![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Lemon on June 5, 2001, at 11:59:21
_I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
What is the experience like?The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
What triggers it?Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
TreatmentSo what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
(From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.
Posted by Mitch on June 5, 2001, at 15:03:57
In reply to Intrusive Music and OCD , posted by Lemon on June 5, 2001, at 11:59:21
My experience is one of an "echoing" effect. Whatever I have most recently been listening to is what my "head is playing". I love music and listen to it all of the time. I get snippets of the same music stuck in my head sometimes for a couple of days. I have had triggers like chairs squeaking, i.e. The SSRI type drugs that treat OCD, while they lessen my social anxiety-they WORSEN the "music in my head thing". Prozac was the worst. I have been on here before about TLE. However, I do have some OCD traits. Don't meet the criteria for OCD-but OCD personality. I am taking Neurontin and Klonopin with a "smidge" of SSRI (most recently Celexa). With all serotonin AD's I have had (depending on which one)auditory, gustatory, and visual hallucinations. Even on amitriptyline I would hear *faint* classical-type music playing in the background all the time. Is it possible to have TLE AND OCD/social anxiety? I feel calmer on SSRI, but the "music thing" can get pretty intense. Someone asked me one time on here about a head injury, and come to think of it I do remember when I was about 8 or 9 when a truck caught the tail end of my bicycle and threw me onto the concrete-I woke up with my family standing over me talking in our house.
Mitch
Posted by Glenn Fagelson on June 5, 2001, at 21:48:44
In reply to Intrusive Music and OCD , posted by Lemon on June 5, 2001, at 11:59:21
> _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
>
>
> Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
>
> The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
>
>
> When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
>
> This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
>
>
> What is the experience like?
>
> The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
>
> A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
>
> A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
>
> Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
>
> In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
>
> It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
>
>
> What triggers it?
>
> Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
>
> Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
>
> It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
>
>
> Treatment
>
> So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
>
> Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
>
> In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
>
>
> (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.Dear Lemon,
I have had this condition for most of my
life; I love classical music and over the
years I have had the good fortune of getting
to know many pieces of classical music.
Sometimes, I will awake in the morning with
a piece by Mozart that I hadn't even listened
to in years. I always thought this was
something rare that God had given to me,
after all Beethoven composed his 9th
symphony when he was totally deaf. As
a result of reading this post by you, I
am now realizing that if I have some piece
of music in my head and I am around other
people, I will tune them out and tune in
to the wonderful music in my head. However,
at times, this condition can be quite
frustrating because I will keep going over
the same piece of music in my head for days
or even longer, especially if I cannot
remember the important passages that leads
to the ending of a particular piece. I can
only get rid of that piece of music if I
listen to another piece of music on my
stereo. Then that piece of music will
start to play in my head. Sometimes,
I think the whole process of my musical
intrusions is just a subconcious defense
against getting too close to people.
Thank you for bringing up this condition;
thank you!
GlennPS: Being around stimulating, interesting
people seems to help.
Posted by grapebubblegum on June 5, 2001, at 22:19:22
In reply to Re: Intrusive Music and OCD , posted by Glenn Fagelson on June 5, 2001, at 21:48:44
I'm not trying to be a smart aleck or make light of the subject but...
Isn't this normal in all people? I didn't know that having a tune in one's head was abnormal in any way. Sure, maybe some people have music present more often than others but...
You see, I'm not trying to discount the idea. Just sort through it. Now that I've stated the above, I will say that I noticed way back when I was a teenager that if I had to go through a very stressful night (I lived with a mother who had dramatic emotional problems that would in turn scare me and keep me on a high-stress level most of the night some nights) that this music would become louder and more insistent in my head. My theory was/is that it is a calming mechanism of some sort.
And when I took zoloft and raised the dose from 100 mg. per day to 150, I immediately noticed what seemed like louder and more pervasive music and/or conversation in my head. Not delusions, just normal tunes-going-through one's head but they seemed just... louder, for lack of a better description.
I never thought that this was a symptom of any disorder, though.
Posted by Mitch on June 6, 2001, at 1:09:38
In reply to Wait a minute, posted by grapebubblegum on June 5, 2001, at 22:19:22
Grapebubblegum,
You might be onto something:)
I mean it kind of gets down to what is pathological and what isn't? You can reduce everything to death and there isn't any central tendency.... any more...
I do "know" what hallucinations are though, I think. I have had some "hallucinations". They aren't delusions, so I guess they should be called "illusions" instead. I can dig that.
That is why I am skeptical (*most* of the time) about all of the TLE stuff that I have been told (even by one neuro). Hey, antidpressants tweak with your head. They are bound to stimulate a range of bizarre phenomena at times in some folks at some times.
I had one EEG, nothing too remarkable. I don't have observable seizures. Benzos and certain anticonvulsants seem to help, but beyond that I am clueless.
