Psychic Factors in Hearing Loss

Abstract

A pilot study illustrates the design, and suggests working hypotheses, for a research aimed at specifying the psychic factors which may predispose, cause, or contribute to inefficiency in the use of available auditory information, at any point in the hearing act (defined as the sequence of events from the impingement of the stimulus on the tympanum—to the subject's meaningful responses to that stimulus). Definitions, and theories relating these definitions are offered, and a rationale and procedure for the testing of these theoretical formulations is demonstrated on seven subjects. These subjects are intensively studied, by medical, audiometric, and social investigation, during a week of hospitalization, and are also given a battery of objective and clinical psychological tests. It is felt that the concepts and definitions of the various events in the hearing act, as presented in this pilot study, provide points of contact between the traditionally (and artificially) separated approaches of psychically-oriented investigators and those whose primary area of interest is somatic and neurological; i.e., the theoretical model herein proposed can be operationally defined in medical and psychological terms simultaneously. Psychic hopotheses are restricted to those for which neural mechanisms can be demonstrated, and somatic and neural hypotheses are similarly limited to those which do not violate psychic function. Hypotheses are tested, concerning the psychic availability, necessity, and maintenance of auditory loss, as an adjustive mechanism, and in general are supported by independently analyzed audiometric indicators of “psychogenicity.” [The research was supported by the National Institutes of Health (NIMH Research Grant ♯M2270(Cl)), and all audiometric work was done under the direction of William Waldrop, Director of the Speech and Hearing Service at Presbyterian-St. Luke's Hospital in Chicago.]