Articles

The Ear and the Alexander Technique

The vestibular system and the ear are one and the same, and sound is movement. How we process sound through the ear, both from outside sources and our voice, is essential for alignment and energy. If the early developmental reflexes don't integrate at the right time we will not process sound correctly, and we may have problems with our visual development as well.

Nerves myelinate (fully develop) in order of their importance for survival. The first cranial nerve to myelinate in utero is the vestibular nerve (sensory nerve with some motor nerve functions) whose primary functions are balance and energy. A two-month-old embryo hears and reacts to sound by opening and closing the arms and legs, these movements are the Moro reflex. "The newborn hears and moves in rhythm to the mother's voice in the first minutes of life. There are no random movements; every movement of the newborn has meaning, with particular movements being linked to particular sounds. For example, with a sudden loud sound the baby will throw out its arms and legs in a Moro Reflex. In response to his mother's voice, he will turn toward her. Studies done using high-speed film show that newborns and infants have a complete and individual repertoire of body movements that precisely synchronize with syllables or sub-syllables of a speaker's voice. This important matching of movement to words, or "entrainment", starts in utero at about four and a half months and leads to full development of the vestibular systems and the ability to language successfully."(i)

The Vestibular Nerve begins to myelinate in utero by registering the movement of the fetus and its environment (mother). After birth the vestibular system is necessary for the infant's survival in the new environment, which is gravity. The vestibular nerve is involved in the sense of equilibrium, maintenance of posture and muscle tone. The other purpose of the newly myelinated nerve of the hearing organ is the electrical charge that the brain receives from sound and that is crucial for brain development. In these early stages, it is the mother's voice that the baby has entrained to, and in particular to the high frequencies that are most enriching for the infants' brain development. "We instinctively talk to babies with a higher voice, called "Parentese", which we now know energizes the baby's brain, making it more alert to all sensory input and able to take in specific patterns and rhythms, thus aiding leaning"(ii)

SOUND IS MOVEMENT
It is important to establish the fact that Dr. Alfred Tomatis never distinguished between the cochlea (a circular conch shaped organ, which is lined with hairs referred to as the body of corti) and the vestibular system. He believed that both help us to perceive movements. "The vestibular system is in charge of the slower movements — those that we see, feel and call movements. The cochlea specializes in faster oscillatory movements — those that we don't see and can hardly see, but those that we hear."iii In other words, sound is movement and how we take in sound is essential to the health of the vestibular system and reticular activating system which sends an electrical charge to the neo-cortex for energy.

THE FACIAL NERVES
The second set of cranial nerves to myelinate in utero are the facial nerves which are involved in sensory and motor control in and around the mouth, which is necessary for breathing, sucking and swallowing. Later the facial nerves are important for lip movements needed for clear speech and clarity of the voice. It takes 72 muscles to speak a single word. Speech is classified as movement. The link between the facial nerve and the stirrup muscle of the ear is called the "ear-face link".

The movements of the tongue, lips and facial muscles used to create language including the sound of our own voice, are movements that nourish our vestibular system and brain. Reading aloud was highly recommended by Dr. Tomatis for balance and energy.

MOTOR NERVES MYLINATE BEFORE SENSORY NERVES
It is the motor nerves that myelinate before the sensory nerves, meaning that movement awakens the senses. We need movement and that includes sound in order to sense or perceive our environment and ourselves. Movement is crucial to learning in both the internal environment and external environment. Both sound and movement are crucial to the early developmental reflexes.