Just an FYI from my own experiences: AD's that hit serotonin help with recall of melody, tone, pitch, feeling, emotion etc. It is like the "flavor" of the music. AD's that hit NE hard helps with lyrical recall and meaning, percussion, timing, movement (like the "structure" of the music).
I also get a corollary with visual stimulii as well: 5-HT enhancement increases visual perception of color intensity (an enhancement of "beauty"), while NE enhancement makes things seem more "contrasty", "detailed", organized.
Hey, maybe this is a completely new avenue of therapy! Re-route your brain by *learning* how to play and understand music-and get *better* connection between the hemispheres. I am sure a BIG long shot there!
Basically, I agree that it is "normal" for people-like you just mentioned. I talk to people that complain at times about having trouble "getting a tune out of their head" and they don't appear to behave like "obsessive-compulsives".
But, the bottom line is "why music?", why is it there-why is it so *hard-wired in*? And why do certain meds tweak with it in so many bizarre ways?
Mitch
> I'm not trying to be a smart aleck or make light of the subject but...
>
> Isn't this normal in all people? I didn't know that having a tune in one's head was abnormal in any way. Sure, maybe some people have music present more often than others but...
>
> You see, I'm not trying to discount the idea. Just sort through it. Now that I've stated the above, I will say that I noticed way back when I was a teenager that if I had to go through a very stressful night (I lived with a mother who had dramatic emotional problems that would in turn scare me and keep me on a high-stress level most of the night some nights) that this music would become louder and more insistent in my head. My theory was/is that it is a calming mechanism of some sort.
>
> And when I took zoloft and raised the dose from 100 mg. per day to 150, I immediately noticed what seemed like louder and more pervasive music and/or conversation in my head. Not delusions, just normal tunes-going-through one's head but they seemed just... louder, for lack of a better description.
>
> I never thought that this was a symptom of any disorder, though.
Posted by Anna Laura on June 6, 2001, at 1:25:49
In reply to Intrusive Music and OCD , posted by Lemon on June 5, 2001, at 11:59:21
> _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
>
>
> Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
>
> The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
>
>
> When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
>
> This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
>
>
> What is the experience like?
>
> The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
>
> A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
>
> A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
>
> Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
>
> In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
>
> It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
>
>
> What triggers it?
>
> Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
>
> Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
>
> It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
>
>
> Treatment
>
> So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
>
> Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
>
> In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
>
>
> (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.
I've been experiencing music in my head in a very mild form and quite rarely (something like three or four times in a year) all my life through.
I experienced that quite often during my childhood.
I guess was triggered by stress (i was frequently abused as a child).
Last time it happened was in the days my TCA (tofranil) kicked in (This January) and was triggered by a continous roaring sound (the sound of an engine going). It was quite frightening 'cause i couldn't control it, but it eventually faded a way in a matter of minutes.
Strangely, I experienced that while i was in love ten years ago: I could listen to my favorite song every time i wanted to; Sometimes i "produced" it: i.e. while i was on the train or sitting in a bus and i was getting bored and had nothing to do.
Sometimes it started in my dreaming and lasted few minutes after awakening. (This was much more frequent when i was a child).
This is my experience so far: hope that it helped to clarify.
Posted by Lemon on June 6, 2001, at 5:06:41
In reply to Re: Intrusive Music and OCD , posted by Anna Laura on June 6, 2001, at 1:25:49
> > _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
> >
> >
> > Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
> >
> > The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
> >
> >
> > When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
> >
> > This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
> >
> >
> > What is the experience like?
> >
> > The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
> >
> > A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
> >
> > A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
> >
> > Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
> >
> > In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
> >
> > It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
> >
> >
> > What triggers it?
> >
> > Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
> >
> > Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
> >
> > It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
> >
> >
> > Treatment
> >
> > So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
> >
> > Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
> >
> > In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
> >
> >
> > (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.
>
>
> I've been experiencing music in my head in a very mild form and quite rarely (something like three or four times in a year) all my life through.
> I experienced that quite often during my childhood.
> I guess was triggered by stress (i was frequently abused as a child).
> Last time it happened was in the days my TCA (tofranil) kicked in (This January) and was triggered by a continous roaring sound (the sound of an engine going). It was quite frightening 'cause i couldn't control it, but it eventually faded a way in a matter of minutes.
> Strangely, I experienced that while i was in love ten years ago: I could listen to my favorite song every time i wanted to; Sometimes i "produced" it: i.e. while i was on the train or sitting in a bus and i was getting bored and had nothing to do.
> Sometimes it started in my dreaming and lasted few minutes after awakening. (This was much more frequent when i was a child).
> This is my experience so far: hope that it helped to clarify.
For a better idea of what Dr. Pupko is referring to: On this site, do a "search with options, every term, all of the above," using the terms [ocd songs], [intrusive music], or [ocd music]. Also, you can go to http://groups.google.com and search for (intrusive music ocd).
