the medical muse

1
PSYCHOSOMATICS SOUNDMAKING-THE ACOUSTIC COMMUNI- CATION OF EMOTION. By Peter F. Ostwald, M.D. 185 pages. Springfield, IUinois: Charles C Tho17UlS, 1963, $7.50. This book presents the results of a four-year investi- gation along bio-acoustic lines of soundmaking, "an activity as necessary to human survival and comfort as are breathing, feeding, sleeping, and other vital processes." There are eleven chapters which range from historical to psychopathologic aspects of acous- tic communication. Chapter 1 "shows how trends in soundmaking have changed throughout history in accordance with man's different views of nature and changes in his attitude toward self-expression." Principles of musical aesthetics which explain Western views on emotional expression by means of sound are summarized. The complementary views of Helmholtz and of Freud in shaping modern scientific approaches to acoustic communication are discussed. Helmholtz, himself a musician, studied the physical aspects of sound; Freud focussed on the psychology of the sound- maker. Chapter 2 contrasts the sounds of animals, human infants, and adult speakers. "No hard-and-fast boundaries exist" morphologically between the acous- tic signals used by these three groups; but speech represents a unique ordering of mdimentary sounds into elaborate symbolic patterns. The infant makes about 18 rudimentary sounds, while the number of verbal sounds usable by adults is unlimited. Dis- crepancies between the individual's capacities and society's demands for meaningful soundmaking ac- count for much of the speech pathology observed by clinicians. Chapter 3 tells "how to make statements about sounds." Seven qualitative attributes of sound are discernible by ear. Some of these can be denoted visually with phonetic or musical symbols. Quantifi- cation of sound requires electro-acoustic filtration and measurement. Half-octave band methods are used in studies reported here. Chapter 4 analyzes the baby- cry, "part of every person's inborn equipment for obtaining attention." Chapters 5 and 6 deal with speech and present four "acoustic stereotypes." The sharp voices of easily-heard, penetrating speakers show prominent octave-reinforcement; the flat voices of muffied, tired speakers show bands of noise; the hallow voices of depleted, depressed speakers lack resonance energy; and the robust voices of exhuber- ant, expressive speakers concentrate large amounts of sound in the center of the frequency spectrum. To relate these acoustic findings with psychopath- ologic patterns, Dr. Ostwald follows the soundmaking of one patient through eleven consecutive interviews and shows periodic focussing of sound energy at 500 cycles per second, which he interprets as a manifesta- tion of the patient's "suppressed desire to cry, an unconscious defense against the expression of passive, anaclitic impulses." He then studies two groups-30 patients and 20 non-patients-in terms of their sounds emitted under two contrasting conditions. By means of statistical comparisons, it is shown that "a change in the loudness of soundmaking by psychiatric pa- 312 tients was the single most reliable acoustic criterion of clinical change. A change in time-duration was also a reliable variable; younger patients tending to speed up, while older patients tended to slow down in their soundmaking measured before and after treatment." Significant fluctuations of sound intensity at 500 cps per second were found in both groups of subjects. Chapter 9 is about listening. Three experimental procedures are utilized: the Wilmer Auditory Pr0- jective Test for stimulating conscious fantasies; masked baby cries for stimulating unconscious fan- tasies; and a juke box experiment for studying the popularity of various sounds. The final two chapters are clinical in nature and present eight patients who have speech disturbances. The material suggests that "nonspeaking patients" (mute, autistic, regressed schizophrenics and mental retardates) suHer from a basic 'inability to use sounds symbolically," while "disturbed soundmakers" (depressives, psychoneuro- tics, and stutterers) find it difficult to "distinguish be- tween emotive and denotative soundmaking." As a concise synthesis of contemporary views about sound from bio-acoustics, linguistics, and psychiatry, this book is probably the only thing of its kind avail- able today. In his brief introduction, the author provides the frame-of-reference for his work. A glossary defines unfamiliar and ambiguous terms. The Charles C Thomas Company has published this book in its beautifully printed and bound "American Lecture Series." K. W. BERBLINcER, M.D. THE MEDICAL MUSE (Or What To Do Until the Patient Comes). By Richard ANnour. 129 pages. New York: McGraw-Hill Book Co., 1963. $3.95. The author, in his delightful, uninhibited verbal expressiveness, takes a panoramic view of medicine. His penetrating pen covers medical meetings, so- cialized medicine, urine analysis, psychoanalysis, school phobia, the maladjusted mother, the "cure-it- yourself" movement and its potential consequences, experiments with hallucinogenic drugs on unsuspect- ing spiders, the effects of TV on the public image of the doctor, and other choice items. His utiliza- tion of scientific news items as a take-off platform provides many excursions into his own world of phantasy. The description of the hypochondriac who finally becomes "sick for real" adds no new material with which readers of PSYCHOSOMATICS are not familiar. Even the lowly enema, in Armour's text, also has a place; the indiscriminate use of tourniquets is pointed out, especially when applied to the neck. Best of all, in this reviewer's opinion, is his descrip- tion of the "normal man"-well adjusted, quite se- cure, without ulcers or stress, yet there are times when others feel for his pulse, since they doubt whether he is living. This book is not only recommended,. it is the Editor's hope that some of Richard Armour's mate- rial will find its way to PSYCHOSOMATICS. W.O. Volume IV

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Page 1: The medical muse

PSYCHOSOMATICS

SOUNDMAKING-THE ACOUSTIC COMMUNI­CATION OF EMOTION. By Peter F. Ostwald,M.D. 185 pages. Springfield, IUinois: Charles CTho17UlS, 1963, $7.50.

