Sound Sensitivity after TBI
Loud noises.Crowded rooms. Public places. These environments can cause great anxiety or even emotional meltdowns for some children and even adults. I’ve felt this first-hand. Several years ago, I suffered a moderate traumatic brain injury after falling on some concrete and cracking my head open playing basketball with a young student. Within days of the injury, I noticed that listening to even one person talk to me was so difficult and exhausting that I just wanted to curl up in a ball. When I returned to work a month after injury, the sound of the students laughing in the gym or a teacher asking me a question was enough to set off a mild panic attack. One day it came to a head when I was in the grocery store and the clerk was talking to me but I couldn’t process what he was saying. The overwhelming noise in the store and his speech were too much for me and I broke down into tears right there. I wondered if I would ever live a normal life.
I went home and immediately started researching sound sensitivity and traumatic brain injury. What I found astounded me a bit. I already knew much of the information I found but now I was living it in my own body and wow! Basically, the trauma of the head injury activated all of my survival/stress responses. These are present from birth and their singular job is to keep you alive. We know these most commonly as Fight or Flight and Fear Paralysis (the deer-in-the-headlight freeze response). We’ve all had moments or periods in our lives when these responses were activated. You are alone in the house upstairs at night and you hear a door rattle-you freeze and are unable to breathe (fear paralysis). Or maybe you broke down into tears and curled up in the fetal position for several days after losing a loved one (flight).
What I didn’t know until my own injury is that these survival/stress responses manifest differently in each of our sensory systems. The kind of perceived or real danger, injury, or assault we experience will dictate how each of our systems reacts. For me, my visual, auditory, and vestibular (balance) systems went completely off-line. I was hyper-sensitive to light, couldn’t read my computer screen or anything at near-point, was overwhelmed by sound, and struggled to keep my balance. What was happening to me and WHY?
Fortunately, I had already done hundreds of hours of training in neurodevelopment and PTSD, so I had some solid foundational knowledge to make sense of my new reality, but I needed more information.
In his groundbreaking work in this area, Dr. Stephen Porgess created the pivotal poly-vagal theory. To put it in simple terms, we have two “circuits” of the vagus nerve-the ventral vagal and dorsal vagal circuits. When we are calm, engaged with the world, and socializing with others, we are on the ventral vagal. When we experience high stress, injury, trauma, or fear, we activate the dorsal vagal. When this happens, the middle ear actually tightens down and our auditory processing is significantly impacted. This is different than hearing. Hearing is the actual mechanism of the cochlea but what we do with that sound after it is taken in is called auditory processing. It is a neurological function and requires the coordination of several parts of the brain along myelinated pathways.
When this auditory stress response is activated, the frequencies we can process are actually reduced and the ones that are filtered out are those of the human voice. In addition, it is more difficult to appropriately process all sounds, particularly when there are competing sounds like in a shopping mall or background noise like in a restaurant. For the listener, it can be incredibly overwhelming and anxiety-inducing, hence my meltdown at Safeway.
Luckily, I have some very intelligent and accomplished friends and they were able to put this Humpty Dumpty back together again. My dear friend is an audiologist and speech pathologist. She has studied Dr. Porges’ work extensively and provides a therapy called the Safe and Sound Protocol. It is a listening therapy delivered through an iPod or app and headphones. For 30–60 minutes per day, you listen to specially filtered music that deactivates the stress response, allowing the middle ear to relax and for you to be able to process the full spectrum of frequencies again.
After the first few sessions, I felt a marked difference. I could talk with people again and not feel like I was crawling out of my skin. After a week, the anxiety attacks were gone. What I found even more remarkable was how it affected my cognitive processing. Post-TBI, I felt like my brain was in slow motion like I was swimming underwater with weights on my arms and legs. It was terribly difficult to think, process information, and complete tasks. However, after the SSP, my processing speed improved and I was able to work more efficiently and with far less struggle. More on that in the next article.
The message here is a simple one. If you have had a TBI or other traumatic experience, it is quite possible you are struggling with auditory processing as part of your stress response. These traumas might be beyond the scope of what you’d normally consider, such as:
physical or sexual assault
loss/change of life circumstances
In the next few articles, we will discuss how auditory processing affects learning, particularly reading, anxiety, and cognitive processing.
For more information about SSP, you can visit here.
(I am not an affiliate of ILS or Dr. Porgess and do not receive monetary compensation from them.)