Posted by grapebubblegum on June 6, 2001, at 8:10:47
In reply to Re: Wait a minute-or a meter » grapebubblegum, posted by Mitch on June 6, 2001, at 1:09:38
You said, "AD's that hit serotonin help with recall of melody, tone, pitch, feeling, emotion etc. It is like the "flavor" of the music. AD's that hit NE hard helps with lyrical recall and meaning, percussion, timing, movement (like the "structure" of the music)."
Would you please classify the following ADs that I have taken in the past as to the two categories you mentioned above? I have taken:
Prozac
Luvox
Zoloft
PaxilI would be interested to know because I have never seen these four compared as you mentioned. The Prozac was a long time ago; the Luvox was a miserable failed experience, and the Zoloft seemed to be the worst "offender" for loud music and conversation in head.
Thanks in advance, GBG
Posted by Mitch on June 6, 2001, at 16:58:14
In reply to Mitch, would you help me out here?, posted by grapebubblegum on June 6, 2001, at 8:10:47
Grapebubblegum:
ALL of the SSRI drugs you list tend to make the "intrusive music thing" for *me* worse. This tends to make me think the temporal lobe thing is a real possibility. However, SSRI type meds set up a "flow experience" where I just get up and get stuff done instead of sitting around thinking about doing it. So...right now I am taking anti-convulsants and a small dose of Zoloft (stopped Celexa-I would rather have GI distress/sleep troubles from the Zoloft than be all *wired* on the Celexa). I have problems with panic as well, so they "help", BUT they do cause a lot of strange phenomena that might lead a neurologist to tell me: "Don't take any SSRI meds".
By definition people with OCD feel distress and perform rituals to relieve the anxiety. I didn't see anything in the original post that discussed anything people did in response to the intrusive music that made them feel better (in the sense that the behavioural response was pathological in some way and that the "intrusive" music created a marked distress).
Mitch
Posted by Autumn Despotis on June 10, 2001, at 11:10:31
In reply to Intrusive Music and OCD , posted by Lemon on June 5, 2001, at 11:59:21
Hello. This article described something I've been experiencing for years! I was
amazed that someone else actually had this problem. When I was a child, I used to
hear soldiers marching, coming toward me, to take me away. I was only a little kid,
but it freaked the hell out of me!
The music thing isn't always so bad. When I try to go to sleep, however, it is an
entirely different story. I've been kept awake many nights because of this. I do have
other problems, which may be contributing factors. I have bipolar disorder, GAD,
and I exhibit a few psychotic symptoms at times. I'm in between doctors right now,
because the last guy just kept handing out drugs like a neverending gumball machine.
He wasn't paying any attention to my medical history, problems with potential side
effects, and has nearly killed me twice, by giving me really insane drugs. Hopefully,
things will improve with the new doctor. We'll see!Autumn
Posted by Blue Cheer 1 on January 19, 2002, at 20:48:44
In reply to Intrusive Music and OCD , posted by Lemon on June 5, 2001, at 11:59:21
> _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
>
>
> Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
>
> The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
>
>
> When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
>
> This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
>
>
> What is the experience like?
>
> The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
>
> A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
>
> A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
>
> Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
>
> In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
>
> It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
>
>
> What triggers it?
>
> Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
>
> Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
>
> It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
>
>
> Treatment
>
> So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
>
> Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
>
> In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
>
>
> (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Most of the images in obsessional-compulsive experiences are visual. However, there are--infrequently--cases of images that are other than visual. Auditory imagery occurring in the obsession is recognized in the literature. For example, textbooks refer to 'tunes in the head' (e.g. Slater and Roth, 1972, p.128; cf. Shepherd, 1978). The Sandler-Hazari Obsessional Inventory (others since then) includes an item intended to tap into this kind of experience. "I frequently find a thought or a tune keeps recurring in my head for a long time" (Sandler and Hazari, 1980, p. 272). Salman Akhtar et al. (1975) refer to a 23-yr-old student who could not rid his consciousness of a currently popular tune--a case that illustrates this phenomenon. A case described by Broadhurst (1976), as far as one can judge by the description provided, may be construed as one with a recurrent auditory image of a slightly more elaborate nature. Broadhurst (Anne) uses the term 'thought jingles' to describe this patient's symptom (p. 176). Samaan (1975) describes a 42-yr-old woman who had frequent auditory and visual images of her mother, which were of a frightening nature. A further clinical example is as follows:An elderly man had the recurrent intrusive auditory experience of a certain senseless phrase ('these boys when they were young'). He would 'hear' this in his own voice. (Case later documented in _The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder_ by Judith L. Rapaport, M.D.).
Obsessional-Compulsive Imagery -- Padmal DE Silva
_Behaviour Research and Therapy_ Volume 24, No. 3, pp. 333-350, 1986
Posted by Blue Cheer 1 on January 19, 2002, at 22:19:33
In reply to Non-Visual Obsessive-Compulsive Imagery, posted by Blue Cheer 1 on January 19, 2002, at 20:48:44
> > _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
> >
> >
> > Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
> >
> > The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
> >
> >
> > When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
> >
> > This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
> >
> >
> > What is the experience like?
