When an everyday-phenomenonbecomes clinical: The case of long-term ‘earworms’Jan Hemming, Music Institute, University of Kassel, GermanyEckart Altenmüller, University for Music, Drama and Media Hannover, GermanyICMPC-ESCOM Thessaloniki, Greece, 2012July 26, 2012
The case of long-term earworms • Research on eaworms as everyday phenomenon • Broad media coverage (peer to public communication) • Subjects with long-term earworms contacting the authors for help
The case of long-term earwormsHemming, J. (2009). Zur Phänomenologie des Ohrwurms. In W. Auhagen,C. Bullerjahn & H. Höge (Eds.), Musikpsychologie - MusikalischesGedächtnis und musikalisches Lernen (pp. 184-207). Göttingen: Hogrefe.
The case of long-term earwormsSome results (1):• INMI occurs with preferred titles/genres in about two thirds (68.2%) of the cases, and in about one third (31.8%) with disliked titles/genres.• Once they are there, INMI is considered to be pleasant in two thirds (62.6%) of the cases, and unpleasant in one third (27.4%) of the cases
The case of long-term earwormsSome results (2): Time between listening to music and its occurence as "tune in the head" 9,8% 9,8% while music is still playing 7,3% directly after listening several minutes 29,3% 17,1% several hours several days several weeks 26,8%
The case of long-term earwormsSome results (3): "Tunes" keep persisting for ... 8,6% 17,1% several minutes several hours several days 37,1% several weeks 37,1%
The case of long-term earwormsSome results (4):• INMI frequently starts in periods of mental relaxation, sometimes paired with physical activity.• There was no difference in the number of INMIs between people inactive or active in music.The preliminary assumption that INMI might be an effect of our cognitivesystem to provide music when it is otherwise absent cannot be held up(e.g. Liikkanen 2012)
The case of long-term earwormsDefinitionsMusical imagery – voluntaryly imagining music e.g. by singing insideInvoluntary musical imagery – double involuntary everyday-phenomenona. music involuntarily gets stored in long-term memoryb. music is involutarily retrieved from memoryThe sound-source is always perceived within the subjective spaceMusical hallucinations – clinical symptom following brain lesions, psychoticdisorders or drug abuse. Typically, there is a strong belief in a sound-sourceoutside the subject.Pseudo-hallucinations or hallucinosis (Griffiths 2000) – perception of soundor music outside the subjective space with an awareness that it is not actuallypresent. Not necessarily a clinical condition.
The case of long-term earwormsMethodAfter a period of informal exchange of experiences, systematic case studieswere set up to investigate the phenomena in detail. Interviews guided by a listof 19 questions were carried out in person, by telephone or video conference.Nothing was recorded, only notes were taken down. If provided by the subjects,medical information and other sources are included in the data.
The case of long-term earwormsSubject A• male, 33 years• professional cook working as a DJ• suffered from lingering sounds after nights in the clubs• switched back to his original profession as no medical advice could be obtained• under psychiatric treatment with permanent medication• suffers from depression and has given up hope to find a cure for his condition.• contact to the researchers has broken up.
The case of long-term earwormsSubject B• female, 87 years• retired after pedagogic / creative profession• very high affinity to music, learned to play various instruments• has suffered from weak tinnitus for a long time• are-related hearing impairment makes own musical activity almost impossible• Starting with the age of 84, a specific canon kept pertaining. This can nowadays be replaced by any other melody, but cannot be stopped• she speaks of hearworms located inside the head, while the tinnitus directly stems from the ears• refuses antidepressants since she considers herself a happy person• Personal coping strategies include breathing and relaxation techniques borrowed from tinnitus-retraining therapies. She also considers it a great relief to now know "Nothing is wrong with me!"
The case of long-term earwormsSubject C• male, 41 years• works in creatively demanding technology development• has a high affinity to music, but never learned to play any instrument• if only a slight clue is given (e.g. keyword Whitney Houston) or when he is confronted with unavoidable music, it keeps haunting him afterwards.• first occurrence of the long-term earworm was paralleled by a personal crisis• general depressive tendency• has long suffered from severe tinnitus originally caused by mal-fitting dental prostheses• reports a continuum between the tinnitus and the earworm is, both located inside the head.• Again, personal coping strategies include breathing and relaxation techniques borrowed from tinnitus-retraining in addition to a general avoidance of catchy music.
The case of long-term earwormsSubject D• male, 48 years• switched from an electronic technician to social pedagogy after a personal crisis• almost completely deaf since childhood• attended an efficient school for the deaf, learned to play xylophone and to dance• high affinity to music, regrets not to have extended his instrumental skills• has long suffered from a severe tinnitus, a continuum between the tinnitus and the earworm is again reported, both located inside the cochlea which he imagines to be thickened• Earworms are a severe obstacle when going to sleep, long-term earworms frequently occur in between sleep and awakening• Personal coping strategies include supporting well-being and avoidance of music which can often be realized by turning off the hearing-aid.
The case of long-term earwormsSubject E• male, 79 years• retired production engineer• high affinity to music, but never learned to play any instrument• exactly remembers the day when his tinnitus started, caused by a deficient dental treatment• for six years, four different, very specific musical hallucinations have taken turns with each other. They overlap with the tinnitus and dominate it.• While the tinnitus is located inside the ear, the hallucinations are felt to stem from the back of the head, accordingly there is no continuum.• All of the pieces are loaded with strong positive or negative personal affection.• eventually agreed on the treatment with initially high-dosed antidepressants to be gradually reduced in the course of one year. In combination with self- chosen relaxation techniques (yoga), this brought significant relief.
The case of long-term earwormsConclusions• the frequency and intensity of earworms might be an indication of a general affinity to music – possible link to conceptions of musicality• physical causes of tinnitus or musical hallucinations (dental and cervical spine disorders, whiplash injuries) need more attention• A treatment with anti-depressants seems promising (even with non- depressive subjects) since these have the potential of eliminating memory traces. Their combination with psychotherapeutic treatment borrowed from tinnitus therapy can result in significant relief of the affected subject.• An adoption of the conception of hallucinosis as a third entity between everyday (involuntary) imagery and clinical hallucinations might help subjects to understand that "nothing is wrong with me"• These findings yet need to be communicated into otolaryngology, neurology, orthopedics and possibly even chiropractics.
The case of long-term earwormsFuture directions of INMI research• link INMI to conceptions of musicality• communicate findings into the clinical world• include not only preferences but also emotional valence in research designs• do brain imaging on the presentation of stimulus material