CBT

Here is the revolution psychology has been waiting for in cognitive behavioral therapy (CBT). The neurology of right-ear-driven left-brain dominance (Tallman Paradigm) that explains fundamental aspects of human behavior, whether normal or aberrant, can be corrected and fine-tuned with focused listening music therapy. This essay is directed to psychologists and other practitioners using CBT, who will find it useful to pair focused listening with their present CBT approaches.

Whether as one-on-one talking therapy, group therapy, or written materials designed to elicit written responses, CBT works with the language communications networks in the brain. Animal studies are designed to elicit physical responses rewarded by food pellets. Human studies are designed to elicit positive emotional responses to complex changes in self-destructive and socially problematical behavior. Unknown to most psychologists, psychiatrists, and physicians is the fact that human language communication networks are controlled primarily by the right ear. The following is a brief and simplified description of my discoveries pertaining to the etiology of normal and aberrant behavior in neurology controlled by audition.

Cognitive Behavior Therapy (CBT) is an effort to change socially or individually problematical, i.e., destructive, behavior by leading the client through a series of rational tasks intended to reinforce rational, healthy responses to unhealthy thought patterns and behavior. Those CBT stimuli may be verbal or written and take the form of exercises in thinking about problematical behavior in new ways. CBT can incorporate physical activity, which helps to embed new learning. Some CBT takes extreme measures of negative reinforcement, which Jeffrey M. Schwartz rejects as unsuitable to professionals and harmful to the client (The Mind and the Brain: Neuroplasticity and the Power of Mental Force, Jeffrey M. Schwartz and Sharon Begley, New York: Harper Perennial, 2002). At the other extreme, practitioners enter into paroxysms of self-examination regarding their “sensitivity” or “techniques” by which they introduce CBT to their clients, as if the therapist is to blame if the CBT does not work. They make efforts to examine new neurological research in respect to the precision of their diagnoses of their clients’ presenting problems.

An understanding of the etiology of many behavior problems as ear-related and an appreciation for the simplicity of effective treatment helps to mitigate some of those diagnostic and interactional anxieties.

Schwarz developed a modality of CBT that drew on his personal experiences of “mindfulness” in meditation. Schwarz succeeded in “reprogramming” OCD and Tourette’s clients by teaching them “willfulness,” a method of thinking in new ways about their problematical behavior that succeeded in changing those patterns of behavior. He explains the success of his work and the work of the practitioners who follow him according to a theoretical paradigm of brain function derived from quantum physics. His theoretical model is speculative, although his successes were practical and indubitable because other practitioners have replicated his results. His effort to induce changes in his human subjects’ brains is founded on laboratory experiments with monkeys that created lesions in the brain and then retrained the monkeys for specific actions that could be identified with neuronal developments in their brains. The premise that the human brain’s neural connectivity is “plastic” and can be reformed, reshaped, retrained, and replaced is essential to Schwarz’s methodology and explanation and, indeed, to all CBT. However, the training of a simple physical response as compared with training a complex ideological response deserves a clearer theory.

Psychiatrist Norman Doidge has more recently explored numerous frontiers in psychology and medicine that attest to the brain’s plasticity (The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science, New York: 2007 and The Brain’s Way of Healing: Remarkable Recoveries and Discoveries from the Frontiers of Neuroplasticity, New York: Viking, 2015).

CBT, Schwarz’s modification of CBT that he calls “willfulness training,” and Doidge’s numerous accounts of neurological changes in the brain are missing an understanding of the role of the ear in brain function pertaining to communication.