> >
> > The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
> >
> > A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
> >
> > A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
> >
> > Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
> >
> > In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
> >
> > It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
> >
> >
> > What triggers it?
> >
> > Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
> >
> > Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
> >
> > It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
> >
> >
> > Treatment
> >
> > So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
> >
> > Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
> >
> > In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
> >
> >
> > (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.
>
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>
>
> Most of the images in obsessional-compulsive experiences are visual. However, there are--infrequently--cases of images that are other than visual. Auditory imagery occurring in the obsession is recognized in the literature. For example, textbooks refer to 'tunes in the head' (e.g. Slater and Roth, 1972, p.128; cf. Shepherd, 1978). The Sandler-Hazari Obsessional Inventory (others since then) includes an item intended to tap into this kind of experience. "I frequently find a thought or a tune keeps recurring in my head for a long time" (Sandler and Hazari, 1980, p. 272). Salman Akhtar et al. (1975) refer to a 23-yr-old student who could not rid his consciousness of a currently popular tune--a case that illustrates this phenomenon. A case described by Broadhurst (1976), as far as one can judge by the description provided, may be construed as one with a recurrent auditory image of a slightly more elaborate nature. Broadhurst (Anne) uses the term 'thought jingles' to describe this patient's symptom (p. 176). Samaan (1975) describes a 42-yr-old woman who had frequent auditory and visual images of her mother, which were of a frightening nature. A further clinical example is as follows:
>
> An elderly man had the recurrent intrusive auditory experience of a certain senseless phrase ('these boys when they were young'). He would 'hear' this in his own voice. (Case later documented in _The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder_ by Judith L. Rapaport, M.D.).
>
> Obsessional-Compulsive Imagery -- Padmal DE Silva
>
> _Behaviour Research and Therapy_ Volume 24, No. 3, pp. 333-350, 1986
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^Some may argue that these phenomena are not images *per se* , but hallucinations, and thus would not need to be taken into account in one's theorizing about imagery. It must be conceded that some obsessional imagery may appear, at first presentation, to be like hallucinations or pseudohallucinations. For example, Hamilton has observed: "At times they may be so vivid that they can be mistaken for pseudohallucinations". And there are, in the literature, instances of authors using these terms to describe particularly clear imagery; an example is the description of an obsessional rumination by Stern et al. as a 'pseudohallucination' of 'Drop dead'. However, closer analysis shows that these are different. There are no grounds for considering the kinds of imagery typically present in obsessional-compulsive patients as hallucinations or pseudohallucinations. Hallucinations have the properties of, among others, external location and realness or 'substance', and are felt to be independent of the person experiencing them. The most important defining feature is that they are experienced as veridical (real; genuine) at the time of their occurrence: the person believes that there is a real stimulus corresponding to his experience. Obsessional-compulsive images, on the other hand, are never experienced as veridical. Further, they are located in subjective space and are not felt to be independent of oneself. These are all properties of non-hallucinatory imagery. The only major feature that hallucinations may appear to share with these images is that of 'unwilledness' or spontaneity, but even here there are important differences. Firstly, the compulsive image is not a spontaneous occurrence. While a hallucination is always beyond the control of the person, the compulsive image is, by definition, brought about by the person. (Not the case, however, in obsessional images -- no cognitive precipitant is necessary -- according to Michael A. Jenike, M.D. in _Obsessive-Compulsive Disorders: Practical Management_.) Secondly, even the other three types of obsessional-compulsive imagery (Obsessional Image, Disaster Image, and Disruptive Image), while spontaneous in their normal course, can be evoked deliberately by the patient, if with some difficulty, as numerous clinical and research reports have shown (e.g. Likieman and Rachman, 1982; Rachman and de Silva, 1978). Thus, one can safely conclude that obsessional-compulsive images cannot be relegated to the realm of hallucinations. Whether they can be regarded as pseudohallucinations is largely a fruitless question as this term has been defined in different ways (multiple citations). Taylor (1983) calls them, along with hallucinations, 'para-percepts' and states that they are not experienced in inner subjective space. All definitions seem to agree that they have the quality of spontaneity; it is stressed that they cannot deliberately be evoked or altered. On both these counts obsessional-compulsive images fall outside the domain of pseudohallucinations. It is worth, too, pointing out in passing that the validity and usefulness of the concept of pseudohallucinations have been seriously called into question (e.g. Gelder, Gath and Mayou, 1983).
Obsessional-Compulsive Imagery, Padmal DE Silva
Behaviour Research and Therapy Vol. 24, No. 3, pp. 333-350, 1986
Posted by Blue Cheer1 on May 28, 2002, at 4:49:21
In reply to OCD Images Hallucinations and Pseudohallucinations, posted by Blue Cheer 1 on January 19, 2002, at 22:19:33
> > > _I've Got the Music in Me: A Look at Intrusive Music and OCD_ by Harold Pupko, M.D.