RETAINED DEVELOPMENTAL REFLEXES CAUSES PROBLEMS WITH HEARING AND POSTURE
Developmental reflexes are crucial to healthy functioning and must be present and then integrate. In the case of the Moro reflex it should integrate and when it disappears it is replaced by the startle reflex also known as the Strauss reflex. This happens at very specific times in our early development. The Moro reflex, our first reflex, emerges at 9 weeks in utero. It should be fully present at birth and integrates at 2-4 months of life. When it is retained (not fully developed) the long-term effects are problems with the ear/vestibular system, that cause learning disabilities from the inability to process sound correctly. Other effects include sound sensitivity and poor posture (the inability to use the muscles to stand up straight).. A retained Moro reflex causes "possible auditory confusion resulting from hypersensitivity to specific sounds. The child may have poor auditory discrimination skills and have difficulty shutting out background noise... poor stamina," possible secondary psychological symptoms, and "tense muscle tone (body armoring)."(iv) Most existing research has been done with children but if these problems are not corrected as a child they remain as an adult.

When observing for retained reflexes one of the clues is body misalignment (poor posture) with either hypertonic (overly tense) or hypotonic (overly slack) musculature, as well as sensitivity or insensitivity to sound. A retained Palmar reflex causes poor manual dexterity, speech difficulties, inappropriate relationship between hand and mouth movement (where there are unnecessary movements of the mouth and tongue when using the hands, such as, learning how to print and the tongue will be out).The independent muscle control at the front of the mouth will not develop, and there will beproblems with speech and swallowing. A retained Asymmeterical Tonic Neck Reflex causes balance problems; and normal cross-pattern movements used in walking, marching, skipping etc. will not develop. There will be difficulties crossing the midline of the body which results in homolateral movement, eye tracking problems, visual perception difficulties, and mixed laterality: no dominate hand, eye, foot etc.

A retained Rooting Reflex causes hypersensitivity around lips and mouth; and the tongue may remain too far forward in the mouth, making swallowing and chewing of certain foods difficult. A lack of mature swallowing movements may cause increased arching of the palate and the need for orthodontic treatment later on as well as speech and articulation problems. A retained Spinal Galant Reflex causes hip rotation to one side when walking. If the Galant remains present on one side only, it may affect posture, gait and any other form of locomotion. This can result in the illusion of a "limp" or contribute to scoliosis. All of these reflexes should be present in utero and integrated by about the 4th month.

The Tonic Labyrinthine Reflex, which is linked to the Moro Reflex, is linked to the ear. Both are vestibular in origin and both are activated by stimulation of the labyrinth movement of the head and alteration of position in space. It is a head righting reflex and categorized as a postural reflex. The Tonic Labyrinthine reflex is for head control and good balance, essential to the automatic functioning of all other systems. Reflexes that are not integrated at the correct time will prevent the complete establishment of both head control and balance. Head forward will cause poor posture and stooping, weak muscle tone, vestibular-related problems, poor sense of balance, propensity to get car sick, dislike of sporting activities, oculomotor dysfunctions, visual-perceptual difficulties, spatial problems, poor sequencing skills and a poor sense of timing. Head backwards will cause poor posture — tendency to walk on toes, poor balance and coordination, hypertonus, vestibular-related problems, a poor sense of balance, tendency to motion sickness, oculomotor dysfunction, visual-perceptual difficulties, spatial perception problems, poor sequencing skills and poor organizational skills.

The Symmetrical Tonic Neck Reflex may not be a true reflex but a crucial stage of the labyrinthine reflex. "It certainly helps to integrate the tonic labyrinthine reflex and it forms a bridge to the next stage of locomotion--creeping on hands and knees. However, while it permits the child to assume the quadruped position, it will prevent forward progress in this position. The baby will be at the mercy of its head movement, unable to move effectively because during this period of development the position of head decides the position of the limbs."(v) A retained symmetrical Tonic Neck reflex causes "poor posture, tendency to 'slump' when sitting, particularly at a desk or table, simian (ape-like) walk, poor hand-eye coordination and difficulties with readjustment of binocular vision; and attention can be affected as a result of discomfort from sitting in one position."(vi)

