Psychiatrist- Acute Hearing Problem

[Lavinia]

My MC has suddenly contracted "acute hearing." As it turns out it will be a sort of autistic-like hearing that she has; well, it's a long story. Anyway- wondering what a psychiatrist would say to a person who comes in saying they hear things really loudly. My MC has lost her job because of it. She hears even the smallest of sounds as if they have been amplified. She now thinks she's crazy. So my question is, "What would a psychiatrist say or suggest to such a person? What kind of therapy or assignments might be offered? Would medications be tried? Would any sort of mental illness be suspected?"

This has come on suddenly and main character is in her mid-20's, if that helps.

I know this is a weird one. Any help appreciated. Thanks! ~Lavinia

[Cyia]

Except that in this case, the MC would most likely be hearing things that make her think she's nuts. From experience I can tell you that with "autistic-like" hearing, she'd pick up things most people wouldn't believe.

"Blue screens" on televisions (pass through a doorway when one's on and you can just about feel it.)

Chargers for cell phones and small devices like video games -- there's a horribly shrill sound.

Even something like hearing surveillance equipment in a supermarket or department store; she'd be able to pick out every security camera because she could actually hear it. (That one used to drive me nuts)


ETA: and all that is on top of hearing through walls and being able to hear multiple conversations at once in crowded room. It's usually a matter of pitch rather than just volume.

[Kitty Pryde]

Earplugs are a $1 solution to her problem. Failing that, those big earmuff thingies that people use when they are around loud noises, like shop equipment. Loads of people with autism use these and then they aren't bothered even by loud noises.

[cbenoi1]

Hearing in the high frequency range decreases dramaticly with age. The small hairs that pick up vibrations in that range break with time and can't be repaired, no matter how much the brain can enhance the signals.

Young people of age below 20 can have a frequency range up to 20KHz and it decreases after that. There are even 'teenager repellent' devices based around that. Check here:

http://www.boingboing.net/2005/11/30/antiteenager-sound-w.html

Some people can experience tinnitus, some sort of resonnant frequencies that stand out from the spectrum and become part of that individual's background noise sensitivity. It's a frequent occurance with music players (drummers, particularly) and with people who work with a sound-repeating tool (ex: a jack hammer).

I don't know how realistic you need your plot to be, but I'm afraid your premise just won't work here.

-cb

[Lavinia]

She's already gone to her regular doctor, who sent her to a specialist. He did learn that she indeed has acute hearing, but has no "cure" for it. On her own she has taken to using earplugs. She has also basically sound proofed her apartment. Of all the things her original doctor suggested, one of them was to see a psychiatrist. She balked as she knew she was hearing things acutely and didn't believe it was a psychological or psychiatric problem. But now she's desperate. In the end, I am using the psychiatrist as the person who will say, "When did this all begin" in a way that will finally trigger when it all began. She's been asked before but didn't tie it to the key event in the story.

I have 15-years of experience in teaching children with autism, so have a lot of knowledge that way. But when it comes to typically developing people, I am less knowledgable. Just want to know what a psychiatrist would say.

ETA: As realistic as possible, except for the part where the MC is experiencing what a little boy (who really existed) did in the 1800's. The boy was an autistic savant who was poorly treated. He is alive in present time and in the end, she will rescue him, in a sense. But your information will help me make it even more realistic, as I can have a doctor state what you did. Thanks.

Cyia- Thanks for the thoughts. I hadn't thought of those. I'll definitely think of adding those in.

Oh and the other thing about this whole, "I think I might be crazy" thing (though she's not admitting it for most of the novel) is that her father committed suicide under suspicious circumstances.

Thanks for the suggestions so far. Still looking for that, "What would a psychiatrist say" thing. ~L

[cbenoi1]

> "What would a psychiatrist say"

I don't think an audiogram will be of any use here. The psychiatrist will be more interested in what she hears specifically rather than dealing with the pure physics of it, and try to match it with some an existing psychological trauma.

> is that her father committed suicide under suspicious circumstances

For example, your MC could be reacting to the hissing sound of propane gas escaping, because she was nearly killed in the gas explosion that took away her father. That sort of thing. Most people would not normally picking this sound out of a cacophony, but she could.

Claiming that your MC suddently inherited Bionic Woman's hearing is stretching it, imho.

-cb

[Lavinia]

Thanks. That gives me a place to start...makes sense too. ~L

[Rabe]

Thanks. That gives me a place to start...makes sense too. ~L

The thing is...