> > >
> > >
> > > Musical Hallucinations (MH) are defined as the experience of music without any coexisting external stimulus. Not restricted to simple tunes or melodies, they can include the experience of rhythms, harmonics, or timbre depending on the musical appreciation level of the "hallucinator." This being the case, diagnosis may depend on the musical-appreciation talents of the diagnostician.
> > >
> > > The medical literature describes the phenomenon of MH as rare, more commonly occurring among those with unilateral or bilateral deafness (transient or permanent), and those with brain disease. As the elderly are more prone to both conditions, MH is more commonly reported in this age group. As a clinician whose practice includes many patients with Obsessive-Compulsive Disorder (OCD), I am surprised that a diagnosis of intrusive music, a form of OCD, is rarely entertained by the psychiatrists and neurologists who write about MH in the scientific journals.
> > >
> > >
> > > When I ask my OCD patients about intrusive music, I find that the phenomenon is quite common, with its expression ranging from mildly irritating to sometimes debilitating. More importantly, sufferers are relieved to finally have an opportunity to talk about these "unusual experiences" openly (as is the case with most OCD symptomatology). Because questions regarding intrusive music are not part of standard OCD inventories, such as the Y-BOCS symptom checklist, I hope that this article will stimulate my professional colleagues to start asking these questions so that OCD patients can be assured that they are not "loony tunes."
> > >
> > > This article is based on a review of the scientific literature, my clinical experience, and letters I received in response to a letter published in this newsleter this past summer.
> > >
> > >
> > > What is the experience like?
> > >
> > > The experience of intrusive music covers a wide spectrum. A common analogy is that of a radio in one's head; the volume can be high or low, ranging from low-level background music to feeling as if a "boombox" is blasting in one's brain. The music may be clear, with rich detail, or jumbled. Some patients report that they can experience two or more songs playing simultaneously (e.g., ragtime on top of a rock and roll). The music may consist of a bar, a phrase, or even an entire piece, followed by other pieces, in what may seem like an endless musical procession. The intrusive tunes are commonly familiar ones (e.g., religious hymns), although new compositions may erupt spontaneously. Intrusive music is usually triggered by hearing music, from the bells of the local ice cream truck to popular music on the radio. Advertising jingles as well as television and radio signature tunes are notorious triggers. Once heard, the music repeats over and over, lasting anywhere from seconds to hours to days, and in extreme cases, months.
> > >
> > > A key point to keep in mind is that OCD sufferers maintain insight into the source of the music, knowing that it emanates from their own minds, and cannot be heard by others (i.e., they are aware that they are not psychotic).
> > >
> > > A common feature of this condition is that, like nature, musical OCD abhors a vacuum. Patients report that when they are highly focused on some outside task or conversation, the symptoms diminish, only to reappear when their minds are not actively engaged. However, when less focused, the music tends to compete, and often draws the attention away from the preferred target.
> > >
> > > Intrusive music may also be triggered by feelings, thoughts, or words that can, in turn, trigger associations. This is not to be confused with synethesia, where one sensory modality is experienced as another (e.g., tasting colors), although there may be an overlap between the processes at work in the OCD sufferers and synesthetics. For example, the color blue may trigger the title "Blue Suede Shoes," which, in turn, may automatically trigger the experience of a random song from one's internal Elvis collection.
> > >
> > > In some cases, intrusive music may "leak" out in the form of humming at inappropriate times. This may lead to embarrassment for the sufferers and/or people close to them, and the individual may not even be aware that this is occurring. This is not to say that humming or hearing music in one's head is abnormal in any way; but rather, that its inappropriateness to the situation makes it pathological. Intrusive music, like other forms of OCD, can truly detract from the quality of one's life, preventing even the enjoyment of the simplest of pleasures, such as a sunset savored in perfect silence. Even when the music stops, the resulting mood can linger on in a person's mind, often to the sufferer's detriment.
> > >
> > > It is important to note that unilateral musical hallucinations which appear to emanate from one's ear may be a sign of neurological disease.
> > >
> > >
> > > What triggers it?
> > >
> > > Muscial OCD, like other forms of OCD, thrives under certain conditions. Stress, depression, or any other condition that deprives one of sleep, resulting in fatigue, certainly aggravates it. Intrusive music can also cause insomnia and poor sleep quality, thus perpetuating itself in a vicious cycle. Sufferers often note intrusive music to be their first experience upon wakening in the morning. There is one report in the literature of intrusive music resulting from a single head injury. I also received one letter reporting on such a case. Interestingly, both cases were well controlled by medication (Anafranil in the former, Paxil in the latter). OCD can be seen in some cases as the result of a susceptible brain being further compromised, with resultant symptomatology. For example, a case is described of a patient with "basal ganglia pathology" who developed repetitive musical intrusions secondary to having a low-blood calcium and phosphorus levels. Correction of this metabolic deficiency eliminated the intrusive music.
