Vertigo

A bilingual lecture: Alfred Tomatis speaks in French, an interpreter translates simultaneously into English. The French transcription was reconstructed from the interpretation (Tomatis’s original voice being partly covered) and then proofread; a few approximations are possible. It serves as the reference source for the translations to come.

Part 1

It must be acknowledged that this is a syndrome described for the first time by a French physician by the name of Prosper Ménière. He described this rather cataclysmic syndrome, with its signs and symptoms: first a pain or a vertigo, then a certain deafness. At the time, this syndrome could be explained only by a haemorrhage. It was not until towards the end of the last century that one began to understand it in terms of the working of the inner ear. When one has this syndrome, one sometimes also observes nausea and a nystagmus. Someone who has truly had an attack generally presents a unilateral involvement, but it may also spread.

How does one recognise it, from the signs we have described? There may be vertigo, there may be a sensation of lightness, and at the same time one may expect headaches. These are phenomena due to internal pressure. As soon as the syndrome is suspected and confirmation is obtained, one of the things one can do is to play on osmosis: in certain cases a saline solution is used to lower the pressure. You have the vestibular apparatus; in the middle are the saccule, then the cochlea and, at the base, this whole assembly is set within a very, very solid bony shell. Someone who presents Ménière’s syndrome, if one observes him, is not in listening: he has a frozen facial musculature, as if he did not want to listen.

In this syndrome, one generally finds beforehand a tense facial musculature and tense jaws. As long as it remains at this level, it is like a nervous tic. But there are very important connections towards the stapedius muscle and towards the fluids. What we are talking about here is the total sum of all the internal agitations of the ear. The fluids are always present, they are constantly moving back and forth. What is wrong, at the level of the stapedius as we have seen, is that it plays the role of shock absorber and regulator of balance.

The labyrinth may be affected, for example by a genuine haemorrhage that destroys it, or by a brutal attack on the system, such as a viral infection. You can then have a vertigo. You can have a vertigo on one ear while the other continues to function well. It is the irritation of the mucous membrane that is the cause. At a certain moment, the mucous membranes are stirred back and forth. There is irritation.

Even when there is a drainage, it is a type of functional, unregulated irritation. I myself came to Ménière’s syndrome from another case that also presented this syndrome. I decided to go ahead and to take an interest in the other, auditory side, telling myself that the Ménière’s aspect could not be treated as it was being done. People told me that the vertigo, or later the tinnitus… but a little later, one realises that one can overcome it in 60 to 70% of cases, and that in 50 to 60% of cases, one can recover. In certain cases, one may not be able to recover the hearing loss, but in the majority of cases, one succeeds.

How does one go about examining someone going through this kind of crisis? First of all, you place yourself directly facing the subject. You ask him to follow your finger with his eyes, without turning his head, from one side to the other. The subject should have no difficulty: one then sees the eye move, both eyes in parallel, from one side to the other, in a fluid, continuous sweep. It is at the extremities that one can observe signs of a slight jerk in the movement. In Ménière’s syndrome, as soon as one turns a little to the side, one already observes jerks.

Then one takes the subject again and one can trigger certain of the vestibular phenomena, those that provoke the impression that the room is spinning. One can thus distinguish which semicircular canal is involved, notably at the level of the two upper canals. If there is a disorder here, the eyes do not turn correctly in a circle. The doctor insists once more on this point: one must make sure of the integrity of the vision and not of something else. One then asks the subject to look at the tip of his nose. In Ménière’s vertigo, there is an internal nystagmus, whereas normally the subject should be able to converge the eyes towards the nose.

Then one can move on to small tests. One consists simply of rapid movements of the hands: in case of dysdiadochokinesia, of imbalance or of difficulty, you will note that one hand works very, very fast while the other is out of sync. One then plays at what is called “pigeon flies”, that little game children play. For this exercise, one has the subject close his eyes and asks him to touch his right knee. With a vertigo, with Ménière’s syndrome, you will see that this is impossible. One then has him close his eyes and touch various points.

One looks first on one side: if it is a Ménière’s, it is impossible. One does the same on the other side. Then one asks the subject to touch the examiner’s finger. One has him practise it once or twice with the eyes open, then one asks him to close his eyes, to the right, to the left, crossing over. If there is a vertigo, here again the spatial orientation is disturbed and the finger misses its target. One then asks the subject to close his eyes, and one asks him to push: he does not move, he holds his position.

If there is a true vertigo, he will tend to fall to one side or the other, depending on which side is out of order. For Romberg’s sign, one asks the subject, with the eyes open, to establish a good balance, then one asks him to close his eyes — keeping your arms around him to prevent him from falling to one side or the other. Here again, if there is a Ménière’s syndrome, the subject will fall to that side. If you note a hesitation, a sign, but without being able to stimulate the phenomenon sufficiently, you ask the subject, with the eyes open, to go further to find out which semicircular canal is affected. You have him turn his head, he opens his eyes again, and he falls: depending on the side towards which you have made him turn, he will fall to the left or to the right, forwards or backwards, which allows an even finer differential diagnosis. That is the vestibular examination that a psychologist can quite well carry out, for there is very little physical contact with the client — one can even do it without any contact at all.

— Let us keep an eye on Ménière’s syndrome. I have a question: can one, in certain cases, expect things to get worse before they get better? Is it possible that the person may have more vertigo? One must not go too fast. One proceeds four times a day, respecting the whole sensitivity. What is most important is that it does not get worse, but above all that one moves slowly: one begins with one session a day, then two sessions, then three sessions, so that things do not evolve too quickly.

One very useful thing: if you do four or five sessions a day, warn the subject that vertigo is possible — most of the time he will not have any, but warn him that it may happen, and that if it occurs, he must not worry. In fact, it is generally a good sign. As I was saying the other day, out of the hundreds of cases of Ménière’s syndrome that I have treated, I recall only two or three cases of relapse. And in those two or three cases, it was because the client had not wished or had not been able to be brought to pursue the treatment to the end. Once you have correctly and completely treated two or three cases of Ménière’s syndrome, you will see that many cases will flock to your practice — they will literally come out of the walls, for they all seem to know one another. In a way I cannot really explain to myself, there must exist a kind of clandestine and silent Ménière’s club.

And it is true: if only through the religious communities, my goodness, it spreads very fast. What must be understood is that, without help, these people can be totally handicapped, to the point of being cut off from all social contact — something very close, in our field of psychology, to the phenomenon of agoraphobia. These people, whatever the case, can no longer leave their home. It is a very good start, a very good basis. The task now is to understand the regulation of the two muscles of the ear in relation to the listening test, with a view in particular to setting up a particular programme. To understand clearly what we are talking about, one must rethink the working of the auditory mechanisms, in particular that of the middle ear.

You have here, from the inside towards the outside, the stapes, the incus and the malleus. You must remember that all this developed phylogenetically in the reverse order of what the theories claim, simply because the classical approach starts from the outside towards the inside. And that is why a correct explanation of the auditory phenomena was never truly reached. I remind you that there are two muscles that work in this system. One, oriented backwards and outwards, is the stapedius muscle. The second is the muscle of the malleus, which goes forwards and downwards.

This is what makes hearing possible: it is the homogeneous and combined tension of the two. What allows the proper passage of the auditory phenomena is the homogeneous coordination of these two muscles. In fact, each is independent. Each plays its own role, except in extreme cases. Take the analogy of the hand and the shoulder: I can move my hand without necessarily moving the shoulder, and I can move my shoulder without necessarily moving the hand. On the other hand, in certain very extreme and unusual movements, I really cannot move the arm without also having to turn the hand.

There are not really three ears, as is usually explained — the external, the middle and the inner. In my conception, there are really only two fundamental parts to the ear. An inner ear, regulated by the stapedius muscle. And an external ear, set by the muscle of the malleus, the tensor of the tympanum. These two normally have a homogeneous, balanced tension. And when we have this homogeneous and balanced tension on the two tensors, we obtain our ideal rising curve.

And this curve seeks to answer the curve of the inner ear itself. This ideal curve reflects the normal response of bone conduction within the inner ear. That is how it was formed, in agreement with the phenomenon of bone conduction. In fact, this ideal curve that we obtain on our trace is the amalgam of three different curves, if one could dissect them. There is the response of bone conduction, the response of the muscle of the tympanum — that is, of the malleus — and a third curve, which is the response of the stapedius muscle. Thus, our listening test, even though it does not show it, would reveal, if one could dissect it, the superposition and the average of these three different curves.

Let us now see the difficulties that may arise in this scheme. I shall have to illustrate them for you with somewhat extreme examples. When I was very young, I had a rather amusing experience, at the opera, during a performance of Manon — Manon Lescaut. On the stage there were two bearers carrying the singer. At the moment when they were to leave the stage, instead of going in the same direction, one went one way and the other in the opposite direction. By the time they realised it, each one turned round, and they were setting off again in opposite directions, each pulling his own way.

If one makes the analogy here: if the two muscles of the ear worked together, in the same direction, one would obtain our beautiful curve. But if the muscles pull in opposite directions, we obtain our middle-ear hollow. And if one pulls in the reverse direction, we obtain the middle-ear peak. If one of the muscles has a force slightly greater than the other, one obtains simply a shifting of the peak or hollow phenomenon, from one side towards the other. The peak will shift upwards, and the same goes for the middle-ear hollow: it can shift upwards or downwards according to the relative force of the stapedius muscle or of the muscle of the malleus. — In which direction do the muscles pull on the diagram?

Let us say the lower one pulls downwards and the other upwards. What happens? In the case of the middle-ear hollow, neither of the muscles pulls: they both relax. On the other hand, if you have the peak, it is because they are both pulling very, very hard. And there is an irritation that accompanies the peak: aggressiveness, because there is a hypersensitivity. As we saw with a previous case, where there was a peak.

To be able to adapt a programme to a particular curve that does not respond to the usual programme, one must keep in mind that the Electronic Ear can give you every possible curve. But to avoid building an oversized apparatus, a system called Bach-Sindal appeared, which makes it possible to reproduce all the curves with a very simplified system. I have adapted such a system, and it gives me a zero point. The price to pay for this simplified and more portable version is that there is a kind of immobile zero line, right in the centre. Now, in the ear, there is precisely an immobile central zone, which rarely changes, between 1,000 and 2,000 Hz. And from there, with the right settings — by adding or subtracting decibels at the input — one can reproduce all the possible curves.

On the settings, we have numbers that go, in the low frequencies, from minus 5 up to plus 5, or the reverse. But one can do 4.5, 4.75, 4.25, 4.01, 4.0, whatever one wants. These are coarse figures: one can set it to plus 4.5 or anything of that kind. It is progressive: as long as one decreases, it is progressive, and likewise in the other direction. One can go from plus 5 at the top to minus 5 at the bottom. When the Bach-Sindal appeared, we were limited in its use because we could increase only by 12 decibels in one direction and 12 decibels in the other.