Doidge in his second book (Chapter 8) reports on the Tomatis Method of “listening retraining” but without an overarching theory of how the method sometimes achieves astonishing results or any explanation as to why it may fail. Practitioners ply their CBT therapies on an unsteady field mapped by neurologists who recognize the terrain, but do not pay attention to one of the primary forces that shapes the geography of the human brain: sound energy. The inputs of the sensory organs to the brain are neglected fields of neurological study. The noted French otolaryngologist Alfred Tomatis made foundational discoveries about the role of the ear, especially of the right ear, in certain human behaviors: singing and speech and the syndrome commonly called dyslexia or attention deficit disorder (ADD) and its variant with hyperactivity (ADHD). He had significant success with stuttering and with autism. His colleague Guy Bérard made further discoveries, especially of the role of the left ear in depression. He treated suicidal depression, dyslexic syndrome, and other ailments with great success using his modifications of the Tomatis Method and specialized electronic equipment.

Our 16-year-old dyslexic son Daniel was treated in Toronto, Canada, with the Tomatis Method in 1997. Simultaneously, I was treated for chronic fatigue syndrome (fibromyalgia). Each of us attained remarkable healing, I within 4 days and Daniel within 10 days. Although the director of The Listening Centre, psychologist Paul Madaule, was accustomed to seeing such healings, neither he nor his mentor Tomatis had full explanations as to the mechanism by which these healings took place, why they sometimes did not, or why relapses occurred. They cured disparate conditions but did not recognize the relationships among them. That naiveté remained the case when Doidge recounted Madaule’s successes in 2015.

Within a week of his successful treatment for dyslexic syndrome (1997) Daniel became acutely schizophrenic, whereupon he was introduced to the psychiatric profession’s treatment modalities with calamitous results. The psychiatrists ignorantly blamed the music therapy Daniel had received for his schizophrenia. When I relapsed into CFS, as I did several times, I fortuitously encountered a curious variety of actions that revived my healing: laughter, singing, the triggering of a smoke alarm. At length, I settled on singing and listening to music through ordinary headphones to keep my illness away. I had not had time to discover a link between Daniel’s dyslexia and my CFS before the onset of his schizophrenia. I most certainly did not connect my CFS to Daniel’s schizophrenia!
During the 10 years of Daniel’s illness, my observations of his symptoms, testing of those observations, and learning about other aspects of his unfortunate psychiatric treatments led me to important discoveries. The first was that his ability to pay attention and to communicate somewhat intelligibly lasted for two minutes and fell apart for two minutes—by the clock. (I am abbreviating test results here.) I noticed his body’s frequent torque to the left and his temporary “loss” of one hand or the other at tasks where both were needed. Eventually, in 2006, Daniel reached out for my headphones. I saw instantaneous changes in his facial expression, posture, demeanor, and communication abilities that reminded me of the changes I had recorded when his dyslexia was cured at The Listening Centre. He and I cured his schizophrenia with a much simpler music therapy than the Tomatis Method: ordinary CDs of classical music amplified by headphones focused only on his right ear and enhanced by simple art exercises that proved, also, to be a useful diagnostic tool.

Tomatis’s discoveries included the asymmetrical neurology in the vagus system activating the larynx (voice). Stephen Porges’s explorations of the ventral vagal complex (VVC) could find additional support through my discoveries. The right-ear-driven stream of sound energy received by the temporal region in the brain and sent to the larynx muscles arrives first. The left-ear-driven stream of sound energy arrives a split second later because the left recurrent nerve (of the vagus system) descends into the chest in its more circuitous route to the larynx in the neck. Vocal responses are dominated, therefore, by the hearing of the right ear, although Tomatis did not fully comprehend that dominance and failed to recognize the necessary role of the left ear in vocalization.

I discovered that the primacy of the right ear in hearing (which Tomatis limits to the attentiveness he called “listening”) has a far greater impact on brain function than he realized. Furthermore, the role of the left ear is complementary, as well as distinctive in certain ways that he does not recognize. For example, it is the left-ear’s connection to the right-brain that creates the voice’s “emotional prosody,” the nuanced tonality to speech that augments the literal, grammatical meaning prioritized in the left-brain.

