by Bradford S. Weeks, M.D.
– excerpted from The Physician, the Ear and Sacred Music, a simplified version of a scientific article written in 1986 detailing Weeks’ work and experiences in high-frequency audition (hearing) research, reprinted in Don Campbell’s 1991 anthology, Music Physician For Times To Come.
Weeks spent a week with Tomatis in Paris interviewing patients, technicians, staff, and observing therapy.
Born in 1920, Dr. Tomatis earned his M.D. from the Faculte de Paris before specializing in otorhinolaryngology. En route to establishing the International Assocation of Audio-Psycho-Phonology, Dr. Tomatis was distinguished as follows: Chevalier de la Sante Publique (Knight of Public Health) 1951; Medaille d’Or de la Recherche Scientifique (Gold Medal for Scientfiic Research) 1958; Grande Medaille de Vermeil de la Ville de Paris 1962; Prix Clemence Isaure 1967, Medaille d’Or de la Societe Arts, Science e Lettres 1968; and Commandeur de Merite Culturel et Artistique 1970.
As a scientist, Tomatis is recognized for his experimental breakthroughs in the field of auditory neurophysiology. For example, while treating hearing impaired factory workers by day and opera singers suffering from spots before their eyes at night (scotomas), Tomatis noticed a similarity of symptoms betwen the two patient populations. After further investigation, he formulated the law describing the feedback loop between the larynx and the ear: “The larynx emits only the range that the ear controlled.” In other words, one can reproduce vocally only those sounds that the hman ear is capable of detecting. This discovery was recognized by the Academy of Sciences of Paris and the French Academy of Medicine who in 1957 named this theory about the ear and voice the Tomatis Effect.
As a clinician, Tomatis has achieved the reputation for successful and unorthodox therapies whose scope sceeds the range of ear, nose and throat disorders: hearing and voice loss (Tomatis, 1960 A), stuttering (Tomatis, 1954), ringing in the ears, inflammation of the middle ear (Tomatis, 1986); neurological disorders: spots before the eyes (Tomatis 1974 B), drooling (Tomatis, 1974 B, 1986), eye-muscle imbalances (Tomatis, 1986); psychiatric disorders: depression, (Tomatis 1974 C); attention deficit disorder, hyperactivity (LeGall, A., 1961); learning disorders, dyslexia (Tomatis, 1967), inability to concentrate (Tomatis, 1986); and a variety of balance/coordination disorders related to problems with the inner ear (Tomatis, 1986.) These therapeutic coups occur by retraining the ear muscles using another Tomatis invention, the electronic ear that utilizes filtered sound. The claims regarding the therapeutic value of this technique were what drew me to France to study with Tomatis.
Among Tomatis’ innovative ideas is the notion that bass sounds are felt throughout the body in a manner similar to the sense of touch. His electronic ear is based on this proposition. It is a machine that contains a microphone, amplifiers, filters, and earphones. It is designed to help the ear acquire three function: listening, monitoring of language, and laterality, or the ability to change from left to right ear dominance in hearing.
The electronic ear works by delivering to the listener’s ear sounds which are progressively filtered along a continuum, from normal, non-filtered sound to sound in which all except frequencies greater than 8000 hz (hertz) have been filtered out. (Hertz is a measure of the frequency of a sound wave; 1 hertz is equal to one cycle of sound waves per second.) In addition, the sound delivered to the listener alternates between two channels which are set to produce maximum bass and maximum treble sounds. Consequently, the stapedius muscle (the muscle of the iddle ear which regulates the stapes, one of the three tiny bones or ossicles) must exert control over the stapes in order for one to hear the ascending high-frequency sounds, as well as hear the fluctuations between bass and treble at a given frequency. This challenge to the poorly toned middle ear muscles (especially the stapedius muscle which is primarily responsible for the ability to discriminate high-frequency sounds) works like micro-gymnastics; the exercise helps one reattain the ear’s ability to focus sound (as opposed to the brain’s focusing on sound.)
The Tomatis test is a critical diagnostic tool for determining hearing disorders. This test determines the ability to detect sound at a predetermined intensity for frequencies ranging from 125 to 8000 hz. The results of this test allow evaluation of the patient’s ability to recognize pitch differences in closely related sounds (auditory discrimination.) The test also determines how well air conduction and bone conduction of sound are functioning in the patient. Finally the ability to detect the direction of a sound (spatialization) and each ear’s individual ability to detect sound (laterality) are tested.
Tomatis is given credit for being the first to appreciate the important distinction between hearing and listening. The former is non-selective and does not require focusing, while the latter does require focusing to pay specific attention to one of the many sounds which may be heard simultaneously. Hearing is less strenuous than listening. Listening involves will power. Tomatis’ listening test differs from the hearing test of the audiologist in that the listening test measures not only the physical capabilities of the ear, but also the degree to which the ear’s potential is being utilized by the patient. Audiologists frustratingly acknowledge that many people who come to them with hearing problems can hear perfectly well according to the results of their audiograms (standard hearing tests.) In fact, the problem is not with hearing but with listening. A course of therapy with the electronic ear has been shown to improve these listening problems.
