SOUND OF SILENCE, SOUND OF MUSIC OR THE SOUND OF NOISE?

Different sounds influence our minds in different ways. Silence benefits deep reflection, music aids creativity, and noise hinders both. “Hello darkness, my old friend,” the opening lines of 1964 folk-rock classic “The Sound of Silence” by Simon & Garfunkel, is about widespread apathy, societal isolation, and the modern lack of communication. It urges people to break their silence and engage with one another. This is even more relevant in this age of smartphone addiction. “The Sound of Music” primarily symbolizes the harmonious, joyous, and transformative power of music in life, representing a universal language that connects people, transcends barriers, allows characters to express emotions that words cannot, fosters joy, and helps overcome adversity, as in the 1965 movie of that name. It also highlights how art and creativity can bring solace, hope, and emotional connection in challenging times. “Sound of Noise,” a 2010 Swedish movie, is about a tone-deaf cop chasing a group of guerrilla percussionists whose anarchic public performances are terrorizing the city. Music and speech therapy, hearing aids, and devices depend on sound to overcome silent suffering due to various mental health, neurological, hearing, speech, and other disabilities.

MUSIC AND SILENCE: Musical rhythm and beat have universal appeal as they synchronise with movement and dance. Lilting music, a light, rhythmic, and cheerful melody that rises and falls in a pleasant, graceful, or swinging manner, is very calming and mood-elevating. Uplifting music with its fast-paced, melody-heavy compositions stimulates dopamine release, improving motivation, optimism, and happiness. Soft instrumental or nature-inspired music enhances concentration, especially during study or work. Rhythmic patterns in music aid recall and language acquisition. Popular music encourages social bonding. Silence and quiet environments foster mindfulness, improve clarity and self-reflection, similar to meditation. Silence, by reducing sensory overload, lowers blood pressure and heart rate, creating a state of calm.

NOISE: Noise is generally defined as any sound that is unwanted, unpleasant, disruptive, or too loud. Unlike the regular, periodic vibrations of harmonious natural sounds or music, noise often lacks a regular structure, consisting of irregular, non-periodic vibrations. It is a subjective phenomenon, meaning a sound becomes noise when the listener finds it annoying or disturbing, like noise-pop music, heavy metal music, or any loud or high-pitched music that is noise for many others. Noise causes discomfort, annoyance, reduced concentration, elevates cortisol levels, creates psychological stress leading to irritability and fatigue, and disturbs sleep. Loud or prolonged noise damages hearing and is linked to hypertension and cardiovascular strain. White, Pink, and Brown noise, noise maps, noise hazards, earbuds, noise-cancelling devices, acoustic engineering, and noise reduction were discussed in detail in my article on noise pollution on 16.03.2025.

Harmonious rhythmic natural sounds (bio- and geophony) like gentle flowing water, chirping birds, forest sounds, rustling wind, and soft rain have a calming effect, reducing anxiety and stress, promoting relaxation, and improving mental health. These sounds are often used to accompany meditation, mindfulness, and study sessions.

EXTERNAL HEARING AIDS Hearing aids are categorized by style and technology, each fitting differently, from sitting behind the ear to being nearly invisible in the canal. They work by amplifying sound, with digital models offering advanced processing for specific hearing loss needs, and reducing background noise. Many connect to phones and other devices via Bluetooth and offer rechargeable batteries. An audiologist helps select a type based on your hearing loss severity, lifestyle, ear canal size, and cosmetic preference, considering that larger devices often provide more power. Types of hearing aids: =Behind-the-Ear (BTE), sits behind the ear with a tube to an earmold; sturdy, easy to handle, and suitable for most hearing loss levels. =Receiver-in-Canal (RIC/RITE) has the speaker in the ear canal, making it smaller and discreet; popular for first-time users. =In-the-Ear (ITE) fills the outer part of the ear, is easy to insert and handle, good for mild to severe loss. =In-the-Canal (ITC) fits in the ear canal, smaller than ITE, suitable for mild to moderate loss. Completely-in-Canal (CIC) and Invisible-in-Canal (IIC) are custom-moulded to fit deep in the canal, very discreet, best for mild to moderate loss, but with shorter battery life.