Daniel’s addictions drove him back into schizophrenia a couple of years later (2008). Not content only with healing him again, I was determined to understand how healing took place. I have personal, academic, and professional training in various kinds of research and set out to learn whether anyone else had noticed the aspects of Daniel’s schizophrenia symptoms that had convinced me his illness was purely physiological, especially his constantly fluctuating levels of cognition. Apparently, no one had. As my learning grew through my research, I found an explanation for those symptoms in something V.S. Ramachandran noticed when studying phantom limb pain: the left and right hemispheres of the brain perform quite different functions, although the plasticity of the brain (and, I would explain, a tertiary system of sound-created networks) allows either hemisphere to take on most of the activities of the other if one of them is lost.

The two halves of Daniel’s brain were alternating their very different modalities of influence on speech and other behavior at two-minute intervals.

Furthermore, in exploring Tomatis’s writing I saw that his neurological explanation for the dominance of the right ear in determining vocal pitch was the same neurological system that controlled many other systems of behavior and organ function. Stimulation of the ears, but more especially of the right ear, was increasing the dominance of Daniel’s rational left-brain over the intrusions of his emotional right-brain. It would be difficult to overestimate the importance of the Tallman Paradigm for understanding human health, states of consciousness, and behavior. I had found the explanation for serious mental illness that Tomatis had been looking for. As my search for healing for Daniel had been utterly without knowledge of Tomatis’s teaching about anatomy, I had replicated aspects of his work through my independent study, but also had corrected some of his errors and had expanded on his concepts of speech production and other integrated activities of the two halves of the brain.

During the 10 months of Daniel’s treatment and recovery, I watched him pass through the following sequence of behavior syndromes: three levels of decreasing severity of schizophrenia; bipolar I, bipolar II; obsessive-compulsive disorder and mild depression; dyslexic syndrome; normal thought processes and behavior. I saw, in retrospect, that he had progressed through those syndromes very rapidly and in reverse order during a run-up to severe schizophrenia. Once his capacity for learning had been restored, he began to learn how to defeat his multiple addictions. His brief psychotic interlude in 2016 allowed me to witness that rapid deterioration of his left-brain control, a validation of my retrospective knowledge. His recovery recapitulated the patterns of his first two recoveries. I have seen personally or have read about a great many children and adults who have moved from some sector of that spectrum through to normal behavior as a result of ear stimulation by the Tomatis Method or by focused listening, or by some other music therapy.

I would note, here, that my full understanding of all of the symptoms of schizophrenia was possible because in schizophrenia the integration of the cerebral hemispheres is running at the lowest possible speed, essentially, at zero. Schizophrenia (and its infantile form, now called “autism”) is extremely low or non-integration of the cerebral hemispheres. The hemispheres exert their influence on behaviour sequentially instead of integratively and at the alarming speed of two-minute switches. Most people exposed to a schizophrenic for a long time see little to no change in the condition. You might as well be staring at the face of a broken mechanical timepiece. However, I was watching Daniel’s healing process as the timing mechanism of his body—the right ear—gradually picked up speed. Changes in his facial expression, speech patterns, use of his hands, co-ordination of his limbs, and complexity in his self-concept and worldview were impelled by changes in his right ear. Integration takes place so fast in people with normal ear function—driven by frequencies up to and beyond 8,000 Hertz—that the connection between sound energy and brain development and brain function has eluded study.

Watching Daniel’s brain speed up as his right ear strengthened was particularly noticeable to me because my academic training in the analysis of English language and literature (among other subjects) made me aware of the changes in his sentence structure, vocabulary, and mental constructs as he steadily progressed from one set of behavior patterns to the next. His artwork reflected his healing as a “maturational” process and was a very useful diagnostic tool.

My most important discovery was that the sound energy stream through the right ear produces dominance in the left-brain over the activities of the right-brain during their integrative processes (in people with audition superior to the schizophrenic). A cascade of other discoveries flowed from that essential neurological paradigm, including the observation that schizophrenia (including autism) is a condition of non-dominance of the cerebral hemispheres due to audio-processing deficits in the right ear. Daniel’s progression through a spectrum of behavior patterns demonstrated that most other forms of “mental illness” are lesser degrees of left-brain dominance than the optimal norm of high left-brain dominance. In fact, that paradigm extends to depression caused by audio-deficits in the left ear that produce the range of depression because sound deprivation to the right-brain is experienced by the left-brain as a “black hole” of silence in its efforts to integrate.