This book presents the results of a four-year investi­gation along bio-acoustic lines of soundmaking, "anactivity as necessary to human survival and comfortas are breathing, feeding, sleeping, and other vitalprocesses." There are eleven chapters which rangefrom historical to psychopathologic aspects of acous­tic communication.

Chapter 1 "shows how trends in soundmakinghave changed throughout history in accordance withman's different views of nature and changes in hisattitude toward self-expression." Principles of musicalaesthetics which explain Western views on emotionalexpression by means of sound are summarized. Thecomplementary views of Helmholtz and of Freudin shaping modern scientific approaches to acousticcommunication are discussed. Helmholtz, himself amusician, studied the physical aspects of sound;Freud focussed on the psychology of the sound­maker.

Chapter 2 contrasts the sounds of animals, humaninfants, and adult speakers. "No hard-and-fastboundaries exist" morphologically between the acous­tic signals used by these three groups; but speechrepresents a unique ordering of mdimentary soundsinto elaborate symbolic patterns. The infant makesabout 18 rudimentary sounds, while the number ofverbal sounds usable by adults is unlimited. Dis­crepancies between the individual's capacities andsociety's demands for meaningful soundmaking ac­count for much of the speech pathology observed byclinicians.

Chapter 3 tells "how to make statements aboutsounds." Seven qualitative attributes of sound arediscernible by ear. Some of these can be denotedvisually with phonetic or musical symbols. Quantifi­cation of sound requires electro-acoustic filtrationand measurement. Half-octave band methods are usedin studies reported here. Chapter 4 analyzes the baby­cry, "part of every person's inborn equipment forobtaining attention." Chapters 5 and 6 deal withspeech and present four "acoustic stereotypes." Thesharp voices of easily-heard, penetrating speakersshow prominent octave-reinforcement; the flat voicesof muffied, tired speakers show bands of noise; thehallow voices of depleted, depressed speakers lackresonance energy; and the robust voices of exhuber­ant, expressive speakers concentrate large amountsof sound in the center of the frequency spectrum.

To relate these acoustic findings with psychopath­ologic patterns, Dr. Ostwald follows the soundmakingof one patient through eleven consecutive interviewsand shows periodic focussing of sound energy at 500cycles per second, which he interprets as a manifesta­tion of the patient's "suppressed desire to cry, anunconscious defense against the expression of passive,anaclitic impulses." He then studies two groups-30patients and 20 non-patients-in terms of their soundsemitted under two contrasting conditions. By meansof statistical comparisons, it is shown that "a changein the loudness of soundmaking by psychiatric pa-

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tients was the single most reliable acoustic criterionof clinical change. A change in time-duration wasalso a reliable variable; younger patients tending tospeed up, while older patients tended to slow downin their soundmaking measured before and aftertreatment." Significant fluctuations of sound intensityat 500 cps per second were found in both groups ofsubjects.

Chapter 9 is about listening. Three experimentalprocedures are utilized: the Wilmer Auditory Pr0­jective Test for stimulating conscious fantasies;masked baby cries for stimulating unconscious fan­tasies; and a juke box experiment for studying thepopularity of various sounds. The final two chaptersare clinical in nature and present eight patients whohave speech disturbances. The material suggests that"nonspeaking patients" (mute, autistic, regressedschizophrenics and mental retardates) suHer from abasic 'inability to use sounds symbolically," while"disturbed soundmakers" (depressives, psychoneuro­tics, and stutterers) find it difficult to "distinguish be­tween emotive and denotative soundmaking."

As a concise synthesis of contemporary views aboutsound from bio-acoustics, linguistics, and psychiatry,this book is probably the only thing of its kind avail­able today. In his brief introduction, the authorprovides the frame-of-reference for his work. Aglossary defines unfamiliar and ambiguous terms.The Charles C Thomas Company has published thisbook in its beautifully printed and bound "AmericanLecture Series."

K. W. BERBLINcER, M.D.

THE MEDICAL MUSE (Or What To Do Untilthe Patient Comes). By Richard ANnour. 129pages. New York: McGraw-Hill Book Co., 1963.$3.95.

The author, in his delightful, uninhibited verbalexpressiveness, takes a panoramic view of medicine.His penetrating pen covers medical meetings, so­cialized medicine, urine analysis, psychoanalysis,school phobia, the maladjusted mother, the "cure-it­yourself" movement and its potential consequences,experiments with hallucinogenic drugs on unsuspect­ing spiders, the effects of TV on the public imageof the doctor, and other choice items. His utiliza­tion of scientific news items as a take-off platformprovides many excursions into his own world ofphantasy. The description of the hypochondriac whofinally becomes "sick for real" adds no new materialwith which readers of PSYCHOSOMATICS are notfamiliar. Even the lowly enema, in Armour's text,also has a place; the indiscriminate use of tourniquetsis pointed out, especially when applied to the neck.Best of all, in this reviewer's opinion, is his descrip­tion of the "normal man"-well adjusted, quite se­cure, without ulcers or stress, yet there are timeswhen others feel for his pulse, since they doubtwhether he is living.

This book is not only recommended,. it is theEditor's hope that some of Richard Armour's mate­rial will find its way to PSYCHOSOMATICS.

W.O.

Volume IV