PMI - In other words, Persistent Musical Imagery
Except musical imagery is not imagined or beautiful. In fact, this condition is persistent and mental torture to nearly anyone suffering.
So what is PMI?
From my perspective, having PMI, the early morning transition from sleep to wake and late afternoon from awake to tired are critical moments for PMI to ignite. Yet what is turning itself on? Songs. Any songs. Songs I am a fan of, songs I am aware of, songs I don't care about. Songs that can be inspiring. Mental mention of a word that is relevant to a song title. Commercial jingle songs. Television show credits. Movie soundtracks. Sound within a television program to enhance the tone of the scene. In summary, songs and musical sound.
Imagine a radio station in your head. There is no DJ. There is just a loop. The loop can stay on one song or mix into a variety. The volume is low. In fact, the volume is faint but just loud enough to hear the lyrics with no instrumental.
The initial hit "play" is enjoyable. I want to acknowledge the interest. However, within less than half an hour I am miserable because the song will not go away. If I distract my mental state, the turntable will find something else. This turntable spins nonstop unless noise or sleep quiet it.
I cannot sleep all the time. Noise is specific and temporary.
Can I listen to music on my own to drown out PMI? No! While the joy of listening to my favorite radio stations or iTunes offers relief, that relief is in the moment because even those favorites will seep into my brain. Listening is sadly detrimental to PMI.
I have been aware of this condition since early summer of this year, 2026. I have been starving my brain of dopamine through music for months out of fear of worsening PMI. In reality, PMI cannot get any worse than it is right now.
Is there relief to PMI? Yes. So let's talk clinical and not personal.
PMI is generally involuntary and without an external source. This is most commonly known as an earworm. The song is spontaneous and repeats without conscious control.
Key notes - Spontaneous (you didn't choose to think of it), Repetitive Loop (plays over and over), Internal Perception (mental play, no external source), Common Triggers (emotional connection, recent exposure, etc.)
Facts - At least 90% of people experience involuntary musical imagery weekly. Links within the brain include phonological loop (short-term auditory memory) and auditory cortex (active when listening and when imagining music).
Musical hallucinations or Musical Ear Syndrome are on the severe end where music is perceived as externally real. In MES, the brain is filling sensory gaps. I have on occasion experienced auditory hallucinations (musical hallucinations are a form), but generally in the form of nonschizophrenia faint conversations. I can't hear the words, just people speaking them. If there is music in the hallucination, it is either sharp like an instrument in a concert or an on-air radio. This severity is best addressed by an audiologist or neurologist. I have not seen either for my experience because I find my hallucinations linked to an overly exhausted brain. After rest, I am okay.
PMI though is not okay. The loop is a musical obsession. This type of obsession, if defined as intrusive, recurrent, unintentional, and distressing, is in fact OCD in type. Obsessive Compulsive Disorder is not necessarily neurological (such as hallucinations). Therefore, examples of treatment include -
Cognitive Behavioral Therapy (CBT) & Exposure and Response Therapy (ERT)
SSRIs (such as fluoxetine, fluvoxamine, sertraline, paroxetine...brands by name include Prozac and Paxil) ... Immediate go-to medications for OCD
Clomipramine (tricyclic antidepressants)
Sources to the above facts are many, so I am relying on simply saying Google search.
Persistent Musical Imagery is anything but musical, pleasant, and enjoyable. The want to engage or entirely distract is real. The want to completely shut down is more than real. What is devastatingly real? When PMI is classified as an OCD (such as me), mental health is given a severe blow.
And when music is an important part of a person's life, whether listening or playing or writing about, that importance becomes extremely fragile and generally gone silent so as not to feed and worsen mental health. Silence can be deafening and make mental health sicker rather than better.
If you or you know of someone find this post relatable, please consult with a healthcare provider. I realize Set List is quiet after 16 years of daily active, but I am always an advocate for my mental and physical health. I am an advocate for you if this post will help in some way.
Side note - While I have PMI, other OCD tendencies, neurological and psychiatric illnesses, my most recent scare is me. Life events in the past two years shifted my brain's baseline acceptable emotions from naturally calm, peaceful, and happy to always irritable and agitated. These events allowed anger reaction to escalating constant agitation. My obsession is not an irritant but the agitated reaction. My compulsion is encouraging the irritant or finding an irritant to become agitated.
This is no way to live for anyone. I am working with a psychiatrist and therapist. I am also working with myself through defusion tactics - acknowledge an irritant but do not react to it thereby not giving my false baseline what it wants. I also affirm my brain every morning (and occasionally during the day) by saying thank you for its protection and that I am safe because calm and peace are safe, so I can move on with the day.
Familiar settings, activities, and feelings are huge to resetting my baseline. This will take time and although I am one for being impatient, taking back my true mental state of mind at its own pace is far greater than getting there in a hurry just to say I am back. I want both. I also want me.
To those who have read this far, thank you. To those have found this post at some point and have read this far, thank you as well. Set List is not a closed book. Music and writing are always open.