I have seen schizophrenics, bipolars, dyslexics, and individuals diagnosed with chronic fatigue, addictions, or some other systemic problem move from their diagnosed location on that spectrum towards normal behavior and health under the influence of focused listening music therapy.

The human brain is a learning mechanism. CBT increases left-brain dominance, as does all communication, spoken or written or conveyed by images in a verbal context. I deduced that the transmission of specific frequencies in the sound energy stream through the ear is controlled by the tiny stapedius muscle in the middle ear. The vibrations of high-frequency sound (which need not be musical, but for practical and social purposes should be musical) exercise the stapedius muscle(s), which strengthens tonicity. Improved tonus allows the muscle to control the vibration of the stapes to better transmit the higher frequencies of sound. The greater precision and force of that transmission has a great effect on the brain, which transmits that energy along specific paths to the rest of the body. As “frequency” (vibrations per second measured in Hertz or kiloHertz) produce “sound energy units (joules) per second (or watt seconds),” the sound energy stream processed through the ear(s) drives integration processes at speeds that probably are measurable. Those speeds will vary depending on the severity of the client’s problem. We can confidently assume so because the specific frequency deficits for depression were determined by Guy Bérard to be predominantly in the left ear: at 1 and 8 kiloHertz for mild depression, at 1.5 and 8 kiloHertz for moderate depression, and at 2 and 8 kiloHertz for suicidal depression. It is highly likely that the range of behavioral disturbances caused by right-ear dysfunction follow a similar type of pattern.

Thus, “mental illnesses” are conditions of sound-energy deprivation to the cerebral hemispheres caused by audio-processing deficits in the middle ear, especially of the right ear but also in the left ear.

Daniel remained left-brain dominant for eight years until his reactions of shock and grief to his younger brother’s massive left-cerebral stroke (August 2015) increased his addictive use of marijuana. When he became schizophrenic again early in 2016, he used focused listening to cure his schizophrenic illness for the third time. He regained left-brain dominance in July after about five months of treatment. Less severe forms of stapedius muscle injury typically take two to four weeks of daily two-hour listening sessions, although the age of the person and length of time of the ear weakness must be considered. Some injuries heal spontaneously (see, for example, the Wikipedia article on Bell’s palsy, which is caused by stapedius paralysis) but may take months.

The Tallman Paradigm of right-ear-driven left-brain dominance in the integrative activities of the cerebral hemispheres explains normal behavior as well as aberrant behavior, provides a neurological explanation for the learning of language and of socialization using language, and of other brain functions such as states of consciousness, memory, imagination and creativity, and of some mental feats categorized these days as “spiritual.” My experience with psychiatry leads me to think that psychology has looked in vain to spurious theoretical stances in that discipline with an unfortunate backlash that has given a pejorative meaning to “psychological” problems.

Behavior, as I have shown through the lens of Daniel’s illness, essentially is physiological. The interpersonal manner of the therapist is of some importance in explaining to the client how the music therapy used to strengthen the ear will provide a strong, accurate flow of sound energy into the brain. CBT supports that shift to more rational behavior that a more dominant right ear will create.

Change for the better can be traumatic in social environments that fail to acknowledge, understand, or support those changes. Trained therapists can contribute importantly to the clients’ adjustments to those changes.