With the new machine, one can go to 40 decibels, in one direction as in the other. One can therefore do much, much deeper work. — The first line, the grey one, you were saying that it was what? The very first year, with the grey Electronic Ear, it was a shift of 12, of 15 — that is, 30 in all. Yes, 30 in all, over a sweep of 30 decibels. Now one can go up to 80.

Sometimes, in fact, it is too strong. What it is important to remember is that there is here a relative zero. Between 1,000 and 2,000, there is an immobile central position. For example, if I have a rising curve at the very beginning, then one that flattens out, and I want to superimpose the correct curve, I take the zero base. From there, as a reference point, descending to the end of the listening test, I would estimate that we have a minus 4. And I would have to place it on the lower stage of the filtering.

That would be the ideal formula. Often, we do not have the time. When I want to go fast in Paris, I do it like this; when I want to go very, very fast, I proceed in this way. If now I have a curve like this one, on the other hand, the middle-ear hollow, for me that is another case. Here again, my baseline is that point between 1,000 and 2,000: I consider it as the zero line. And I mentally project the number of decibels down to the end — for example plus 4, plus 5.

If I want to correct that, I am going to try to fill in this hollow between 500 and 3,000 with sounds, to fill the hollow. And I place on the upper stage, the corrective stage, the reverse. One must regularly check not to go too far. I must monitor very frequently with the listening test to make sure that we are not forcing things to go too far. For example, every ten sessions, every two days, one measures these three or four frequencies, no more. One can very simply, by a rapid sweep, measure two, three or four frequencies to find out how far one has gone in filling the deficit.

— And what if one has a flat curve, a bone conduction and an air conduction well parallel? How is that explained in terms of the play of the muscles? Should both be flat? — Both ears or both curves? — Both curves. Good conduction, particularly good conduction…

but that means that there is not enough harmony between the two. Some people do not work harmoniously: there is conduction from one end to the other, but no harmony between the two. The stapedius muscle is in relation to the inner ear and to bone conduction. The muscle of the malleus is in relation to air conduction. I am convinced that the stapedius muscle regulates bone conduction, and that the muscle of the malleus regulates air conduction. But why exactly?

I do not know. How does it come about? I sense it, but I cannot explain it to you. Two years from now, I will tell you why. Likewise, within this frame of reference, I cannot yet explain to you how this mechanism commands the vestibular apparatus, nor which part plays the greatest role. It is something that teases me, that I cannot explain, that leaves me somewhat perplexed — but no one else can explain it either.

— What would you like to know on this point? On the physiology of… — If we can stop for a moment, I am going to ask you a question. I am not very clear. What do you use to calculate, on a middle-ear hollow? You were speaking of going to plus 4.

On what do you base yourself for this calculation? Is it just an estimate? Can one count the number of missing decibels? One tries to see the direction of the slope. If I have this… — It is the difference from the bottom line, your baseline?

The baseline. It is a projection between one interval and two intervals. It is a relative zero. It is the difference between this baseline and the 40 decibels above. What one does is to try to estimate visually — one can do it more precisely — the depth of the valley, of the hollow. Taking the bottom of the hollow as a reference point, as a zero line, then measuring the height of the rise on one side and the other, one can estimate, in decibels, that each point from one to five is worth about 10 decibels.

If we have the reverse — a peak — one calculates the other way round: the upper part, around 1,000, is the zero line, and one calculates downwards. But these are relative zeros. In certain cases, one can obtain a broken curve. Instead of a nice straight hollow, one can have something irregular. And at that moment, one takes an average: instead of taking one or the other, one averages. — So, whatever the curve looks like, the zero point is always between 1,000 and 2,000?

Yes. It is always somewhat of an approximation. One can never be 100% exact with this.

Part 2

You accept that as if it were two thousand, quite simply. It is, here again, an approximation. All the more so since, as you realise, three thousand hertz is perhaps for us the least known domain in terms of understanding the phenomena at that level. It is at three thousand hertz that the conjunction of bone conduction and the stapedius muscle takes place. It is a really very confused zone as regards the auditory mechanisms. You know that at 800 hertz, it is the junction, the conjunction of air conduction and the muscle of the malleus.

But at three thousand, there, we are not sure. Let us come back to the working of the ear. For most people, as we pointed out earlier, in the classical explanations, the working of the ear is understood from the outside towards the inside. It seems obvious and generally admitted that the sound arrives in the ear, strikes the tympanum, and is conducted towards the inside through the three ossicles to the inner ear. This is in reality a reasoning that would suit a twelve-year-old child better, for as soon as one studies it in more detail, one quickly realises that it certainly cannot work like that. And yet, we remained stuck for a very long time in this way of seeing, notably because it was the great Helmholtz who was one of the first to propose it.

And no one had the audacity or the courage to call it into question, so considerable a figure is he in physiology and in psychophysiology: no one would even dare to think of it. What comes to confirm and illustrate it is von Békésy, who won the Nobel Prize in 1961. All of this is false. But today, we think it is false. We admit that it is false, and that is somewhat embarrassing. Békésy’s pupils, such as von Tondorf — who is one of his own students — no longer quite know what to do.

If, however, we go back, towards 1843 or 1848, Ohm — the one who gave us Ohm’s law on electric currents in electronics — Ohm had suggested that the ear works rather like a Fourier analyser. But he could not prove it. What is a Fourier analyser, a Fourier-type analysis? It is a form of analysis discovered by a man called Fourier, in 1802, to explain thermodynamic phenomena. What is interesting is that no one read Fourier. One of the first to have read Fourier’s ideas was perhaps Ohm himself.

And we did not discover, or rediscover, Fourier until the modern era. Fourier’s law is the following: Fourier says that any complex movement can be decomposed into simple movements. It can be decomposed, dissected into simple elements, into simple parameters. Fourier proposes, for example, that the upper part of the phenomenon is in reality the amalgam, or the average, of a certain number of lesser phenomena. In other words, this upper curve is the integration of a certain number of sinusoidal curves, or the average of a certain number of sinusoidal curves. Helmholtz, however, opposed Ohm’s proposal.

He set back our understanding of this phenomenon by at least a whole century. To come back to what we do, it becomes clearer that the results we obtain go far more in the direction of a confirmation of Ohm’s and Fourier’s approaches. Someone who wants to listen immediately turns his inner ear, to prepare the inner ear to listen. It is the bone that prepares itself to listen. He who wants to listen turns the ear to listen; it is the bone that prepares itself to listen. In preparing the inner ear — you will remember — to prepare ourselves to listen, in particular through the inner ear, we must prepare our whole body.

We sum up the vigilance of the body through the vestibular system, and shortly after, it is the external ear that follows. At that moment, in this preparation of the inner ear, in this preparation of the external ear, we pull on the stapes; so that the tympanum of this schematised ear, with the malleus opposed to it, this part begins to vibrate, and the lower part of the tympanum begins to vibrate a little, in the manner of a tuning fork, and makes the bone itself vibrate, forces it to vibrate. Just as a tuning fork does. And at once, the sound is conducted towards the inside by bone conduction and attacks, transmits all the way to the inner ear; the energy penetrates the inner ear. And at once, the stapedius muscle reacts, in the manner of a shock absorber, to attenuate or to adjust the tension within the system. Now, if we go further and examine, analyse and study how the cochlea is constituted.

No one seems to have studied, nor sought the reason, nor asked why the cochlea has the shape of a snail. It has this shape, with three and a half turns. If you take a snail-shaped cochlea like this, which is called a parabolic shape — if you take a shape like this, paraboloid, as it is known — and I send a sound into it, we shall quickly see that there is a distribution of the sound over the whole surface. The high frequencies culminate towards the base, and the low frequencies resonate right at the top, at the apex. Exactly as the ear works, exactly as the ear functions. If I wanted to study in detail where each frequency resonates the most, I can dissect this like a segment of an orange.

If I peel the whole orange in a single continuous peeling, I shall see that what differentiates the various frequencies are the tangents. If I have a tangent, a very, very long extension, that gives a very, very long wavelength, hence a low-frequency sound. One will pick up a shorter wavelength, which is a mid-frequency sound, and right near the apex, a much smaller wavelength is picked up. And for this analysis to be possible, I must have here a compression, always at a certain level, so that all my intensities are equivalent in amplitude. There must be some kind of mechanism that compresses these wavelengths and keeps them all within one and the same relative range. That is what von Békésy does: he carries out a compression between 40 and 60 decibels.

This is what is called the dynamic range of the ear. And it is exactly what the stapes does. It creates a kind of pressure regulation within the inner ear, which keeps the incoming sounds always between 40 and 60 decibels — which is exactly what we call the dynamic range of the ear, that is to say the intensity at which most people hear comfortably. That is the dynamic range of the ear. That is where the ear is accurate, at that precise point. The auditory phenomenon, from 40 to 60 decibels, is linear here.

The stapes therefore works like a shock absorber to try to balance the frequencies within a certain range and to improve their analysis. One thing that no one can explain with the classical theoretical approaches to the auditory phenomenon is the well-known masking effect, often used by the examiner of hearing. If I take a low frequency that is too strong, my shock absorber, the stapes, works very hard in order to be able to balance it and keep it within this zone of 40 to 60 decibels. But, in doing so, it must cancel, erase, wipe out all the other frequencies: hence the masking phenomenon. Now, if we look at exactly what happens inside the inner ear — and it is precisely there that von Békésy went astray. Here is an enlargement of the inner ear.

Suppose we are in the high frequencies, at the base, at the base of the cochlea. And again, all this is surrounded by very thick, hard, ivory-like envelopes. Here, I have the basilar membrane, in three layers. Here, I have Reissner’s membrane, which is a single layer. Here, I have the vascular part. Here, I have the five layers of the organ of Corti.

And here, I have the tectorial membrane. Above, we have what we call the tectorial membrane. It is a membrane that vibrates. And there are erect hairs. The hairs are the small hairy formations of the cells of Corti which, right at the top, are in a way glued into the tectorial membrane. When the sound sets a part of the cochlea in motion, that part begins to vibrate.

The tectorial membrane begins to vibrate. It excites the hairs that are on the cells of Corti. If the sound is very, very weak, very small, it will touch only a single cell of Corti. If it vibrates more strongly, it also touches the second cell of Corti. That is where we obtain the notion of intensity. But at the same time, here, if there is movement, the fluids will begin to move.

However, if it is even stronger and it begins to undulate all the way to the end, it creates a return wave at the level of the fluids. If we arrive right at the top, at the apex, then the return, the breaking wave, will be even stronger. If it is even stronger, too strong, it becomes very, very dangerous for the cells at the upper extremity. The lower one also begins to vibrate. But here, the fluids displace Reissner’s membrane. The fluids can displace Reissner’s membrane.

