Musical Ear Syndrome

As printed in Hearing Health, volume 20:4, Winter 2004

By Neil G. 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.”

“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. A kind of 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.”

“I was afraid I was going nuts when I thought I was hearing things in my head after my cochlear implant 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.”

The Secret Sounds Many Hard of Hearing People Experience

What do these people have in common? They are all hard of hearing (HoH) and they all hear strange phantom voices, ethereal music or other spooky sounds that no one else hears. They are not rare and isolated cases. Thousands of people who are HoH “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 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 which was my main motivation for writing my book, Phantom Voices, Ethereal Music & Other Spooky Sounds.

Two Kinds of Auditory Hallucinations
Most people have never heard of the types of auditory hallucinations that thousands of HoH people experience. These auditory hallucinations have nothing whatsoever to do with mental illness. There are two basic types of auditory hallucinations – psychiatric auditory hallucinations and non-psychiatric auditory hallucinations. People with mental
illnesses often experience the former, while people who are HoH often experience the latter.

Typically, the voices many HoH 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 (which we will simply call “auditory hallucinations”) comprise a wide range of sounds 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.

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, with formed auditory hallucination, 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 three or four months, I have had the most calming and repetitive choruses and wind ensembles usually led by a bass, sax and a baritone singing in a low octave, older Christian hymns and some oldies from the forties such as ‘Near the Cross’, ‘Amazing Grace’ and ‘The Star Spangled Banner.’”

Claudia describes her auditory hallucinations saying, “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.

The Fear Factor
Few people have the courage to admit they are having 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 believes I am wacky because I told them I hear music every waking moment.”

Because of this fear factor, 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 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 (MES). I am hoping that by using a name that has no negative connotations (and one that even sounds like it might be something good to have), that the stigma of hearing non-psychiatric phantom sounds will fade away and people who experience them will soon be able to share their experiences and realize they are normal.

I define MES as auditory hallucinations of a non-psychiatric nature, often musical, but also including voices and other associated sounds commonly experienced by, but not limited to, elderly people who are HoH, have tinnitus and lack adequate sound stimulation. Often the person also is either anxious or depressed.

Musical Ear syndrome affects significant numbers of people with hearing loss, 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 percent of people who are HoH experience these phantom sounds at some point – that’s anywhere from 2.8 to 3.3 million people. When I speak to groups of people with hearing loss, I sometimes ask how many have heard such auditory hallucinations and in those sheltered circumstances, invariably 10 to 30 percent of the people present feel brave enough to put up their hands.

Women more readily seem to report having auditory hallucinations, however, this does not mean that more women than men have MES. In my experience, MES does not seem to favor either gender. It is just that more women than men are willing to speak up and seek help.

Causes of MES
There are a number of possible causes of MES. The primary contender is a lack of adequate auditory stimulation. My theory is that when a person’s world becomes too quiet, the brain manufactures its own sounds. This is why MES is so common among elderly people. They often have significant hearing loss and live in quiet environments and many live alone after the death of a spouse. To compound the problem, people’s hearing loss often causes them to withdraw from social situations further limiting auditory stimulation. Social withdrawal often results in depression or anxiety which can exacerbate phantom sounds.

Medications can be another cause of auditory hallucinations and, in rare cases, brain abnormalities such as tumors, infections, etc., may be to blame. It is important to rule out this possible cause, particularly if you do not fit the common profile of elderly, HoH and living in a quiet environment.

Controlling MES
There are a number of things you can do to bring your auditory hallucinations under control. First, learn as much as you can about MES. 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. One good resource is my new book, Phantom Voices, Ethereal Music & Other Spooky Sounds from which the information in this article was taken.

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, redirect your mind to things you enjoy and you will not notice them as much.

Finally, if you are HoH and have MES, look on the bright side. Auditory hallucinations aren’t all bad. Many people actually find them pleasant. They allow you to experience often beautiful music without hearing aids, assistive devices, players, headphones or other paraphernalia.

Neil Bauman, Ph.D. is a hearing loss coping skills specialist, author and speaker. He was born with a severe hearing loss and thus experiences many of the same strange things as other hard of hearing people. Neil is the author of 10 books and numerous articles related to hearing loss. You can read a number of his articles at www.hearinglosshelp.com. Email him at neil@hearinglosshelp.com.

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