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6. Musical Hallucinations

#81: April - May 2010 (Non-Fiction)
bleachededen

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6. Musical Hallucinations

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Chapter 6.
Musical Hallucinations
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oblivion

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Re: 6. Musical Hallucinations

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Please excuse my absence....I just got the book but am up to this chapter which iI find highly unsatisfying.
The examples of musical hallucinations are indeed, to those of us not affected, fascinating and even entertaining. The trials and tribulations of experimenting with various therapies and the drugs (complete with dose) that are mentioned are, obviously, pertinent.
However, from the point of view of a non-neurologist, I am less interested in which treatments may work or how they affect people in general than in the recurring mention of the type of music that is being heard.
It would be worth an investigation to figure out why Christmas carols (or patriotic songs, which are often based on simple religious tunes from other cultures) seem to be the "hallucination of choice". Granted, some patients hear excerpts from Beethoven or Bach but the majority mentioned tend to hear carols and marches.
But why? I feel he leaves the most exciting question out of the chapter. Is it due to the simplicity? The rhythm? The repitition within the music? How does this relate to the part of the brain that is responsible (Boyer) for religion? And this brings up the question of music and its role within the religious realm.
I'll continue reading. Perhaps insights are in spe in the following chapters!
Gods and spirits are parasitic--Pascal Boyer

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Re: 6. Musical Hallucinations

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Perhaps the common thread across musical hallucinations is music hear/learned early in life. That would make Christmas carols and patriotic songs reasonable since they are often first heard as young children. There is no hint of religion, per se, having an influence on muisical hallucinations other than the fact that religious music is often early music.
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Re: 6. Musical Hallucinations

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No, there isn't any hint of religion having an influence on musical hallucinations, that is correct. I was going ahead of my thoughts there. But I am indeed interested in the proximity of the areas of the brain responsible for music and for religion. Guess Wikipedia will have to do for now. Sigh. I do think, however, that music underlines aspects of our lives, both conscious and unconscious and I believe religion uses this aspect to its full intent. As to Christmas carols, as mentioned, the tunes are usually catchy and easy to remember, perhaps underscoring some pleasant memory. But some of the music brought more unpleasant memories back to life.
A science magazine show on tv here called NANO presented a recent study suggesting any active participation in music, be it singing, playing an instrument or consciously listening intently to music, exercised the "brain" more than anything else and worked against some of the more frightening aspects of aging, such as Alzheimer and dementia. I unfortunately missed most of the programme and need to check into this.
I have also spent the better part of the day thinking about what horror it must be to constantly have a few bars of some ditty playing in your ears at full volumne all day. On the other side, what an almost religious experience it is walking into a cathedral and listening to Gregorian chant.
Gods and spirits are parasitic--Pascal Boyer

Religion is the only force in the world that lets a person have his prejudice or hatred and feel good about it --S C Hitchcock

Believe those who are seeking the truth. Doubt those who find it. --André Gide

Reading is a majority skill but a minority art. --Julian Barnes
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Re: 6. Musical Hallucinations

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oblivion wrote:A science magazine show on tv here called NANO presented a recent study suggesting any active participation in music, be it singing, playing an instrument or consciously listening intently to music, exercised the "brain" more than anything else and worked against some of the more frightening aspects of aging, such as Alzheimer and dementia. I unfortunately missed most of the programme and need to check into this.
.
I don't remember which chapter but Sacks makes the statement somewhere that even just one year of music lessons at a young age causes a specific area in the left hemishere of the brain to enlarge and stay enlarged for life.

Interesting stuff, more interesting than all thoses individual stories that pretty much reinforce each other but often don't offer any explainations.
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Re: 6. Musical Hallucinations

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AHHHHH everyone's ahead of me again!! I will be returning to this thread once I get caught up on this chapter and probably the next so I'm not behind again!!

Stay tuned, true believers...;)
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Re: 6. Musical Hallucinations

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This chapter was long and, as oblivion said, pretty unsatisfying. I felt that Sacks made his point with the first few cases, but then continued on and on until I almost couldn't read anymore.

What was interesting to note, for me, however, is that every medication mentioned so far in the treatment of seizures or these hallucinations are medicines I have been prescribed or have been highly recommended to me. For example, the use of the drug Lamictal (lamotrigrine) in the musical seizures chapter is also used to treat the manic and depressive cycles of bipolar disorder, which I was diagnosed with several years ago, and I was on different doses of it at length several times throughout my different courses of treatment. I have also been prescribed Seroquel (quetiapine), which is an anti-psychotic drug that is often used to calm psychotic episodes in schizophrenics and is approved to treat the manic side of bipolar disorder. One of my former psychiatrists called it a "rescue drug" that she would prescribe for a few weeks when a patient was in a severe manic or depressive state, then taper off as the episode slowed down. It is very sedative, as the patients in this chapter have expressed, and at the dosage useful for psychiatric and mood disorders, it makes everyday functioning extremely difficult. It can make you sluggish, dazed, and is notorious for short term memory loss and inability to concentrate. Overall, I found it to be a terrible drug, and have since refused to take it or any other anti-psychotics, as I have had allergic reactions to most of the others in this class of drug.