This provokes a displacement of the fluids here. And that creates a displacement of the fluids in the inner ear. It immediately reaches the stapes, the oval window. And the stapes absorbs the shock, the impact. It reduces, reduces again. Once again, to reduce the tension, so that everything can be picked up always within this range of 40 to 60 decibels, the most comfortable, the easiest to analyse.

In other words, it works in an entirely reverse manner to what had been proposed. Well, that is enough for us. The listening test was developed, certainly, over a certain number of years. At the start, there was the audiogram, the hearing test, because at the beginning I administered hearing tests in the arsenals of aviation, in France. And after a few years, I realised that, without my noticing it, I had integrated a host of parameters that were the symptoms of the patients. With time, after accumulating a certain number of audiograms over a few years, I realised that the audiograms were revealing: they revealed not only the auditory constitution of an individual, but also took into account and revealed many of his symptoms and personality traits.

This is all the more striking in that, even if I had become aware of it, I had not become aware of it at a conscious level. I had integrated it into my practice. So that, when a client or a subject came in, I would look at the hearing test and automatically venture an opinion of the kind: “You have difficulties with your…” And there seemed to be no difficulty in interpreting it correctly, most of the time. My assistant, who was training and practising, simply told me, simply asked me: “All these hypotheses, all these comments, but where, exactly, do you draw them from on the audiogram?” For me, it was like a hammer blow to the head.

I had never thought about it. Although I had integrated all this, I concluded that the brain is really fantastic: a large part of the integration had happened on its own, without my being fully aware of it. The more one lets one’s brain do the work… It is the middle part. Alone, right in the centre, there exists a direct, straight relation. It is a median at 60 dB.

And the central point lies somewhere between 40 and 60 dB. It is called the zone of the dynamic range. It is what is called the zone of the dynamic range of the ear. It is also called the Munson curve. Munson-Fletcher. And that complicates everything from the point of view of research, from the point of view of audiology.

Because an apparatus that would make it possible to detect all these curves, each one being each time put back in its true place, is complex to build. An apparatus that would be set to reflect the true curve and the true characteristics of hearing becomes very, very difficult to build. Here, we also have an optimal band. In the centre, we also have a band, a width from 800 hertz to nearly 2000 hertz. From 800 to 2000 hertz, which is the optimal zone of hearing. There are also here ranges where one gives true correspondences to the ear.

When one is there, one is sure that one is really measuring the ear. When one is here, one no longer knows what one is doing. At the coordinates of this particular zone, of this lemon-shaped curve, one can be sure that one hears something, that one measures something fairly accurate. But the further one moves away from these coordinates, the more it becomes indefinite. And the apparatus that would be of service to me would be an apparatus that each time measured the ear. The ideal instrument, which would help us in our aims, would measure in this way, by taking slices all along the registers.

But for that, one practically needs a computer. That is why the usual audiogram was transformed. It was determined that there would be a hypothetical zero, a hypothetical zero line. And there, the two extremities were raised by 30 to 40 decibels. It was said that, when one obtained a curve like this one — in other words, when, on an audiogram, one obtains a straight-line curve — it reflected a physiological level, which corresponds in reality to the lemon-shaped curve. Otorhinolaryngologists throughout the world use this curve, this flattened baseline.

I think it is anti-physiological. It is anti-physiological. Anti means against, against psychophysiology. It is unnatural. It is a way of proceeding that is not natural. For psychologists, it would mean always working on this curve.

And in reality, what would be closer to the truth and more ideal, in particular for a psychologist, would be to come back to Wegel’s lemon-shaped curve. And that is precisely what we are doing, at this moment, in Paris. We are fortunate to have a small computer that allows us to carry out these modifications. A computer that I built myself, here, in Canada. And that is why I have it in Paris and you do not have it here. Oh!

Oh! I hope we will have it here soon. The interest is that one recovers exactly… And the main interest of returning to this physiological curve is that, by proceeding in this way, we recover all the answers to some of the psychophysiological indications that we draw from our tests. If I widen the central zone a little, you see that here the whole thing, I cut it into three pieces. The dimension, the overall width can be subdivided into three zones.

And that is what you must do each time you find yourself faced with a test. In your head, it must be like this. Each time you look at a listening test, what I ask you to do is to divide it mentally into these three particular zones. The first subdivision lies between 750 and 1000 hertz. The second, around 3000 hertz. Always — it is not marked on the curve, but in your head, you must always…

You will not find it on the profile, but you must subdivide it mentally in this way. The curve we have here is surely the result of that curve, and the result of at least three curves. The curve you see here is certainly the result of the eternal lemon-shaped curve, but it is also the product of three other curves, as we understand better how the ear works. But fundamentally, it already responds to articulation. That is why it responds to articulation. Those two points respond to the articulation of the three curves.

The two points, the two pivot points, reflect in reality the interaction of the three curves that we are going to examine. The lower part of this new test will always represent the body. It represents, most of the time, the body. It is obvious that the body will manifest itself throughout the whole, but that part is specially reserved for it. It is obvious that the body is reflected throughout the whole, however… the lower part plays a more pre-eminent role for the body.

We shall see that this goes up at least to two or three thousand. It is well to remember that the body, the influence of the body, is reflected up to two or three thousand hertz. But with a curve. In doing so, it climbs the scale with less and less intensity. Consequently, the bodily representation has a kind of descending curve. The upper part — unfortunately we have only words for this.

All I can do is… the upper part, it is the upper part that is the most important. But one must remember it, and one must retain it. So the lower part is the part of the body. And the upper part of the test: we have many words to try to designate what it relates to, and none of these words suffices in itself. It is the part of intuition.

One could call it the zone of intuition. Or perhaps of spirituality. But these are only words. Spirituality has a descending trace. We then have the middle part, the central zone, which is the part — here again a word is lacking — of the intellect, which we can call the zone of the intellect, even if this word in itself does not suffice. In fact, it is also the zone of language and the zone where most of the vowels find their roots.

And if now one looks under another application, under another terminology, one will see that the lower part, that is to say Freud’s id — there is no ambiguity. Viewed under another dimension, from another angle, the low zone, which we call the bodily zone, could also be interpreted, in Freudian terminology, as the zone of the id. This one, here, is that of the ego. The middle zone, linked to language or to the intellect, we could interpret as the zone of the ego, as well as of the superego; for language, structure, at a given moment — the identification and the acquisitions of the person come under the register of communication, the central register. It is interesting: analysis, psychoanalysis, it remains very simple. Consequently, it is well for us to realise, from this scheme, that the domain of psychoanalysis is limited to this middle register, of 2000 or 3000 hertz.

The part here is the part… Following this same line, the upper part represents neither the id, nor the ego, nor the superego, but, beyond the psychoanalytic frame, it represents the self, the self not in the egotistic or egocentric sense, but rather in the metaphysical sense. I believe one would rather say here the self. It is a new dimension, that. It is true. Doctor Tomatis suggests that, beyond the self, to a certain extent, one might perhaps say the “I”, even though there is here a dimension difficult to integrate, and the self already encompasses a great deal.

Where does the self stop? Where does it come from? The self is still within the individual. There, one risks falling into a difficult dimension, for it is very difficult to define this particular zone. Even with the terminology of the self, one is always, up to a certain point, within the ego. That is to say that one is always within the individual.

One risks entering into many philosophical and metaphysical considerations. Is there, in this play, still an instance that one would call “the being”? Is it the question of what Jung called “the soul”? In the Jungian spirit, the “soul” is the soul. The soul, in this sense, is there. But the soul is the reason, the why.

I suggest that perhaps the Jungian terminology of the soul is, itself too, not quite sufficient. It is a domain of spirituality. For the moment, it remains very difficult to define. Without falling into this kind of debate, what we must retain is that, for us, this particular domain exists, and that it is very, very important. The instant we can access the higher frequencies, in terms of listening capacities, at that instant, we are sure that the individual resonates very, very strongly within his own being. And that is explained, to a certain extent, to a large extent, by a neurophysiological substrate that we are going to examine.

You will remember that, in the ear itself, there are three different levels: the external ear, the middle ear — the ossicles — and the inner ear. And the inner ear… the cells it contains. I am going to see that there are very, very few cells in that part. I shall realise that there are very, very few cells — forty cells — at most, at the large extremity. There are only about ten.

There are a few hundred in the mid-range part. There are 24,000 in the mid-range part, in relation to the listening test… and there are about 24,000 in the high registers of the listening test. If we can develop, put to use these 24,000 cells in the high registers, that allows the person to have a great deal of energy and mental capacity. Someone who can develop these higher frequencies will have an enormous amount of energy — but energy in the sense in which we define it: creativity, reflection, the capacity to approach the metaphysical domain. The middle part is the one that will make it possible to intellectualise the system.

The middle part, the middle zone, will allow us to intellectualise the whole. It uses the body, of course, to do so. And when one sees the correspondences of the whole with the body, one will see that the head corresponds to it. And when we study the correspondence between the various registers of frequencies and the bodily zones, we will become aware of the fact that the head is situated around 3000 hertz. Beyond 3000, we are out of the body. One can see it as a kind of terminal point, but beyond, there is also an enormous amount of energy.

How can the body intervene in this process? Because, in the lower and middle parts, a large part of the nervous excitation comes from the vestibular system rather than from the cochlear system. … towards the mid-range frequencies, and especially the higher ones, acting through the cochlear system, we will note that we are not at all invited to dance, but rather to relax and to be present. All the musics and all the chants qualified as sacred — even though we must remember that there is nothing sacred in itself — are fundamentally sacred because they induce both charge and energy, and put the person in a disposition to reflect on his own being and on metaphysical considerations. You will notice that, in this particular register, we will find a music such as that of Mozart.

Last week, I myself experienced this a little. I had a chalet at Georgian Bay, in Ontario, and I had quite a few things to do. I had at my disposal all the albums of music that I like; I could not manage to work at the same time. I had there all the concertos, in particular because they fall into this rising zone. That is to say that, at the same time, it is true, it is in the zone of relaxation. That is why here you can get into it.

Everyone should find how to name his own foundations. That is why, even in this room, we should be able to reflect on this. Now that we know the psychophysiological roots of this subdivision, we should be able to define it ourselves. In psychology, we will find that many, many people have defined their typologies and their ways of subdividing people. I think it is important to go and look at them, for it can be interesting. Many ways of subdividing the personality, by modes and manners, come essentially under these three particular zones.

It is all the more difficult to recover one’s former place now, in terms of energy. It becomes a little more difficult with the rising curve, and fundamentally, no one knows what energy is. One always comes back to the same words, nothing but words. Here again, we are confronted with the same difficulty: we often have nothing but words to try to explain things that are somewhat intangible. Now, I realised, a few years ago, I became aware of the fact that children — the children of around the year 95 — had hearing curves that were not excellent, gave listening tests and listening curves far from being models, far from being good. I give you an example: I had the chance to examine 3800 children.

I give you, for example, an interesting phenomenon. I had the chance to examine 3800 children. They were children who arrived in Paris; every day, they arrive in Paris. No one really knows where they come from. No one knows where they are going. It is true for all the big cities.

