Readings — From the August 2014 issue

Cash Only

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From a clinical case study by Mariska Mantione, Martijn Figee, and Damiaan Denys published in May in Frontiers in Behavioral Neuroscience.

Mr. B., a fifty-nine-year-old married man, was referred to the department of anxiety disorders at the University of Amsterdam, having suffered from obsessive-compulsive disorder for forty-six years. In spite of extensive treatment with pharmacotherapy and cognitive-behavioral therapy, symptoms were still overpowering and Mr. B. remained extremely hindered in daily living. Mr. B. was included for treatment with deep-brain stimulation (DBS) targeted at the nucleus accumbens. After DBS surgery Mr. B. entered an optimization phase in which optimal stimulation parameters were adjusted. Within six weeks after surgery, Mr. B. experienced a decline in anxiety and obsessions. Mr. B. reported that he felt very confident, calm, and assertive, and he started to call himself Mr. B. II, the new and improved version of himself.

Mr. B. had never been a huge music lover. His musical taste was broad, covering Dutch-language songs, the Beatles, and the Rolling Stones. While music did not occupy an important position in his life, his taste in music had always been very fixed. Half a year after DBS surgery, Mr. B. stated that he was turning into a Johnny Cash fan. He had been listening to the radio when he heard “Ring of Fire” and was deeply affected by the song. Mr. B. started to listen to more of Cash’s songs and noticed that he was deeply moved by the raw and low-pitched voice of the singer. Moreover, he found that he preferred the performance of the songs in the Seventies and Eighties, because of the fullness of the voice of the older Johnny Cash.

Mr. B. reported that he felt good following treatment with DBS and that the songs of Johnny Cash made him feel even better. From this moment on, Mr. B. listened solely to Johnny Cash and bought all his CDs and DVDs. He reported that there was a Johnny Cash song for every emotion and every situation, feeling happy or feeling sad, and although Mr. B. almost exclusively played Johnny Cash songs for the following years, the music never started to annoy him. From the first time Mr. B. heard a Johnny Cash song, the Dutch-language songs, the Beatles, and the Rolling Stones have been banned. Except when the stimulators run down or accidentally go out.

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