> > >
> > > Prescription drugs, especially stimulant drugs, or the withdrawal of sedative drugs (with the resultant stimulation of the cortex) as well as those that lower blood pressure, can precipitate MH, especially in those already at risk (e.g., the deaf, etc.). For example, Anafranil was described in one case to trigger musical hallucinations.
> > >
> > > It is interesting to note that there is some evidence that representation of musical information shifts with musical training from the non-dominant to the dominant hemisphere of the brain. As OCD is considered by some to be an information-processing problem, it may, for purposes of speculation only, be possible that a flawed transfer of musical information between the hemispheres of the brain contributes to the problem.
> > >
> > >
> > > Treatment
> > >
> > > So what's a sufferer to do? Avoidance of music in our daily lives is virtually impossible. Behavior therapy (BT), although potentially useful, is not that impressive, based on my clinical experience. Nevertheless, techniques such as visualizing the music as coming from a tape recorder and then hitting the pause button, or manipulating the volume control as a form of thought-stopping, should be considered. "Cranking the volume up" as exposure therapy has been suggested by some behavioral therapists as an effective technique, but I have yet to hear of a successful treatment with this approach, specifically for sufferers of intrusive music.
> > >
> > > Once underlying conditions, as discussed above, are eliminated, medication should be seriously considered for those with significant impairment. This form of OCD can be responsive to the traditional medications for OCD (i.e., Anafranil, Prozac, Paxil, Zoloft, Luvox). There is no specific drug preferred for this condition, and finding the right one and correct dosage os still a matter of trial and error. The goal should be the elimination of symptoms, but realistically, sometimes all one can achieve is alleviation. If medication fails or severely aggravates the symptoms, one diagnosis that should not be overlooked is temporal lobe epilepsy, as it too can produce hallucinations. Consultation with a neurologist who is competent in this area should be considered.
> > >
> > > In summary, intrusive music is common, can be debilitating, and is often overlooked in the management of OCD. I hope this brief review will stimulate discussion about this topic for the increased well-being of OCD sufferers everywhere. Comment on this article would be greatly appreciated. Please write to me at (author's address). I would like to thank all of the readers who took the time to share their experiences with me.
> > >
> > >
> > > (From _OCD NEWSLETTER_ Volume 11, Number 2; April, 1997 -- by Harold Pupko, M.D.
> >
> > ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
> >
> >
> > Most of the images in obsessional-compulsive experiences are visual. However, there are--infrequently--cases of images that are other than visual. Auditory imagery occurring in the obsession is recognized in the literature. For example, textbooks refer to 'tunes in the head' (e.g. Slater and Roth, 1972, p.128; cf. Shepherd, 1978). The Sandler-Hazari Obsessional Inventory (others since then) includes an item intended to tap into this kind of experience. "I frequently find a thought or a tune keeps recurring in my head for a long time" (Sandler and Hazari, 1980, p. 272). Salman Akhtar et al. (1975) refer to a 23-yr-old student who could not rid his consciousness of a currently popular tune--a case that illustrates this phenomenon. A case described by Broadhurst (1976), as far as one can judge by the description provided, may be construed as one with a recurrent auditory image of a slightly more elaborate nature. Broadhurst (Anne) uses the term 'thought jingles' to describe this patient's symptom (p. 176). Samaan (1975) describes a 42-yr-old woman who had frequent auditory and visual images of her mother, which were of a frightening nature. A further clinical example is as follows:
> >
> > An elderly man had the recurrent intrusive auditory experience of a certain senseless phrase ('these boys when they were young'). He would 'hear' this in his own voice. (Case later documented in _The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder_ by Judith L. Rapaport, M.D.).
