Pas si fort

This is what I look like at 7 a.m. when the incessant honking begins…

Recently, one of my clients shouted in French, “Pas si fort” after her neighbor repeatedly slammed his front door during our massage session. The sound was magnified by the thinness of her walls and affected her ability to fully relax. Translated to English it means “Not so strong.” The reality of living in a building with multiple apartments is the constant noise. While the sound levels vary, most people consider it a form of white noise. I am not one of those people. I don’t want to hear the next door neighbor screaming Farsi curses and the people upstairs throwing up in their bathroom at 1 a.m.  every night like clockwork. It’s an odd thing to know the intimate details of people’s patterns and routines without ever having a conversation with them. I feel voyeuristic; almost stalker-like. But these observations are hardly forgettable. I can’t help but listen.

I am one of a percentage of the population who has a heightened sensitivity to sound, also known as hyperacusis. It is characterized by a collapsed tolerance to environmental sounds of a certain volume that can happen gradually over time or suddenly when in crisis. Mine began about 2 years ago after being terrorized by constant partying and threats in my own home from the son of my then landlord. I barely slept and my nervous system was on high alert at all times. Consequently, the sound of sirens, loud music, screaming and beeping became almost intolerable when previously I had never been bothered by such things. Gone are the days of restful sleep through anything. I hear EVERYTHING now.

Is that who’s making all that noise outside my window???

Beyond a crisis, hyperacusis can be caused by hearing loss, where the tiny hairs in the inner ear have been damaged and become sensitive to certain frequencies played at louder levels. This is known as recruitment. Also, hypersensitivity to certain frequencies at louder levels can occur in conditions like Autism, which exist from birth. Phonophobia and misophonia can occur with hyperacusis. The former is a fear of the sound that one is intolerant to in the environment it is occurring in both real time and when anticipating its next occurrence. The latter has been associated with an adverse response to soft sounds like that of eating, chewing and lip movements. Interestingly, misophonia has been listed with specific diagnostic criteria in the diagnostic “bible” of psychological clinicians known as the DSM-5, but it’s not considered a discrete psychological disorder. Its origins are thought to be more neurological and need to be studied further. And speaking of the brain…

From an evolutionary standpoint, being able to pick up on sounds that others ignore lets me respond to potential danger much sooner and thus, will ensure my survival. DNA testing exists now that has isolated the gene that makes one more likely to have heightened sensitivity to sound. So it’s both environmental and biological – go epigenetics!! Nevertheless, those of us with sound sensitivity have to find a way to deal with the loud world that surrounds us. Aside from moving out of my apartment building and city limits, there are some therapeutic options. The main one is a combination of cognitive therapy and desensitization through retraining. Its goal is to get you to think about the sound with less of an emotional response and expose your ear to intolerable sounds in order to neutralize them. This weakens the neuronal activity associated with the fight-or-flight response these noises often produce. Other forms of treatment are cognitive behavioral therapy (CBT) alone, psycho-therapeutic hypnotherapy and occupational therapy. CBT allows the person to gain control of that automatic emotional response produced by the sound and desensitizes them to it. Hypnotherapy, through a reputable practitioner who is often a psychologist as well or recommended by one, uses the power of suggestion to overcome the emotions (usually the fear/rage response) to the sound. Lastly, occupational therapists deal with the sensitivity as a sensory processing disorder; therefore, they introduce each offensive sound at varying degrees of intensity along with other sounds in order to help the brain accommodate and then dismiss them. Guess I won’t have to move after all 🙂

 

 

 

SOURCES:

https://en.wikipedia.org/wiki/Misophonia

http://www.hyperacusis.net/hyperacusis/4+types+of+sound+sensitivity/default.asp

My Plastic Brain

My intellectual crush….Professor Eagleman, I am all ears!!