The electronic ear also trains the right ear to be dominant. This is beneficial because of the assymetry of the pathways over which sound travels through the body (Gacek, 1972.) According to Tomatis right ear dominance has the effect of speeding up the processing of both sensory information and knowledge (Tomatis, 1974 A.)
Perhaps the most provocative theory involves fetal audition (Tomatis, 1981.) He suggests that the mother’s voice can penetrate through her bones to the intrauterine world, and it is the child’s first target of communication with the extrauterine world. Traumas during pregnancy can result in unpleasant associations with certain sound frequencies and have been associated with hearing loss. Tomatis has had success in treating this kind of hearing loss as well as neurosis by simulating sounds experienced during uterine life, including the mother’s voice. These sounds are progressively filtered from 8000 hz to 100 hz. He calls this procedure “sonic rebirth.” A fascinating spinoff inolves learning a foreign language such as Arabic by undergoing sonic rebirth while listening to a course of filtered Arabic, thus sensitizing one’s ears to its idiosyncratic sounds (Tomatis, 1960 B.)
Other innovations Tomatis introduced include the idea that the brain receives more stimuli from the ears than from any other organ. he makes further startling assertions: the skin is derived from cells that become ear tissue rather than vice versa; the ear preceded the nervous system (Tomatis, 1974 A); the cells of the body which “sense” evolved from the tissue that produces the cells of Corti of the ear (see Flock et al, 1983.) Tomatis successfully treats many problematic maladies by using his appreciation of the peculiarities of the human ear.
The most exciting theory of Tomatis, and the one which led me to consider the role of sacred music as therapy, is the concept of cortical charge. Experience tells us that some sounds put us to sleep (lullabies) and some keep us awake (traffic); some calm us (surf on the beach) and some make us dance all night (rhythm.) A hard driving beat practically forces us to tap our feet. The screech of chalk on a black board makes us scream and contract in discomfort. We are constantly bathed by sound.
Tomatis has devoted his career to analyzing the effect various components of sound have on our bodies. The claim that music exerts a profound effect on us is beyond question. What remains is only to establish how the components of sound affect our bodies. (Psychosomatically? Physiologically, due to the wandering path of the vagus nerve?) According to Tomatis, the primary function of the ear is to provide the cells of the body with electrical stimulation or cortical charge. The cells of Corti deep in the inner ear (the cochlear-vestibular area) transform sound waves into electrical input. According to Tomatis:
The charge of energy obtained from the influx of nervous impulses reaches the cortex [of the brain], which then distributes it throughout the body toning up the whole system and imparting greater dynamism to the human being (Tomatis, 1978.)
Tomatis has stated that not all sounds have an effect upon cortical charge. The cells of Corti respond much more intensely to high frequency sound than to low frequency sound. He calls sounds rich in high harmonics “charging sounds,” in contrast to sounds rich in lower tones, which he calls “dis-charging sounds.” Tomatis feels that low frequency sounds supply insufficient energy to the brain and may even exhaust the individual. This may help explain why a depressed person may listen more intently to the sounds of his or her own internal being (heartbeat, breathing, etc.) which fall in the low-frequency range. For the depressed person, hearing no longer is a route of communication, but the sense becomes directed inward (Tomatis, 1978.)
Sonic training with high-frequency sound can be very useful therapeutically, according to Tomatis. A cortical charge generated during sonic therapy could be used to energize the individual. The effects of this treatment might manifest in increased motivation and competence in work, better concentration, increased memory skills, lower susceptibility to fatigue, and generally more dynamism and energy (Tomatis, 1978.)
Application: Anecdotal evidence suggests that certain high-frequency sounds confer alertness and stamina to the listener and result in enhanced performance. For example, students report that listening to Gregorian chants or classical music increases their ability to concentrate. Or consider the time-honoured prescription, “whistle while you work.” The fife, bugles and bagpipes (high frequency sounds) traditionally were used to motivate soldiers going into battle. Perhaps these shrill high-frequency tones impart an enthusiasm by stimulating a cortical charge. Drums (a low frequency sound) simulating the heartbeat were used to give order to this enthusiasm (left-right-left-right.)
Scientific method is the ultimate test for the reinterpretations of the time-honoured theories of hearing. This requires that the new theories must agree with observations, be internally consistent and be comprehensive. The first criterion can be tested in labs or clinics that have the opportunity to reproduce Tomatis’ studies. The internal consistency of new theories may be determined by the presence or absence of any logical contradictions. Simplicity and elegance of a theory are desirable as well. Lastly, the comprehensiveness of a theory is measured in terms of its ability to show the relationship of phenomena previously thought to be unrelated. Therapeutic usefulness is a marker that also serves to positively evaluate the work of Tomatis.