Music is not the only form of high-frequency sound that improves the flow of sound energy to the brain as my experiences with laughter and a smoke alarm taught me. I have seen Alzheimer’s symptoms recede under the constant whine of broken bearings in a clothes drier in a boarding house, augmented by a radio playing classical music to drown out the racket of the clothes drier. Tomatis showed that even “whispers” of high-frequency sound, like the static on a radio, can have a transformative effect on those tiny muscles in the middle ear. Talking therapy requires an effort of listening to the counsellor by the client that can strengthen the stapedius muscle somewhat and accomplish the “rewiring” of the plastic brain to a modest degree. However, most talk therapy does not proceed as a two hour lecture in a high-frequency voice, the way a CD or Internet access to a music channel can produce uninterrupted sound. In mindfulness training, the client learns to internalize that voice to strengthen left-brain responses to the obstreperous “right-brained self” so the therapy can become continuous, if sub vocal. However, the gently amplified sounds of music composed for string instruments is one of the most efficient means of exercising the stapedius muscle so that all of the higher frequencies of sound, including those in speech, reach the left brain more powerfully, making CBT more effective at the same time as the extant communications networks are prioritized, by focused listening, to the dominant right ear.

Even those systems for bringing oxygen (respiration) and nutrients (digestion) into the blood come under controlling influence by the flow of sound energy through the ears into the brain through the fiber of the vagus nerve network attached to the stapedius muscle. Human mental psychology is neurologically connected through the ears to most of the body’s systems. Psychology as a discipline has shone when it sticks to the science of the laboratory, which can include the laboratory of the home, classroom, and other elements of society where the trained observer can add to our knowledge about human behavior. Psychology is diminished by attachment to false paradigms of personality and behavior that are primarily speculative or even phantasmagoric, for example, those of Freud, a neurologist, who looked for etiologies in parenting strategies and primal urges in paradigms that he drew from Greek drama and invested with his own imagination, and those of Jung, a neurologist, who looked for etiologies in broadly held social constructs in the subconscious and individual’s reactions against them. Not so incidentally, Jung’s mother was mentally ill and he held music in profound distrust. Genetic ear weakness usually can be strengthened with music.

When you realize that the “subconscious” is the right-brain and the “ego” is the left-brain’s integrated self-concept to the extent that it dominates the right-brain, personalities become much more easily understood as a product of integration speeds and the degree of access the left-brain has to its emotional twin and the degree of success the left-brain has in distracting itself from that noisy twin. Experiences lodged in the right-brain’s memories play a part that is largely determined by the right-ear’s strength, which creates the capacity for forgetting them. The client’s ability to respond to counsel is determined by the ears’ receptivity to sound, particularly high-frequency sound. These are statements of neurological fact based on observations of changing ear function, not speculation based on creative opinion.

Normally, the flow of sound energy through the right ear dominates the flow of sound energy through the left ear as a matter of timing: the right-ear stream of sound energy reaches the rational left-brain first and more efficiently.

Thus, via the left-brain, the right ear dominates, meaning that it controls the choreography of the two brains, the limbs, and many body systems. The relationship between the parts of the inner ear—the vestibular components and the cochlea—which are affected by stapedius tonus, draws the structural control of the muscles and skeleton fed by the vestibular nerve into the same matrix as the language systems in the left-brain and the brain stem components fed by the cochlea’s acoustic nerve.

“Body work” with CBT takes advantage of the way the muscles of the body are controlled by the stapedius, an extensor that controls the extensor muscles, and by the tensor tympanum, a tensor that controls the tensor muscles (Tomatis). Feedback from the body’s muscles to the ears is beneficial, within the capacity of those ear muscles to sustain feedback. In a condition of ear weakness, such as chronic fatigue syndrome, feedback from the body’s muscles quickly overwhelms the ears’ muscles causing mental and generalized physical collapse. Mental illnesses are syndromes caused by ear dysfunction that affect most body systems. They can be cured by stimulating the appropriate ear or both ears with high-frequency music. Thus, for example, illnesses such as asthma, eczema, irritable bowel syndrome, and immune dysfunction can disappear following music therapy while posture, muscle strength, balance, flexibility, endurance, and overall energy can improve dramatically. Waking, sleeping, attentiveness, and other states of consciousness improve because they are directly controlled by the action or inaction of the stapedius muscle(s) that have become flexible and responsive to “willfulness,” i.e., the decision-making processes of the left-brain. We call that “self-control,” in which the “self” refers to the tendencies of the right-brain. (We must be careful, now, with some terminology because English was not developed with an understanding of how the ears control the brain and behavior.)

