The Otorhinolaryngologist Before the Problems of Language (1964)
Article by Doctor Alfred Tomatis published in the journal L’Hôpital — Special Issue of April 1964 (pp. 248-250). Tomatis here pleads for the central role that otorhinolaryngology should take in the study of language: through three fundamental parameters — delivery, quantity, quality — he describes audition as the true regulation loop of the phonatory gesture, and concludes on the decisive function of auditory laterality.
The Otorhinolaryngologist Before the Problems of Language
by Dr TOMATIS
From all points of the world, emerging from the most diverse specialists, language appears as the object number one towards which numerous researches are oriented. And if it was, but yesterday, the exclusive domain above all of the philosopher, it becomes today the common place of preoccupation for the linguist, the phonetician, the acoustician, the cyberneticist, the psychologist, the educator and the physician. Doubtless this common place is in truth only a meeting place, and it is at this crossroads of paths that we should like to dwell on the aim of the Otorhinolaryngologist.
Indeed, should not the latter be solicited, more than any other, for the problems pertaining to this central point of the integration of language, since he holds in his speciality the almost total mastery of the major organs which intervene in the execution of the spoken act?
However, it must be admitted, his initial orientation does not, at first sight, invite him to occupy himself with all the desired interest in the function of phonation, to which he henceforth seems destined. His medico-surgical training has him long practise upon an organicity affirmed or invalidated by examination, but it will rarely be offered to him to consider these same organs in their normal state, in their function, in their relation.
To be sure, the Otorhinolaryngologist knows that the larynx emits sounds; he also knows why it cannot emit them, and hoarseness or aphonia are for him only signs evoking simple clinical lesions in which nodules take their place. Phonation in itself, this function curiously grafted onto the aero-digestive sphincter, does not seem to preoccupy him much, any more than the role of the supra- and sub-jacent cavities in their play of resonantial reinforcement of the fundamental laryngeal sound, any more than the articulatory, buccal, lingual, velar and nasal functions.
Now, is there not a complex which gathers in a paradoxical way less of organs than of the function “to speak” that one must exploit? And it seems to us that we should insist most particularly on the monitoring mechanism which falls under its purview, the regulation of this daily functional ensemble of the effector of the act of speech.
It is the study of audition alone, in my view, in the language that we should like to approach here, so much is there not only material to evoke the primordial role that the ear plays in the realisation of the phonatory gesture.
The ear, certainly, is not the whole of language — let us not be made to say so —, any more than speech is the whole of the palate. It is a threshold offered, but a principal entrance whose broad portico permits its guardian to see entering, depending on the moment, depending also on the degree of opening, the linguistic returns which might be preserved in the supra-jacent enclosure. And if the ear offered itself yesterday still to the fervent and vigilant Otorhinolaryngologist, at the very least as the vertiginous tympanum, it poses to him today, in the great field of integration that it describes, the enigmatic problem of its psycho-physiological opening.
The role of audition
The most salient trait of our clinical approach is indeed that of a listening to ourselves, this ear stretched towards another, towards another language, this convergence of our speaking self.
With this self-information, the discourse advances, coherent, and is at every moment regulated in its different parameters; intensity answers to the reference threshold we have chosen in order to ensure transmission to others; timbre evokes moreover our will, our varied personality; finally the linguistic quality, which colours us the reflex as a function of our nervous state, of our emotional charge, of our tensional outpourings and of the idea to be transmitted.
The phonemic unfolding ceaselessly implies regulations whose complexity is glimpsed, and yet a few clinical facts can help us considerably in the comprehension of this ensemble.
Those which we shall report, chosen among many others, aim to evidence the ruptures which hold under their sway the delivery, the quantity and the quality of this dual informational notion called language.
a) Delivery
It is, of course, the rhythm with which the progression of the spoken act is ensured. The succession of the elements of the articulated chain implies a monitoring which, very rapidly, seems to undergo the stroke of automatism — at least so it is in the normal subject. It is quite otherwise when the rhythm disorder imposes this passage towards the automatic act by a “hooking” which renders very rapidly conscious this gesture of phonation. There is a classic clinical test of this deficit which, evidenced by John Lee and John Black in 1949, marvellously illustrates what this loss of control can be, which executes itself rightly during the self-listening phase. This test introduces, during the spoken act, a delay in the listening of the speaking subject.
To attain this, our experimenters used a mounting whose aim was to modify partially or completely the voice to be heard by the experimenter — as we have called it on our part: an apparatus generally composed of what is conventionally called a “recording” head, which imprints on the magnetic tape the information to be heard, while a reading head, located beside it, has the function of reproducing this same information. Both heads are positioned along the same direction. The particularity of the apparatus that Lee and Black used consisted in the introduction of a mobile reading head that one can place at chosen distances in which nodules take their place after recording, so that one can, thanks to the distance thus memorised, conserve the delay one introduces however much the time T1 corresponding to the moment of reading. This delay time causes a perturbation in the rhythm of elocution to appear very rapidly; this is what is called experimental stammering.
What has happened? Simply a lengthening in the spontaneous and obligatory self-listening of the voice. The introduction of a delay entails a disharmony between the monitoring of the elaborated articulatory act and the intensity, the timbre — equally for the monitoring of the auditory receptor. It is this dysrhythmia which appears singularly and which we feel in those rooms too rich in echo which make us lose even the control of our thought, however much we strive to maintain the normal cadence of our elocution.