> >
> > Obsessional-Compulsive Imagery -- Padmal DE Silva
> >
> > _Behaviour Research and Therapy_ Volume 24, No. 3, pp. 333-350, 1986
>
>
> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>
> Some may argue that these phenomena are not images *per se* , but hallucinations, and thus would not need to be taken into account in one's theorizing about imagery. It must be conceded that some obsessional imagery may appear, at first presentation, to be like hallucinations or pseudohallucinations. For example, Hamilton has observed: "At times they may be so vivid that they can be mistaken for pseudohallucinations". And there are, in the literature, instances of authors using these terms to describe particularly clear imagery; an example is the description of an obsessional rumination by Stern et al. as a 'pseudohallucination' of 'Drop dead'. However, closer analysis shows that these are different. There are no grounds for considering the kinds of imagery typically present in obsessional-compulsive patients as hallucinations or pseudohallucinations. Hallucinations have the properties of, among others, external location and realness or 'substance', and are felt to be independent of the person experiencing them. The most important defining feature is that they are experienced as veridical (real; genuine) at the time of their occurrence: the person believes that there is a real stimulus corresponding to his experience. Obsessional-compulsive images, on the other hand, are never experienced as veridical. Further, they are located in subjective space and are not felt to be independent of oneself. These are all properties of non-hallucinatory imagery. The only major feature that hallucinations may appear to share with these images is that of 'unwilledness' or spontaneity, but even here there are important differences. Firstly, the compulsive image is not a spontaneous occurrence. While a hallucination is always beyond the control of the person, the compulsive image is, by definition, brought about by the person. (Not the case, however, in obsessional images -- no cognitive precipitant is necessary -- according to Michael A. Jenike, M.D. in _Obsessive-Compulsive Disorders: Practical Management_.) Secondly, even the other three types of obsessional-compulsive imagery (Obsessional Image, Disaster Image, and Disruptive Image), while spontaneous in their normal course, can be evoked deliberately by the patient, if with some difficulty, as numerous clinical and research reports have shown (e.g. Likieman and Rachman, 1982; Rachman and de Silva, 1978). Thus, one can safely conclude that obsessional-compulsive images cannot be relegated to the realm of hallucinations. Whether they can be regarded as pseudohallucinations is largely a fruitless question as this term has been defined in different ways (multiple citations). Taylor (1983) calls them, along with hallucinations, 'para-percepts' and states that they are not experienced in inner subjective space. All definitions seem to agree that they have the quality of spontaneity; it is stressed that they cannot deliberately be evoked or altered. On both these counts obsessional-compulsive images fall outside the domain of pseudohallucinations. It is worth, too, pointing out in passing that the validity and usefulness of the concept of pseudohallucinations have been seriously called into question (e.g. Gelder, Gath and Mayou, 1983).
>
> Obsessional-Compulsive Imagery, Padmal DE Silva
>
> Behaviour Research and Therapy Vol. 24, No. 3, pp. 333-350, 1986******************************************
Excerpts from _The Boy Who Couldn't Stop Washing: The Experience & Treatment of Obsessive-Compulsive Disorder_ -- Judith L. Rapaport, M.D. (1989)
Chapter 15; "The Music Goes 'Round and 'Round""You have to see how it is with these tunes," he pleaded. [16-year-old boy to Dr. Rapaport]
"Other people joke when they complain about tunes stuck in the head, but they *enjoy* it. (asterisks denote author's emphasis) Mine are never enjoyable. They continue for hours, days, weeks, months, and years. They cannot be blocked out, these songs are like free spirits who come and go whenever they please."Another case: (Don)
"In Don's case, we were also sure that the tunes were obsessive because Don had the other symptoms--washing, counting and checking--that were typical. The tunes in some way felt sort of the same. There was nothing pleasant in these tunes: they were senseless, stuck in the head, a relentless repetitive force that is the essence of any obsession. He had to fight against this music just to get on with the day."
"Most of the images in obsessive-compulsive experiences are visual. There are, however, infrequent (far more common than Dr. Rapoport, I believe, realized in 1989, as Dr. Harold Pupko's article, _Intrusive Music and OCD_ delineates) cases of images that are other than visual. Textbooks have referred to tunes in the head.""These specific musical images of OCD are quite rare; visual images are relatively uncommon among our patients. (I think Dr. Rapaport is referring to a patient population she was studying at NIMH around the time of the publication of the book.) But because OCD is so much more common than we ever believed, it is likely that there are several thousand others like Don and George (another case) walking around who think that only *they* have the tunes, who don't know that they might be helped by drugs or therapy. Unless you spend time to talk about such things [something our patients avoid most of their lives], you never will find out about help. Reptitive tunes in the head are hardly an everyday topic; and anyway obsessives are a secretive group. Possibly only musicians would have trouble concealing this affliction, as the repeating tunes could influence their composition (example detailed by Dr. Rapaport about Eric Satie)."
"The images in Obsessive-Compulsive Disorder are concrete and detailed. They are not hallucinations; they are seen as definite projected images recurring in the same form, down to the same detail. Obsessive images come from "inside," unlike hallucinations which are seen "out there." All that obsessive images have in common with hallucinations is that neither patient wants them around!"