Your brain’s fitness is largely overlooked. Most of us focus on cardiovascular exercise for a healthy heart and strength training for a healthy musculoskeletal system. The mass of nerve tissue in your skull also needs its own training regimen. The “use it or lose it” adage is often quoted, but it wasn’t until I did some focused reading on the living organ that is our brain that I truly understood how this works (or doesn’t). The brain is comprised of precious real estate maps that correspond to regions of the body, as well as various cognitive activities. Should that particular region of the body become useless or an activity cease, the real estate doesn’t die off, but gets replaced by another area altogether. And in cases where are a part of the brain dies or is damaged, other parts are recruited to compensate for that loss. No corner of the working brain is squandered. Here’s an example:

A man working a job site accidentally saws through his hand, severing the nerve that feeds his pinky and ring fingers. After recovering from the initial trauma, he begins doing physical therapy to strengthen his hand and get the rest of his fingers to work without the 4th and 5th fingers. If we cut open his brain and mapped out the region that represents those two useless fingers with little lights, you would see a pretty amazing thing happen. Every time he recruits his other fingers and working parts of his affected hand, the region representing the two appendages that no longer receive commands from the brain will light up. How is this possible? In a remarkable feat of engineering, the silenced region of the brain is over grown by the working areas around it. They take over and grow stronger, thus maximizing their neurological property.

This is just one demonstration of the brain’s adaptability. Calling one’s brain “plastic” means that with the right exercises and activities, we can train our minds to circumvent any issue, like say a stroke, allowing us to recover lost function by recruiting other regions’ maps to take over those activities. Here’s another example:

Acclaimed American nueroscientist, Paul Bach-y-Rita, was a pioneer in the field of nueroplasticity. Early in his career he created a system of vibrating plates that were attached to a blind individual’s back. The plates would vibrate in connection to a forward facing camera that “observed” objects in what would be one’s visual field. The patterns of vibration were different depending on the object, but what ended up occurring was the ability for the blind person to “see” the world surrounding him. His skin sensors sensing the vibrations were sending the information to his visual cortex. One sense, touch, compensating for the other sense that did not function.

Further along in his career, he created a device that helped people whose vestibular systems (i.e. what helps us maintain balance and spatial awareness) were damaged. These people literally couldn’t stand upright; their world was in perpetual motion, like being on a rocky boat. The device attached sensors onto the patients’ tongues, which is a region saturated with sensory receptors, that interpreted forward, back and side to side movement. Accelerometers attached to them and linked to a computer would give the “position” in space of the patients and allow them to stay balanced. After using the device initially, a patient would experience the residual affects for many hours, despite still having a damaged vestibular system. Used for several weeks and many patients were completely cured. This just shows how the brain is able to reorganize itself and adapt to new information from an unlikely source.

Perhaps the best example from Bach-y-Rita’s career was his father’s massive stroke. After his father passed away years later, an autopsy indicated a large part of his brain stem had died, which would have left him unable to do most basic functions. However,  through neuroplastic exercises that Bach-y-Rita and his brother gave to their father, he was not only able to recover the basic functions, but more complex ones as well, which allowed him to return to teaching. His brain reorganized itself on very large scale.

After reading so much about nueroplasticity, I can’t help but think about my grandmother and how her brain was eaten away by a combination of stroke, Alzheimer’s and Aphasia; the latter two being a one two punch of memory loss, dementia and the inability to speak. I wonder if nueroplastic exercises done early after the stroke that started the ball rolling would have helped her brain remap itself enough to prevent many of the symptoms of the other two neurological diseases to manifest. There is some fascinating research out there that makes a brilliant case for this.

I guess the “use it or lose it” adage should be changed to just “USE IT!!!!” Crack open some of the below books if you are as intrigued as I am and get started this new year.

Recommended Reading List:

http://www.normandoidge.com/normandoidge.com/ABOUT_THE_BOOK.html

http://www.amazon.com/Incognito-The-Secret-Lives-Brain/dp/0307389928

http://www.amazon.com/Sum-Forty-Afterlives-David-Eagleman/dp/0307389936/ref=la_B001JRX0OQ_1_2?s=books&ie=UTF8&qid=1387720746&sr=1-2