallucinations

Most people have never heard of the kind of auditory hallucinations that thousands of hard of hearing people experience. These auditory hallucinations have nothing whatsoever to do with mental illness. You see, there are two basic "kinds" of auditory hallucinations—psychiatric auditory hallucinations and non-psychiatric auditory hallucinations. People with mental illnesses often experience the former, while hard of hearing people often experience the latter.

If you are hearing phantom voices, music or other sounds, how can you tell which kind of hallucinations you are experiencing? Here are two "rules of thumb."

1. People who experience psychiatric auditory hallucinations generally hear voices, as opposed to music or other sounds. People who experience non-psychiatric auditory hallucinations mostly hear music or singing, rather than just plain voices.

2. The voices that people who experience psychiatric auditory hallucinations hear are generally clear and distinct. These voices almost always talk to or about the person, and may engage the person in conversation. Consequently, the content is of a meaningful personal nature. In contrast, when people who experience non-psychiatric auditory hallucinations hear voices, the voices they hear are often vague and indistinct and do not contain information of a meaningful personal nature. These voices neither talk to or about the person, nor engage them in conversation.

Typically, the voices many hard of hearing people hear sound vaguely like a radio broadcast playing in another room. For example, Ruby explained, "I get Red Barber calling the game. I can't distinguish the words—but I'm sure that's who is talking." Catherine described her auditory hallucinations as "what sounded like the voice of a radio announcer on a badly tuned radio station."

Characteristics of Auditory Hallucinations

Non-psychiatric auditory hallucinations (hereinafter referred to simply as "auditory hallucinations") comprise a wide range of sounds, ranging from simple to complex. Simple sounds are single, unmodulated sounds such as the various tinnitus sounds (ringing, roaring, buzzing, hissing, rumbling, etc.) millions of people hear. In fact, tinnitus is the most common kind of auditory hallucination.

In contrast, complex sounds include multiple, modulated sounds such as tunes, singing, music and voices. These are the kinds of sounds that people have traditionally considered auditory hallucinations. Many people have mistakenly called these sounds "musical tinnitus."

Depending on their clarity, phantom sounds may be either "unformed" or "formed." Unformed auditory hallucinations consist of hearing distorted music, sounds, or voices. These sounds are vague, "fuzzy" and indistinct. For example, Jane described her unformed auditory hallucinations as "like the wind blowing, but with a musical quality, as if someone off in the distance was singing without words." Rachel explains, "The words are never distinct—it's like they are several rooms away." Sarah relates, "I sometimes hear phantom "radio broadcasts" that I can't quite make out."

In contrast, formed auditory hallucinations are where speech, music or singing is so clear and recognizable that people hearing it can identify the various voices and musical instruments. For example, James explains, "For the past 3 to 4 months I have had the most calming and repetitive choruses and wind ensembles, usually led by a bass sax and a baritone playing and singing in a low octave, the older Christian hymns and a few oldies from the forties such as, Near the Cross, Amazing Grace, His Eye Is on the Sparrow and The Star Spangled Banner."

Claudia, who has normal hearing, describing her auditory hallucinations, says, "I hear passages of what sound like Strauss waltzes, Russian symphonies, Italian operas—distinctively enough to identify various instruments, male or female choruses, and the occasional soloist."

Many people find their auditory hallucinations begin with clearly-formed complete sentences or songs. Later, the repetition of lengthy passages of music may degenerate into short snatches of repetitive phrases or rhythmic patterns, or even into unformed auditory hallucinations that are more like the common forms of tinnitus. Tyler's father's auditory hallucinations followed this pattern. He explains, "My dad's musical hallucinations started out as recognizable songs (Battle Hymn of the Republic for 2 weeks, then started changing to a variety of other songs, The Music Man, Ride of the Valkyries, etc.) then turned into unrecognizable orchestral or vocal-like sounds."

The Fear Factor

Few people have the courage to admit they are hearing auditory hallucinations for fear of being thought crazy. Cheryl says, "I was afraid I was going nuts. I never said one word to anyone about the strange music I was hearing because I didn't want them to think I was crazy." Sharing with family members often elicits a similar response. Anna declares, "All my family believe I am nuts because I told them I hear music every waking moment."

Because of this fear factor, many people describe their auditory hallucinations in terms such as musical tinnitus to avoid using the word "hallucinations." Obviously, there is a real need for a new name to describe non-psychiatric auditory hallucinations—a name that has no "bad press" associated with it and that does not include the word "hallucinations." Since the vast majority of people who experience auditory hallucinations hear some sort of phantom music, I have named this condition Musical Ear syndrome.

Definition of Musical Ear Syndrome

"Musical Ear Syndrome (MES): Hearing phantom sounds (auditory hallucinations) of a non-psychiatric nature, often musical, but also including voices and other associated sounds, commonly found in, but not limited to, elderly, hard of hearing people with tinnitus who lack adequate sound stimulation."