It must be the same phenomenon, I imagine, for many big cities. There were two reception centres that received these young people, where they stayed perhaps two or three days, the time of their passage. And a few volunteers administer tests. There are a few psychologists who usually play with them, allowed to do so, but who do not have the right, otherwise, to intervene with these individuals. And we received authorisation, a special authorisation, to administer listening tests to these young people. And I had found 48% of poor listeners.

48% of these young people were so in their listening abilities. And among these 48% of poor listeners, there was only one who had a school-leaving certificate. There was only one who possessed a certain school diploma. It is the first degree, the very first rung of the educational system. And that shows to what extent there exists a relation between poor listening abilities and learning difficulties. And since then, I have tried to decipher all the parameters that could come into play.

From that moment on, I drew out the various parameters of the listening abilities, in a schematic form, a few markers fairly easy to remember. By looking at the listening test for both ears. And one remembers that the ideal curve is this one. Keeping in mind that the ideal curve is the rising curve, the one we call the curve of the musical ear. With at the same time the bone curve. And as you know, the bone-conduction curve must follow in parallel, a little below.

As usual, on the left we have the curve representing the right ear, and on the right that representing the left ear. We look at it as if we were looking at the right ear; we look at it as if we were looking at the left ear. Facing the subject. Face to face with the subject. Here, always in a solid line: on the solid line, we have the air curve, and the dotted line represents the bone-conduction curve. And as a general rule, they are superimposed.

As a general rule, as a basic principle, one must keep in mind that the air-conduction curve and the bone-conduction curve are superimposed one on the other. And as they are superimposed, you could not distinguish them. If they were superimposed in this way, there would be no way to read or interpret them. There was an international agreement to place bone conduction 15 decibels below the air curve, in order to allow us to read the difference. You can see them. You know what they are.

There is always a gap. As soon as we believe they are 15 decibels below, it means that they are on the other side. We must keep in mind that, if there is a difference of 15 decibels, in reality, they are superimposed one on the other. That is important. There is one that comes here. For example, it is the rising curve.

It rises here. Compared to the other, it is important to keep this in mind. For if, for example, the curve is very, very high, on this ideal curve, what can happen? To come back to our ideal curve, the rising curve: it can be fantastic and never be used. On the one hand, we can have a fantastic rising curve. That does not however mean that the individual will use it.

The individual may not use it. All the information that passes will be barred. It will not be integrated. Thus, all the information that passes through such an ideal curve, perfectly set in place, remains unintegrated. This is defined in particular in this case. On the neurophysiological plane, what does that mean?

In neurophysiological terms, and of closed selectivity in particular, it means that the subject… that is one of the problems. It means that he is overwhelmed, that he will not be able to integrate the information; it cannot be integrated. And the deposit of these problems, in the cerebral system, is found in an enormous zone that we call the thalamus. The fibres that emanate from the cochlea come towards the thalamic centres. The two pathways, homolateral and heterolateral, end up in the posterior zone of the thalamic centre.

We represent here, roughly, in dotted lines, the cortex; and the thalamus would be found inside. The posterior part, linked to the auditory fibres, is called the posterior part. I cannot let the information pass. If, because of my personal baggage, I am overwhelmed by personal preoccupations or by a background of many painful memories, for one reason or another, the transmission does not take place, the memory disappears. And it is one of the reasons why I came, over the course of my experience, to affirm more and more strongly what fundamentally blocks human memory. All of a sudden, you have a mind.

At this very moment, you are in your mind with all that I am telling you today, which should be able to pass into our zone. The viscosity of the thalamic centres must be reduced. If it is too viscous, it does not allow transmission. What does that mean? Does it mean that I am going to forget everything that bothers me? Does it mean that I am going to forget everything that bothers me, that there is no transmission?

No. It simply means that, if it passes, it will disappear. I will not erase them. I only know that I have erased things. Allow me to go back. If, by chance, the information rises well from the cochlear system through the thalamic zone, through the pulvinar, and goes beyond, through the cortex — does it mean that my problems will no longer bother me, Doctor Tomatis?

It means very simply that I can take on these difficulties. I can make them my own. I can take responsibility for them. And the system is difficult. The human system is difficult. It is a very difficult connection.

And to explain it is somewhat difficult, for we must enter into the domain of the relations between psychophysiology and the human spirit. If I am in this domain, in this situation, I am deprived of my problems. If, for example, I am overwhelmed by my difficulties, and the selectivity is closed, I cannot overcome my difficulties, because I cannot generate enough energy or mental force to confront them. And one sees how one is engulfed in a problem. There is not enough of it. How, consequently, one ends up stuck.

If I have the good fortune to have a great deal of energy, I can overcome all that. If, on the other hand, I have enough mental energy, then I can sweep away, open wide all this selectivity and manage my difficulties with greater ease. How, then, to reach this level of cortical energy and consciousness, if then we are stuck? The thalamic zones stand in our way, because of the viscosity and the memories they contain. What can I do to let go onto sounds that have no memory? I think the explanation is the following: one day, I had the good fortune to come upon the possibility of using certain sounds which, fundamentally, have no mnesic basis, which are beyond the zone linked to memory — to bad memories, for example.

And it is precisely for this that we use the filtered sound, the filtered sounds of the high frequencies: because they bypass those sounds that are generally linked to language, to memory and to communication. I give you an example of what I mean by a blockage, a viscosity, at the thalamic level. A stammerer, in French as in English, has a great deal of difficulty pronouncing the “b"s and the “d"s, the “p” in particular too, because it refers to… and the “m” also, the “m” referring to “mummy”. And the stammerer, in English as in French, each time he encounters a word that begins with “p” — whatever that word may be, whether it be “paradise” or “parrot” or any word beginning with “p” — because of the memorisation associated with the sound “p”, which in its deep roots goes back to the word “memory”, all this is anchored in the letters themselves, in the very earliest acquisition of the letters. And by the end of the week, as we review our theory again, I will show you to what extent a single letter can have an emotional, cognitive or affective colouring.

If then we use sounds that we call intra-uterine sounds, high-frequency sounds, they bypass these sound zones and all these affective colourings that can be very negative. Consequently, to come back to our starting point: we can have an excellent ear, in terms of the listening curve, but if the selectivity is closed, it means that we cannot use it correctly, that we cannot make the most of it. And this closed selectivity can be completely closed, or else partially closed.

Part 3

For example, it can close only in the high frequencies, whether on one side or the other. If it closes only in the high frequencies, that too has its particular meaning. It is a reason why I do not want to listen; it is simply a zone that represents something I do not want to listen to. In general terms, it represents the fact that it is a zone in which I do not want to listen. It represents a certain domain of life, or of experience, in which we do not want to listen, which we do not want to confront. In general, you will note that the young person who has difficulties in the high frequencies is the one who has difficulties with his mother, the young person who does not want to listen to the female voices that, most often, pass into the zone of the high frequencies.

The young person who does not want to listen to the father’s voice, for his part, will close even lower. One must however keep in mind that if the young person does not manage to overcome the difficulties encountered with the mother, he goes no further: he can neither confront nor manage any of the other difficulties that may arise later in life, for example those encountered with the father, and so on. One of the major difficulties on the plane of personal evolution is to overcome, if there are any, the difficulties with the mother. Thus, from a physiological point of view, each time we have a closed selectivity, we can automatically affirm and presume that, on the physiological plane, the thalamic zones do not transmit correctly, or do not let the message pass. A detail I should like to take up from there. Another detail I can add here, from a psychological point of view: when we have the closed frequencies and that refers back to a problem with the mother, whether we like it or not, we remain blocked at that precise level.

Even if we ourselves are father or mother, we cannot extricate ourselves from it. We are stuck with it. We are against it. And particularly in French, to be against something is to be stuck against it. It is interesting: in French, it is the same word. To be against is to be against.

The word “against” has at the same time the meaning of being glued, and of not being able to move. It is the same thing. You have someone who… If you have a problem with someone today, it does not create a distance; you are still stuck against it. Even in our daily life, I think we observe it today: we encounter a difficulty with someone. As long as we have not resolved this difficulty, we remain, at least mentally, at a certain level.

What is interesting is that, even if we want to, we remain stuck with it. We remain stuck with it. One wants to free someone… And it is interesting to go even further: we want to free ourselves from many of these blockages, in particular those linked to people. The only way to bypass them is to manage to love that precise thing. Keep in mind that, particularly in English, the word finds its root in a Sanskrit term that refers to, that means “to give”.

In English, give, they give. Live, they live. They are found in the words, they live. They live. They are found in the words live (vivre), love (aimer) and believe (croire). Likewise, the French word “amour” draws some of its roots from Latin, in particular from amare; but it is very difficult to find its roots.

Dr Tomatis suggests that it comes from a term derived from Hebrew, which means to speak, to communicate. Let us come back once more to our listening test. With this training programme on the Electronic Ear, we manage to open the selectivity. One observes that those who are not already under an Electronic Ear programme, or who have already begun a psychoanalysis or various forms of becoming aware, end up compensating for the closed side: for them, fundamentally, it remains closed. One allows the individual to cope with things, as best one can. Let us examine other distortions or disorders that may appear in subjects with irregular curves, a little jagged, you see, irregular, more or less symmetrical.

There, you already have a few clues, a little lower down, that raise this question. The only way we can come up against this is when the two ears are distorted or inverted. Let us use ourselves as a point of comparison: we can have a certain number of different sub-types in terms of right and left. One can consider that they are not symmetrical, and it is important to be able to make the distinction, because that crossing is much more difficult than when they are symmetrical. Beyond that, one can add another dimension: according to whether the curves are rising, whether they are symmetrical, whether they are crossed. We can also consider the dimension of spatialisation.

One can obtain indications of spatialisation on the air-conduction curve and on the bone-conduction curve, even though, as a general rule, it is the bone-conduction curve that we look at. For those of you who have had the opportunity to administer listening tests, or even to take them here, you may have realised how difficult it is, for certain people, to localise the sound within the test. Take for example this particular case where an individual inverts the spatialisation: on the right, all the low frequencies are perceived on the left, and at the same time, on the left, all the high frequencies are inverted and perceived on the right. That means that, each time the person receives an information or words, they are going to be distorted because of this switching from one side to the other. And that leads to a kind of dyslexic perception. What must be retained here, kept in mind, is that when we pronounce certain words, we use a whole spectrum of sounds: some come from the low frequencies, others from the high frequencies.

Within a single sentence, we can employ sounds situated in the low frequencies, which would be sent back to the opposite side and create a temporal lag. Then, as the person continues this same sentence, she can also employ higher-frequency sounds, which would invert the whole process. In French, you may want to say a word or a sentence, but as the sounds contained in this short sentence sweep across the whole register, and because of the temporal lags in this switching, the person may end up saying something quite different. It is a very, very frequent sign of dyslexia: the low frequencies being inverted, and the high frequencies likewise. Another useful sign here is auditory laterality. When there is no clear laterality, in one direction or the other, with the help of the audio-lateral meter, we generally indicate it by setting the balance to 50.