BONE-CONDUCTION AND DEVICES: Dame Evelyn Glennie, a Scottish virtuoso percussionist, achieved international fame despite becoming deaf by age 11. She learned to feel low-frequency sounds through her bare foot on wooden stages, and higher frequencies in her hands, leaning against drums to sense their resonance, allowing her to perceive complex rhythms and tones. Bone-conduction headphones are commonly used to safely listen to music during outdoor activities like running, cycling, and travelling, while keeping the ear canal open for maximum situational awareness. They are also used by those with conductive or mixed hearing loss, as they bypass damaged outer and middle ears to send vibrations directly to the cochlea in the inner ear. Bone-anchored hearing aids (BAHA) are surgically implanted medical devices for permanent, severe hearing loss (conductive/mixed), offering direct bone conduction for superior sound quality.

COCHLEAR IMPLANT: A cochlear implant is a surgically implanted electronic device that restores a sense of sound to individuals with severe-to-profound sensorineural hearing loss by bypassing damaged inner ear hair cells. Unlike hearing aids that amplify sound, it directly stimulates the auditory nerve using external sound processors and internal electrode arrays. CROS (Contralateral Routing of Signals) and BiCROS (Bilateral Contralateral Routing of Signals) are non-surgical alternatives to cochlear implants to treat single-sided deafness by using a transmitter on the non-functional ear to send sound wirelessly to a receiver on the better ear (CROS if it has normal hearing, and BiCROS if it is hearing-impaired). These systems improve sound localization and reduce the head-shadow effect.

MUSIC THERAPY: Music is used to treat depression, for anxiety reduction, pain management, trauma, and palliative care. It also helps manage emotions and cravings during addiction recovery, and in physical and neuro-motor rehabilitation. There is also a book titled “Music and Mind: Harnessing the Arts for Health and Wellness.”

Primary Methods of Music Therapy =Improvisation (Active): Clients spontaneously play instruments or use their voices to express emotions, which helps improve communication and emotional regulation. =Receptive Music Listening (Passive): A therapist plays live or recorded music from patients’ past favourites, often combined with guided imagery, to induce deep relaxation, pain relief, or memory stimulation, especially in dementia care, as in the documentary “Alive Inside: A Story of Music and Memory” (2114). In many movies, a song revives lost memory (amnesia), as in “Yaadon Ki Baaraat” (1973). =Songwriting (Compositional): Clients create their own songs or lyrics to process emotions, trauma, or personal experiences. =Re-creative/Performance (Active): Clients sing or play existing songs, promoting motor skills, social interaction, and cognitive engagement. A study has shown that a group of elders with chronic pain got dramatic relief when they sang together, associated with improved breathing, and an increase in oxytocin levels, which promotes positive emotions. =Many specialized therapeutic approaches exist, like Neurologic Music Therapy (NMT) for stroke, Parkinson’s, and traumatic brain injury rehabilitation; Analytical Music Therapy to promote dialogue and unconscious expression, etc.

SPEECH FOR DIAGNOSIS AND TREATMENT: Speech analysis, a low-cost tool, uses AI to identify subtle voice changes too faint for human ears. It detects slurring, tremors, or changes in pitch and speed, and vocal patterns linked to neurological disorders (Parkinson’s, cognitive decline, Multiple Sclerosis, ALS), mental health conditions (depression, anxiety, schizophrenia, and PTSD), and respiratory disease, enabling early diagnosis. Convolutional Neural Networks (CNNs) are deep learning algorithms used in computer vision, medical image analysis, and video processing to analyse speech data for diagnosing mental health issues and other conditions. Smartphones and apps are used for remote, continuous monitoring of patient symptoms. Speech-in-noise testing identifies hearing difficulties, even when standard tests are normal. Speech-Language Pathologists (SLPs) use tailored speech exercises to treat speech disorders of all kinds and causes, including articulation disorders, aphasia (language disorder), apraxia (disorder of coordination of muscle movements for speech), and communication issues.

SPEECH DEVICES: Augmentative and Alternative Communication (AAC) tools range from low-tech picture boards to high-tech, specialized, speech-generating devices (SGDs) and tablet apps. They enable individuals with speech impairments to communicate using voice output, symbols, or text, with common options including tablet-based apps, Dedicated Speech-Generating Devices (SGDs), and eye-gaze systems.

The advances in hearing assistance technologies and devices, speech analysis technologies for early diagnosis, speech therapy and devices for the speech impaired, music therapy, and noise reduction are helping mitigate a wide range of sound-related problems in society. Awareness about these, availability, and affordability of these technologies and devices will go a long way in helping those with hearing and speech problems and in early diagnosis and management of neurological, mental health, and respiratory disorders.

Dr P.S.Venkatesh Rao is a Consultant Surgeon, Former Faculty CMC (Vellore), AIIMS (New Delhi), and a polymath in Bengaluru, drpsvrao.com