I am hoping that by using this name, which has no negative connotations (and even sounds like it might be something good to have), that the stigma of hearing non-psychiatric phantom sounds will fade away.

Musical Ear Syndrome Symptoms

Musical Ear syndrome (MES), as its name implies, is comprised of a number of symptoms, which, when taken together, form a syndrome. Typically, but not always, there is a constellation of five symptoms that seem to predispose people to hearing such phantom sounds.

1. Often the person is elderly.

2. Generally, the person is hard of hearing.

3. Often the person lacks adequate auditory stimulation.

4. Almost always the person has tinnitus.

5. Often the person is either anxious, stressed or depressed.

A person does not have to exhibit all five symptoms in order to have Musical Ear syndrome, but many people with MES exhibit three or more of the above symptoms. For as yet unknown reasons, there are people that prove to be exceptions to this rule. Perhaps, in the future, researchers will discover why.

How Common Is Musical Ear Syndrome?

Musical Ear syndrome affects significant numbers of hard of hearing people. However, because few people are willing to admit to hearing these phantom sounds, it is difficult to obtain accurate figures. The best estimates suggest that in excess of 10% of hard of hearing people experience these phantom sounds at one time or another.

When I speak to groups of hard of hearing people, I sometimes ask how many have heard such auditory hallucinations, and since they feel "safe" with me, invariably 10% to 30% of the people present feel brave enough to put up their hands.

Interestingly enough, typically the people reporting hearing such sounds are women. However, this does not mean that more women than men experience Musical Ear syndrome. In my experience, MES does not favor either gender. It is just that more women than men are willing to speak up and seek help.

Musical Ear Syndrome is Not New

Musical Ear syndrome has been around for a long time. Composer Robert Schumann also heard auditory hallucinations toward the end of his life. At night, he heard musical notes and believed that he heard an angelic choir singing to him. He also heard the music of Beethoven and Schubert. He jotted down the music in February, 1854 and called it the Theme (WoO, 1854). He said he was taking dictation from Schubert's ghost.

Causes of Musical Ear Syndrome

There are a number of things that are thought to cause MES. The primary contender is lack of adequate auditory stimulation. The theory is that when your world becomes too quiet, your brain manufactures its own sounds. This is why MES is so common among elderly, hard of hearing people. First, they often have significant hearing losses. Second, they typically live in quiet environments. Third, they generally live alone after the death of a spouse.

In addition, because of their hearing losses, hard of hearing people tend to withdraw from social situations and thus do not have much social interaction. This just further compounds their world of silence. At the same time, hard of hearing people may feel depressed over their hearing losses and anxious about what is happening to them. This just exacerbates their phantom sounds.

Another cause of auditory hallucinations is drugs and medications. Elderly people tend to take more and more medications as they age. Unfortunately, numerous drugs can cause auditory hallucinations.

In rare cases, brain abnormalities (tumors, infections) can cause auditory hallucinations. Have a neurologist check you out-especially if you do not fit the common profile of being elderly, hard of hearing and living in a quiet environment.

Controlling Musical Ear Syndrome

There are a number of things you can do to bring your auditory hallucinations under control. Here are a few of the main ones. First, learn as much as you can about Musical Ear syndrome. This will reduce your fear and anxiety over the phantom sounds you are hearing. Often this is all it takes for them to fade away. My book, Phantom Voices, Ethereal Music & Other Spooky Sounds explains in detail what you need to know about Musical Ear Syndrome and the steps you can take to reduce or eliminate it.

Second, enrich your environment with sounds. This gives your brain real sounds to listen to so it won't feel the need to generate its own phantom noises. Third, eliminate any medications (with your doctor's permission of course) that may be causing your auditory hallucinations. Fourth, don't fixate on your phantom sounds. Instead, concentrate on the loves of your life and you will not notice them as much.

Finally, if you are hard of hearing and have MES, look on the bright side. Hearing auditory hallucinations isn't all bad. Many people actually find them pleasant. Where else can you hear beautiful music without hearing aids, assistive devices, players, headphones or other paraphernalia?

If you desire to know more about Musical Ear Syndrome, get your copy of Phantom Voices, Ethereal Music & Other Spooky Sounds now. In it, Dr. Neil relates the fascinating accounts of hundreds of people who have Musical Ear syndrome. You will discover what causes these auditory hallucinations, and more importantly, what you can do to reduce or eliminate them. An added bonus—you also get a list of the 269 drugs and other substances known to cause such hallucinations.

This basic article, in slightly different format, and titled Musical Ear Syndrome was published in the Winter 2004 edition of Hearing Health magazine, pp 16-19.