Through my study of 107 people suffering SSRI withdrawal syndrome, I learned that most of the drugs used to treat mental illness or mood disorders—not just the ones Daniel used and stopped taking—produce symptoms of ear dysfunction. Thus, as for Daniel, music therapy is the appropriate treatment for drug withdrawal syndromes. The same explanation applies to most substance abuse: alcohol and harmful drugs affect the muscle of the ears (among other things); therefore, music therapy supports ear function in addiction withdrawal treatment, even if that treatment is another ototoxic drug. In other words, sound energy helps to support the ear muscles so that harmful drugs can be withdrawn, including the interim drugs that reduce cravings. Then, continued music therapy can restore normal tonus to those battered muscles. Daniel’s success in overcoming his former addictions is directly related to his use of appropriate music and his recidivism is directly related to harmful sound and drugs.

Many other drugs impact ear function, for example, prednisone, anesthetics, muscle relaxants, certain antibiotics, and anti-seizure medications. Toxic chemicals people come into contact with during warfare, through industrial and agricultural processes, and as a result of accidents also can harm the ears. The symptoms of PTSD are the symptoms of stapedius muscle damage.

Generally, therapists need to be aware of events that can impact ear function, which include but are not limited to: genetic ear muscle weakness (which does not rule out therapy); loud sound, low-frequency sound, or lack of sound in the environment (e.g., rural or wilderness habitation, monastic life, isolation, or imprisonment, especially solitary confinement); infections of the ear, nose, throat, lungs, or stomach (bacterial, viral, yeast); blunt trauma (e.g., objects forced into the ear canal; blows to the head; auto accidents; ear or other head surgeries); traumatic sound (e.g., verbal abuse, ambulance sirens, air raid sirens), toxic chemicals (in air, water, or food as well as in pharmaceuticals legal or illegal); hormonal disturbances; aging (an accumulation of ototoxic impacts).

Psychologists and other counselors who use CBT should consider audiological examination as a primary diagnostic tool, which will involve learning how to analyze the audiogram from the standpoint of behavior.

Audiological correlates of behavior constitute a nascent field to which psychologists can make material contributions.

My publications paired with the audiograms and other data in Guy Bérard’s Hearing Equals Behavior (New Canaan, Conn., Keats Publishing, 1993 and Hearing Equals Behavior Updated and Expanded, with Sally Brockett [Shires Press Manchester Center, Vt., 2011]) provide some guidance.

If, as Bérard writes and I have observed, correcting hearing corrects behavior, why bother with CBT? Ignorance of the relationship between audition and behavior is almost universal. People who have been transformed by a music therapy face disbelief, ridicule, and argument in their social environments, including the psychiatric and medical professions, religious and educational authorities, legal and political representatives, and the general public. While some awareness of the power of music to alter behavior has existed since ancient times, the scientific understanding of how the physics of sound impacts human neurology is fairly new, and is not fully explored. We have been correcting vision for centuries. The correction of audition has barely begun. However, our means of communicating scientific discoveries has grown exponentially in my lifetime. CBT therapists can help clients to understand what music accomplishes as a therapy, how CBT reinforces those changes, how to protect their ears, how to maintain their healing, and how to cope with their new, normal behavior in their various social settings

Adding focused listening music therapy to the psychologists’ repertoire as the foundational treatment for ear-related cognition problems will not obviate CBT, which is important for reinforcing the corrected neural pathways created by the music therapy intervention. These therapies can be conducted simultaneously. Attention to the data provided by Guy Bérard (Hearing Equals Behavior, New Canaan, Conn., Keats Publishing, 1993), by other Tomatis practitioners, and by me in my publications will greatly enhance psychologists’ therapeutic strategies. CBT practitioners using focused listening will find their healing strategies for ear-related behavior problems greatly advanced in most cases, and at minimal cost. The faster results obtained by pairing music therapy with CBT allow for an expanded client base.

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