THE NON-LISTENING POSITION
There is a position that I call the "non-listening position", which is what Alexander Teachers call "head back and down". I believe one of the functions of head back and down is to protect the listener whose Acoustic Stapedius Refelex doesn't function from either the sound of their own voice or from loud sounds in the environment. If there are traces of a retained Moro Reflex, the Acoustic Stapedius Reflex doesn't fully develop. "The stapedius muscle of the inner ear is attached to the stapes (a tiny bone in the middle ear) and it is the smallest muscle in the human body. If there is a loud noise, the acoustic stapedius relfex should activate involuntary contractions of the stapedius muscle immediately after the sound (usually noises louder than 80 to 90 decibels). The effect is to dampen the sound thereby protecting the inner ear from noise damage. The reflex should also occur just before a person vocalizes to reduce interference from the sound of their own voice."(vii)

I have seen children and adults pull their head back and down just before speaking and wondered if it is a reflex to protect themselves from the sound of their own voice. When a person, who is sound sensitive (inundated with sound) and is frozen in what looks to me like a startle reflex, jaw tightened and head rotated back and down, I believe that they are sound sensitive and that the early developmental reflexes are still active. The hands-on movement that we provide as Alexander Teachers is working with the vestibular system. When the vestibular system is not functioning, as the result of unintegrated reflexes, the muscles are hypotonic or hypertonic, causing poor posture.

THE EMBRYOLOGY OF THE EAR
The embryology of the ear shows a direct connection between the jaw, ear and the skin. The organ of hearing develops on the surface of the skin. First, there is a small indentation in the skin, in the area of the so-called gilt slit, from which the breathing and the eating apparatuses are developed. This occurs in an early phase of embryonic development; gradually the organ of hearing moves back. The ears end up in a different location from where it started and the indentation in the skin becomes a fluid-filled vesicle out of which the three semi-circular canals of the organ of balance are formed.

The inner ear gradually takes shape from a small area of skin on the surface. At the same time as the vesicles are formed, they move to a greater depth under the skin, and are transformed into the cochlea. What was at first the skin ends up deep down in the petrous bone in the base of the skull. Only in man is it tucked away safely deep down in the hardest bone of the entire body.

The ear bones, malleus, incus and stapedius, are formed from a section of the jaw as it draws back and subsequently is transformed into the ear bones, together with what will later become the tongue bone. Part of the jaw draws back to metamorphous into the ear bones. The lateral pterygoid muscle, a muscle that is triangular, with three corners of the triangle consisting of the sphenoid, temporomandibular joint and mandible, has a direct connection to the middle ear. Embryologist have stated that a portion of the tendon from this muscle passes through the temporomandiblular joint during development and inserts on the malleus, one of the tiny middle ear ossicles. The malleus, incus and stapedius muscles of the middle ear focus the eardrum like turning a satellite dish, to respond to different incoming frequencies to facilitate sound discrimation.

The outer ear, finally, develops out of a few skin tubercles, which grow to form the external ear shell. It would not be wrong to say that we hear with what once started out to be our jaw. There is a connection between the skin, tongue and jaw and the ear as you can see from the embryology of the hearing organ.

THE RELATIONSHIP BETWEEN THE SKIN AND EAR
Dr. Alfred Tomatis believed that there was a very direct relationship between the skin and the ear from experiments that he performed. "Tomatis expresses this point in a literal sense. He contends in Ver L'Ecoute Humaine (1974) that phylogenetic data suggest the ear preceded the nervous system and further that the sensory cells found in the skin ... are differentiated cells of corti. He points to this evolution of the sensory cells of corti toward cutaneous hair cells of the skin as support of his hypothesis."(viii) We not only take in sound with the organ of our ear but with our bones, tissues, and skin, however the primary source of sound should be the ear. When we hear primarily with the physical body it creates a sound sensitivity that causes anxiety.