The reason why we use 50 is that we refer to 50 decibels. On the Munson curve, the zone of comfortable communication lies between 40 and 60 decibels. Thus, at 50 decibels, you function in this speech range, which should be comfortable and easily perceptible by most people. With the help of the audio-lateral meter and the headphones, we let the sound enter each ear at a level of 50 decibels, while the person is seated right in front of us, and we ask him to speak. With the audio-lateral meter, we can then increase or reduce the number of decibels in the left ear, for example. For example, Bob, here, speaks essentially through the right ear.

What would interest me is to discover how many decibels I would need to add in his left ear, in feedback, to fool this process and force him to listen through the left ear. You can see that between 20 and 30 decibels, it is quite possible that he will switch to the left. By subtraction, I could very easily say that he has a right-ear advantage of 20 decibels. If we start from a person whose speech is very, very poorly articulated, coming from the throat, very, very far back inside, typical signs of a left-ear dominance, what we would then have to do is to decrease the amount of input into the left ear. Reduce the input into the left ear enough to allow this person to take the right-ear advantage. One could reduce from 50 decibels to 40, to 30, until the characteristics of the speech become very, very clearly right-dominant: very forward, very clearly articulated.

Our most recent apparatus, which here again was built in Canada and is now in Paris, allows the subject to do this test himself. The moment the person is connected to this test machine, the machine takes over and carries out the whole test by itself. On the apparatus, you will find a small lever, a stick, which allows the individual to find his comfortable level and his appropriate speech level. In general, right from the start, in terms of intensity, people situate themselves on the Munson curve, between 40 and 60 decibels. Some will set the level at 40 decibels: they have a fine ear. Others at 70 decibels.

But already there, we have an indication of the degree of closing, of proximity or of perception of the sound. Then, on the side, with the same stick, no longer going up or down but laterally, one sees that he is going to seek to feel, to locate his habitual listening state. And immediately, on the printout or on the screen, we obtain the number of decibels needed to trace his auditory profile, his particular listening profile. Then, we ask the person to speak. With this, you see what you are doing: once the person has, in a way, situated himself in relation to his habitual speech, we can add 20, 30 or 40 decibels, or subtract as much, to try to find the proper right-ear dominance. Another thing that one sees much more rarely, but that you will perhaps see more frequently here, in some of the most disturbed cases you deal with: when one presents two curves particularly compatible with a hearing loss.

They descend as low as 30 or 40 decibels, in other words what we would call a moderate, even severe, hearing loss. As a psychologist, if you follow these young people closely, you will realise that, despite this apparently moderate or severe deafness, they still manage to communicate with you. Consequently, they have, at a given moment, established communication, are capable of communicating. Otherwise, if it were a genuine loss, there would be no language at all. The fact that their voice is not at all marked by this is a decision point. As clinicians, we must make a decision: is it organic or psychological?

And in certain cases, this decision is not easy to make. We generally propose, at the centre in Paris, a trial, a certain number of sessions. If it is psychological, one usually sees the changes occur very, very fast. If that is not the case, there is a chance that it is organic. But fundamentally, at the very start, in certain cases, nothing really allows us to say whether we are dealing with something physiological or psychological. What you can also find, occasionally, is a very, very marked drop from a certain frequency.

But that can be read. In the case of a physical hearing loss, for a rapid transmission from the inner ear, the curve of perceptual difficulty is generally rising up to a certain point, then there is a complete drop. That is already a sign. Now that we have simply enumerated or described some of these possible patterns, let us try to understand how they appear, what they really mean, what they reflect. If we understand the meaning, physiological and psychological, of these various curves, that will also allow us to set up programmes with more precision and finesse. In a centre like the one in Paris, you have the chance to meet people from all over the world.

We have received an enormous number of people, with very varied difficulties. We have now reached the point where we are capable of setting up certain standard programmes. In Paris, we do 500 sessions a day. In Paris, on average, we do 500 half-hour sessions a day. If we had to personalise each one of them for all these individuals, we would be running about non-stop. We know that with a standard programme, it works.

We know that with a standard programme, we will obtain good results. And if we could individualise the programme… individualise the programme. Apart from the first case that we examined and explained in terms of closed selectivity and its roots, its thalamic origin, apart from this first listening, all the rest can be explained by the dynamics of the external, middle and inner ear. We have here the external ear, the inner ear, and between the two, the three ossicles. Here is the external ear.

We have a very, very powerful muscle, a tensor muscle, which comes forwards and inwards, called the tensor muscle of the malleus, or tensor of the tympanum. There is another that pulls more towards the inside, the top and the outside, the tensor muscle or tendon. This one is the smaller. Interestingly, it measures only 6.2 millimetres in length; it is perhaps the smallest tendon in the whole body, and it is the one that appeared latest in animal evolution. It is perhaps because it is a latecomer in the evolution of the species that it is difficult to make active and to bring under conscious control. In fact, the most important work we do here, with the Electronic Ear, is to make this particular tendon efficient and subject to the intentional control of the individual.

And here again, perhaps, because, among the extensor muscles, it is one of the last, a latecomer in evolution. It is perhaps for this reason that it is one of the most difficult to set in motion, to make work. At the same time, although it is a latecomer and rather difficult to activate, if we manage to set it in motion, by counter-reaction, it sets in motion everything that came before. For example, verticality, which is very much linked to the extensor-type muscles, is brought into play, brought into action, by working on this tensor. The incus, the middle ossicle, is attached by a ligament. The malleus and the incus are practically welded to each other, one against the other.

Between the incus and the stapes, on the other hand, there is a space, an opening. The reason that explains this separation lies in this: the phylogenetic, or architectural, group is different. The first pair, the malleus and the incus, has its origin, on the phylogenetic plane, in the first branchial arch. The first branchial arch gives the malleus and the incus, and it is also in relation to the jaws. By branchial arches, we mean the very first form of cell division, and the beginnings of the structuring of the foetus. The second, which is more linked to the stapes, towards the internal part, is in relation to the musculature of the whole face.

At the same time, it creates and contributes to the development of the larynx. Thus, the first branchial arch, linked to the malleus and the incus, shows its role in terms of articulation. The second branchial arch, which is much more linked to the stapes, plays its role rather in terms of phonation. It is the muscle that has the most work to do. On the whole, the tensor muscle that has the greatest role to play is the tensor of the stapes. It is thanks to it that we will carry out the analysis.

It is thanks to the work of the stapes that we are able to analyse the sounds. The tension of the stapes. If we could represent the degree of tension, the limits of tension available to the stapes range from plus five to minus five. We will see that if we give the stapes an enormous tension, that is going to pull it towards the outside. And to understand what follows, we must come back to a few notions of psychophysiology and physics. I take, for example, a very low frequency, a long wavelength, or a mid frequency, or a higher frequency.

But in nature, these are complex sounds. In reality, in nature, it is a complex organisation of all these sounds. Where does one find pure sounds? If I put it all together, I obtain a curve roughly like this, which I can analyse with what we call the Fourier curve. The ear works like Fourier analysis, like this method of analysis. I will explain that to you later; it is very important.

I am going to subtract, what we call subtract, the sounds. I diminish, I cut off the perception of the high frequencies. I tense too much: I diminish the perception of the high frequencies. If I want to analyse all that, if, on the contrary, I wanted to be able to analyse all the fine variations in terms of vibrations, I will have to give a very, very brief tension. I need to release the tension. I can rather soften, soften.

There, there is a release. To carry out the analysis, I must be more relaxed. To carry out the analysis without the high frequencies, I must be here, relaxed. And in this sense, we do nothing. So, to be able to analyse these sounds, what is needed is a certain balance between the two extremes, a certain degree of suppleness. But if I pull very, very hard here, I push the whole chain, I push it like this.

I twist the play of the ossicles and I push very strongly towards the outside. And the malleus will come like this. And it releases the membrane. The first ossicle twists and loosens. It releases the membrane. And it relaxes the membrane of the tympanum.

I then risk hearing only the low sounds. In doing so, the risk I take is of not being able to pick up anything other than the low-frequency sounds. The low-frequency sounds are sounds that impose themselves on the individual: you do not have to make any effort. And if you do that, you end up… If I go too far, in very, very brief tension, if I tense too much at the level of the stapes, I destroy all the possible frequencies, and the only thing that will come in is the low frequencies. If, on the contrary, I want to have a supple tension, if I want to be more relaxed…

I am going to draw all that along with me… the ossicles in the opposite direction. The lower I go here, the more I act on the tympanum, the more it will hear, the more it will cut off the low frequencies. And the more tension there is at this point, acting on the tympanum, the more the possibility of picking up the high frequencies appears. If I also place the figures, I will obtain all the possible curves. If we tried to represent that, then the degree of tension and of opening at the level of the tensor, of the tympanum, and if I reason symmetrically, suppose I take, for example, that each time the sum gives zero: if I put, for example, plus three, minus three, that will make zero.

It will always be an average. It seems that, even looking at those curves, there is a certain balanced aspect, where the middle part of the curve, the curve at the level of the thousandth, seems to be the pivot point, below or beyond which you will note that the curve often balances out. Rather than a point of rotation, it will always be symmetrical. There always seems to be a certain balance, a certain rotation around a pivot point. But the sum, whatever way one looks at it, generally ends up giving zero. Now, if I continue with two symmetrical numbers, like for example three.

The two numbers are symmetrical. I am going to have curves like this one. All are going to be symmetrical. Plus five, plus one, plus one. Minus one, minus one. As long as they remain symmetrical…

I do not know if I am being followed; I am getting a little lost there. As for the others, I am going to get lost. Let us look at this from another angle. Let us take the simplest curves. For example, the midpoint, which is 1,000, which is the pivot point. That is where the curve divides into two.

That is where the curve divides again into two. Between 800 and 2,000 hertz, there is an important point here, a middle zone, the point of rotation. Between 2,000… the central zone, the point of rotation is around 1,000. Now, here, I have two scales. The zero is here.

We have plus five and minus five, plus five and minus five. We are going to subdivide that in terms of extremes that rise, plus five and minus five, in one way or another. The antagonists are always going to meet at the midpoint. I can have indications according to which the antagonist, the opposite, will always cross at 1,000. For example, I take two. For example, plus two, minus two.

A plus two in terms of the perception of the low frequencies will give way to a minus two in terms of the high frequencies. Or I can have the reverse too. These curves are fairly frequent curves, but they always cross. The rising curve and the descending curve always cross with the zero line around 1,000. If we have the same indications, the same value, crossing at the same moment, we will always have a median cut. We shall see.

