The medical muse

PSYCHOSOMATICS

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

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

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

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

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

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

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

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

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

K. W. BERBLINcER, M.D.

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

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

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

W.O.

Volume IV