I'm not sure what a psychiatrist would say in this case. If a medical doctor said there was something actually wrong with her physiologically then a psychiatrist would only be interested in how she's dealing with it.

Now, if every doctor she went to said she was 'normal' and she still insisted she heard all of this then it might become a psychological problem. However - as it stands...until she starts having actual psychiatric problems...I'm not really sure what a psychiatrist can do for her.

Does it NEED to be a psychiatrist to ask when it started? I mean, you said she went to a doctor who referred her to a specialist. Surely one of them would actually ask when this began. That seems to be what should trigger the revelation more than going to a pyschiatrist for a physiological problem.

And autistic people have a higher hearing range? Or that they just react to sounds differently? (I'm actually asking this because it sounds interesting) I know, for myself, once you get more than three or four people in a room and side conversations begin - I need to leave because it's just too much jumbled noise for me.

rabe...

[cbenoi1]

> And autistic people have a higher hearing range?

No they don't. They just react to specific sounds. I think there is confusion here between the degradation of the sensor (human ear) which is expressed as a frequency range and what is processed by the brain. Let me put this in situations.

BAD: "Sarah, 30, freaks out whenever she hears the vertical retrace buzz sound of her TV". She can't physiologically hear the sound. It's at around 18KHz and her hearing has degraded significantly at this frequency.

GOOD: "Sarah, 12, freaks out when she shops at XXXX. There is a terrible buzz near the windows". At 12 years of age, she's likely to be annoyed by some 'teenager repellent' device.

VERY GOOD: "Sarah, 30, talks to her friend Brenda over the phone. Then she hear this weird sound in the phone and freaks out.". The phone works in the 300 - 3KHz range. That would be a Litmus test for any freaky sound you can come up with. If you can hear it in the phone, then anybody can physiologically hear it. Then your MC can have a psychological reaction to that particular sound. I suggested propane gas hissing, but it could well as be anything your story needs.

So, you will be find if you can find a sound that could be heard over the phone. It's a matter of associating it with a psychological trauma.

-cb

[Cyia]

Yes, people who express certain forms of autism and autistic traits have more acute hearing and senses of scent. It's not just being bothered by sound; it's picking up sounds that no one else notices. And it's annoying.

[veinglory]

If the doctor established her hearing is actually acute the psychiatrist would probably refer her to a counsellor who would help her develop coping strategies (wearing earplugs designed to normalise her hearing range seems appropriate to me). The psychiatrist would not be equipped to treat anything other than secondary depression or anxiety.

[IceCreamEmpress]

I would think the GP would refer her to a neurologist long before referring her to a psychiatrist, and so would the audiologist. Odd auditory symptoms could be a sign of a variety of neurological issues.

Also, I'm 44 and I can still hear "teenager repellent" devices and various TV static. Unusually acute hearing is not always a blessing!

[Cranky]

Yes, people who express certain forms of autism and autistic traits have more acute hearing and senses of scent. It's not just being bothered by sound; it's picking up sounds that no one else notices. And it's annoying.

Downright painful for some, including my son. Too much input...it's overwhelming.

ETA: He's classically autistic.

[SirOtter]

Noise sensitivity can be a symptom of Asperger's Syndrome, which is an Autism Spectrum Disorder. It's rarely the only manifestation, though.

[Cyia]

Picking up unusual sounds (not just by pitch, I mean things that no one else can hear because they aren't there) can also be an indication of a brain tumor; they'd probably want to do a scan.

[Lavinia]

She has seen a neurologist. The students I worked with over the years did have very acute hearing (not all of them, but many). I also heard Temple Grandin speak once and she said that it is the same for vision. One thing she spoke of was looking at a person's hair. For us, we see it as basically, a whole. For her, she saw each single hair, making it almost painful and terribly distracting.

So yeah, it's a complicated deal, but one I continue to learn a lot about. Lots of great thoughts here. Thanks all! You all are giving me lots of new directions to continue my research. ~L

[veinglory]

Grandin is speaking not of the ability to perceive, but the way attention is focussed. She can't see more about a persons hair than anyone else, but she is programmed to focussed on specific whereas most people would garner a general impression and not choose to focus on the hair.

Likewise a person with an attentional disorder (i.e. schizophrenia) might tell you how they just met a person with shiney black shoes, but have failed to notice it was a policeman who was arresting them.

Any psychiatrist finding an actual difference in hearing, would realise the underlying problem was not attentional.

