PSYCHOSOMATICS
SOUNDMAKING-THE ACOUSTIC COMMUNICATION OF EMOTION. By Peter F. Ostwald, M.D. 185 pages. Springfield, IUinois: Charles C Tho17UlS, 1963, $7.50. This book presents the results of a four-year investigation along bio-acoustic lines of soundmaking, "an activity as necessary to human survival and comfort as are breathing, feeding, sleeping, and other vital processes." There are eleven chapters which range from historical to psychopathologic aspects of acoustic communication. Chapter 1 "shows how trends in soundmaking have changed throughout history in accordance with man's different views of nature and changes in his attitude toward self-expression." Principles of musical aesthetics which explain Western views on emotional expression by means of sound are summarized. The complementary views of Helmholtz and of Freud in shaping modern scientific approaches to acoustic communication are discussed. Helmholtz, himself a musician, studied the physical aspects of sound; Freud focussed on the psychology of the soundmaker. Chapter 2 contrasts the sounds of animals, human infants, and adult speakers. "No hard-and-fast boundaries exist" morphologically between the acoustic signals used by these three groups; but speech represents a unique ordering of mdimentary sounds into elaborate symbolic patterns. The infant makes about 18 rudimentary sounds, while the number of verbal sounds usable by adults is unlimited. Discrepancies between the individual's capacities and society's demands for meaningful soundmaking account for much of the speech pathology observed by clinicians. Chapter 3 tells "how to make statements about sounds." Seven qualitative attributes of sound are discernible by ear. Some of these can be denoted visually with phonetic or musical symbols. Quantification of sound requires electro-acoustic filtration and measurement. Half-octave band methods are used in studies reported here. Chapter 4 analyzes the babycry, "part of every person's inborn equipment for obtaining attention." Chapters 5 and 6 deal with speech and present four "acoustic stereotypes." The sharp voices of easily-heard, penetrating speakers show prominent octave-reinforcement; the flat voices of muffied, tired speakers show bands of noise; the hallow voices of depleted, depressed speakers lack resonance energy; and the robust voices of exhuberant, expressive speakers concentrate large amounts of sound in the center of the frequency spectrum. To relate these acoustic findings with psychopathologic patterns, Dr. Ostwald follows the soundmaking of one patient through eleven consecutive interviews and shows periodic focussing of sound energy at 500 cycles per second, which he interprets as a manifestation of the patient's "suppressed desire to cry, an unconscious defense against the expression of passive, anaclitic impulses." He then studies two groups-30 patients and 20 non-patients-in terms of their sounds emitted under two contrasting conditions. By means of statistical comparisons, it is shown that "a change in the loudness of soundmaking by psychiatric pa312
tients was the single most reliable acoustic criterion of clinical change. A change in time-duration was also a reliable variable; younger patients tending to speed up, while older patients tended to slow down in their soundmaking measured before and after treatment." Significant fluctuations of sound intensity at 500 cps per second were found in both groups of subjects. Chapter 9 is about listening. Three experimental procedures are utilized: the Wilmer Auditory Pr0jective Test for stimulating conscious fantasies; masked baby cries for stimulating unconscious fantasies; and a juke box experiment for studying the popularity of various sounds. The final two chapters are clinical in nature and present eight patients who have speech disturbances. The material suggests that "nonspeaking patients" ( mute, autistic, regressed schizophrenics and mental retardates) suHer from a basic 'inability to use sounds symbolically," while "disturbed soundmakers" (depressives, psychoneurotics, and stutterers) find it difficult to "distinguish between emotive and denotative soundmaking." As a concise synthesis of contemporary views about sound from bio-acoustics, linguistics, and psychiatry, this book is probably the only thing of its kind available today. In his brief introduction, the author provides the frame-of-reference for his work. A glossary defines unfamiliar and ambiguous terms. The Charles C Thomas Company has published this book in its beautifully printed and bound "American Lecture Series." K. W. BERBLINcER, M.D.
THE MEDICAL MUSE (Or What To Do Until the Patient Comes). By Richard ANnour. 129 pages. New York: McGraw-Hill Book Co., 1963.
$3.95. The author, in his delightful, uninhibited verbal expressiveness, takes a panoramic view of medicine. His penetrating pen covers medical meetings, socialized medicine, urine analysis, psychoanalysis, school phobia, the maladjusted mother, the "cure-ityourself" movement and its potential consequences, experiments with hallucinogenic drugs on unsuspecting spiders, the effects of TV on the public image of the doctor, and other choice items. His utilization of scientific news items as a take-off platform provides many excursions into his own world of phantasy. The description of the hypochondriac who finally becomes "sick for real" adds no new material with which readers of PSYCHOSOMATICS are not familiar. Even the lowly enema, in Armour's text, also has a place; the indiscriminate use of tourniquets is pointed out, especially when applied to the neck. Best of all, in this reviewer's opinion, is his description of the "normal man"-well adjusted, quite secure, without ulcers or stress, yet there are times when others feel for his pulse, since they doubt whether he is living. This book is not only recommended,. it is the Editor's hope that some of Richard Armour's material will find its way to PSYCHOSOMATICS. W.O. Volume IV