We have evidenced the fact that one can introduce, into the audition of our own discourse, delays that we know how to call physiological delayed feedback. They apply in large part to rhythm disorders which contain stammerings. The techniques which tend to eliminate these delays bring about a disappearance of the observed disorders. One must, of course, at the same time as the subject is conditioned to self-monitor as does the subject benefiting from a good audition, jam, suppress the cause that is at the origin of this loss of verbal monitoring. It may be a purely automatic or organic disorder, more often still psychological.
A notion has appeared essential to us, although difficultly admitted and yet evident for whoever simply concerns himself with research: it is, as a rule, the disappearance of a rhythm disorder of language. It is thus, it seems, through the physiological delay introduced. Indeed, there exists a directing ear just as there exists a directing eye. Its investigation is simple. On it depends, beyond the regulation of rhythm, that of the other parameters of our verbal flow which we shall now study, namely its quantity and its quality.
b) Quantity
In function of the couple of delivery, it defines the quanta of sonic energy that spreads during phonation. This quantity represents what is conventionally called intensity. It must be sufficient to satisfy the listening conditions of the interlocutor; in other words, it is here that the listener benefits from information that can awaken his auditory receptor and that the sonic substance reaching him be sufficient to analyse, these sonic couples having to be capable of being effectors and to continue being analysed among themselves. The force of our voice depends, of course, on the fact of respecting this observance; any deregulation entails perturbations. Indeed, if one exceeds the upper threshold of the comfortable zone of audition, breakings appear, linked to the saturation of the effectors and to the introduction of the voice on the pathway. On the contrary, if one diminishes the voice too much, below a certain level — and this is what happens for example during the raising of the ear — the effort required of the interlocutor will be such that he will rapidly awaken to fatigue.
The habit of communication with others, born of the sociological needs of transmitting and perceiving information, leads us to dose and regulate our phonation in function of the aim to be reached, having to the quantity of sound to furnish. This becoming aware appears one day to oneself, by dint of skirting automatism, to free itself from this called punctuated for the passages of louder, less loud and outside even our own discourse. Publicity has demonstrated that the dolphin in force resorbs itself from a play of self-listening of our receptor to compel us to the quantity that it is fitting to grant to our verb, just as it is fitting that the comprehension of our listeners be truthful by the high intelligibility we desire to see arise.
This regulation, it is known, is easily perturbed however much the audition is modified in its elementary characteristics. And the audiophonia is conducted, in the framework of the transmission apparatus, the subject during the very measurement as a function of what he can emit, and the voice diminishes to a very poorly intelligible plane. Moreover, if one plunges the operator into a threshold of self-listening, the subject cannot stop screaming to hear himself, and the ears of his listeners scarcely suffer from it.
Experimentally, it suffices for us to evoke the case of Lombard’s speech which, by simple attenuation at the level of the ears on a normal ear, causes to appear instantaneously an increase of vocal energy in the emission of the subject submitted to this trial, testifying to a disorder having occurred on the regulation process.
c) Quality
The third and last parameter that we shall study, its appearance brings us to conceive and determine fittingly timbre.
Like the two parameters previously studied, quality depends on rhythm, on the parameter and on intensity; timbre, itself too, places the monitoring upon the auditory receptor.
Clinically, a diminution of the auditory frequency field, whether due to a blockage of the ear, organic, or whether it result from a psychic blockage of analysis of the ear, the fruit of a psychological inhibition, is always translated by a modification of phonation reflecting eloquently in the timbre.
Experimentally, we have shown many times how much the voice was bound to auditory regulation, every change in the listening pass band of the speaking subject entailing a modification superposable in parallel at the level of his phonation.
Doubtless these few ease-points succeed in reproducing in a striking manner what is a cybernetic loop in a self-regulated system of which the auditory finds itself to be the receptor of delivery, of the system, and the mouth the effective output.
Auditory laterality
The systematic study of our different parameters tending to bring “accent on the extraordinary and profoundly evident role of our audition on our phonation, leads us naturally to speak of a major clinical element: that of auditory dominance.
There exists — may we be pardoned for this reaffirmation that we wish formal — a dominant directing ear in this laterality of listening that engages us, that is worth a functional speciation elaborated to allow us as much the acquisition of a language by the ideal nation, as the defection of fibre, by opposition of our. It is very specifically attached to articulated language, therefore to sound.
Its clinical investigation is fundamental. On it depends lateralisation or dyslateralisation. Every cell at its functional appearance entailing a lack in the development of laterality, just as in the function of acquisition causes to fade the dominances which whatever-counts whatever-questions.
In the course of this rapid exposition on the essential role that audition plays in the spoken function, it is the duty of the Otorhinolaryngologist to bend himself most particularly to the study of the auditory function in its relations with language and to acquire it in its refinements. So all are invited to consider the physiological and psychological mechanisms of audition and phonation, a vast therapeutic field which risks extending to becoming one of the essential elements of future for Otorhinolaryngology under the title of specialised physician.
Source: Tomatis A., “L’Oto-Rhino-Laryngologiste devant les problèmes du langage”, L’Hôpital — Hors Série, April 1964, pp. 248-250. Digitised document from Alfred Tomatis’s personal archives.