The Neurontin (gabapentin) that seemed to be the most helpful for a few patients was highly recommended to me by a psychiatrist I had no trust in because he advised me to continue taking an anti-psychotic medication when it was clear I was having the kind of negative reaction the pharmaceutical company recommends to stop taking immediately if present. This doctor kept trying to push Neurontin on me, even when I showed reluctance and found many lawsuits being launched against the company that made it because it isn't approved to treat the disorders many psychiatrists have been trying to prescribe it for. It is mainly approved only to treat epilepsy, and has many dangerous side effects that it is not worth being a guinea pig for some doctor's pet treatment idea. I found it interesting that it was used in the cases in this chapter and received well, for I have heard nothing but horror stories about it from everyone except that one doctor.

Nothing in this chapter seemed new to me, or that intriguing, really, because it made sense to me that once the physicality of hearing is impaired or lost to the extent in most of these cases, that the brain would then try to "make up" for the lack of stimuli. My own brain does this frequently, and although I do know it is internal and not external, it is fairly constant and is often fragmented or reduced to one or two notes, as some of the patients mentioned. Concentration or physical aural stimulation overrides it, and when there is nothing it starts again. It also isn't always music. Sometimes it's the last line of the movie I just watched, or the last sentence I read, or the last thing I said to someone that repeats several times. Having obsessive-compulsive disorder also plays a part in this, I think, because I do tend to repeat things I say over and over in my head, the way some people count the tiles in the bathroom or how many stairs there are as they are climbing. Having OCD may lend itself to this kind of constant repetition of music or words, I'm not really sure, but I can't control it and either just try to tune it out or find some other distraction to keep me from falling into a panic attack.

I find I really am relating to all of these people because of my musical background as well as my psychiatric disorders. Even though what I go through isn't as volatile as seizures or hearing loss and fierce auditory hallucinations, my brain can cause me to feel just as much agony, and I would like to see how Sacks would face someone with problems similar to mine with a musical but medical mind. I think it could be very helpful for me and others who suffer the same.

Some links to make some of my points clearer:
Bipolar disorder: http://en.wikipedia.org/wiki/Bipolar_disorder
Schizophrenia: http://en.wikipedia.org/wiki/Schizophrenia
Lamictal (lamotrigine): http://en.wikipedia.org/wiki/Lamictal
Seroquel (quetiapine): http://en.wikipedia.org/wiki/Seroquel
Neurontin (gabapentin): http://en.wikipedia.org/wiki/Neurontin
OCD (obsessive-compulsive disorder): http://en.wikipedia.org/wiki/Ocd
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Re: 6. Musical Hallucinations

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Thanks for the explanation concerning the drugs, Bleached. Having no idea what he was referring to, I rather glossed over those sections. The insights were very welcome!
Gods and spirits are parasitic--Pascal Boyer

Religion is the only force in the world that lets a person have his prejudice or hatred and feel good about it --S C Hitchcock

Believe those who are seeking the truth. Doubt those who find it. --André Gide

Reading is a majority skill but a minority art. --Julian Barnes
bleachededen

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Re: 6. Musical Hallucinations

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I'm glad they were. I find it interesting that, in this book, at least, I'm suddenly the pharmaceutical expert because I've taken most of the drugs he refers to (but doesn't explain, oddly enough). I find it interesting that he includes the use of these drugs in his stories, but doesn't explain what the drug is usually used for and how it works. Having personal experience with these drugs, I happen to know how they work, but unless you have one of these disorders or have a good medical background, most other readers wouldn't understand why these drugs are helpful, and I think Sacks could have explained that better.

That being said, I am glad my experience could be helpful. :)
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Re: 6. Musical Hallucinations

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I guess I am in the minority here but I actually like this chapter although I will admit Sacks' propensity for describing maladies with little connection to the actual brain systems can be disappointing.

I have MS (in long term remission fortunately) and I have experienced at different times hallucinations myself. I know they are not real, there is no doubt in my mind about the reality, it is nerve damage. With less frequency now than after my attacks, 26 years ago, I could see images or hear noises. The image was like after image, or similar to if you apply pressure to your eyes. I often would see in the bottom third of my vision a chain of colored beads with yellow and black being the predominant colors. It often moves as though one were pulling on a string of beads in a circular loop. It is sort of weird, if I try to look at it directly, it will fade, if I look across the room it will strengthen. It can remain for hours. Again it is more of a after image than a strong visual image. I can see it better in the dark or with my eyes closed, but it defies a direct look. The other hallucination I frequently had was a fluttering in usually my right ear but sometimes both. Imagine restraining a small bird about 4 inches from your ear. The fluttering could last anywhere from a few seconds to a few minutes, and often repeats every 10 minutes or so but not with a timed regularity. It was very audible but not uncomfortably loud, but also had somewhat of a physical sensation of something quivering but I could never feel anything with my fingers. A cochlea quake perhaps.

Like I say I never had any doubt to the reality of these sensations and they actually in themselves were not unpleasant. But there is always that question of now what and where is this going to stop? I had a whole body muscle spasm shortly after my original attacks that I genuinely thought was going to kill me. It eased up as suddenly as it started. I mentioned it to the neurologist and he said "Yeah that stuff happens with MS." I said "Well thanks for warning. I thought I was going to die." He replied "If I were to tell you every weird thing that can happen as a result of MS, we would be here for days."

Even though I have always known this stuff was the result of nerve damage from the MS, I still found the distinction between neurological and psychotic hallucinations in the book to be comforting.
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