Audiologist Melanie Herzfeld, interviewed by Dr. Jennifer Jo Brout. Melanie Herzfeld, Au.D., provides complete audiological assessments for all ages, including Tinnitus Evaluations and treatments, Auditory Processing Disorder Tests, Hearing Aid dispensing.
Q: How did you become an audiologist? What drew you to this field?
A: My father was a physician. My mother didn’t believe in education for girls. There were people in my family who were hard of hearing.
I skipped my senior year of high school and started college after 11th grade. I was only 16 and immature. I had to pick a major, which meant I had to spend a day going from department to department, meeting with each chair. I wore a mini-skirt.
The English chair was the first person I met. She was frumpy, obese, wearing a blue serge dress with bread crumbs down the front. I couldn’t look her in the face.
The Sciences chair had body odor. The mathematics department would not allow mini-skirts or slacks and required a computer lab that had to be taken in another bldg. In those days, a computer lab would mean learning how to punch cards.
At the end of the day, I was a speech and hearing major. The chair was the only person I met that day to whom I had no objections.
Q: How did you get started?
A: I was teaching and I needed an M.A. I got a fellowship to Long Island colleges, but I was required to quit my job at a school for handicapped boys. In spite of my fellowship, I couldn’t make ends meet, so I had to withdraw from graduate school.
But if I studied audiology, I was allowed to work part time. That made graduate school affordable for me.
Q: What does an audiologist do?
A: Most of audiology practice is test heavy: working with the hard of hearing to find the right hearing aide, adjust it, and continue to monitor it to be sure it works correctly. A few practitioners , like me, work with patients who have tinnitus or misophonia. We are not typical.
Q: How did you become involved with misophonics?
A: I was part of a private practice, and I always had patients who asked about the Jastreboffs. We were offered an opportunity to be trained in misophonia treatment. Of the group in the practice, only 3 or 4 of us were interested. In the end, there was only me.
Q: How do you work with tinnitus sufferers?
A: Tinnitus sufferers often hear a constant high-frequency background sound, like a “sh-sh.” I use a program called normonics, a form of music therapy that uses slow music timed to the rhythm of the patient’s heartbeat. I use it to retrain the patient’s brain not to pay attention to the background sound.
Patients still hear the “sh-sh,” but are not bothered by it. I find a way to neutralize the sound. That is what an audiologist like me does: neutralize sounds.
Q: How do you treat misophonics?
A: Like people with tinnitus, misophonics want to hear certain specific sounds differently. What I do is work to put the sounds that set them off in a different context, neutralize the stimulus. Behavioral therapy talks about white, pink, brown noise. The name of a noise corresponds to its energy. For instance, brown noise is lower frequency. I try to change the color of the noise that bothers them. Some people can’t listen to campfires or popcorn popping, someone eating chips.
I begin by making sure the patient’s auditory mechanisms, like the hair cells inside the ears, are intact and not damaged. Then I start using guided imagery: I walk the patient along a beach or through the woods while they hear the triggering sound. Again, I try to take the sounds out of their usual context, like a specific person, place, or thing.
I also send them to Dr. Jennifer Brout, whose work on the psychological level complements what I do with the patient.Want to learn more? Join a Workshop with Dr. Jennifer Brout or Duke CMER at Misophonia Education.