It is the voice, not the eye, that is the window to the soul. Emotion is normally (and unconsciously) reflected in the voice, certainly in the untrained voice. One of the aims of vocal training is to consciously master the components of voice production and thus assume control of a function that is normally reflexive. Actors and singers normally make use of this control to convey emotions by change in inflection, pitch, and articulation.
Turned the other way, a well-trained singer or actor, even when under considerable personal stress, can keep the associated emotions out of the voice. There are, however, times when emotion colors, and even takes over, the voice. These emotions are usually negative and include stage fright or other fears of failure. Rarely, the intensity of emotions can be so great as to literally take away the voice completely.
How and why does this happen? Emotions inevitably translate into physical changes. The great Hungarian physiologist, Hans Selye, was the first to work out details of this “stress response,” which includes the liberation of adrenaline, followed by rapid heartbeat, heightened neuromuscular tone; and, if chronic, exhaustion occurs due to depletion of the adrenal glands. Heightened activity in the nerves and muscles, if moderate, makes us more alert and responsive. This probably occurs with most performances. If the tension is uncontrolled, however, excessive muscle tone makes fine voice control difficult. We’ve all experienced nervousness, which can cause a tremor.
Loss of voice control leads to compensatory maneuvers, such as forced glottal closure. If the closing force applied to the vocal folds is excessive, greater pressure must be generated from the lungs to overcome this. Excessive muscle contraction can cause discomfort in the neck. Additionally, since the elevating muscles of the larynx are normally stronger than those that lower it, a tug-of-war will often lead to the larynx coming to rest at an excessively high position. This decreases the size of the pharyngeal resonators. The overall result is a voice that is thin, almost metallic, and lacks projection.
A less common but highly fascinating phenomenon is complete loss of voice due to stress. Every year I see two or three patients who have lost their voices and cannot get them back. They seem to be in no particular distress but are unable to produce anything more than a whisper. One such patient was a secretary who worked for years under an abusive boss. She was humiliated and scolded daily but could not afford to leave her job. One day, the boss said to her: “You know, you say such stupid things, it would be better if you didn’t speak at all!” Needless to say, the following morning she woke up with no voice. These cases, people with what was referred to as “hysterical aphonia” in the past, are not crazy patients. They are people under tremendous emotional strain who have manifested their stress by forgetting how to use the voice. The gain was so overwhelming for this woman (she would no longer be abused for “saying stupid things”) that she let go of a normally reflexive act, voicing, and could not bring herself to remember how to do it.
Less extreme, and more common cases I have seen include opera singers who lose their voice before a premiere or get hoarse before an important audition. Examination in all of these cases reveals a perfectly normal instrument, that is, however, positioned in such a way as to be unable to produce a voice.
If you have the tendency to lose your voice, and you have made the association with stressful situations, what can you do? First, know what is going on, rather than attribute the voice loss to allergies, postnasal drip, or the apparently pandemic gastroesophageal reflux (GERD). Relaxation techniques (massage, meditation, Alexander, visualization) can be helpful. Beta blockers can occasionally help, if there are no contra-indications. If you do find yourself resorting to laryngeal compensatory behavior (controlling a tremor with increased glottal pressure, for example), know what you are doing and return to good normal vocal technique as soon as possible. Many cases of hoarseness are due to persistent laryngeal malpositioning left over from a triggering event (stressful audition, cold, etc.) that was over and done with months earlier. A diary of how the condition began is very helpful in making this diagnosis. A good laryngeal examination, with a photograph, will confirm your suspicion. A couple of sessions with a voice therapist with expertise in the singing voice, is the treatment of choice. Remember, stress can affect the voice and you are not alone.