Posted by Ritch on May 28, 2002, at 9:54:49
In reply to The Music Goes 'Round and 'Round, posted by Blue Cheer1 on May 28, 2002, at 4:49:21
Blue,
A really fun "compilation" you have made there! (I also just happen to have Blue Cheer's "Good Times Are Hard to Find" compilation on CD) I think the authors should also have talked about intrusive music as symptoms of possible epileptiform activity. The SSRI meds used to treat OCD always *worsen* the intrusive music I experience. Psychostimulants *and* anticonvulsants seem to *suppress* it. I ran out of a Depakote script recently and whew! it definitely got worse. My alarm was beeping and I turned it off and continued to hear it for nearly an hour! The most pleasing intrusive music situation I can remember was a class in college where we all had these squeaky wood chairs. The professor had the largest squeaky chair and he would drag it on the tile floor at the beginning of class. The minute the wood would begin to scoot it would hit the *exact* key the woodwind at the beginning of "Strawberry Fields Forever" hits. I would sit there listening along not paying any attention or taking any notes until it finished. Ok, now you have got me listening to the bass lines in "Parchment Farm"! :)
Mitch
Posted by Blue Cheer1 on May 28, 2002, at 22:52:37
In reply to Re: The Music Goes 'Round and 'Round » Blue Cheer1, posted by Ritch on May 28, 2002, at 9:54:49
Thanks, Mitch. I'll reply as soon as I can. Right now, I'm really spaced out and crashing on Provigil. SSRIs worsen my music and all the other OCD symptoms, too - right off the bat (Provigil, also). I liked Blue Cheer, too, but I made up this nick after the first hallucinogen I used. I never had this intrusive music until Valium d/c. I'll describe the way I experience it when I have the energy. It's just like Dr. Pupko describes for me. For example, when my daughter put a Beatles poster on her wall, I looked at it and "Penny Lane" was in my head the rest of the day. I agree with you about the various causes and types. I don't like being bipolar and telling doctors about this, because some want to attribute it to mania or the illness (even though I was hospitalized for OCD and the symptoms began right before that time - following Valium d/c after 20 years. The only time mine really fade is when I'm hypo/manic. When I crash hard into a depression, they're at their worst.
Blue
> Blue,
>
> A really fun "compilation" you have made there! (I also just happen to have Blue Cheer's "Good Times Are Hard to Find" compilation on CD) I think the authors should also have talked about intrusive music as symptoms of possible epileptiform activity. The SSRI meds used to treat OCD always *worsen* the intrusive music I experience. Psychostimulants *and* anticonvulsants seem to *suppress* it. I ran out of a Depakote script recently and whew! it definitely got worse. My alarm was beeping and I turned it off and continued to hear it for nearly an hour! The most pleasing intrusive music situation I can remember was a class in college where we all had these squeaky wood chairs. The professor had the largest squeaky chair and he would drag it on the tile floor at the beginning of class. The minute the wood would begin to scoot it would hit the *exact* key the woodwind at the beginning of "Strawberry Fields Forever" hits. I would sit there listening along not paying any attention or taking any notes until it finished. Ok, now you have got me listening to the bass lines in "Parchment Farm"! :)
>
> Mitch
Posted by omega man on June 1, 2002, at 22:25:44
In reply to The Music Goes 'Round and 'Round, posted by Blue Cheer1 on May 28, 2002, at 4:49:21
all that well researched info reminds me how an analysis of a problem leads to no creative or "fun" solution...
When creating music ..usually the driving force is music "going round and round" in the head..
The finest music making tools today all operate on a loop creating system ..meaning the people who make the tools seem to have a better insight into what relieves the brain of the aurally loopy than the psychiatrist..
Theres more too...
After many years of being involved in this creative solution you actually look forward to getting a label..
hopefully the record type....
Posted by Ritch on June 2, 2002, at 9:20:45
In reply to Re: The Music Goes 'Round and 'Round, posted by omega man on June 1, 2002, at 22:25:44
> all that well researched info reminds me how an analysis of a problem leads to no creative or "fun" solution...
>
> When creating music ..usually the driving force is music "going round and round" in the head..
>
> The finest music making tools today all operate on a loop creating system ..meaning the people who make the tools seem to have a better insight into what relieves the brain of the aurally loopy than the psychiatrist..
>
> Theres more too...
>
> After many years of being involved in this creative solution you actually look forward to getting a label..
>
> hopefully the record type....
Maybe what causes people so much "pain" isn't really OCD (musicwise at least), it is an undeveloped outlet for *creative* control of their loops! It would be neat if one could take a cross-section of people's daily thoughts and see how they get hosed up by "work 24/7" culture.
Posted by omega man on June 2, 2002, at 14:01:56
In reply to Re: The Music Goes 'Round and 'Round » omega man, posted by Ritch on June 2, 2002, at 9:20:45
the problem is if you cant support yourself with the creativity you have to work..
some of were born not to ....in the traditional sense that is..
Posted by kpo2002 on June 6, 2002, at 11:51:06
In reply to Re: Intrusive Music and OCD , posted by Glenn Fagelson on June 5, 2001, at 21:48:44
this is an interesting thread...I doubt this disorder is in the DSM. I can see that there is a definite difference between a musical hallucination and intrusive music. The person having a hallucination would perceive it as real and expect that other people could hear it as well, and intrusive music is just in your own thoughts.
Well, I had a musician friend who suffered with schizo-affective disorder and he told me of an episode where he spent the day at the zoo with a bunch of friends and he had one particular song playing over and over in his head for the whole entire day and he could not get rid of it for anything and it ruined his whole day, and even though it happened years ago every time he hears that song or even thinks about that song or the zoo he is reminded of that whole awful experience.
This is the end of the thread.
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