[ideagirl]

My MC has suddenly contracted "acute hearing." As it turns out it will be a sort of autistic-like hearing that she has; well, it's a long story. Anyway- wondering what a psychiatrist would say to a person who comes in saying they hear things really loudly. My MC has lost her job because of it. She hears even the smallest of sounds as if they have been amplified. She now thinks she's crazy. So my question is, "What would a psychiatrist say or suggest to such a person? What kind of therapy or assignments might be offered? Would medications be tried? Would any sort of mental illness be suspected?"

The psychiatrist would say, "See a neurologist. Here's a referral."

[Lavinia]

Vein- You are right.

Ideagirl- Already been done.

I always try to keep my posts and questions as short as I can. I assume that most people are like me...busy. But I am seeing that the problem with that is that I end up getting great suggestions in directions that I've already covered (though you all have no way of knowing that). And I end up doing a lot of backtracking explaining that, instead of focusing on the original question. Don't get me wrong, there are suggestions I will pursue further. I guess I just have to look at this as a process. And afterall, that's what writing a book is all about, right?

So back to the original question. Let's say, for sake of argument that all other avenues have been pursued and that it makes total sense for her to be here. My MC is sitting in front of the psychiatrist. What might a psychiatrist say to her? Would any sort of mental illness be suspected? And if so, what?

Thanks for hangin' in here with me. ~L

[IceCreamEmpress]

The only reason your MC would be sent to a psychiatrist is if the sounds she was hearing were assumed to be hallucinations rather than actual sounds.

This seems unlikely, because the GP would have sent her to an audiologist first, and he or she would have detected a change in your MC's hearing (if there actually was such a change).

[veinglory]

I think something must be missing. Because a good psychiatrist would require a direct organic cause be elminated first. It would only make sense to be there if that had not been found.

In which case a range of possibilities would exist divided roughly into attentional disorders and depression/anxiety.

[Cyia]

A psychiatrist would be interested in whether or not the MC is hearing voices. THAT could be a sign of mental illness; ambient sounds would be a tougher sell.

[Izunya]

Actually, you know, I can see a character being railroaded toward a psychiatrist if she doesn't know how to stand up to doctors.

I have fibromyalgia. I can tell you that people with screwy diseases—especially screwy diseases with highly subjective symptoms—sometimes get a bit of a runaround. I can see someone being referred to a psychiatrist or psychologist if, for whatever reason, the medical doctor they're relying on doesn't believe them.

For this to happen, I'd say you need a number of things:
1. No easily testable symptoms. No scoring unbelievably high on your standard audiologist's test, etc.
2. Either a somewhat unsympathetic doctor or real trouble explaining exactly what she means.

You could also have your character scheduled for a whole bunch of different specialists and talking to a psychologist because that's just the first one she managed to get. I don't know what the waiting list for a neurologist is like, but I guarantee they have one.

Izunya

[nevada]

But physically hearing things can be measured with brain waves. so the neurologist would be able to do actual physical tests that prove she is hearing things. i just dont see how this could in any way lead to a psychiatrist.

[veinglory]

You don't even need brainwaves, a simple hearing test with a hand raising response will pick up high acuity.

[GeorgeK]

Even something like hearing surveillance equipment in a supermarket or department store; she'd be able to pick out every security camera because she could actually hear it. (That one used to drive me nuts)

.

I have hyperacusis and always have. Yes you can hear things that others don't, but in my case I've never been able to filter out and selectively listen to one particular thing. It's nice when you are walking alone in the forest. You can hear a snake crawling in the branches looking for birds or eggs and would be a big advantage for hunter-gatherers, but in an urban setting it is horrible. Crowded rooms become a cacauphony of voices and depending upon the acustics of the room and the pitch of the voices I can sometimes hear a conversation across the room better than the people next to me. Lawn mowers are just the wrong frequency and volume for me. We don't mow the lawn anymore. We have sheep mow it and the sound of their chewing is much gentler on the ears. Earplugs help, but they won't stay in. In the long run it's easier to avoid crowds and other loud places like movie theaters and concerts. You go to restaraunts etc. at off hours when they aren't crowded.

[GeorgeK]

You don't even need brainwaves, a simple hearing test with a hand raising response will pick up high acuity.


I imagine with digital stuff the tests are better than I was a kid. I could hear them pressing the buttons. There was a characteristic "click-clunk before every sound. They might as well have said, "I'm going to press the button now, can you hear a sound?"

But, for the OP, I guess it would be different suddenly developing hyperacusis as opposed to always having it. When you hear things that others don't it is natural to investigate the source and usually it is easy to determine the source and realize that you aren't crazy. It's just as if everyone around you is hard of hearing.