I have plus two. Plus two. We shall see. Another curve is the one we call the central-hollow curve. Here again, it presents a balanced aspect, but according to a kind of inverted pattern. You can have a plus two in terms of low frequencies, a plus two in terms of high frequencies, but here again, at 1,000, that is the base point, the pivot point.

What does that mean? A moment ago, we saw that the two are directed towards 1,000. It is that which directs everything. Now, this one begins to oppose. What does that mean? A moment ago, we saw, in the previous curves, that it is the tension on the stapes, the stapedius muscle, that in a way dictates the other curve.

In this precise case, when we have this central cut, what happens is that the muscle, the tensor of the malleus, now begins to oppose the stapedius muscle, with the same value, on a balanced basis. As this one is very strong and the other is very strong, we are going to have a curve like this one, which is very marked. Consequently, we can have a situation where, in the muscular play, there is a great deal of tension pulling inwards on the stapes, a great deal pulling on the malleus, and we obtain this particular type of low point. We obtain a peak curve. The traction of one muscle does not let the low-frequency sounds pass, and the traction of the other muscle does not let the high-frequency sounds pass. The only place where they can have any play is at the centre.

Thus, the only sensitivity you would have would be situated in the middle zone. The one as much as the other, this peak curve or what we call the middle-ear hollow, are extremely, extremely difficult to correct. If we know the physical reasons for this, then, rather than using a standard curve or a standard programme, we can use a programme that will be exactly the reverse of what they present, which allows us to work much faster. How do we individualise? Let us take a particular curve, for example. Let us take a curve that we encounter frequently, in particular in centres like ours, namely what we call the middle-ear hollow.

In particular a curve where the two traces, air conduction and bone conduction, are similar. If we use the usual approach, the usual standard music programme, which has a rising curve, the minus five, plus five, and I oppose it, in the lower channel, with the plus five, minus five, which is the standard programme, I will not be able to give this person the experience, first, of being able to come into contact with his habitual listening posture, then of contrasting it with a more efficient posture. I must modify the programme, first, to make him feel and recognise his habitual posture, which is the minus five, minus five, and which corresponds to the middle-ear hollow, plus five, plus five, and I am going to oppose it with the minus five, contrast it with the opposite, plus five, minus five. It is not inverted on the other side, but I would say that, on the machine, we will not put a minus five, minus five at the top, plus five, plus five at the top. It is rather… Ah, for the labels!

Ah yes, those are the channels! It is the top channel! Yes, that is it! It is the top channel! We must invert the channels if we want to proceed in this way. That is the idea, fundamentally.

If now it is the reverse, if I had this one… If, on the contrary, I have to invert the peak itself… I will do minus five. You could trace up to five, five, five, five, five, I would try to contrast, plus five, plus five… You see that the numbers are always the same. And how to be…

You will therefore see that there is always a certain balance between the two, the first and the second, the first and the third, the second and the fourth: that is what I do for the top. You will therefore see that there is always a certain balanced aspect. For the point, the hollow or the summit, I take it as a zero reference. To calculate the degree of modification, I take the peak for the bottom, and I use it as a kind of zero point. And I calculate, according to the distance, how many degrees there are. And I try to calculate, in my head, the quantity of decibels in terms of the variation of the profile.

In fact, the number of decibels in terms of the variation of the profile is the same as the number of decibels at the level of the peak, and here, it varies by a maximum of 20 decibels. In general, we will note that there is a latitude of about 20 decibels for these patterns. That is the boundary. Even if there are irregularities in between, I do not pay attention to them. I look at where this line lies, and I take the average. One must average that out, to a certain extent.

At this stage, one switches to zero. It is relative. I do not pay attention to the rest of the curve. The rest, in terms of the type of curve, is very, very relative. We do not have the off-centre central zone and the extremes of the curvatures that we look at. That allows me to calculate in terms of plus or minus five.

I calculate, and I always place it in the opposite direction. That therefore allows me to calculate the person’s current listening posture, then to contrast it with its exact opposite. And when one does that, it works very well. When you manage to do it with the exact opposite of where the person is, you note that the changes occur very, very fast. This has a drawback, however. One must not leave it for long, in the same position.

Five in the low frequencies and a plus three: it is unbalanced, like this. When it does not balance out, you note that the pivot zone shifts, that the centre comes to place itself inside this particular range, from 750 to 3,000. One can recover the pattern fairly well. For example, if we have minus three in the low frequencies, then that rises up to a certain point, then arrives at a plus two: here again, it is not a very balanced thing, but the central pivot zone will probably fall from 1,000 to 750. Yesterday, a young girl whom we had first seen in Toronto, and whom we continue to follow here as an outpatient, presented at the start a very, very particular connection. There was no connection between the muscles, the tensor of the stapes and the tensor of the tympanum, strong for breathing.

I began to try to modify some of these curves. On the functional plane, it is like a slider: with the switch set to zero, you go to plus five or minus five in one direction or the other. Where do you put the high frequencies, and below them the low frequencies? And that is exactly what we have on the Electronic Ear: plus five, minus five. I then began to attack… always going from zero to five, I mean reducing it, fundamentally, in the right direction.

Part 4

Now, here, that part is almost flat. In the centre, that zone is generally flat, and that is what makes the ear — the middle part, there where it should be, and where it works best. It is between a thousand and two or three thousand hertz, and it is the zone in which the ear works best. And it is from this point that we add or subtract decibels to build our curve. Let us keep in mind that at this extremity we act on the muscle of the malleus, and at the other extremity we act on the stapedius muscle. By attributing a figure to each of them, we can visualise the quantity of muscular tension exerted in these systems.

If I pull hard enough on the muscle of the malleus, the tympanum rises. If I pull hard on the muscle of the malleus, I push the one of the stapes towards the inside. If I pull too hard on the stapedius muscle, the one of the malleus is pushed back towards the outside. There is therefore a kind of synergistic balance system. We always take the opposite. We always take the opposite.

And we always end up with opposites or with a balance in one direction or the other, either by negation or by addition, and always with the centre as a reference point. If the two muscles give way completely at the same time, then we obtain this bowl shape, this middle-ear hollow. But they are both always alive, both in activity; it is deliberately that they are less tense, but they always remain in tension. They are always in a certain form of tension, or of agreement between them. That is important. It is an agreement.

An agreement. But they are alive. They are alive. They are never dead, these muscles. They always function in one way or another, either very relaxed or very tense. Now, suppose there is an asymmetry in the tensions.

If the tension in these two muscular systems is asymmetrical. This one, for example, is going at a given moment to act very, very hard, is going to cut very hard. If the tensor of the malleus pulls very, very hard, it will cut. It will cut off the low frequencies. If we had a good system of muscle balance, the other would take over at least on the high end. Let us say the muscle of the malleus decides to pull very, very hard and that, in the reverse direction, the tensor muscle of the stapes pulls just as hard: we then obtain this peak.

Now, on the contrary, if it is this one that pulls very, very, very hard — if this lower muscle pulls very hard — and the other pulls very little, one will have a shift. There will be a shift of the point of support, of the centre of gravity, which will pass perhaps from 1000 to 2000 or 3000 hertz. Likewise, if this one is very, very strong — plus 5, I take extreme values — one will have this, and the other weighs in. If there is on the contrary an enormous release of the tensor of the tympanum and a little tension on the stapes side, we will have here again a balancing effect, but the centre of gravity, the point of support, will shift. For this, one does plus 2, plus 1. Here is how one obtains the curves.

Here is one: descending almost all the way along, except for a slight rise at the very beginning. That is a very, very big alarm curve. It is a very, very marked state of alarm. If ever it gives way, it is depression. It descends, and one falls into depression. There still remains a little bit of resistance in the rise at the beginning.

The person is still hanging on, but his energies collapse very, very fast: it is a state of alarm. You see, that allows one to play on this, on the overshoot of the mid-range. On this last curve, the point of support is perhaps 150. I have 150, 500. I have 150, 750. Here is an interesting thing I can offer you: I myself work on those two figures.

I have been working on this for years, on the possibilities, on the extremes, for more than thirty years. It is exactly 800 hertz and 3000 hertz, exactly. And what interests me is that the physiologists — those who know — have found these same two figures. What interests me is that for seven or eight years, all the physiologists who try to understand the working of the inner ear have arrived at the same conclusion. It is now known that the 800 hertz reflects the tension, the play of the musculature. And everyone, on the other hand, wonders what the 3000 corresponds to.

The 3000 reflects the other side of the curve, and in particular bone conduction. The 3000 reflects the counterweight aspect of this Maxindale-type pattern. Perhaps it is easier now to ask questions. — I should like to know what the “plus 5” corresponds to in terms of decibels? 20 decibels, 30 decibels? — A true Maxindale is considered to be at most 20 decibels.

The weight is the Maxindale. But the gap can reach more than 35-40 decibels. One must count 20 decibels, that is a true Maxindale. The limits are plus 20 at the top and minus 20 at the bottom. We therefore have a range of 40 decibels at most. To achieve this electronically, it took fifteen years to manage to reproduce these parameters on the electronic plane.

With the equalisers usually found on the market, the range, the one we work with… one must talk about it with Mark. I think that is what we will do in the years to come. Thanks to the apparatus we have, which allows us to see the curve over all the frequencies we want — thanks in large part to the new listening test which makes it possible to see the curve rapidly over all the frequencies, and at all the decibels we want — we are now able to take up the Maxindale again. We even have the possibility of measuring what happens over 40 decibels. We are starting again to rethink this whole Maxindale system within this range of 40 decibels, which corresponds very well to the dynamic range of the ear, to the dynamics of tuning and de-tuning, over a range of 40 decibels.

I give you an example — you may not see it. From time to time, for example, there are children who have a very, very good ear. From time to time, for example, we come upon something we do not quite know what to do with, and that puts us in difficulty. We have a young person whose ear is perfectly rising, but who does not function at all. You have had some, I do not know… — The boy we had there, with the drugs, from Saskatoon.

— Ah, drugs give that. That is heroin. — Wayne McDonald, yes. LSD, heroin, drugs give this curve. That boy had this completely open, rising curve. We looked at that and we said to ourselves: why is he here?

He was left-dominant. The only thing we could find was the left ear. If you have the underlying dynamics, that is something else. Beneath this curve, there is another underlying dynamic. There is an underground dynamic to this curve, which can now be considered as superficial to a certain extent. And if we could see the underlying curve, it would give us a better idea of the true dynamics at play.

It is an image I often give, but it is true. The same thing happens inside the ear. An image to keep in mind to understand what we are talking about: imagine you are at the seaside. The water can be very, very calm, everything seems peaceful. The sea looks hard, frozen. And suddenly, a ground current, a tidal wave arrives and sweeps everything onto the shore.

It is the same thing here. We can have a great many invisible underground currents. Or else it is the reverse. One can have here small things well set, a few obvious distortions, very visible on the listening test, but underneath everything is calm. One can then be more at ease. What we do now is to go and look for what is happening inside.