THE FACIAL AND VESTIBULAR NERVES
Again, the first two nerves to myelinate in humans in utero are the vestibular nerve and the facial nerve. The ear actually precedes the nervous system developmentally. Interestingly, when the nervous system myelinates it is the motor nerves that myelinate before the sensory nerves. It is the audio nerve and the facial nerve that myelinate first and they are both for survival. At birth the ear is needed to deal with gravity and mouth is needed for sucking.
I assumed that the sensory nerves would have developed first, but it is the other way around: We need to move before we can have feedback about that movement from the sensory nerves. In working with the eyes my first and foremost job is to get my students to release the holding in the structure of the eye so that the natural movements of the vitreous humor, lens, and aqueous humor resume. It is the same with the ear-allowing the muscles of the middle ear to move is extremely important to listening. Listening to music that has been specifically gated peaks the muscles of the middle ear, exercising and toning them. It is designed to activate those muscles which are primary for the act of listening. I distinguish between hearing and listening. Hearing is unconscious and listening is conscious. Many people take in sound but listening is a conscious act.

THE VESTIBULAR SYSTEM
"The registering of movement is not only the responsibility of the Vestibular Nerves, it is sensed through special receptors located throughout the body. The vestibular system is composed of the inner ear, vision, proprioceptive, kinesthetic, and touch receptors located through the body, and interceptors in the organs. To these I would add the movement of each cell."(ix)

THE JOB OF THE INNER EAR
The job of the inner ear is to give us information about our relationship to the earth and postural tone. In the inner ear there are little stones called otoliths and little hairs called cilia. The stones fall toward gravity and stimulate the cilia. This stimulation of the cilia by the otoliths tells us where our head is in relationship to the earth. The inner ear also establishes basic postural tone throughout the body. Postural tone is the readiness of the muscles to respond. Low tone or high tone shows our relative ability to process sound.

Another function of the vestibular system of the inner ear is to establish our relationship to our body in space. It receives information, via the brain, from the other movement receptors (proprioceptors, interceptors and kinesthetic receptors) throughout the body telling us where we are in space and how we are moving through it. When the ear is not processing that information correctly, "false sensory awareness" occurs.

As movement specialists our role is to re-educate the body; in so doing we are working with the whole hearing organ. When the head is balanced on the atlas and axis properly we give new input to the cochlear/vestibular system, providing balance. The organ of hearing operates closely with all the reflexes to facilitate balance and posture. When primitive developmental reflexes don't integrate properly they interfere with the postural reflexes; this causes false sensory awareness and we lose our balance, energy and audio/visual perception. The structure fails. When we are unable to process sound properly we accommodate by misusing the structure to protect ourselves from sound. One of the ways that we accommodate is by pulling the head back and down in an effort to dampen the sound of our own voice and environmental sounds. When we take in sound with our whole body, including the skin and bones, and when we shorten and tighten to protect ourselves from sound, we are not allowing the organ of hearing to function fully. This feeds into faulty sensory awareness which includes sight, sound and movement.

"Rudolf Steiner made a very curious remark about our organ of hearing, to the effect that although the temperature sense was the first sense of man, hearing was there even before the beginning .... Sound is a reality. It is not a semblance, not an image, as with sight, but reality itself. You will never dance in front of a painting, but it is hard to keep still with music. Music touches us in our muscle and bones."(x)

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i Hannaford, C. (2002). Awakening The Child Heart. Jamilla Nur: Hawaii.

ii Ibid.

iii Madaule,P (1994). When Listening Comes Alive. Toronto, Canada: Moulin.

iv Goddard, S. (2002). Reflexes, Learning and Behavior. Eugene, Oregon: Fern Ridge Press.

v Bobath and Bobath 1955

vi Goddard, S. (2002).

vii Goddard, S. (2002).

viii Tomatis, A. (1991). New York: Station Hill Press.

ix Cohn, B. (1987). The Action in Perceiving. Contact Quarterly 12. 114-121.

x Soesman, Albert. (1990) Our Twelve Senses: Wellspring of The Soul. Hawthorn Press, Stroud, Glos.