The second webinar of the AHRC Inner Music and Wellbeing Network was led by Dr Jan Coebergh, who works as a Consultant Neurologist in the UK. Dr Coebergh has documented cases of musical hallucinations (MH) in over 60 patients to date.
Dr Coebergh gave a comprehensive overview of the variety of experiences that can characterise MH on the basis of the many cases he’s seen over the years. MH are more common in people with some degree of hearing loss, and also seem to occur more in older women—although it was noted throughout the talk that MH may of course be prevalent in other subgroups of the population who simply haven’t reported their experiences to a neurologist. Indeed, some groups or individuals may fear stigmatisation and therefore fail to report the experience, meaning the prevalence of MH could be much higher than current estimates.
Childhood songs and the national anthem were commonly reported as MH, although many other styles of music were also experienced. Quite often, songs that hadn’t been heard in many years were experienced as MH. People with MH also frequently reported other types of hallucinations, like visual hallucinations, that can cooccur with these. Dr Coebergh also emphasised that many people don’t necessarily want or seek treatment: Around 75% of people simply wanted an explanation of why they were having MH, but were not actively disrupted in many aspects of their daily lives and did not seek further treatment.
Dr Coebergh also delved into research literature on musical obsessions, tinnitus, and earworms as a means of exploring the potential overlap between these other inner auditory experiences and MH. He pointed out that defining MH solely based on whether they are perceived internally versus externally (i.e., whether the experiencer knows the music is imagined or whether they think it is coming from an external source, the latter of which is traditionally used to define MH) can be problematic. Specifically, many MH experiencers report a mix of internal/external perceptions and once they know they have MH they can often quite easily attribute the music as being internally generated.
He also noted that MH seem to have less defined environmental triggers compared to earworms (although one experience was discussed where an MH was elicited by watching a video of a guitar and the (deaf) experiencer’s brain seemed to be “filling in” the sound). Although perceptions of the volume of earworms have not been systematically documented in previous research studies, it seems MH may also be perceived as louder than earworms, which can be a major reason for seeking treatment.
When considering factors that explain why some instances of MH (or other varieties of inner music) become troublesome, Dr Coebergh referred to the lack of a sense of agency (i.e., inability to control the experience), MH taking a disproportionate amount of an experiencer’s attention away from other tasks, the degree to which meaning could be ascertained from the experience, and emotional responses to the MH. Interference in sleep was another theme that came up throughout the session. These factors seem to have clear resonance with existing literature on related experiences like earworms, which can also vary substantially in their degree of daily disturbance in accordance with similar factors.
A highlight of the webinar was hearing from two guests, one with lived experience of MH and the other with tinnitus/persistent earworms. Attendees from across a whole range of disciplinary backgrounds were highly engaged and had many questions for the guests, who generously elaborated on their own inner experiences.
Thanks very much to both Jan and his guests for their contributions to a thought-provoking session!
Kelly Jakubowski