With the new listening test, we obtain a better picture of the true inner dynamics, which is not always visible, and we can act on it right from the start. Here is how one proceeds. One gives here, for example, a sound of 50 dB. While we do the test, we give a preliminary sound. At 1000 Hz. For example, at 50 dB, at the frequency of 1000 Hz.

Then, once this frequency is chosen, one presses a button called “Dual Tone”. One gives another frequency, at a half-level, but one still hears the first and the second — the first remains present. The subject, with the help of a joystick, tries to equalise the two. With this new approach, we have a preliminary sound. One chooses the frequency one wants. Then comes a second sound at a different frequency.

When the ear is good in the low frequencies, one seeks to obtain a straight line. One asks the person to indicate when the two frequencies are at the same level of intensity. If the ear is fundamentally good, one obtains a more or less flat line, nice and straight. We send the sound, and we, we make it vary. The subject, with his joystick, searches, indicates to us, seeks the same pitch. Normally, if he gives us the same pitch, the line is straight.

If he manages to balance the two at the same level, one obtains a more or less straight line. I have a child, for example — I cite that one because it is striking. It is a child who stirred up almost a whole team in Holland. Wait: Bakker and Van der Vlugt. It is a child whom they followed for seven years, without being able to do anything. By contrast, I give you the example of a case that somewhat defeated a great many people who tried to work with this young boy.

In particular in Holland, there was a very, very well-known researcher in the field of learning disorders, a certain Dirk Bakker. He has published an enormous amount. He worked seven years with this boy without arriving at anything. He ended up sending him on. Van der Vlugt came with him. Van der Vlugt and Dirk Bakker worked together, the two of them.

Van der Vlugt came to Paris bringing this boy to Doctor Tomatis. And his ears were like this: a perfectly rising curve with the first system. When I did the dynamics of the ear — when I went deeper with this new system — the ear was like this. The right ear was like this. The right ear had the rise underneath and the left ear had a descending curve. He did about a hundred sessions, and it was over.

After about a hundred sessions, everything fell back into order and it was finished. The child changed very, very fast. There was only that to organise. At a given moment, he had to organise that. It can exist. One can therefore encounter cases where the initial test gives a surprisingly, apparently perfect curve, and where nonetheless one gets nowhere because it is a somewhat false picture.

That holds for all adolescents, especially adolescents. I told you that there is a young person whom you saw long ago, who has a very beautiful curve, and with whom we have moreover worked, and who nonetheless resists us a great deal, a great deal. It is a possibility. We hope to obtain this test shortly. Have you understood? To do a good listening test from now on, it will be necessary in certain cases to go further than what we do.

In most cases, when we do our listening test, the inner picture and the outer picture coincide. But in certain cases, we can be deceived. When one reads a listening test: from the outset, one must take into account both the left ear and the right ear. In your head, you superimpose them. And, mentally, you subdivide into three zones. It would perhaps be well, moreover, on the tests, to strengthen the line a little.

Indeed, it would be desirable, to help in this direction, to strengthen with a darker line, on the listening test, these possible subdivisions. From experience, from the experience of many cases, the right side represents the whole dynamic side of the subject. Everything that is of a dynamic nature: his action, his intentionality, his future, his aspirations, what he has done. The relation to the other, and especially the relation to the father. The relation to the father. Whereas the left side is turned towards the past, the mother, the earth.

The left ear relates far more to all the symbolism of the past, of the mother, in terms of birth, passivity, receptivity. It is a difficult notion to make digest. It is obvious for a psychoanalyst, very, very clear for those who come from a psychoanalytic training. But for someone who works only on behaviour in its pure state — the behaviour modifiers, for example — such a scheme is of course very difficult to accept. But I am going to give you one of the first elements that came to me, that allowed me to understand that the rhythm of the person plays out between a right and a left. At the time.

I am going to share with you an experience that came to me at a moment when I was still doing surgery, at a time when, manifestly, I had no interest in thinking in terms of right or left, of the dynamics of the father or the mother. It is a child who had come to see me because he was left-handed. The boy came to see me because he was of the left. It was not for his left hand in itself that he had come to see me, it was because he did not live up to his potentialities. It was not fundamentally because of his left hand that I was consulted, but simply because this boy did not function up to his supposed capacities. It is the most renowned college in Paris, the Franklin College — the Jesuit college, the best in Paris at the time — that had sent me this boy.

They had sent me this child because they knew him to be intelligent and that he did not obtain the results one could hope for. He was twelve years old. He was a young pupil. An American boy. And really very brilliant. And I simply touched his right ear, and nothing else.

And he came to see me just afterwards saying to me — without my understanding the dynamics, without his understanding it himself: “I do not want your business, it brings me too close to my father.” He told me point-blank: “I no longer want to have anything to do with you, I no longer want to have anything to do with your device or your approach, because it brings me too close to my father.” At the time — that was thirty, thirty-five years ago — I had absolutely no idea what to reply to this boy. I respected his wish. Today, I would be far more convincing, I believe, in persuading him to continue. He remained left-handed, and so he remained with his problems of not using his potential.

He kept his left-handed posture, of left dominance, and he never truly reached the full effectiveness of the programme. You have seen that we always work the right ear. You have seen that we always favour the right ear. From the outset, we already work with 7. Instead of putting 10 at the start, we already put 7, and we give a right dominance. From the very beginning of the treatment, the right ear is favoured to a certain extent.

For example, one sets the balance at 10 for the right and 7 for the left. We already provoke an advantage on the right side. From the start, we seek to provoke a right-ear advantage. The fact of activating the right side is rather surprising, because it is the left ear that moves first. It is always the left ear that changes first. Even if we concentrate on the right ear from the start, it is curious that it is generally the left ear that begins to change first.

So it is the whole deep, emotional side, of the past, that is modified first. In our framework, it is the deeper layers of the personality, the most primitive, the most anchored, that change first. And the dynamics linked to the right ear follow afterwards. It is true that, when you see the left side move the fastest, even at 7, that means that the left side has remained even more excitable. If you observe that, keeping in mind that it is the right ear that one favours, it means that the left side is even more excitable. Even if the right side is favoured and the left ear is diminished, from the start, you must conclude that the dynamics, the deep emotional dynamics, remain very present.

The deep cases, like those of Venezuela, would perhaps deserve to be brought down faster. The deepest, the most disturbed cases, that we will no doubt find here, at Bosco, should perhaps be advanced more rapidly through laterality, as we do now in Paris. Or perhaps, sometimes, it is rather the reverse. In certain cases, it may even be desirable to do the contrary. If we have a person of extreme right dominance — which generally gives a very paranoid picture — we can begin by completely inverting the process and making this person more left-dominant, to a certain extent. And we do this because of the very, very spectacular changes that it provokes in the personality.

One must be very, very careful, of course, and follow them very closely so that they do not lose the whole of their right dominance. One wants to reduce the right dominance, but without tipping them into the sphere of left dominance. What are the parameters one has at one’s disposal from the start to approach a listening test in terms of left ear and right ear? Well, the left ear. The left ear reveals to us what is imprinted in depth. Even if the right ear can be seen or understood as the more dynamic, more active part of the personality, we can never forget that the left ear has deeper roots and carries a strong emotional charge.

Sometimes, you have a completely re-established right ear, but the child is completely transformed and you want to stop the treatment. For example — something you will encounter very often here — after so many sessions, you will note that the right ear is perfectly re-established, and you will be tempted at that moment to interrupt the treatment. But if you have not corrected the left side, you will have made a beautiful house with termites inside. If you have not pursued the treatment to the point where the left ear aligns with the right, all you have done is to build a pretty outer façade, with nothing inside to cement it. For example, the young girl we saw yesterday, Gita: the right ear is fairly good. The left ear still shows a deeper resistance, in the encounter with the father.

If we stop the treatment now, if we interrupt it on the basis of the observable behaviour — which is positive at this moment, the young girl beginning to dialogue with her father for the very first time in her life, which the father is very impressed by — we risk seeing the deep roots resurface again. Each time, the left ear brings up elements from the depths, with which one must go all the way. The left ear therefore gives you an indication of the depth of the difficulties and of the degree to which you must pursue the treatment to obtain lasting effects. Each time you have a distorted profile on the left ear, and that same thing recurs, is reflected on the right ear, you know that the vital reaction of the moment is caused by something else. You can automatically suppose that the behaviour problems that manifest themselves in the ear have very, very deep roots in the past. Suppose that, on the left ear, we have a peak at 1500 hertz.

And I bring it here from the right side. With the same thing on the right ear. I can be sure that the child is in a very strong, very aggressive position. I can be sure that the child is experiencing a very strong aggression at this moment, an aggression that is lived physically at the level of 1500, and that may even affect his health in the form of self-destruction. And as it is in the region of the lungs, everything is going to happen at the level of the lungs, asthma, and so on. The pulmonary, respiratory zone: the problems are going to manifest themselves through asthma attacks, allergies, breathing difficulties.

If the peak occurs at 1000 hertz, but it is not on the right ear, we know that the subject has an enormous problem of negation, which is not expressed. We can automatically suppose that the young person carries within him, in a latent state, a very, very strong aggression against the father, but that it is neither manifested nor lived. If, suddenly, one day, it manifests itself on the right ear, it can also translate into stomach ulcers. Now that we have all eaten well, it is possible that, if we do the examinations, we will see something, and that we will be able to establish it on the right side. It is quite possible that this morning, after what we ate last night or this morning, we will show a peak on the right ear only. If there is nothing on the left, it means that we ate too well last night.

But only on the right ear, at 1000. And that would indicate to us that — since it is not on the left ear — it is not something deep, it is something more transient, which reflects the fact that we have perhaps eaten too well this morning or last night. It is therefore very, very important to take into account the play between the left ear and the right ear to measure the depth of the here and now. With the more recent equipment, we can target with far more precision the exact degree of frequency and the exact degree of decibels for a given peak. And I believe it is important, in fact, to point out a zone that we cannot reach with the microphone. It is the zone that is here.

I am not certain, but I think that is it. It is at 1200 Hz, it is the heart rate. A zone that we cannot explore for the moment with our micro-audiometer is the heart rate. 1200 hertz, says Doctor Tomatis, and that reflects the zone of the heart. And if we can locate it on the left ear, we can anticipate, predict, and prevent a myocardial infarction, a heart attack. That is very, very important from a preventive point of view.

750: the duodenum and the pancreas. At 750, we have the duodenum and the pancreas. 500: the small intestine. 250: the colon, the lower intestine. From 125 and below, it is the whole zone that we call sexuality. When one looks at a listening test like this one, from the outset, are we capable of untangling and bringing out all the parameters at once?

It is true that our mind is a marvellous computer, and that, whether one realises it or not, our mind could probably take into account all the parameters at once. If someone comes to see me in Paris because he wants to sing, I do not talk about it, I integrate it, but I do not talk about it. And all that lower part, linked to sexuality, I do not take into account. No, what interests me is to see how this zone here presents itself, because it is the zone where he wants to sing. All I look at is that zone, between 500 and 3000 or 4000, which is more linked to singing; the rest, I do not talk about. If he has something here, I will tell him: you sing badly, it is not right, and so on.

I will talk to him about his singing, I will stay calm. I will concentrate only on what the person brings me as a problem: you cannot sing well in such-and-such a zone. The rest, I leave aside. The amount of information one can draw from the listening test is often so vast and so personal that we cannot — fundamentally we have no right — to reveal everything, unless the person comes to see you with a request for an in-depth analysis. And even then, just in relation to my own feeling, it is not something I like to do. I am loath to treat the whole dynamics.

For example, the air-conduction curve can be very, very good, but the bone-conduction curve can be far, far below. Each time there is a different curve, I know that we will be able to help the subject considerably. It is better. Each time I see the greatest gap, I automatically know that we will be able to help the person feel more alive and better within himself. But I do not want to enter into the details of his inner world. I do not want to enter into the whole story, open a Pandora’s box, if you will.

But if it comes to the point where the person requests it, then we do it. If the client comes to see you with this precise request — “I want to examine deeper questions” — then we can accept it. Sometimes, it is the reverse. Sometimes, we analyse for example the air conduction, then the bone conduction. Yes, that is it. Sometimes, we have the reverse here: we have the bone conduction fairly high and moderately rising, with the air conduction below.

There are others. This one, for example, is a very, very big sign of clinical trauma. Here is another profile that, for me, really, is a dangerous sign. We have here a situation where the bone-conduction curve — and remember that bone conduction is the guts of the personality, the deepest part — the right ear can present the alarm profile, a very, very rising schizoid profile. That, for me, is a very, very dangerous indicator. Beyond that, there is an epileptic solution to this.

So I can refer for an electroencephalogram. I do not talk about it, but I will do an electroencephalogram. I will look to see whether there is an epilepsy or not; and if there is no epilepsy, I will do it all the same. When I see this type of trace, I do it automatically, whether there is a manifest epilepsy or not. It is not the ambivalent side of the subject… He was attracted by the sea, and there was a rejection.

The psychodynamics is fairly telling. In the background, in the deep roots, there is an extremely rising curve of a person who seeks very, very hard, to the point of being schizoid, a return to the mother, a return to the maternal breast. Whereas in the more active part, the here and now, this person tries to cut himself off completely from the mother. It is a very contrary, very contradictory dynamic. Keeping in mind that the bone-conduction curve also reflects the spinal column, we can make the hypothesis — and verify — that an individual like this has a spinal column that is rather twisted and deformed. Is that not so?

— What were your studies? They concerned… where, precisely, the informational or emotional cycle attaches to the body for its function of the moment. — Yes, exactly, segmented like that. — I do not quite understand how you work from the base, how you could first integrate singing, what it is supposed to say… Doctor Tomatis says that, even if he does not talk about the dynamics, he goes ahead and works with the whole profile, but he is not going to sit down to discuss the fact that, of course, one can help you to sing, but that one must first rid you of a little of this conflict with your mother.

He simply does it, without saying it: you talk about singing, hoping that the rest will come along with it, in passing. If someone comes to tell me that he does not feel comfortable in his own skin, then I begin there, and I talk about the skin. It is very important for us: we do not encounter this difficulty here with our young people, because the fact that they are here, at Bosco, we know they are here for deep reasons. Where we encounter difficulties is with the parents. The parents sometimes arrive with extraordinarily disturbing things, and we must put them on a standard programme; at certain moments, the problems surface into consciousness, and they perhaps talk to us about them. But in many cases, we must keep that to ourselves.

Doctor Tomatis says that, in the most disturbed cases, with the parents, in Paris, they are obliged to go to a much deeper level. For example, in the case of schizophrenia, where one generally deals with three generations: a schizophrenic child will generally have a schizoid or schizophrenogenic mother. One must therefore have even the grandmother in the process: treat the mother first, then the child. The reason is that the grandmother always agrees. What is interesting is that I have never yet met a grandmother who did not agree, across the three generations. One generally imagines that they would be against it, but they are always very, very favourable.

And they are more conscious that they are at the head of the phenomenon; generally, they are very, very conscious that the problem begins with them. For example, autistic mothers refuse very strongly. An adoptive mother would be more admirable in this respect. — The profile of an autistic child, would it be a lowering of the threshold, or a closed selectivity? What kind of profile could one obtain with a child with closed selectivity? — Closed selectivity, for sure.

Very often a very good ear. Often a good underlying ear. The fact is that, often, they can sing very well. That means that one can often see whether it is a schizophrenia. Whereas with a schizophrenic person, our experience here is that very often we have a completely open selectivity, but they are very, very… a very, very rising curve.

Often, there is a lot of energy, very, very direct. It leads nowhere. It is just an overload, again and again. There is a problem here. Schizophrenia in France. Doctor Tomatis talks about it, and it is something I had already noted ten years or so ago, when we got into this.

In France, what they call schizophrenic, we call autistic. What we call autistic, they call the complete reverse. That therefore explains to you what you have with a schizophrenic. An autistic child, with an extremely rising curve: they are not connected to their body, but there is a lot of energy, a lot of excitement and shouting. But the curve being so rising, nothing passes through the zone of communication. With a schizophrenic — as we understand it — we generally find a closed selectivity.

Another thing we know: this type of curve here. We have noted, with our schizophrenics, in particular those who have decompensated… You have a very, very rising curve. They would like to live, they would like to… Very often, they intellectualise a great deal. But underneath, they are sitting on an enormous quantity of depression and insecurity.

And they try to… It is so contradictory and self-destructive that they end up cracking. Tony Miller was like that. Or Sheldon, to a certain extent. They cannot stand on their legs. The outer life is very, very different from what happens inside.

There is a real split. Generally, the selectivity will be closed at the start. It is generally someone very intelligent. — Would you therefore work very, very slowly with these people? Because I imagine what could happen if you… — One works very slowly.

And generally, what we try to do is… We hope, we pray that the selectivity remains closed, at the start, and we try to bring down the bone conduction. Bone conduction is the inner fear of being attacked, of being hurt, of being abandoned. And if you open the selectivity too fast… it requires a consciousness for that. Otherwise, one can make him crack.

And then, one can say goodbye. In cases like those, says Doctor Tomatis, what one must do is reduce the air conduction. Try to work with it, reduce it as much as possible. We use a lot of pre-sessions. Yes. With the new machines, we can bring the bone conduction down quickly, underneath, and try to put it back in place as late as possible.

So as not to have to… Work more with the air conduction. Well, we will have to examine cases like that. One can help you, air conduction and bone conduction. Yes, we have quite a few cases with a high bone conduction. All the children who have undergone…

physical ill-treatment. High bone conduction. In the low frequencies. In the lowest frequency. Yes. The moment you talk to them about attack, they feel…

they feel a desire. And it must be something, because they are very interesting. Doctor Tomatis says that they feel they are being attacked, and that they seek out this attack. They provoke it. And it is exactly the dynamics of Curtis Kozak and of… They have been ill-treated, but they try to repeat, to confirm this ill-treatment, because it is the only way of acting that they know.

What I have been able to research further is what rapes failed in. When a girl has been at risk of being raped, it haunts her all her life. It is perhaps that it failed, I believe. An interesting thing: he thinks that cases of rape did not exist. In certain cases, some of these women seem to seek out an interruption, to provoke the stopping of the rape. It is a very, very big problem.

Is there really another possible reading? In certain cases, it is a very, very thorny question to know whether the rape was a true rape. — On what basis did you decide on the left and the right? What led you to decide to open the zone of communication? — I have already given part of the answer earlier, some of the keys, a few minutes ago, speaking of that American boy in Paris. And then, each time we have had the chance to open the zone of communication, the drama, especially between the father and the child…

Each time we have been able to open the subjectivity between 1 and 2000 hertz, inevitably, the child seeks a communication with the father. At the start, he has a new voice, he has a new curve. Generally, they come to us according to a certain progression that we often find again. They arrive with a curve like this, with a hollow in the middle. There is a desire, but it does not succeed. Sometimes, one sees the bone conduction very, very high: there is therefore a search for this relation.

It is a stake, but it does not happen. And it is as if a candlestick were needed to integrate the father. If we have the opportunity to involve the father in the treatment programme, we will see the air curve like this, and very often a hollow underneath. The child does not yet want to respond. Have the father take part, have him talk to the young person. The next curve we may obtain for the young person is that the air-conduction curve corrects very, very well, but that an inner resistance remains.

And even if, on the surface, the young person goes along with the process, fundamentally, there is still a hesitation. The great element in favour of the father… It is not the right and the father, it is the right and language. The key to understanding this is to represent the right as representing not necessarily the father, as we understand it, but as representing language in general, communication in general. And the father then takes on a more symbolic dimension. The father, in this case, is anyone beyond the mother, beyond the very personalised form of communication.

Take for example the families that have no father, and where the mother wants to stay strictly with the child. As long as she has found no one — a brother, a grandfather… In the cases where the father is absent from the family, for one reason or another, where the mother is in a way stuck with them, cannot move, and an uncle, a big brother or someone else arrives and manages to draw the young person away from the mother… Here, you have the chance to see many left-dominant people. And you will see to what extent they are against — against the system, against everything, quite simply. And I think that being of the left is already to recognise the image of the other.

It is interesting to see that fundamentally… I came to this conclusion, and I am only verifying it on the basis of clinical experience and intuition. And it answers the whole dynamics, while at the same time reflecting the dynamics that one finds inside the analytic system. It is interesting to see that one arrives at the same system. And if we look at the subject in relation to language — if we approach it from the subject in relation to language — it is at the moment when a person truly engages in communication, truly wants to reach out and communicate, that automatically a certain laterality imposes itself at the neurological level, so that the whole body can be taken and used as an instrument of speech. There is an axis — a vertical axis — that can also be taken into account in this process.

Anatomically, the left side, inherited from the vibrations, and then, secondly, the trachea on the right side. To speak like this is more difficult than to speak like that. But like this, it is better. If I turn my head too much to the left, my voice and my possibilities diminish. There therefore seems to be an innate axis, an orientation, for reaching out and speaking. One finds here all the symbolism — the same symbolism that recurs ceaselessly in certain Eastern religions, certain philosophies, in the Bible, under other words perhaps, but with the same roots.

Something very, very beautiful. It is the same intuition. It is what comes out of the mouth of God, from the right side. The symbolism of the word that comes out. It refers to an image, to a painting, which, in one of his books… which comes out of an abbey…

coming out of the right side of the mouth of God. And biblically, we say that… if we had the opportunity, we would know when… If there are slides… I hope to get hold of an overhead projector, because the transparencies are prepared in advance. We made them ourselves.

It is just, in a general way, for us, in this university. Yes. Absolutely. We did it. Wonderful. We talked about it, right there.